Tuesday, October 19, 2010

Protein and Parkinson’s Diseas

Recent medical studies have proven that enjoying a diet which happens to be better in proteins is definitely an excellent section of remedy for patients with Parkinson’s disease. Anumantha Kanthasamy, professor of biomedical sciences at the ISU school of Veterinary Medicine, has been working on this concept regarding the disease, and believes that proteins could perhaps be considered a section of the cure.

The research that Kanthasamy has completed shows that there may be a definite insufficient dopamine, a chemical in the brain, in Parkinson’s patients. This research also shows that there may be a specific proteins (protein kinase-C) that kills the mind tissues that generate dopamine. it could perhaps be proposed that patients be on the low-protein diet. They nonetheless will need proteins in purchase to survive, however they need to make particular which they are following a doctor-recommended diet and enjoying the suitable proteins.

Getting the proteins You will need from Your Diet

There undoubtedly are a choice of methods that Parkinson’s patients can obtain the proteins which they will need in their diets with no obtaining too much. you can get a huge amount of delectable dietary sources, too as a choice of proteins supplements, this kind of as fluid and powdered supplements.

Protein in Meat, Poultry and bass – Lean red-colored meat, white meat poultry and bass are all excellent resources of protein, too as a choice of other vitamins and vitamins and minerals that are necessary regarding renal care. In fact, these foods undoubtedly are a handful of of the richest resources of proteins that you may be in a position to find.

Turkey requires 28 grams of proteins per hundred gram serving, and lean beef requires twenty five grams of protein. A delectable cod fillet has 22 grams of proteins per hundred gram serving, and good old tuna in essential oil requires 26 grams of protein.

Proteins from Nuts and Seeds – this could be still another terrific way for vegetarians with renal troubles to obtain the proteins which they will need in their diets. Nuts are filled with protein, and as lengthy when you are not allergic to nuts, they ought to be included into your renal attention diet. Some tasty, protein-rich nuts are cashews, peanuts, pumpkin seeds, almonds and sunflower seeds. Also, hemp seed is a superb way to obtain proteins and it is also total of antioxidants, vitamins too as other nutrients.

Proteins from Grains – you can get a huge amount of delectable foods that you may be in a position to make from grains that are better in protein, and these foods could perhaps be vegetarian or with meat included. just between the extra desired grains which happens to be quite protein-rich is brown rice, which goes superb with a huge amount of several meats too as other foods. Barley is also a high-protein grain that ought to be considered a section of the renal attention diet, and when additional to home made chicken soup, the number proteins that you receive is within most conditions as a great offer as doubled.

Protein products – Parkinson’s patients who are not obtaining sufficient proteins from dietary resources can use any number of the terrific proteins products that are available. you can get fluid products that could work as food replacements and powdered products that could perhaps be included into shakes too as other recipes. only one desired proteins supplementation is Profect, by Protica. This supplementation provides twenty five grams of proteins and has only one hundred calories from fat per 2.9 fluid ounce serving.

Parkinson’s and Protein: A condition Study

Sam was diagnosed with Parkinson’s disease a number of years ago. So far, his medications have kept his signs or symptoms pretty at bay, but he’s concerned. he’s unbelievably fascinated with watching any and all developments regarding the research because of this disease. He also enjoys reading about Michael J. Fox as he deals while using disease himself. Sam performs with his medical doctor and nutritionist for just about any food program that keeps him as wholesome as achievable and also keeps his medications working properly. For instance, he has realized to time his largest proteins foods for right after his medications are employed to make sure which they in most conditions do not interfere owning only one another.

In inclusion to good nourishment which happens to be properly timed, Sam is being encouraged to obtain actual exercise and make an effort to continue to be as active as possible. He has also joined a support special event to make sure that he can continue to be good and focused.

Another point that he’s title to be executing is adding Profect, a proteins supplementation from Protica, into his diet, each as a between-meal snack and occasionally just just before a meal. it could perhaps be easy-to-consume and arrives within a choice of flavors to make sure that he can move them near to as he needs. The benefit of Protica could perhaps be the ability to mix it with other foods or beverages if only one is wishing for to.

Sam will keep monitor of his wellness and keep monitor of for signs or symptoms that his signs or symptoms are returning or progressing. He will go regarding the medical doctor at regular intervals to make sure that he can keep his strength and his wellness at the degree that it could perhaps be at this point. He discusses tips and wellness hints with his support special event and waits hopefully for just about any treatment and even a better remedy plan.

