Foods for PD

• Foods high in Antioxidants: molecules that clear out free radicals (substances that are potentially toxic to cells). Free radicals contribute to a condition known as oxidation stress, which is associated with PD.    

• Veggies: artichokes, kale, okra, bell peppers, potatoes

• Fruits: berries, pears, apples, grapes 

• Whole grains

• Legumes: kidney beans, edamame, lentils

• Nuts: pecans, walnuts, hazel nuts 

• Dark chocolate                                                                                         

• Supplements: Turmeric, CoQ10, Vitamin D 

 

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Diet and PD medications

PD medications may have interactions with foods, other medications, vitamins, and supplements. 

 

Carbidopa/Levodopa competes with protein for absorption in the intestine. This can cause some PwP to experience poor responsiveness to the medication – its effectiveness may be diminished, resulting in the need for increased dosage, or the medication may take longer and longer to become effective. 

 

Suggestions to combat this issue: 

• Eat meals that are high in protein, such as meat, fish or cheese, in the evening. 

• Take on an empty stomach- 30 minutes before or 60 minutes after a meal.  If nausea occurs, combine with carbohydrates: cracker, toast or oatmeal. 

• Dopamine agonists do not require any dietary adjustment. 

• MAO-B Inhibitors increase a substance called tyramine. High blood pressure can result when MAO-B Inhibitor medications are mixed with foods that contain high amounts of tyramine. 

 

Food and supplements to avoid when on MAO-B Inhibitors: 

• Cured, fermented or dried meat or fish 

• Aged cheeses 

• Fermented cabbage: sauerkraut, kimchi 

• Soybean products, including soy sauce 

• Red wine and tap beer 

 

Iron supplements decrease absorption of levodopa. Allow at least two hours between taking iron and levodopa. 

 

Foods that can help some of the non-motor symptoms of PD

Constipation can interfere with medication absorption and effectiveness.  In addition to regular exercise, it is recommended to: 

• Drink 6-8 glasses of water per day 

• Drink warm liquids in the morning 

• Dietary source of fiber: fruits (with peel), vegetables, legumes, whole grains and cereals, add gradually 

• Eat foods containing probiotics: yogurt, kefir, miso soup, sauerkraut, pickles 

• Eat dried foods: prunes, figs, dates, apricots, raisins 

• Eat fresh fruits: peas, plums, apples 

 

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Nutritional concerns with PD

Bone thinning: Studies show that Parkinson’s also increases the risk of bone thinning. With the frequency of falls combined with bone thinning can lead to injury in PwP. Eating meals rich in bone-strengthening nutrients such as magnesium, calcium and vitamins D and K are important. Regular sunlight can increase vitamin D. Walking and other weight-bearing exercises can help strengthen bones. 

 

Dehydration: Parkinson’s medications can lead to dehydration. Dehydration can lead to confusion, weakness, balance issues, respiratory failure, kidney problems, low blood pressure. 

 

The gut microbiome

A microbiome is a universe of bacteria mostly inside the gastrointestinal tract.  The microbiome can reach the brain through the vagus nerve and the circulatory system. The incidence of Parkinson’s is higher in people with ulcerative colitis, inflammatory bowel disease and Crohn’s disease.  

 

Research has found a link between bacteria in the gut and PD. PD “may” start in the peripheral nervous system in the gut and spreads via the nerves into the brain. One of the earliest symptoms of the disease, often before diagnosis, is constipation. Studies have found toxic forms of the protein alpha-synuclein in the colon of PwP. PwP have an altered microbiome, with higher levels of H-Pylori bacteria.

 

Weight or gain weight with PD 

Weight gain may occur as a result of reduction in exercise/activity, lifestyle changes and or dietary changes in the first few years after diagnosis. Weight gain may also be a side effect of Deep Brain Stimulation (DBS) surgery or of dopamine agonists medications, which can cause compulsive eating behavior.  Weight gain can result in heart disease, diabetes, metabolic syndrome, joint damage and other complications so it is important to discuss with your doctor if weight gain occurs. It often can be corrected by medication change.

 

Weight loss may initially occur as a result of loss of taste and smell causing depressed appetite. It is important to monitor because extreme weight loss can result in malnutrition. This can lead to a weakened immune system, muscle wasting, loss of vital nutrients, risk for other diseases and even death. 

 

Unintentional weight loss of more than 5% within one month or more than 10% within six months and/or low body weight should receive medical attention. 

 

Depression and anxiety can also cause significant weight gain or loss.