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Thursday, September 18, 2014

Parkinson's Patients May Be at Higher Risk for Malnutrition

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Parkinson's Patients May Be at Higher Risk for Malnutrition

Posted by  Kimberly Sawicki, September 15, 2014
Parkinson's Patients May Be at Higher Risk for Malnutrition
A recent study published in the Journal of Parkinson’s Disease found that approximately 30 percent of patients with mild to moderate Parkinson’s disease (PD) are at risk for malnutrition.  Researchers from the Karolinska University Hospital in Stockholm, Sweden theorized that people with PD may experience difficulty with food preparation and ingestion, as well as chewing and swallowing. Additionally, depression and constipation, two things commonly experienced by people living with PD, may also lead to a decreased appetite.
The study was conducted with two groups of people from Iran, 143 patients with mild to moderate PD and 145 patients of the same gender and age. Patients suffering from chronic conditions (e.g., diabetes, hypertension) that would impact nutrition were excluded.
Participants answered questions on diet, appetite and self-perception of health, and researchers assessed body mass index (BMI), weight loss and arm and calf circumferences.
While the people living with PD did better than control participants on some measures, such as psychological stress, weight loss and consumption of fruits and vegetables, arm and calf circumference was dramatically lower in the patients with PD.
A well balanced and regulated diet can play an important role in maintaining a healthy lifestyle when living with Parkinson’s.

Diet and Parkinson's Disease

 

Is there a special diet for people with Parkinson’s disease?

As is true for many aspects of Parkinson’s disease, each person's diet is a little different. You may need to experiment to see what is most effective for you. Generally speaking, taking your levodopa 20-30 minutes prior to eating, or an hour after the completion of a meal, increases its efficacy because your stomach is empty and the drug reaches the first part of the intestine where it is absorbed in a faster manner. However, some medications can cause nausea and a small snack with the medication may be necessary.

Protein Consumption and Parkinson’s disease

It is also important to know that because levodopa is an amino acid, it competes for absorption with other proteins: Eating a very proteinic meal would reduce the likelihood of efficiently absorbing levodopa. That’s why it is better to eat carbohydrates and vegetables at lunch and leave meat, cheese and fish for nighttime. Good news: The dopamine-agonists (pramipexol and ropinirole, for example) do not need this dietetic adjustment! Finally, those who take the MAO-B inhibitors (rasagiline or selegiline) should eat with moderation (but not eliminate) foods that contain high concentrations of tyramine such as air-dried and fermented meats or fish, aged cheeses, most soybean products, yeast extracts, red wine, beer, and sauerkraut.

How can I adjust my diet to maintain bowel regularity?

Constipation might be a taboo subject, but it is fairly common in Parkinson’s disease. Once again, it can be different for each person, so you may need to try several things. In addition to a well-balanced diet, try increasing your fiber intake. A couple of teaspoons of flax seed eaten with foods that contain probiotics (like yogurt) can be helpful in maintaining regularity. If you experience persistent constipation, consult your physician for help.

What about alcoholic beverages with meals?

It is best to consult your physician about drinking alcoholic beverages. Alcohol may interfere with some of the medications, or make you sleepier, but each patient reacts differently.

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