Sunday, October 10, 2010

Parkinson's Disease Nutritional Supplements

Parkinson's disease is a progressive neurological disease that affects nearly 1 million people in the U.S., according to the Parkinson's Disease Foundation. People affected by the disease may experience stiffness in the limbs, tremor, difficulty moving and impaired balance and coordination. Parkinson's disease occurs when cells that produce the a neurotransmitter called dopamine, start to die. As a result, dopamine levels in the brain fall, which in turn leads to movement and coordination problems. There is no cure for Parkinson's disease but it can be managed with medication. Nutritional supplements may also play a role in Parkinson's disease management; however research findings are somewhat inconclusive. Always check with your doctor before taking supplements.

Coenzyme Q10
Coenzyme Q10 is an antioxidant that plays an important role in energy production. It occurs naturally in every cell of the body. It plays a particularly important for the mitochondrial bodies found in every cell as mitochondria are responsible for converting food into energy. According to the charity, Parkinson's UK, people with Parkinson's disease have less coenzyme Q10 in their cells than people who don't have the condition. They also have impaired mitochondrial function, which leads to an increase in free radicals, which cause cell damage. Since coenzyme Q10 is an antioxidant, it can neutralize free-radical damage. Coenzyme Q10 is found in small quantities in some foods, though Parkinson's UK notes that taking a coenzyme Q10 supplement is a more effective way of obtaining the antioxidant.

Creatine is an antioxidant that improves mitochondrial function and helps protect brain cells from free-radical damage. Creatine has been shown to prevent the loss dopamine-producing brain cells in a mouse model of Parkinson's disease. The benefit to humans has not been conclusively proved. In 2007, scientists at Rush University Medical Center initiated a clinical trial to determine whether taking a creatine supplement can slow disease progression, reports Medical News Today. According to Rush University Medical Center, the study is expected to last for at least five years to accurately determine creatine's effect on disease progression.

According to Medical News Today, a study published in "The Lancet Neurology" in 2005, vitamin E may reduce the risk the of developing Parkinson's disease. Lead author, Dr. Mayhar Etminan from the Royal Victoria Hospital in Quebec, says that the benefits noted during the study were confined to vitamin E obtained through the diet. Dr. Etminan said that no definitive conclusions could be made as to whether vitamin E supplements would have the same benefit. Earlier research, published in 1991 in the "Annals of Neurology," found that administering a high dose of vitamins E and C to patients with Parkinson's delayed disease progression.

by Charlotte Waterworth

Sunday, September 12, 2010

Parkinson's Disease Genetic Link That Implicates the Immune System

Hunt throughout the human genome for variants associated with common, late-onset Parkinson's disease has revealed a new genetic link that implicates the immune system.

The long-term study involved a global consortium, including Johns Hopkins researchers from the Center for Inherited Disease Research (CIDR) who performed genome-wide association studies on more than 4,000 DNA samples — half from unrelated patients with Parkinson's and half from healthy "controls." The team confirmed that a gene in the human leukocyte antigen (HLA) region was strongly linked with Parkinson's disease; this region contains a large number of genes related to immune system function.

The new data bolsters previous studies that hinted about a role for infections, inflammation and autoimmunity in Parkinson's disease. This genetic finding demonstrates that inflammation isn't simply a result of having Parkinson's disease, but somehow is involved as a player in its origin.

"This is an exciting finding from a genome-wide association study (GWAS) which is completely hypothesis-independent and bias-free, based solely on looking at the whole genome and finding out what genes might be related to Parkinson's," says Kimberly Doheny.

It was long believed that common, late-onset Parkinson's had no genetic components — that environmental factors were the exclusive cause. Since genes were first implicated almost two decades ago, Parkinson's has proven itself a "tough nut to crack," Doheny says, adding that a handful of GWAS done prior to this one revealed nothing new other than to confirm genes that previously had been found to confer risk.

Setting this GWAS study apart, Doheny says, was the investigators' meticulous choosing of patients and care of the DNA samples tested. The study's principal investigator Haydeh Payami describes CIDR's contribution as "huge."

