Parkinson's Disease: Eating Right

While there is no special diet required for people with Parkinson's disease, eating a well-balanced, nutritious diet is extremely beneficial. With the proper diet, our bodies work more efficiently, we have more energy, and medications will work properly.

This article addresses the basics of good nutrition. Please consult your doctor or dietitian before making any dietary changes. A registered dietitian can provide in-depth nutrition education, tailor these general guidelines to meet your needs, and help you create and follow a personal meal plan.

The Basics

• Eat a variety of foods from each food category. Ask your doctor if you should take a daily vitamin supplement.
• Maintain your weight through a proper balance of exercise and food. Ask your doctor what your "goal" weight should be and how many calories you should consume per day.
• Include high-fiber foods such as vegetables, cooked dried peas and beans (legumes), whole-grain foods, bran, cereals, pasta, rice, and fresh fruit in your diet.
• Choose foods low in saturated fat and cholesterol.
• Try to limit sugars.
• Moderate your use of salt.
• Drink eight 8 oz. glasses of water per day.
• Ask your doctor about drinking alcoholic beverages (alcohol may interfere with some of your medications).

Medication and Food Interactions

The medication, levodopa, in general, works best when taken on an empty stomach, about ½ hour before meals or at least 1 hour after meals. It should be taken with 4-5 oz. of water. This allows the medication to be absorbed in the body more quickly.

For some patients, levodopa may cause nausea when taken on an empty stomach. Nausea is an uneasiness of the stomach that often accompanies the urge to vomit, but doesn't always lead to vomiting. Therefore, your doctor may prescribe a combination of levodopa and carbidopa (called Sinemet) or carbidopa by itself (called Lodosyn). If nausea is a continual problem, your doctor may be able to prescribe another medication to relieve these symptoms. There are also tips listed below that can help relieve nausea.

Also, ask your doctor if you should change your daily protein intake. In rare cases, a diet high in protein limits the effectiveness of levodopa.

Controlling Nausea

There are several ways to control or relieve nausea, including:

• Drink clear or ice-cold drinks. Drinks containing sugar may calm the stomach better than other liquids.
• Avoid orange and grapefruit juices because these are too acidic and may worsen nausea.
• Drink beverages slowly.
• Drink liquids between meals instead of during them.
• Eat light, bland foods (such as saltine crackers or plain bread).
• Avoid fried, greasy or sweet foods.
• Eat slowly.
• Eat smaller, more frequent meals throughout the day.
• Do not mix hot and cold foods.
• Eat foods that are cold or at room temperature to avoid getting nauseated from the smell of hot or warm foods.
• Rest after eating, keeping your head elevated. Activity may worsen nausea and may lead to vomiting.
• Avoid brushing your teeth after eating.
• If you feel nauseated when you wake up in the morning, eat some crackers before getting out of bed or eat a high protein snack before going to bed (lean meat or cheese).
• Try to eat when you feel less nauseated.

If these techniques do not seem to ease your queasy stomach, consult your doctor.

Relieving Thirst/Dry Mouth

Some Parkinson's disease medications may make you thirsty. Here are some tips for relieving thirst and dry mouth:

• Drink 8 or more cups of liquid each day. But, some people with Parkinson's disease who also have heart problems may need to limit their fluids, so be sure to follow your doctor's guidelines.
• Limit caffeine (contained in coffee, tea, cola, and chocolate) as it may interfere with some of your medications and may actually make you more thirsty.
• Dunk or moisten breads, toast, cookies, or crackers in milk, tea, or coffee to soften them.
• Take a drink after each bite of food to moisten your mouth and to help you swallow.
• Add sauces to foods to make them softer and moister. Try gravy, broth, sauce, or melted butter.
• Eat sour candy or fruit ice to help increase saliva and moisten your mouth.
• Don't use a commercial mouthwash. Commercial mouthwashes often contain alcohol that can dry your mouth. Ask your doctor or dentist about alternative mouthwash products.
• Ask your doctor about artificial saliva products. They are available by prescription.

I am Too Tired to Eat in the Evening, What Should I Do?

If you are often too tired to eat later in the day, here are some tips:

• Save your energy. Choose foods that are easy to prepare. Don't waste all your energy in preparing the meal because then you'll feel too tired to eat.
• Ask your family to help with meal preparations.
• Check to see if you are eligible to participate in your local Meals on Wheels Program.
• Keep healthy snack foods on hand such as fresh fruit and vegetables, pretzels, crackers, high-fiber cold cereals.
• Freeze extra portions of what you cook so you have a quick meal when you're too tired.
• Rest before eating so you can enjoy your meal.
• Try eating your main meal early in the day so you have enough energy to last you for the day.

