Diet and Parkinson's Disease

No singular diet can treat Parkinson’s disease or its symptoms, but a healthy and balanced diet can improve general well-being. Eating fruits and vegetables may help keep you energized and hydrated. Fiber-rich foods and fluids may ease symptoms of constipation or low blood pressure.

Your medication regimen may impact your diet, too. Adjusting the timing and composition of meals might allow medications to work better, and you may need to avoid specific foods to prevent side effects.

Work with your physician or a dietitian to design a diet that fits your needs.

• Should you avoid any foods or supplements with Parkinson’s disease?
• What dietary changes can ease Parkinson’s symptoms?
• What are antioxidants and what foods contain them?
• Should I eat fava beans or any other special foods?

SHOULD YOU AVOID ANY FOODS OR SUPPLEMENTS WITH PARKINSON'S DISEASE?

The medication levodopa (Sinemet) is a protein building block so it competes for absorption with other proteins. Eating a very proteinic meal reduces the likelihood of effectively absorbing levodopa, so you may want to leave meat, fish and cheese for dinner and eat more carbohydrates and vegetables during the day. Taking medication on an empty stomach – 30 minutes before or 60 minutes after a meal – allows the drug to reach the small intestine and absorb faster. However, a carbohydrate snack (crackers, toast, oatmeal) with the medication may be necessary to prevent nausea.

Dopamine agonists (pramipexole and ropinirole) do not require any dietetic adjustment. Those who take MAO-B inhibitors (rasagiline or selegiline) should eat with moderation – but not eliminate – foods that contain high concentrations of tyramine. MAO-B inhibitors increase tyramine, and the combination could elevate blood pressure. This list of foods to avoid includes:

• cured, fermented or air-dried meats or fish
• aged cheeses: aged cheddar or Swiss, blue cheeses, Camembert
• fermented cabbage: sauerkraut, kimchi
• soybean products, including soy sauce
• red wine and tap beer

Iron supplements can also decrease absorption of levodopa so they should be separated from medications by at least two hours.

WHAT DIETARY CHANGES CAN EASE PARKINSON'S SYMPTOMS?

Constipation is common in Parkinson's disease. Increased fluid and fiber consumption can help maintain regularity. Aim to drink six to eight 8 ounce glasses of water per day. Warm liquids, especially in the morning, can stimulate bowel movements. Dietary sources of fiber consist of fruits (with the peel), vegetables, legumes, whole grain breads and cereals. Most of these are high in antioxidants as well.

Low blood pressure is a symptom of Parkinson's and a side effect of some medications. Raising fluid and salt intake will boost blood pressure, but talk with your physician, especially if you have heart or kidney problems. Increase cold fluids – water, Gatorade, V8 juice – to five 8 ounce glasses per half day. Limit caffeinated beverages, hot liquids and alcohol as these encourage dehydration and low blood pressure. Eating frequent, small meals can also smooth blood pressure fluctuations.

Swallowing problems can present as coughing, choking or a sensation of food feeling “stuck.” A speech therapist can prescribe appropriate, individualized dietary modifications and adaptive strategies. These may include adding foods with increased “sensory input” (e.g., seasoned, cold, sour or carbonated items) or altering the consistency of solids and/or liquids. In addition, you might be asked to sit up straight, take smaller bites at a slower pace and allow for longer mealtimes.

Some people with Parkinson's experience painful muscle cramping, especially at night and as medication wears off. Eating yellow mustard, which contains the spice turmeric, or drinking tonic water, which contains quinine, may help. Others endorse salt, vinegar or pickle juice. Maintaining adequate hydration may prevent or limit cramping.

WHAT ARE ANTIOXIDANTS AND WHAT FOODS CONTAIN THEM?

Antioxidants are one of those “good for you” things you hear about all the time. They're molecules that clear out free radicals – toxic substances formed from stresses like air pollution, sunlight, cigarette smoke and even the process of converting food to energy. Oxidative stress is a biological condition caused by too many free radicals. It's associated with aging and Parkinson's disease, so a diet high in antioxidants may offset oxidative stress and cellular damage.