It took 18 years to build the study, according to Payami, at whose insistence the collection of DNA and clinical information was standardized using the most rigorous research criteria. Patients from whom samples were taken were tracked for at least a dozen years after their initial diagnoses to assure that they indeed had Parkinson's, Payami adds, explaining that about 20 percent of Parkinson's disease patients' diagnoses are actually misdiagnoses.

A neurodegenerative disease affecting between 1 and 2 percent of people over the age of 65, Parkinson's disease can be difficult to diagnose as no definitive test exists. Its symptoms, which include tremors, sluggish movement, muscle stiffness and difficulty with balance, can be caused by many other things, including other neurological disorders, toxins and even medications.

The GWAS itself took about four months, Doheny says, and cost about $400 per sample tested; whole-genome sequencing costs about $10,000 per sample.

Since 1996, CIDR has provided high-quality genotyping services and statistical genetics consultation to gene hunters: researchers who are working to discover genes that contribute to common diseases by ferreting out variants in the genome. Its role in the Parkinson's study was to assure that the genotyping dataset was of high quality, that data cleaning was done appropriately and that association analysis was stringent.

"We now have another window into what may be going on in Parkinson's," Payami says. "This finding anchors the idea of immune system involvem

Sunday, September 5, 2010

What Is the Best Diet for Parkinson's Disease?

The best diet for Parkinson's disease is similar to the best diet for most people, which includes eating lots of fresh fruit and vegetables, preferring fish and dairy protein to meat, and eating whole grain foods. No specific diet has consistently been recommended for those with Parkinson's disease. That said, people with Parkinson's disease may benefit from some dietary changes.

Parkinson's disease is caused by increasing damage to the brains cells that produce dopamine. Dopamine is a chemical messenger that is necessary for making smooth, controlled movements, among other things. The decrease in dopamine results the most familiar symptoms of Parkinson's disease, including tremors and a shuffling gait. The dopamine deficit at the root of Parkinson's disease cannot be treated by diet alone. Eating healthy foods, though, along with beneficial fats from nuts and legumes, will supply adequate nutrition.

The risk of developing Parkinson's disease has been linked to insufficient vitamin D intake. Raising vitamin D intake in a diet for Parkinson's disease probably won't have a therapeutic effect, but it may make bones healthier. People with Parkinson's disease seem to be at more risk for osteoporosis, a condition in which the bones become weaker and more prone to breaking. Vitamin D can be obtained in supplements containing 400-1,000 international units (IUs) of this vitamin. Good food sources of Vitamin D include milk and fatty fish like salmon and sardines.

People with Parkinson's are often prescribed l-dopa, a prescription drug that can raise dopamine levels in the brain. One strategy in a diet for Parkinson's disease includes eating very little protein at breakfast and lunch, and getting most dietary protein at dinner. This strategy seems to increase the effectiveness of the l-dopa drug. As with other broad dietary changes, this should be done in consultation with a qualified dietitian to ensure the diet provides enough protein as well as overall nutrition.

Those with Parkinson's disease can become constipated more easily than the general population. Drinking plenty of water and eating more fiber are good strategies for a diet for Parkinson's disease, especially one aimed at relieving constipation. Fiber intake can be raised by eating more fruits, vegetables, and whole grains, or by taking a fiber supplement.

Thursday, August 12, 2010

Parkinson's Disease & Good Nutrition

While there is no special diet required for Parkinson's disease, eating well is extremely beneficial. A well balanced diet makes the body work more efficiently as well as helps medications for Parkinson's work properly. What follows are basic guides to eating well and managing symptoms of Parkinson's. To ensure your body and Parkinson's disease medications function properly, speak to your doctor and/or registered dietitian for an in depth, tailored nutrition plan.
Good Nutrition Practices for Managing Parkinson's Disease

* Eat high fiber foods. Vegetables, wholegrain foods, nuts, seeds, fava beans, and fruit will manage constipation problems as well as manage weight, and control blood sugar levels.
* Consume broad beans. Broad beans, or fava beans, contain Ldopa, which is used as a drug for the treatment of Parkinson's disease and may help in maximizing the effects of Parkinson's disease medications.
* Eat foods that are low in cholesterol and saturated fats.
* Drink at least eight 8 oz. glasses of water daily.
* Reduce and moderate the intake of sodium.
* Eat foods rich in antioxidants such as berries, prunes, barley, oregano, and kale.
* Daily intake of 10001500 mg of calcium can reduce the risk of osteoporosis.
* Ingest easy to swallow foods such as well cooked vegetables, soup, yogurt, pureed fruit, rice, and casseroles.
* Avoid caffeine and alcohol as these substances can aggravate constipation.
* Avoid high protein foods. Certain meats and other high protein foods may hinder the body's ability to absorb levodopa (a synthetic substance used in the treatment of Parkinson's disease).
* Eat meals at the same time every day.