I Don't Feel like Eating, What Should I Do?

Here are some tips for improving poor appetite.

• Talk to your doctor; sometimes, poor appetite is due to depression, which can be treated. Your appetite will probably improve after depression is treated.
• Avoid non-nutritious beverages such as black coffee and tea.
• Eat small, frequent meals and snacks.
• Walk or participate in another light activity to stimulate your appetite.

Here are some tips to help you eat more at meals.

• Drink beverages after a meal instead of before or during a meal so that you do not feel full before you begin eating.
• Plan meals to include your favorite foods.
• Try eating the high-calorie foods in your meal first.
• Use your imagination to increase the variety of food you're eating.

Here are some tips to help you eat snacks.

• Don't waste your energy eating foods that provide little or no nutritional value such as potato chips, candy bars, colas and other snack foods.
• Choose high-protein and high-calorie snacks. High calorie snacks include: ice cream, cookies, pudding, cheese, granola bars, custard, sandwiches, nachos with cheese, eggs, crackers with peanut butter, bagels with peanut butter or cream cheese, cereal with half and half, fruit or vegetables with dips, yogurt with granola, popcorn with margarine and parmesan cheese, bread sticks with cheese sauce.

How Can I Make Eating More Enjoyable?

• Make food preparation an easy task. Choose foods that are easy to prepare and eat.
• Make eating a pleasurable experience, not a chore. For example, liven up your meals by using colorful place settings and play background music during meals.
• Try not to eat alone. Invite a guest to share you meal or go out to dinner.
• Use colorful garnishes such as parsley and red or yellow peppers to make food look more appealing and appetizing.

Maintaining Your Weight

Malnutrition and weight maintenance is often an issue for people with Parkinson's disease. Here are some tips to help you maintain a healthy weight.

• Weigh yourself once or twice a week, unless your doctor recommends weighing yourself more often. If you are taking diuretics or steroids, such as prednisone, you should weigh yourself daily.
• If you have an unexplained weight gain or loss (2 pounds in one day or 5 pounds in one week), contact your doctor. He or she may want to modify your food or fluid intake to help manage your condition.

Here are some tips for gaining weight.

• Ask your doctor about nutritional supplements. Sometimes supplements in the form of snacks, drinks (such as Ensure or Boost), or vitamins may be prescribed to eat between meals to help you increase your calories and get the right amount of nutrients every day. But, be sure to check with your doctor before making any dietary changes or before adding supplements to your diet. Some can be harmful or interfere with your medication.
• Avoid low-fat or low-calorie products. Unless other dietary guidelines have been recommended. Use whole milk, whole milk cheese, and yogurt.

Here are some high-calorie recipes to try.

Chocolate Peanut Butter Shake

Makes one serving; 1090 calories per serving.

Ingredients:

• 1/2 cup heavy whipping cream
• 3 tablespoons creamy peanut butter
• 3 tablespoons chocolate syrup
• 1 1/2 cups chocolate ice cream

Directions:
Pour all ingredients into a blender. Mix well.

Super Shake

Makes one serving; 550 calories per serving

Ingredients:

• 1 cup whole milk
• 1 cup ice cream (1-2 scoops)
• 1 package Carnation Instant Breakfast

Directions:
Pour all ingredients into a blender. Mix well.

Super Pudding

Makes four 1/2 cup servings; 250 calories per serving.

Ingredients:

• 2 cups whole milk
• 2 tablespoons vegetable oil
• 1 package instant pudding
• 3/4 cup nonfat dry milk powder

Directions:
Blend milk and oil. Add pudding mix and mix well. Pour into dishes (1/2 cup servings).

Reviewed by the doctors at The Cleveland Clinic Neuroscience Center

Edited by Charlotte E. Grayson, MD, WebMD

Disease de jour: vitamin D deficiency

For every month, there is a disease, and in February, it’s vitamin D deficiency. (It’s also Heart Health Month and I’m sure I’ve neglected to mention a slew of others.)

If you haven’t heard, vitamin D — or the lack thereof — is a hot health topic. The McClean, Virg.-based UV Foundation says that people in states above the 37th parallel (read sun-starved) are increasingly susceptible to the affliction.

The Foundation recently targeted a news release to media outlets in the state of Washington, including this newspaper. We didn’t tell them that, despite the winter inversion doldrums of late, Central Washington still gets more than 300 days of sunshine annually.

Vitamin D deficiency has been linked to increasing the risk of heart disease, Parkinson’s disease, rickets and many types of cancer. It’s also the suspected culprit behind winter-time complaints, including fatigue, depression and aches and pains.

