How to eat well with Parkinson’s Disease?

Healthy eating with Parkinson’s

Whilst there is no prescribed diet specific to PD, maintaining a balanced diet is important to support patients’ physical and mental health. For instance, emerging research suggests that following a mediterranean diet may help slow down PD progression, thanks to its high content in fruits, vegetables, nuts, and fish. 

In addition, some specific foods may help maintain PD patients’ well-being, such as: 

• Healthy fats: consuming foods rich in omega-3 fatty acids or omega-3 supplements has been linked to improved brain function in older adults and PD patients, thanks to their anti-inflammatory properties and role in neurone communication signals in the brain. They can be found in fatty fish (salmon, mackerel, sardines, etc.), nuts (walnuts, pecan, etc.), and seeds (chia, flax, etc.). 
• Polyphenols: polyphenols are natural bioactive compounds founds in fruits and vegetables and they are particularly abundant in blueberries, plums, cherries, and dark olives. They have powerful antioxidant properties and have been linked to improved brain function in PD patients thanks to their regulating effect on the microbiota-gut brain axis (MGBA). 
• Micronutrient-dense foods: malnutrition is common among PD patients, so it may be helpful to boost their vitamin and mineral consumptions through a varied and colourful diet. Patients can work with registered dietitians to cover their needs in iron (found in red meat, tofu, pulses, etc.), vitamin B1 (found in pork, eggs, pulses, etc.), zinc (found in fish, wholegrains, etc), and calcium (found in dairy foods, leafy greens, etc.). 

To make the most of these benefits, and help prevent other diseases such as cardiovascular diseases, diabetes, and cancer, patients may also need to consume added sugar and saturated fat in moderation. This means reducing their consumption of butter and palm oil-rich industrial foods, and to limit red and processed meat to 70g per day.

Food choices to ease Parkinson’s symptoms 

 PD symptoms vary in nature and intensity across patients, and some of them have a major impact on patients’ autonomy and daily lives. While no diet can make Parkinson’s symptoms disappear, food choices may help alleviate some of them. 

• Constipation: drinking lots of fluids (at least 8 glasses of water per day) and eating fibre-rich meals can help maintain a regular bowel schedule. Fibre can be found in vegetables, fruits, wholegrains, and pulses.  
• Low blood pressure: fluids will also help maintain a steadier blood pressure, especially drinks with higher salt content. However, patients should talk to their doctor before increasing their salt consumption – especially if they have a history of heart or kidney issues. 
• Swallowing or chewing problems: softening food can help reduce jaw muscle stimulation and reduce chewing issues. In addition, eating sour or carbonated foods, along with adding spices and seasoning to dishes, can stimulate the production of saliva and ease the swallowing process. During meals, it can also be helpful to eat smaller bites and at a slower pace. Patients may also seek the support of a speech therapist to find the right strategy for easier mealtimes. 
• Muscle cramping: Staying hydrated may help reduce the risk of cramping. Apart from drinking plenty of fluids, patients may need to limit their consumption of caffeine and/or alcohol, which both promote dehydration. Some limited research also suggests that turmeric and quinine supplements may help prevent camps, although these should only be taken under the supervision of a healthcare professional.  

Meal planning and PD treatment 

Some Parkinson’s treatments have unpleasant side effects and interactions with foods. It is thus important to always discuss dietary changes with a healthcare professional. Here are some common challenges faced by PD patients under treatment and tips to tackle them.  

• Some medication, like levodopa, are not as effectively absorbed if they are taken close to a protein-rich meal or with iron supplements. This can lead to fluctuation in PD symptoms and give the impression that the treatment is not effective. Similarly, some treatments work best on an empty stomach and should be taken away from meals. Personalised meal plans tailored by a registered dietitian can help ensure nutrition targets are met without interfering with Parkinson’s treatments. 
• Nausea is a common side effect of PD medication and can be really difficult to overcome. For some people, spreading food over several small meals throughout the day, starting meals with saltines or toast, and limiting fluids when eating meals can help reduce this uncomfortable feeling.  
• Inhibitors of type-B monoamine oxidase (MAO-B), which are commonly used for PD treatment, reduce the body’s ability to process the amino acid tyramine. If consumed in high quantities, tyramine may accumulate in the blood stream and lead to hypertension or even a hypertensive crisis. Thus, patients under MAO-B treatment should consume tyramine-rich foods (e.g., cheese, cured meats, fermented pickles, alcohols like sheery or vermouth) in moderation. 

Last words

Although changing their whole diet can be quite challenging for patients, small changes can quickly add up and contribute to their general well-being in the long run. Apart from their doctor, it is also important for patients to seek the support of healthcare professionals to improve their quality of life – such as registered dietitians for meal planning, occupational therapists to look into assistive device options, and speech-language pathologists to help with jaw and swallowing issues.