Antioxidants are present in:

• vegetables: artichokes, okra, kale, bell peppers, potatoes
• fruits: berries, pears, apples, grapes
• grains
• eggs
• legumes: kidney beans, edamame, lentils
• nuts: pecans, walnuts, hazelnuts
• dark chocolate
• some beverages such as red wine, coffee and tea

SHOULD I EAT FAVA BEANS OR ANY OTHER SPECIFIC FOODS?

Fava beans contain levodopa, so adding them to one’s diet is an attractive idea. Unfortunately the concentration and availability of levodopa in fava beans are unknown and likely minimal.

No other special foods are recommended for those with Parkinson’s disease. Talk to your doctor or dietitian to craft a diet that helps you manage your Parkinson’s symptoms and feel energized and healthy.

* NOTE: The medical information contained in this article is for general information purposes only. The Michael J. Fox Foundation has a policy of refraining from advocating, endorsing or promoting any drug therapy, course of treatment, or specific company or institution. It is crucial that care and treatment decisions related to Parkinson’s disease and any other medical condition be made in consultation with a physician or other qualified medical professional.

https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?nutrition&utm_source=social&utm_medium=facebook&utm_content=foundationnews&utm_campaign=diet-pd&s_src=diet-pd&s_subsrc=facebook#antioxidants

Nordic skiing helps Steamboat doctor with Parkinson's disease

Dr. Donald Cantway

 Steamboat Springs — Retired emergency room physician Dr. Donald Cantway, of Steamboat Springs, is living well with Parkinson’s disease thanks to an exercise regimen that includes the classic style of cross country skiing and the medical marvel of a battery-operated neurostimulator implanted in his brain two years ago.

 “The change was just amazing to me,” Cantway said about the surgically implanted electronic stimulator that significantly mitigated the impacts of Parkinson’s, which include tremors, rigid joints, slowed movements and difficulty walking.

Parkinson’s is a result of the degeneration and damage to the dopamine-producing cells in an area of the hypothalamus of the brain called the “substantia negra,” according to Brown University. It is dopamine that enables the coordinated movements of a person’s muscles.

Not coincidentally, cross country skiing is part of Cantway’s exercise regimen.

 “Parkinson’s takes away your fine motor movements, and exercises that require big motions help,” Cantway said.

He said the diagonal stride of classic cross country skiing with swinging arm motions is particularly effective for him.

 “It’s ideal. The only problem is that if you fall down, it can be hard to get up,” he said.

He and other people living with Parkinson’s in Steamboat Springs also attend regular exercise classes tailored specifically for their needs.

 “Exercises designed to improve balance and mobility — those are the things you lose,” Cantway added.

Clinical sociologist Lindarose Berkley told the Steamboat Today in 2013 that 15 people who had been diagnosed with Parkinson’s were attending regular support group meetings.

 “I know there are many more people out there. I know of one woman whose husband (has Parkinson’s) and won’t come, but she will,” Berkley said at the time.

For 35 years, Cantway, 72, commuted from his home in Steamboat to a hospital in Laramie, Wyoming, where he worked for a week at a time as an emergency room doctor. He said he preferred practicing that form of medicine in a city where he wasn’t familiar with patients who had been in an emergency. When diagnosed with Parkinson’s six to seven years ago, he had to give up his practice.

 “I couldn’t multitask any more, and I was becoming slower in making decisions,” he said.

Deep brain stimulation isn’t appropriate for all patients — some are more suited to treating the reduced dopamine production that leads to Parkinson’s with prescriptions, Cantway said. But he consulted a neurologist in Cheyenne, Wyoming, who encouraged him to undergo deep brain stimulation surgery “sooner than later.”

Like the typical patient, Cantway put it off for five years. And then, the initial surgery resulted in an infection. When that cleared up, Cantway underwent a different form of surgery that was very successful.

Today, he self-regulates the neurotransmitter to meet his needs. Cantway continues to drive his car around Steamboat, walks without shuffling and has no noticeable hand tremors.

