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?

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.

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