- Leah Beth Ward

Want to reach Leah Beth Ward?
E-mail her: lward@yakimaherald.com

Confusion About Mediterranean Cuisine

February 11, 2009, 1:14 pm

What is a Mediterranean diet anyway? This week researchers reported on a link between Mediterranean-style eating and better brain health. But every time a new report emerges on the health benefits of Mediterranean eating, many consumers are left scratching their heads. How could countries that gave us pizza, lasagna, steak frites and lamb souvlaki teach us anything about healthful eating?

Here are answers to some common questions about Mediterranean eating and health.

What foods are included in the typical Mediterranean diet?

Mediterranean eating is focused on simple cooking and includes all the foods you already eat, just in different proportions. The diet is plant-based in nature, with a heavy emphasis on fruits and vegetables, nuts, grains, seeds, beans and olive oil. Eggs, dairy, poultry and fish are consumed regularly, but the portions are smaller than typically consumed in a Western diet. Meat makes only an occasional appearance, and it’s usually added in small amounts to make sauces, beans and pasta dishes more flavorful. Refined sugar and flour and butter and fats other than olive oil are consumed rarely, if at all. Mediterranean eating also typically includes moderate consumption of red wine. One of the key components of Mediterranean eating has to do with the elevation of the meal as a social event. Meals are consumed at leisure with family and friends.

“One of the basic tenets is the enjoyment of food, and respect and pleasure of food,” says Nicki Heverling, program manager for the Mediterranean Foods Alliance, part of Oldways, the nonprofit food issues think tank that has promoted Mediterranean eating for nearly two decades. “When you’re in the Mediterranean, your meals are three hours and you savor your food.”

Why do so many of my recipes for French, Italian and Greek foods have loads of cheese and meat in them?

The Mediterranean eating plan is based on foods that have traditionally been consumed by communities situated along the Mediterranean sea. Many of the recipes we typically associate with Mediterranean countries don’t come from coastal communities, but from regions farther to the north. Today’s Mediterranean diet pyramid is largely based on the dietary traditions of the Greek island of Crete and southern Italy around the 1960s, when rates of chronic disease were among the lowest in the world, and adult life expectancy was among the highest. Unfortunately, many of the communities where the diet was first studied have changed dramatically, a concern chronicled in the recent Times story “Fast Food Hits Mediterranean; a Diet Succumbs.”

How do we know Mediterranean eating is good for you?

The original work that sparked scientific interest in Mediterranean eating habits came from researcher Ancel Keyes at the University of Minnesota. His landmark seven countries study focused on the link between eating habits along the Mediterranean and better health, despite inferior medical care in the region. Research on the diet took off in the 1990s, as scientists noted that people in Mediterranean countries lived longer and had low rates of serious disease despite high rates of smoking and drinking. Last year, the British medical journal BMJ published an extensive review of Mediterranean diet studies. It found that the eating plan is associated with significant health benefits, including lower rates of heart disease, cancer, Parkinson’s disease and Alzheimer’s. More recently, researchers found a link between Mediterranean eating and diabetes risk as well as lower blood pressure. The Oldways Web site offers a lengthy list of studies of Mediterranean eating and health.

Do I really have to eat meat only once a month?

While the traditional diet included meat only about once a month or on special occasions, most health experts say adhering to Mediterranean eating doesn’t have to mean giving up meat. It just means consuming smaller portions less often. If you are packing your diet with produce, nuts, legumes and whole grains, you won’t have a lot of room left on your plate for big servings of meat anyway. “What we try to convey to people is don’t cut anything out of your diet you enjoy,” says Ms. Heverling of Oldways. “Make smaller portions and when you have it, really enjoy it. In the traditional diet, someone wasn’t eating a 12-ounce Porterhouse steak. They ate small bits of meat in a sauce. It was there to get flavor and taste from. Meat is delicious and they knew that.”

How can I learn more about Mediterranean eating?

The Web is filled with resources. Click on the links above, or visit the Oldways Web site to get started. The Mayo Clinic also offers a useful summary of the eating plan. About 150 products are labeled with the Med Mark from the Mediterranean Foods Alliance. And “The New Mediterranean Diet Cookbook: A Delicious Alternative for Lifelong Health” received a starred review from Publisher’s Weekly and includes a foreword by New York University nutritionist Marion Nestle.

Finally, the Mediterranean diet has its own food pyramid. A version can be found on the Oldways site, or below you can find one created by the Greek Health Ministry to explain the diet. They pyramids have some differences but both support the idea that a Mediterranean diet is largely based on plant foods and whole grains.