And Cantway thrives on exercise.

 “I’ve been working out all my life,” he said.

To reach Tom Ross, call 970-871-4205, email tross@SteamboatToday.com or follow him on Twitter @ThomasSRoss1

If you go

What: Benefit for people exercising to manage Parkinson’s disease

When: 10 a.m. to 2 p.m. Jan. 10

Where: Haymaker Nordic Center, 34855 E. U.S Highway 40

Details: For a minimum donation of $50, participants can enjoy a day pass at Haymaker, 30-minute mini lesson, lunch, access to silent auction, voucher for a pass at Steamboat Ski Touring Center, $10 discount on rental gear day of event (reserve ahead of time) and an opportunity to purchase Haymaker season pass at early season rates (day of event only).

For the Parkinson’s support group in Steamboat Springs, call 970-875-1088.

Steamboat Springs has an increasingly active Parkinson’s support group, which includes people who are among the 1.5 million Americans living with the disease and their families and professionals such as exercise therapists, yoga instructors and, yes, ski instructors.

Mark Traum, an employee and instructor at the Steamboat Ski Touring Center, who has been diagnosed with Parkinson’s himself, is helping to organize a Jan. 10 fundraiser at Haymaker Nordic Center including lunch, a mini-lesson, a Haymaker day pass and a voucher for a pass at the Steamboat Ski Touring Center, discounts on rentals on event day and a silent auction, for the minimum donation of $50.

http://health.einnews.com/article/242493142/bxii5ZI1D2G64zzt

Regular exercise may improve lives of people with Parkinson's disease

Thursday, 1 January 2015

Washington, January 01: A new study has explored that exercise may help people with Parkinson's disease to improve their balance, ability to move around and quality of life. The study approached 231 people with Parkinson's disease either received their usual care or took part in an exercise program of 40 to 60 minutes of balance and leg strengthening exercises three times a week for six months. This minimally-supervised exercise program was prescribed and monitored by a physical therapist with participants performing most of the exercise at home. On average, 13 percent of the exercise sessions were supervised by a physical therapist. Study author Colleen G. Canning, PhD, of the University of Sydney in Australia, said that the resulting injuries, pain, limitations of activity and fear of falling again can really affect people's health and well-being. Canning said that these results suggest that minimally supervised exercise programs aimed at reducing falls in people with Parkinson's should be started early in the disease process. The study observed that compared to those in the control group, the number of falls by participants who exercised was reduced in those with less severe Parkinson's disease, but not in those with more severe disease and for those with less severe disease a 70 percent reduction in falls was reported in those who exercised compared to those who did not. The study is published in the online issue of Neurology, the medical journal of the American Academy of Neurology. http://health.einnews.com/article/242273262/YAKQwrUX3LIUkAL-

ARIA Widens Sales Turf, NRX Skips A Beat, NDRM Triples On Parkinson's Study

RELATED NEWS

12/30/2014 11:12 PM ET 

Aquinox Pharmaceuticals Inc. (AQXP: Quote) has initiated dosing in a phase II clinical trial of AQX-1125 for the treatment of atopic dermatitis.

The trial, dubbed KINSHIP, designed to enroll about 50 adult patients with mild to moderate atopic dermatitis is being conducted at clinical research centers in Canada.

AQXP closed Tuesday's trading 6.46% higher at $7.25.

ARIAD Pharmaceuticals Inc. (ARIA: Quote) has granted Angelini Pharma exclusive rights to commercialize leukemia drug Iclusig in seven Central and Eastern European countries.

The seven countries include Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia and Slovenia. The commercial launches of Iclusig in these Central and Eastern European countries are expected to begin in 2015.

With this distributorship in place, Iclusig will be available to patients with resistant and intolerant Philadelphia-positive leukemias in more than 23 countries in Europe.

Net product revenues from sales of Iclusig were $14.5 million for the quarter ended September 30, 2014, an increase of 22% from the second quarter of 2014.

ARIA closed Tuesday's trading at $6.82, down 1.23%. In after-hours, the stock was up 1.25% at $6.90.

