1. NUTRITION & PARKINSON’S
Elizabeth Nelson, MS, RD, CDE
Clinical Dietitian & Diabetes Educator, UC Health
Barbara A. Smith, PhD, RD Food Science & Human Nutrition, CSU: Retired
February, 2019

2. This Photo by Unknown Author is licensed under CC BY
This Photo by Unknown Author is licensed under CC BY-SA-NC

3. General Health Outcomes
MEDITERRANEAN DIET
General Health Outcomes
Reduces risk of
Cancer
Coronary Heart Disease
Depression
Alzheimer’s disease
Parkinson’s disease
Supports gut motility & healthy gut microbiome
Good for the planet too!

4. OVERVIEW Evidence of Dietary Role in PD Progression
Characteristics of Mediterranean-type Diet
Special Considerations in PD

5. Chart of PD Progression (PRO-PD)
Mischley, 2013

6. FOODS ASSOCIATED WITH SLOWER PROGRESSION OF SYMPTOMS
Fresh vegetables Fresh fruit Nuts & Seeds Non-fried Fish
Olive Oil
Wine
Coconut oil
Spices
Mischley, 2017

7. FOODS ASSOCIATED WITH MORE RAPID PROGRESSION OF SYMPTOMS
Canned fruit & vegetables Diet & non-diet soda Fried foods Beef
Ice Cream
Yogurt
Cheese
Mischley, 2017

8. SUPPLEMENTS AFFECTING RATE OF PD PROGRESSION
Slower Progression Fish oil
Faster Progression
Iron
Mischley, 2017

9. MEDITERRANEAN DIET PLANT-BASED
Emphasis on vegetables, fruits & dark leafy greens
Legumes & fish, nuts, seeds
Whole grains
Olive oil
**High in vitamins, minerals, fiber & phytochemicals (healthy plant-based components)**

10. General Health Outcomes
MEDITERRANEAN DIET
General Health Outcomes
Reduces risk of
Cancer
Coronary Heart Disease
Depression
Alzheimer’s disease
Parkinson’s disease
Supports gut motility & healthy gut microbiome
Good for the planet too!

11. FIBER TIPS Recommended Daily Total = 30-35 grams
Switch to whole grain breads & cereals
Add bran cereal to breakfast menu
Vary bread/cereal sources to maximize diversity
Substitute legumes for meat in soups & stews
Increase fluid intake
READ LABELS!

12. EFFECT OF AGING ON PROTEIN STATUS
Hormonal changes, inactivity, dietary shortfalls reduce muscle mass
Illness & injury risks increase
Efficiency of muscle repair & build-up decreases
Feeding difficulties may arise: decreased sense of smell, eye-hand coordination, chewing or swallowing.
Protein is used as protein only if total calories are adequate to meet energy needs.

13. PROTEIN CALCULATION
Protein requirement range: g/kg body wt/day
Example:
132 lb = 60 kg x 0.8 g protein / kg = 48 g protein/day lb = 60 kg x 1.0 g protein / kg = 60 g protein/day
Therefore for a 132 lb person, the acceptable range of protein intake is g /day
Divide by three to see recommended grams of protein per meal.

14. MILK & MILK SUBSTITUTES Why we need to read labels
ITEM
Cow’s milk
SILK soymilk
SILK almond milk
SILK soy yogurt alternative
Serv. Size
1 cup
Protein (g) 8 6 1 10
Fiber (g) 1 3

15. BREAKFAST CEREALS Why we need to read labels
TYPE OF CEREAL
Kellogg's All Bran
Kroger Nutty Nuggets
General Mills Rice Chex
Old-fashioned Quaker Oatmeal
Cream of Wheat
SERV. SIZE
½ cup
1 cup
½ cup dry
3 tbsp dry
PROTEIN (g) 4 6 2 5
FIBER (g) 10 7 1 4

16. FOOD-DRUG INTERACTION
Transit time through stomach
Water, carbohydrate, protein, fat
Interaction with protein
Amino acids share carrier with levodopa
Holden

17. FOOD DRUG INTERACTION (cont.)
Take Levodopa minutes before meal
Divide protein equally among 3 meals
Snacks: No protein or low protein
Holden

18. FOOD-DRUG INTERACTION (cont.)
Effect of protein source:
Plant proteins affect levodopa < animal proteins
Milk may interfere the most.
Nausea or stomach irritation:
Snack on small amounts of carbohydrate, such as crackers, when you take your levodopa.
Holden

19. CONSIDER . . .
SUPPLEMENTS Speak with your medical provider or a registered dietitian to determine if supplements are indicated along with the appropriate diet. ORGANIC FOODS Exposure to pesticides is the strongest link between the environment and Parkinson’s disease. Giroux 2016

20. IN SUMMARY . . .
Think COLOR! PLANT PROTEINS (legumes, nuts, seeds) & FISH FIBER Choose MONOUNSATURATED OILS (Olive, Peanut, Avocado)

21. ENJOY!! Be social!

22. Food is more than just something to eat . . .

23. REFERENCES
BOOKS:
Giroux, ML, MD. Optimal Health with Parkinson’s Disease,
Holden, K., MS,RD. Parkinson’s Disease: Nutrition Matters. National Parkinson Foundation, no date given.
ONLINE sources:
Newson, C & S O’Connell. Protein Requirements & Recommendations for Older People: A Review. Nutrients, doi: [ /nu ]
Mischley, LK et al. Role of Diet and Nutritional Supplements in Parkinson’s Disease Progression. Oxid. Med. Cell Longev
Academy of Nutrition and Dietetics. Recipes.

24. Thank you!
Questions?