Diet and nutrition have been found to play a crucial role in Parkinson’s. In a recent ‘Ending Parkinson’s Disease: Live’ webinar on Parkinson’s EU, Parkinson’s expert Dr Bastiaan Bloem, epidemiologist Dr Alberto Ascherio and Parkinson’s campaigner Omotola Thomas, considered how different foods can affect the risk of diagnosis, maintaining bowel health and more.
We share five key takeaways from their discussion.
1. Which foods can affect your risk of developing Parkinson’s?
Diet, said Dr Bloem, “is a really hot topic in the field of Parkinson’s”. Alongside exercise, diet and nutrition “are the big new kids on the block when it comes to improving symptoms, and perhaps, slowing down the progression of the disease.”
Dr Bloem and Dr Ascherio praised the Mediterranean diet, which varies by country and region, for its potential to lower the risk of developing Parkinson’s. The Mediterranean diet is generally high in vegetables, fruits, grains, healthy fats and fish, and is typically low in meat and dairy. Such a diet is rich in nutrients and antioxidants, making it “better than the traditional Western diet”, according to Dr Ascherio.
On the other hand, Dr Bloem theorised that “a lifetime of exposure to dairy” is associated with a higher risk of developing Parkinson’s, likely due to the pesticides ingested by cattle from contaminated grass.
Dr Ascherio added: “I don’t think that globally, dairy products are known to be a major cause of pesticide exposure. Dairy also has other effects like reducing the level of uric acid in blood, which we found to be related to a risk of Parkinson’s disease.”
2. Could you be malnourished if you have Parkinson’s?
While Dr Bloem pointed out that a regular diet should offer all the necessary nutrients, he did note that vitamin D and vitamin C can be exceptions. “Many people, particularly when you age and particularly when you’re a woman, are at risk of developing a vitamin D deficiency. There are fascinating anecdotal reports of people taking vitamin D and experiencing improved motor symptoms.”
Meanwhile, he explained, vitamin C supplements can help to prevent bladder infections in Parkinson’s patients by acidifying the urine. “Bladder infections can trigger a cascade that leads to worsening Parkinson’s symptoms.”
Dr Bloem also debunked the use of supplements like vitamin E, curcumin and Coenzyme Q190, which have been found to offer no benefits to people with Parkinson’s.
3. How can you maintain your bowel health?
Bowel problems are common in Parkinson’s patients, which Dr Bloem said can be alleviated by drinking a lot of water and eating a diet rich in fibres. People with Parkinson’s should see their general practitioner for laxatives only if all else fails. “The rule is you need to have bowel movements at least once every other day.”
Thomas added: “I have a three litre water bottle that I finish by the end of the day. It is a challenge, but I try to finish it. Because I struggle very greatly with constipation, I take three or four ounces of prune juice in the morning and that seems to help me.”
4. How should you take your Parkinson’s medication?
As food can interfere with the efficacy of levodopa medication, Dr Bloem recommended taking levodopa at least half an hour before or after a meal. In particular, he advised that protein intake be spread across the day.
“For most patients, taking your medication with a protein rich meal including dairy products and meat, can reduce gastrointestinal absorption of your levodopa. So, you need the proteins in order to keep up your muscle strength and avoid weight loss but try to spread the proteins over the day.”
Thomas acknowledged that this can be hard to do. She said: “I have a struggle spreading my proteins with my levodopa because I can’t take more than 15mg of levodopa at a time, so I’m taking it every two hours.
“That is one of those things whereby theoretically, I know what I’m supposed to do, but practically, I’m not able to.”
5. Should a dietician be part of your standard Parkinson’s care?
Yes, said Dr Bloem. “I think paying attention to the gut is part of routine clinical care at every consultation for people with Parkinson’s. Parkinson’s starts in the gut for many patients and slow bowel movements are very common, impacting the efficacy of your medication and appetite for food. It needs attention.”
While a Parkinson’s doctor or nurse can offer useful dietary advice, Dr Bloem himself recommends that his patients see a dietician at least once. “I think it’s part of standard care.”