Idera Pharmaceuticals Inc.'s (IDRA: Quote) drug candidate IMO-8400 has been granted orphan drug designation by FDA for the treatment of Waldenström's macroglobulinemia, a type of non-Hodgkin lymphoma.

IMO-8400 is currently under a phase 1/2 clinical trial in patients with Waldenström's macroglobulinemia who have a history of relapse or failure to respond to one or more prior therapies. The company expects final 24-week safety and clinical activity datafrom the trial in the second half of 2015.

IDRA closed Tuesday's trading at $4.36, down 3.00%.

Shares of NephroGenex Inc. (NRX: Quote) were up more than 118 percent in Tuesday's extended trading following successful completion of a thorough QT/QTc (TQT) cardiac safety study on the company's drug candidate Pyridorin. 

Pyridorin is under phase III testing in patients with diabetic nephropathy.

A TQT study is a specialized clinical trial designed to assess whether an investigational drug has the potential to prolong the QT interval. Note that a prolonged QT interval increases the risk of sudden cardiac death and arrhythmias.

NRX closed Tuesday's trading at $4.65, down 1.90%. In after-hours, the stock was up 118.28% at $10.15.

NeuroDerm Ltd. (NDRM: Quote) surged more than 193% on Tuesday following encouraging topline results of a phase IIa pharmacokinetic study of its product candidates ND0612H and ND0612L for the treatment of Parkinson's disease.

According to the European Parkinson's Disease Association, people with Parkinson's have reduced levels of dopamine, a chemical messenger in the brain involved in coordinating the nerve cells and muscles which control movement. 

Levodopa, which is converted into dopamine in the brain, is considered the gold standard treatment for Parkinson's. However, due to the short half-life of oral Levodopa, patients are required to take multiple doses daily. But steady Levodopa delivery can currently only be achieved after undergoing an invasive surgical procedure whereby a tube is permanently implanted into the duodenum, the upper part of the small intestine.

Given the fact that continuous, subcutaneous delivery of product candidates, ND0612H and ND0612L, led to clinically-significant plasma levodopa levels in the phase IIa study, the company expects the high dose version ND0612H to offer a simple and effective treatment option that will minimize the need for surgical intervention in advanced Parkinson's patients.

NeuroDerm expects to proceed with the clinical development of ND0612H and ND0612L in the United States and the European Union in 2015.

NeuroDerm went public as recently as November 14, 2014 priced at $10 per share. The stock closed Tuesday's trading at $18.14, up 193.53%.

Sucampo Pharmaceuticals Inc.'s (SCMP: Quote) New Drug Submission for AMITIZA for the treatment of chronic idiopathic constipation in adults and opioid induced constipation in adults with chronic non-cancer pain has been accepted for review by Health Canada.

The drug is already available in the U.S., Japan, U.K. and Switzerland, with over nine million prescriptions written in the US alone.

Sucampo has a global license, development, commercialization and supply agreement with Takeda Pharmaceutical Co. Limited for AMITIZA.

SCMP closed Tuesday's trading at $13.89, down 0.29%.

Synthetic Biologics Inc. (SYN: Quote) has initiated a phase 1b clinical trial of its drug candidate SYN-004 for the prevention of Clostridium difficile infection.

The company expects to report topline data from the phase 1b clinical trial and initiate a phase 2 SYN-004 clinical trial during the first quarter of 2015.

SYN closed Tuesday's trading 1.34% down at $1.47.

http://health.einnews.com/article/242118840/xpVLYnvwVEp-Tb_T

NeuroDerm Parkinson's Drug Shows Promise In Mid-Stage Study

12/30/2014 9:52 AM ET

Clinical-stage pharmaceutical company NeuroDerm Ltd. (NDRM: Quote), which went public in November, announced Tuesday topline results for a mid-stage study for its proprietary liquid levodopa/carbidopa (LD/CD) product candidates as a treatment for Parkinson's disease.

Following the announcement, the company's shares are skyrocketing more than 49 percent in early deals.

