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\u201cFood matters when you\u2019re living with\u00a0Parkinson\u2019s<\/a>\u2014not just because what you eat can help ease certain symptoms and help you feel better, but because Parkinson\u2019s can change how eating fits into your day,” said Rachel Dolhun, MD, DipABLM, and the Michael J. Fox Foundation\u2019s principal medical advisor. “The key is to start with what\u2019s realistic for you, keep the foods and traditions you love in the picture, and make changes you can live with\u2014because that\u2019s what diet is: a way of life, not a rigid set of rules.\u201d<\/p>\n Benefits of a healthy diet<\/p>\n \u201cDiet is something people with Parkinson\u2019s can control and modify to help with several symptoms and complications they [may] experience,\u201d says Benjamin L. Walter, MD, MBA, a movement disorders neurologist at the Cleveland Clinic. Food and fluids can help with Parkinson’s-related symptoms and prevention, such as:<\/p>\n Constipation Experts like Dr. Dolhun and Dr. Walter, as well as the\u00a0Parkinson\u2019s Foundation<\/a>\u00a0and the\u00a0Michael J. Fox Foundation,<\/a> recommend following the Mediterranean diet<\/a> or the MIND diet if you have Parkinson\u2019s disease.\u00a0Both feature fresh fruits and vegetables, nuts, seeds, fish, legumes, and olive oil. The diets recommend a moderate amount of dairy and limiting red and processed meat, refined carbohydrates, added sugars, and ultra-processed foods.<\/p>\n The MIND diet specifically calls for leafy greens, nuts, beans, and berries several times per week.<\/a> A multivitamin can fill some gaps, suggests Heather Zwickey, PhD, an immunologist at the National University of Natural Medicine in Portland, OR, who studies diet and Parkinson\u2019s disease.<\/p>\n The Mediterranean diet is full of fiber, healthy fats, protein, and a wide range of vitamins and minerals. It can also help people with Parkinson\u2019s disease prevent and manage other common health risks, including dementia, diabetes, high blood pressure, and cardiovascular disease.<\/p>\n However, Parkinson’s disease symptoms and medication management may make it hard to get optimal nutrition. Symptoms like difficulty chewing and swallowing can make eating and drinking more challenging, and tremors can make using utensils especially difficult. Brain fog<\/a> and fatigue<\/a> can also make planning, shopping, and preparing a healthy meal seem like too much to do. At the same time, the most common medication for Parkinson’s disease, levodopa, may require coordination of dosing with meals to ensure appropriate absorption.”<\/p>\n \u201cEating well can be a real challenge in Parkinson\u2019s,\u201d says Angel Planells, MS, RDN, a registered dietitian nutritionist in Seattle, WA, whose clients include older adults with Parkinson\u2019s disease. \u201cEffective and easy strategies can help people get around [the challenges] so they can follow a good diet, get the nutrition they need, and stay healthy.\u201d<\/p>\n Practical solutions to common eating challenges People with Parkinson\u2019s disease are advised to take levodopa 30 to 60 minutes before a meal or 1 to 2 hours after, because amino acids in protein can reduce and slow levodopa absorption. This can make it challenging to get enough protein throughout the day, and protein is critical for maintaining muscle mass, Dr. Walter notes. You need about 0.5 to 0.7 grams per pound of body weight. This is 89 to 109 grams of protein a day if you weigh 150 pounds, according to the US Department of Agriculture.<\/a>\u00a0\u00a0<\/p>\n If you\u2019re having trouble fitting in protein, Dr. Walters suggests talking with your doctor about whether you could safely take levodopa and eat meals or snacks at the same time or closer together. \u201cIf you\u2019re early in Parkinson\u2019s or you take levodopa-carbidopa that makes you feel nauseous, you may be able to do this with your doctor\u2019s approval,\u201d he says. \u201cIf you have more brittle or advanced Parkinson\u2019s with off periods between doses, you need your medications to work quickly and keep working for as much of the day as possible, and you should follow meal-timing advice.\u201d<\/p>\n Try including eggs or plain Greek yogurt at breakfast, a chicken breast, chili with beans and cheese, or fish at lunch and dinner. A snack of cheese and crackers, a handful of nuts, or plain Greek yogurt with fruit may also help. Another option is to sip a high-protein shake in the evening after your last levodopa dose of the day. Add yogurt, frozen fruit, or peanut butter. \u201cYou could make up a pitcher in the morning, keep it in the refrigerator and have a few ounces every couple of hours, too,\u201d Planells says.<\/p>\n For a quick snack, Dr. Zwickey suggests a healthy protein bar\u2014one that\u2019s low in sugar and includes nuts or nut butter for good fats and fiber.<\/p>\n Challenge: Drinking less fluid due to tremors, slow movements, and concerns about getting to the bathroom on time. Staying hydrated helps relieve three big Parkinson\u2019s complications: constipation, gastroparesis, and sudden low blood pressure when you sit up or stand up. All are caused by Parkinson\u2019s-related brain, nerve, and muscle changes, Dr. Walter says. \u201cStaying hydrated is critical,\u201d he says. \u201cPeople with Parkinson\u2019s need eight 8-ounce glasses of water a day, possibly more in hot weather.\u201d He suggests drinking throughout the day to stay hydrated.<\/p>\n You may find it easier to hold and drink from an adult sippy cup or a water bottle with a built-in straw, says Dr. Zwickey. \u201cUsing a short straw in a shorter glass or cup is helpful. It takes less effort to suck in fluid than with a long straw,\u201d she says. She also suggests juicy produce like oranges, peaches, and tomatoes. And while one cup of coffee or caffeinated tea can count toward your daily fluid total, stop there. \u201cCaffeine can be dehydrating,\u201d she notes.<\/p>\n Challenge: Trouble cooking and eating because tremors and involuntary muscle movements make utensils hard to control.
\nGastroparesis<\/a>\u2014a condition where the stomach takes too long to empty because the stomach muscles are not working properly
\nNeurogenic orthostatic hypotension\u2014dizziness or fainting when sitting up or standing up, due to a sudden drop in blood pressure
\nBone and muscle strength
\nBalance
\nUnintentional weight loss<\/p>\n
\nChallenge: Getting enough protein around levodopa doses or feeling nauseous when taking levodopa-carbidopa on an empty stomach.
Solution: Talk with your doctor about meal timing. Focus on protein in meals and snacks.<\/p>\n
Solution: Use adult sippy cups, short straws, and take sips throughout the day.<\/p>\n
Solution: Adaptive utensils for food prep at the table.<\/p>\n