Too Tired to Eat Tips

Parkinson's disease along with certain medication side effects may cause you to feel to worn down to eat at all, let alone eat nutritionally. Follow the suggestions below when you find yourself too tired to eat.

* Plan periods of rest before meals to restore your energy.
* Ask family, friends, or caregivers to prepare meals so you can save your strength for eating.
* Assistance with Speech
* Choose foods that are easy to prepare.
* Participate in your local Meals on Wheels Program.
* Snack on healthy foods throughout the day such as fresh fruit, vegetables, crackers, and cereals.
* Store extra meal portions in the freezer and defrost them when you are feeling too tired to prepare a meal.
* Eat larger portions early in the day so you have lasting energy into the evening.

Parkinson's Disease and Controlling Nausea

The following suggestions can help relieve nausea. If these techniques do not help you control nausea associated to Parkinson’s disease, consult your doctor.

* Drink liquids between meals rather than during meals. Drink slowly.
* Drink ice cold sugary or clear liquids. Sugary drinks may relieve an upset stomach.
* Avoid acidic juices such as grapefruit and orange juices as they may worsen nausea.
* Avoid greasy or sweet foods.
* Eat light, bland foods especially when your stomach is uneasy.
* Eat slowly, chewing food completely.
* Do not mix hot food with cold food.
* To avoid getting nauseated from the smell of hot foods, eat foods that are cold or at room temperature.
* Eat small meals frequently throughout the day.
* Avoid heavy activities after eating as such movement may trigger or worsen nausea.
* Rest after eating, keeping your head elevated.
* Try to eat food even when you feel nauseated.
* Keep light, bland snacks next to your bed in case you wake up feeling nauseated.

Parkinson's Medications & Meals

Treatment of Parkinson's disease includes taking medications that restore the brain chemical dopamine. While taking drugs are necessary to improve Parkinson's symptoms, they also may cause side effects, react to certain foods, or not be absorbed adequately into the body through the stomach. The following suggestions may reduce side effects and help the body absorb the medication so it can work properly.

* Take medication 1520 minutes before meals to assure more predictable absorption.
* Divide medication into smaller portions so that the pills are easier to digest.
* Taking medication with food may reduce nausea. But it consider that different food causes the stomach to empty at different rates, which means that the time taken for the medication to absorb into the gut may vary. While you're waiting for your medication to absorb completely, you may experience Parkinson's symptoms.
* Avoid high protein foods as they interfere with certain levodopa absorption such as found with Sinemet and Madopar.
* If you are going to eat foods with a lot of protein, plan to eat the meal late in the day when a slow response to medication is not as important as it is during other times.
* Take medication with 58 oz. of water to help the body absorb the medication faster.

Relief from Thirst/Dry Mouth

Common Parkinson's disease medications may cause thirst and dry mouth. To relieve these side effects follow the suggestions below:

* Suck on candy or popsicles to help increase saliva and moisten your mouth.
* Drink plenty of water (at least eight 8 oz. glasses). If you have heart problems and must limit your fluids, consult your doctor for the proper amount of water per day.
* Eat something cold and sour such as sherbet or lemon ice before a meal to help prevent dry mouth.
* Sip a drink while you eat to moisten food and help the mouth swallow food.
* Add sauces to your meals to soften food. Gravy, broth, yogurt, or salsa can be added to many recipes and will enhance the flavor of foods.
* Drink smoothies, purees, thickened juices, or blended soups.
* Talk to your doctor about any food specific issues related to your medications. For example, meals high in protein may interfere with the absorption of levodopa. So if you use levodopa, you may need to adjust the amount of protein in your diet.
* Cut back on diuretics, especially caffeine and alcohol which can leave your mouth dry.
* Don't use mouthwash that contains alcohol. Instead, reach into your spice rack for alternatives to mouthwash and remedies for bad breath. Fennel, rosemary, mint, and aniseed can be combined with water to create a refreshing mouthwash.
* Resent studies suggest that chewing gum not only increases mouth secretion, but also improves swallowing frequency and latency. Try chewing gum before a meal to stimulate secretion glands.
* Ask your doctor to recommend an artificial saliva product.