The company said the continuous, subcutaneous delivery of the liquid product candidates, ND0612H and ND0612L, led to clinically-significant plasma levodopa levels. The company added that ND0612H, the higher dose version, provided an effective alternative to current treatments that require surgery.

"Maintaining consistent levodopa concentrations has been the most significant hurdle in Parkinson's disease therapy. The results from this study demonstrate that ND0612H can reach high LD plasma levels that, to date, could only be reached and maintained by products that require surgical intervention," said Sheila Oren, NeuroDerm's Vice President of Clinical and Regulatory Affairs.

The phase IIa study was conducted on 16 patients with an advanced form of Parkinson's disease having motor fluctuations that was chronically treated with standard of care oral LD/CD. The primary endpoints of the study were to assess the safety, tolerability and pharmacokinetics (PK) of six dose regimens of ND0612H and ND0612L.

The patients were treated with ND0612L (n=9) or ND0612H (n=7) for eight hours per day, for three consecutive days, with high and low doses of CD, and with adjunct oral entacapone. The LD/CD product candidates are continuously administered subcutaneously through a belt-worn pump.

The trial results showed that patients receiving ND0612H achieved maximum daytime levodopa plasma concentrations of 1,333ng/ml and 1,807ng/ml with oral entacapone added.

Meanwhile, patients receiving ND0612L achieved maximum daytime concentrations of 528ng/ml and 596ng/ml with oral entacapone added.

The company confirmed that all patients completed the study and treatment with ND0612L and ND0612H did not raise safety and tolerability concerns.

Rehovot, Israel-based NeuroDerm focuses on developing drugs for central nervous system (CNS) diseases.

The company noted that it will now proceed with the clinical development of ND0612H and ND0612L in the U.S. and the European Union in 2015, based on the promising mid-stage trial results.

Parkinson's disease is a progressive neurodegenerative illness characterized by reduced dopamine in the brain, resulting in a debilitating decrease in the patient's motor and non-motor functions. Its symptoms, such as trembling in the extremities and face, slowness of movement and impaired balance and coordination, worsen over time and gravely impact the patient's quality of life.

In Tuesday's regular trading session, NDRM is currently trading at $9.23, up $3.05 or 49.35% on a volume of 2.32 million shares. In the past 52-week period, the stock has been trading in a range of $5.67 to $9.45.

http://health.einnews.com/article/242017194/ItAVG8YB69zTAz2e

Multimodal Imaging of rare Synucleinopathies.

Neurodegenerative diseases (NDD), such as Parkinson’s disease (PD) and Alzheimer’s disease (AD), are progressive, disabling disorders, which pose an increasing burden on health care systems and societies. Despite remarkable progress in the understanding of their molecular pathogenesis, no causative or disease-modifying treatment is currently available. Aggregation of misfolded proteins is thought to play a crucial role in the initiation of the pathogenic cascades, but attempts to exploit this knowledge to develop novel treatments have so far not been successful, partly because the relationship between protein aggregation on the one hand and neuronal dysfunction and neurodegeneration on the other is still poorly understood and pathogenetically relevant biomarkers of protein aggregation are lacking.

In order to overcome this critical road-block, we have assembled an interdisciplinary consortium, consisting of world-leading experts in structural biology and ligand development, multimodal neuroimaging, animal models and clinical trials to develop a novel imaging system for combined simultaneous molecular and functional imaging (PET-MRI/fMRI) for two rare subtypes of parkinsonism caused by excessive accumulation of misfolded alpha-synuclein (αSYN), multiple system atrophy (MSA) and parkinsonism caused by mutations in the alpha-synuclein gene (SNCA), which will serve as proof-of-principle models for the more common and heterogeneous NDD like AD and PD. With the PET/MR technology and novel imaging biomarker development we will pioneer the monitoring of protein aggregation as a surrogate marker for therapeutic effects in the framework of individualized causative treatment. The central aspects of the work-flow including ligand design, software development and drug trials will be driven by three highly specialized SMEs, while imaging workflow, translation to animal models and clinical use will be implemented by top academic centers.

http://www.multisyn.eu