The Mediterranean Diet (The New York Times)

Coffee drinkers show lower dementia risk

Tue Feb 3, 2009 4:20pm GMT

By Amy Norton

NEW YORK (Reuters Health) - In more good news for coffee lovers, a new study suggests that middle-aged adults who regularly drink a cup of java may have a lower risk of developing dementia later in life.

Whether coffee itself deserves the credit is not yet clear, but researchers say the findings at least suggest that coffee drinkers can enjoy that morning cup "in good conscience."

The study found that among 1,400 Finnish adults followed for 20 years, those who drank three to five cups of coffee per day in middle-age were two-thirds less likely than non-drinkers to develop dementia, including Alzheimer's disease.

The findings, reported in the Journal of Alzheimer's Disease, add to a string of studies finding that coffee drinkers have lower risks of several diseases, including Parkinson's disease, certain cancers and diabetes.

No one is recommending that people start drinking coffee to ward off any disease, however. Researchers do not know if it's components of coffee itself -- like caffeine or certain antioxidants -- or something else about coffee drinkers that explains the recent study observations.

The current study was an epidemiological one, explained lead researcher Marjo H. Eskelinen, which means it can point to an association between coffee and dementia risk, but does not prove cause-and-effect.

Still, "the results open a possibility that dietary interventions could modify the risk of dementia," Eskelinen, a doctoral candidate at the University of Kuopio in Finland, told Reuters Health.

There are a few potential reasons why coffee could help stave off dementia, researchers point out. One reason is related to the fact that coffee drinkers may have a lower risk of type 2 diabetes, and diabetes, in turn, is linked to a higher risk of dementia.

Coffee also contains plant chemicals, such as chlorogenic acid, that act as antioxidants and may help protect body cells from damage over time. For its part, caffeine may have a protective effect on brain cells because it blocks receptors for a chemical called adenosine, which has depressant effects in the central nervous system.

More research is needed to determine whether coffee is truly protective, but for now, Eskelinen said, "those people who have been drinking coffee can still do so in good conscience."

SOURCE: Journal of Alzheimer's Disease, January 2009.

Eat Less, Remember More?

By Rachel Zelkowitz
ScienceNOW Daily News
27 January 2009

Did Grandma seem forgetful at the holiday parties last month? It could be time to put her on a diet. Sharply reducing calories improves memory in older adults, according to one of the first studies of dietary restriction and cognitive function in humans.

Research on the benefits of an extremely low-calorie diet stretches back to the 1930s, when scientists found that rats lived up to twice as long when they nibbled less than control animals. Since then, some studies with rodents and nonhuman primates have shown that this spare diet, known as calorie restriction, improves some markers of diabetes and heart disease, such as blood glucose and triglyceride levels, and possibly prevents neurological declines similar to those seen with Alzheimer's disease and Parkinson's disease. In humans, however, the results have been mixed. Subjects on low-calorie diets generally have lower blood pressure and blood sugar levels than their chow-happy counterparts. But these studies were small, and none was designed to test how calorie restriction might affect cognitive performance.

To fill that void, neurologist Agnes Flöel and her colleagues at the University of Muenster in Germany recruited 50 healthy elderly subjects. The average volunteer was 60 years old and overweight, with a body mass index of 28. The researchers randomly assigned the volunteers to one of three groups. Twenty people were instructed to reduce their daily calorie intake by 30%, while still eating a balanced diet of nutrient-rich carbohydrates, fats, and lean proteins. Another 20 were told to keep their caloric intake the same but increase their consumption of unsaturated fatty acids, such as those found in salmon or olive oil. (Previous studies have linked a diet rich in these fats to improved cognition.) The remaining 10 volunteers did not change their diets.

After 3 months, all of the volunteers took a memory test in which they were shown 15 words and asked how many they could remember after 30 minutes. On average, those in the calorie-restriction group showed a 20% improvement over their baseline memory scores taken before they started their diets. Subjects in the other two groups showed little or no improvement, the researchers report online this week in the Proceedings of the National Academy of Sciences. "Our study only provides some of the first evidence on the impact of [calorie restriction] on memory in the elderly, but this study has to be followed up now," Flöel wrote in an e-mail to Science. Her team plans to conduct larger studies to determine exactly how calorie restriction enhances memory.

Neuroscientist Laura Dugan of University of California, San Diego, cautions that subjects in the study were overweight at the outset, so their memory improvement could have come from returning to a healthier body weight rather than from simple calorie restriction. Being overweight can cause sleep apnea, for example, which could interfere with cognitive function. But Giulio Pasinetti, a neuroscientist at Mount Sinai School of Medicine in New York City, praises the study as the first controlled test of calorie restriction and memory. "The most important message is that moderation in lifestyle--dietary lifestyle--is probably beneficial for our mental activities," he says.