Overcoming Swallowing Problems Caused by Parkinson's

Parkinson's disease can cause someone to lose control of their throat and mouth muscles, making chewing and swallowing very difficult. People with Parkinson's disease are at risk of aspiration and pneumonia because of swallowing problems. There are dietary changes that can be made and swallowing techniques that can be practiced to ease swallowing problems. Contact your doctor if you are having problems swallowing. Your doctor will recommend a speech pathologist to examine your swallowing abilities and evaluate your aspiration risk. In the meantime here are some tips to make swallowing easier.

* Eat slowly.
* Suck on popsicles, ice chips.
* Avoid foods that stick to the inside of the mouth such as tomato skins, flaky biscuits, bran flakes, and dry mashed potatoes.
* Avoid crumbly, stringy, and dry foods.
* Softened foods such as yogurt, jelly, custard, sauces, and soups are easier to swallow. Try these individually or mix some into dry foods to make eating easier.
* Eat small portions frequently throughout the day. Do not place more than ½ teaspoon of food in your mouth at once. Try eating the portions while sipping a drink to keep the food and your mouth moist.
* Chewing gum will exercise the jaw muscles while also improving swallowing abilities.
* Position your body so chewing and swallowing is more convenient. Sit upright, tilting your head forward slightly, and remain in this position for 15 minutes after eating.
* Try to keep conversation to a minimum.
* Focus on the task at hand. Often awareness of the process of eating and drinking can assist the muscles in clearing the mouth and throat. Concentrate on swallowing frequently.
* Try to eat one texture at a time. Liquid with solids in it is often more difficult to swallow.
* Enjoy your food. Relax and focus your attention on enjoying the aromas and flavors of your food.
* Swallow two or three times per bite or sip.
* When food or liquid gets caught in your throat, clear your throat or cough gently then swallow again before taking another breath. Repeat if necessary.

Any body will benefit from eating a well balance, nutritious diet. People living with Parkinson's disease are obviously no exception. But having Parkinson's means paying a little more attention to what it is you are eating to gain as much benefit as possible.

A healthy diet not only gives us more energy but helps our bodies to work more efficiently. This is vital for those living with Parkinson's disease. Making smart diet decisions may even slow onset progression.

Saturday, July 24, 2010

Nutritional Treatments for Parkinson's Disease

First described in 1817 by Dr. James Parkinson, Parkinson’s disease (PD) is a term used to describe specific loss of motor function. Over 50,000 new cases of Parkinson’s are diagnosed each year [Source: NINDS]. This disease is characterized by four specific symptoms: tremors, rigidity, slow movements, and a loss of coordination and balance. Walking often becomes very slow, and patients often experience tremors in the hands, arms or face while at rest. Patients are at a high risk of falling due to the loss of balance and coordination, and muscle stiffness. The disease typically progresses with further deterioration of motor skills though medication may slow these effects. Doctors are now studying nutritional therapies for prevention and treatment of afflicted patients.

Nutritional approaches for treating Parkinson’s should not rest solely on vitamins. The diet must include fresh, organic fruits and vegetables and water. Artificial preservatives and ingredients will serve no benefit to brain health. Clinically, patients have more success treating symptoms early in the course of the illness. Later stages of the disease usually require more aggressive dosing and more time for results. Prevention should remain a focus. Eliminating excess toxins from the workplace and home, sound sleep and a healthy diet are integral to a healthy brain and prevention of chronic conditions.

Another area of major concern for Parkinson’s disease, along with many other chronic diseases, is toxin damage. Even as a developing fetus, we are exposed to all kinds of toxic insults. These can be in the form of pesticides, heavy metals, cleaning chemicals and pollution. In the past 100 years, toxins from various sources have dramatically increased while the nutritional value of the food we eat has substantially decreased. This is a costly combination that many experts believe is leading to chronic diseases including Parkinson’s, dementia and autism [Source: Etminan].

