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PD and nutrition

Parkinson's disease (PD) is a motor-system disorder caused by damage to brain cells. If you have PD, you may have difficulty with sleeping and eating, and managing everyday tasks like dressing and moving around.

For anybody, eating well is vital for wellbeing, energy and general health – including brain health. Paying attention to nutrition is particularly important if you have PD:

- Proper diet can alleviate symptoms like constipation. It’s important to drink sufficient water, and to take in enough fibre. Fruits and vegetables are good choices. A mild laxative like senna tea may be helpful – but consult with your doctor about this.
- People with PD suffer from weak bones, which can fracture easily in falls. Eat foods containing bone-strengthening nutrients such as vitamins D, vitamin K, calcium and magnesium.
- Dehydration is a side effect of certain PD medications. Drink sufficient fluids throughout the day.
- People with PD may also have concurrent health problems that make them prone to malnutrition. Poor nutrition can also exacerbate conditions (e.g. diabetes and hypertension) that make PD harder to manage.
- PD can directly or indirectly result in undesired weight loss or gain. This may be due to nausea, appetite loss, fluid retention and slowed colon movement (which affects the body’s ability to absorb nutrients). Depression and compulsive eating may also be factors. A careful diet can help to control these changes.

However, PD symptoms can make eating a difficult task:

- You may have physical problems with chewing and swallowing.
- Nausea caused by medication can put you off your food.
- Tremor, slowness and stiffness can make it tricky to use regular cutlery and crockery.
- You may need to time meals and medications carefully. For example, patients starting levodopa may initially take it with food to decrease nausea; but later on, levodopa often doesn’t work well when taken at mealtimes, as it “competes” with food (especially proteins) for absorption.

Tips for making eating easier if you have PD:

- Limit your coffee intake. Lots of caffeine will make you need to urinate more frequently.
- Schedule meals and medication for the most effective times.
- Drinking through a straw helps to control the size of sips.
- Cut solid food into little pieces.
- Eating aids – such as specially shaped utensils, plates and cups – can make eating easier. These might include angled utensils, cups that let you drink without tipping your head, rocker knives, scoop-shaped plates and non-slip matting to keep your plate still.
- Try to sit up as straight as possible during meals and shortly afterwards, to aid digestion.

Here are some guidelines for healthy eating:

- Reduce your intake of saturated fat, refined sugar and sodium.
- Eat a balanced diet that provides you with sufficient energy, protein, vitamins, minerals and fibre. Include grain products, fruit and a variety of vegetables.
- Antioxidants may help prevent some cell damage. Antioxidants include vitamins A, C and E, as well as selenium, lycopene and polyphenols, which occur in many fruits and vegetables.
- Fish is a good source of healthy omega-3 fatty acids.
- Vitamin B12, found mostly in meat, fish and milk, is important for brain health. So is folic acid, found particularly in green leafy vegetables.
- Balance the food you eat against your levels of physical activity.
- Drink alcohol in moderation.
- It’s not advisable for someone with PD to go on a low-carb diet: you need those nutrients.

Sources: Breslow, D., ‘Parkinson’s Onboard: Traveling with PD’, Northwestern University, National Parkinson Foundation Center of Excellence; Brandabur, M.M., ‘Nutrition and Parkinson’s Disease’, The Parkinson’s Institute; Parkinson’s Disease Foundation: www.pdf.org; National Parkinson Foundation: www.parkinson.org

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