Following a Parkinson's Disease diagnosis, proper nutrition is important for hydration, minimizing symptoms and general well being. Although there is no specific diet to treat Parkinson's, adjusting your nutrition is an important step in maintaining strength and ensuring medications work properly. Diet and nutrition can have an impact in addressing these common Parkinson's concerns:
Bone Thinning and Osteoporosis
Studies have shown that people with PD are at increased risk for bone thinning. Additionally, as PD symptoms advance, physical instability can increase the likelihood of falls. For those with PD, it is especially important to eat meals that provide the bone-strengthening nutrients including: calcium, magnesium, vitamins D and K. Regular exposure to sunlight is also important, as it increases vitamin D in the body and serves as a bone-strengthening agent. Walking and other weight-bearing exercises can also help in keeping bones strong and less likely to fracture or break.
In the United States alone, dehydration is responsible for 1.8 million days of hospital care each year (about ten days per patient) and costs more than $1 billion annually. PD medications can raise the risk for dehydration leading to: confusion, weakness, balance problems, respiratory failure, kidney problems and death. Dehydration itself can cause fatigue, energy loss, and constipation- all of which are complications of Parkinson's. Drink plenty of fluids and eat water dense foods like fruit and vegetables throughout the day in order to avoid exacerbating symptoms. Parkinson's medications sometimes cause parched mouth. Limit caffeine intake, as coffee, tea, and cola can sometimes make you feel thirstier.
Constipation and Bowel Impaction
PD can slow the movement of the colon, thus causing constipation. Therefore, you must get enough fiber in your diet. Add fresh fruit and vegetables or high-fiber cold cereals. If the constipation does not get resolved it can lead to bowel impaction where a mass of dry, hard feces becomes impossible to pass normally. When bowel impaction occurs it may require hospitalization and even surgery.
Unplanned Weight Loss
People with PD often lose weight without meaning to, due to nausea, loss of appetite, depression and slowed movement. Unplanned weight loss along with malnutrition can lead to a weakened immune system, muscle wasting, loss of vital nutrients and risk for other diseases and possibly even death over an extended period of time. It may be necessary to adjust your thinking about meal times. If food preparation is exhausting pick simpler more frequent foods that are easy to eat. Save your energy for eating, not prepping. Consider meal delivery service or frozen portions so that nutritious meals are available without a lot of advance planning. Eat a larger meal at the beginning of the day to provide better energy throughout the day.
Medication Side Effects
While medications play an important role in managing the symptoms of PD they may also have unwanted side effects. Taking more than one medication may increase the level of unwanted side effects.
Common side effects related to diet and nutrition include:
- Appetite loss, often followed by weight loss
- Edema (fluid retention)
- Compulsive eating and weight gain
- Diarrhea or in the other extreme, constipation
Don't let side effects automatically rule out a certain medication, but do discuss any side effects you are experiencing with your doctor. The doctor and pharmacist should be working together to manage medications to prevent side effects or manage them until your body adjusts.
One of the more important medications used to treat PD is Levodopa. However, Levodopa must compete for absorption from the small intestine with proteins in food, and it may be necessary to take care with the timing of meals and medications. In order to avoid protein-Levodopa interactions the medication is ideally taken on an empty stomach. Work with your doctor to evaluate the amount of protein in your diet as well as the timing of your dose to avoid absorption issues.
Sources: 1. Nina Browner, MD—Medical Director of the NPF Center of Excellence at the University of North Carolina at Chapel Hill in North Carolina. 2. Fernando Pagan, MD—Medical Director of the NPF Center of Excellence at Georgetown University Hospital in Washington, D.C. 3. https://www.parkinson.org/expert-care/centers-of-excellence