Saturday, July 17, 2010

Parkinson's disease: diet and nutrition

Eating the right food is important for any person, but for people with Parkinson's (PD) it is essential to maintain the right dietary intake. Difficulty with swallowing and chewing, or manipulating a knife and fork, are not excuses for eating the wrong foods. With medication having to be taken before or after meals, it is important to eat regularly and well, as this will not only help in digestion, but will aid the absorption of medication.
Medication and meals

It is usual to take medication 15-20 minutes before meals to assure more predictable absorption, or take tablets divided in half (i.e. same amount but cut in two). Take levodopa 30 minutes before meals if response fluctuations are worsening.

People with PD are often advised to take levodopa with meals. By reducing levodopa absorption, food may reduce side effects such as nausea on first exposure to levodopa medication but when people start experiencing motor (or movement) fluctuations, other factors need to be considered.

Unpredictability is a major feature of severe motor fluctuations. Although people experience the fluctuations every day, the timing of dramatic changes in motor disability, and the amount of 'on' and 'off' time per day, vary even if the medication regime is constant. Research is now indicating the role that food plays in this unpredictability.

Different food causes the stomach to empty at different rates, which means that the time taken for levodopa to get from the stomach to the part of the gut where it is absorbed will vary as well.

Another factor leading to unpredictable motor fluctuations is that the effect of the medication on symptoms may not correspond to the amount of levodopa in the bloodstream. This is because of the competitive effect of amino acids (found in protein) which are also in the blood.

Protein competes with or interferes with Sinemet or Madopar absorption at 2 sites: during absorption at the part of the gut nearest to the stomach, and as it passes from the blood to the brain. If a meal high in protein is eaten at the same time as medication is taken, less levodopa will be absorbed into the intestine and less absorbed across the blood/brain barrier.

For people on Sinemet or Madopar noticing fluctuations in mobility, protein manipulation may be helpful. For example, reducing protein earlier in the day may help avoid the unpredictable motor fluctuations and may aid the response to the medication. Having the day's protein meal in the evening may also be useful, as slow response to medication may not be as important as at other times of the day.

It would be most unwise for any person with PD to put themselves on a low protein diet without consulting their doctor or dietician. Problems such as weight loss, poor immunity and other complications from lack of sustenance could result if the diet is too low in protein.
Weight loss

Weight loss is common in PD, in spite of increased caloric intake. A special programme must be worked out with each person to determine individual needs.
Causes of weight loss

* Tremor may use extra calories: energy is used while inactivity is increased.
* The desire for food may be reduced because of reduced sense of smell, nausea, depression and cognitive impairment.
* There may be changes in the brain thermostat for weight control, raising the metabolic rate.
* Damage to the hypothalamus can cause central appetite suppression.
* Tiredness and weakness in the arms can slow down speed of eating, making people give up before the meal is finished.
* Difficulty chewing and swallowing makes meal times tiring, as do poor-fitting dentures.

Types of food

High protein foods

* All meat — red and white, fish, sausages, preserved meats.
* Dairy products — milk, yoghurt, ice cream, cheese and egg whites.
* Legumes — kidney beans, lima beans, lentils, soya beans.
* Gelatin.
* Nuts of any kind, including peanut butter.

Some of these foods are essential in order to achieve a balanced diet. A very low protein diet is not balanced and can lead to deficiencies in zinc, iron and calcium, and other elements.

Foods low in protein

* Cereals — wheat biscuits, rice bubbles, corn flakes, semolina, rice, pasta, white bread (not enriched), tapioca, sago.
* Vegetables — green and yellow, cooked or raw, potatoes.
* Fruit — all fresh, tinned, stewed or dried.
* Soups — clear, vegetable, not creamed or containing lentils or peas.
* Spreads — honey, jam, Vegemite, marmalade, treacle.
* Sweets — boiled lollies, butterscotch, jelly beans, gum (very little nutritional value: included for interest and variety only).
* Fats — margarine, unsaturated oils, salad dressing, mayonnaise.
* Beverages — tea, coffee, soft drinks, cordial, soda water.

High fat foods (providing maximum calories)

* Oils, butter, margarine.
* Cream, sour cream, ice cream, mayonnaise, cheese.
* Peanut butter.
* Chocolate, Milo, Ovaltine, cocoa, drinking chocolate, full-cream milk.
* Eggs.
* Meats such as ham, luncheon meat and sausages.
* Biscuits, cakes and pastry.

High sugar foods

* Dried fruits.
* Chocolate.
* Honey, marmalade, jams.
* Fruit juice.
* Confectionery.
* Biscuits and cakes.

Energy supplements may be added to food without changing the taste.
Other dietary guidelines

Moderation and balance are the keys to any diet. Drink plenty of liquids throughout the day and remember that food that is difficult to swallow can be modified (e.g. moistened, minced or pureed). A qualified dietitian may need to be consulted.

* Eat a balance from all the food groups.
* Maintain calories at 25-30 calories per kilogram of body weight with additional calories if dyskinesias are present.
* Carbohydrate to protein proportion should be 4-5:1.
* Recommended daily protein allowance is 0.8 g/kg of body weight.
* Fibre and adequate fluids (6-8 glasses of water daily) are important in the control of constipation. Fibre is present in breads, vegetables, cereals, and fruit with the skin on.
* If calories are needed, they are best added in the form of complex carbohydrates and unsaturated fats; cholesterol consumption should kept lower than 300 mg daily.
* The benefits of multi-vitamins remain unclear. If a person is taking levodopa rather than Sinemet, only pyridoxine(B6)-free vitamins should be taken.
* Pay careful attention to daily calcium intake; 1000-1500 mg will help reduce the risk of broken bones from osteoporosis.
* Iron supplements may interfere with Sinemet absorption so should be taken separately.
* If appetite is poor, take smaller meals every 2-3 hours, perhaps with a little alcohol (if medically allowed).
* Broad beans contain dopamine; some people find they help in maximising the effects of medication.
* Depression and cognitive impairment may reduce appetite.
* The sense of smell may also be reduced; stronger flavours and aromatic foods can be used to make food more interesting.

Swallowing difficulties

Your speech pathologist can give specific individual advice about swallowing difficulties and food management.

It is important not to eat soft food all the time (unless that is all you can manage safely), as the muscles in the jaw need exercise too. While each individual will have different problems and therefore different solutions, the following suggestions may help.

* Food that is soft and moist, with a good flavour and smell, tends to be easier to swallow: custards, jelly, pureed fruit, sauces, spices and herbs.
* Avoid foods which are hard, dry, crumbly or stringy.
* Avoid mixed consistencies (e.g. solid plus liquid).
* Be careful with foods which stick to the roof of the mouth or get caught around the mouth: dry mashed potatoes, tomato with skin on, biscuits, bran flakes, hard-boiled eggs.
* Thicker fluids (e.g. nectars, milk shakes) may be easier to control and swallow than thin, clear liquids, as they move more slowly.
* Keep food presentation appetising: flavour, smell and appearance of food.
* Relax and enjoy your food. It is good to have a break between mouthfuls and take sips of water during the meal. This will not only help you relax but also allow you to clear your throat and mouth. You may need to swallow twice to clear each mouthful.
* Eat smaller portions more frequently, especially if time for meals is limited.

Possible problem foods

* Mixed textures, such as liquid with 'bits' in it (e.g. minestrone soup or watery mince).
* Flaky biscuits.
* Hard toast or nuts, chocolate, grains, seeds.
* Fresh white bread (try wholemeal bread; it is easier to swallow).

Foods that may be easier to swallow

* Boiled milk.
* Mousse, custard, yoghurt, ice cream.
* Souffle, omelette.
* Casseroles.
* Soup.
* Fruit juice, pureed fruit.
* Pancakes (with syrup etc.).
* Rice.
* Well-cooked vegetables.
* Banana.

If you are using more and more liquid meals, it is important to keep up your energy intake. Your dietitian may recommend appropriate supplements and guidelines. You can make liquid foods thicker by using instant pudding, yoghurt, gelatine or instant potato powder.
Hints to avoid nausea and gastric upset

* Take medication with small amounts of food (usually not protein).
* Eat only when you are hungry.
* Eat foods which you know you enjoy.
* Avoid fatty food.
* Avoid spicy foods or gassy drinks.
* Avoid too much caffeine or nicotine.


Probably the most important point to remember is that good nutrition is based upon a balanced diet including a variety of foods from the main food groups, in particular, plenty of fruit, vegetables, complex carbohydrates, some protein and fluids. For people with PD, this may also involve a rearrangement of protein-rich meals. Maintaining a balanced diet helps to ensure a minimum of weight loss and a healthy outlook on life.