Top 10 healthiest foods to eat

by Melissa Martinelli, Atlanta Food Examiner


We all know there are no real magic foods. The road to optimum health is not in a pill or one magic food. But there are foods that pack such a nutritional wallop and possess such powerful health benefits, that they are referred to as "super foods".

This healthy food list consists of foods that are nutrient dense. That is, they have more nutrients per calorie than most other foods. They have also been proven to contain vitamins, minerals and other nutrients that prevent disease: from cancer to heart disease to arthritis, and many more.

These super foods are perfect for heart healthy, low fat cooking and most fit perfectly into a low carb lifestyle as well.

The 10 healthiest foods are foods that are so exceptionally good for us that we should include them in our healthy diet on a regular basis. Our list of super foods is arranged alphabetically, not in order of importance. Each is an amazing food, jam packed with health giving benefits.

The 10 Healthiest Foods to Eat

1. Berries
Berries are extremely rich in antioxidants which help protect the cells in our bodies from damage and therefore from diseases like cancer. Among other things they are also an excellent source of Vitamin C and soluble fiber. Blueberries might help reverse the short term memory loss that often comes with aging.

2. Broccoli
Broccoli (and other cruciferous vegetables like cauliflower and cabbage) helps fight cancer, especially breast, colon and lung. It boosts the immune system. Broccoli also contains antioxidants and a substance called sulforaphane, which research is showing to be a powerful cancer fighter and preventer.

3. Citrus Fruits
The citrus bioflavanoids in oranges, lemons, limes and grapefruit have anti-cancer and antioxidant properties.
Many of these citrus bioflavanoids have also been shown to have anti-inflammatory and blood clot inhibiting abilities.

4. Garlic
Numerous studies have shown that regular consumption of garlic can lower our blood pressure. It also prevents the blood from being overly sticky and decreases LDL cholesterol (the "bad" one) while increasing the good HDL cholesterol.

5. Nuts
Walnuts are an excellent source of omega-3 fatty acids, a special type of fat that is essential for our bodies, but that the body cannot produce. Omega-3 essential fatty acids protect us against heart disease.

Almonds are also known for their ability to help lower LDL cholesterol levels.

6. Oats
Oats also help reduce cholesterol. Research shows that one bowl of oatmeal per day can reduce cholesterol by up to 23%. Oats are also considered an excellent grain for diabetics as they have less impact on blood sugar levels than some other grains.

7. Salmon
The Omega-3 fatty acids in salmon and other fatty fish may help prevent heart disease and stroke by lowering the body's rate of blood clotting.

8. Spinach
Spinach's secret weapon, lutein, makes it one of the best foods in the world to prevent cataracts, as well as age related macular degeneration, the leading cause of preventable blindness in the elderly.

9. Tomatoes
Tomatoes contain high levels of lycopene. Lycopene is a powerful antioxidant and as such helps to protect the cells in our bodies from damage.

10. Turkey
Turkey is one of the leanest protein foods and is low in calories, making it an excellent healthy food choice. Turkey also contains selenium which has been shown to inhibit cancer development, improve the immune system, and aid in the metabolism of our thyroid hormone.

You can see that the top 10 healthiest foods, or "super foods", are also some of our favorites. By including these super foods in a healthy diet on a regular basis you can easily gain many health benefits.

Making healthy food choices just got easier.

Health Corner

DATE: Monday, 12 January 2009 (Vol. 26, No. 04) WEBSITE: www.mmegi.bw DATE: Monday, 12 January 2009 (Vol. 26, No. 04) R. CHINDOMU S. CHIDZOMBA& K. BHAGAT Drink Up Morning coffee The caffeine content of coffee may wake you up and give you a bit of a buzz in the morning, but what else does it do? Some research suggests that drinking large amounts of coffee can increase the risk of developing heart disease, while other studies show that there is no link and coffee is actually beneficial. Drinking four to five cups of coffee a day may help to protect against Type 2 Diabetes, Alzheimer's disease liver cancer and Parkinson's disease. A nice brew There is growing evidence that drinking tea daily can be beneficial to heart health. Tea contains antioxidants that work by neutralising the damaging free radicals in the body. Recent research has shown that tea improves blood flow and the ability of the arteries to relax, however adding milk counteracts the protective effect against cardiovascular disease. Water Recent work concluded that women who consumed five or more glasses of water a day were 41percent less likely to die from a heart attack than those who drank less than two glasses. The protective effect of water was even greater for men. Good news for weight loss, as evidence shows that many people mistake thirst pangs for hunger pangs and reach for the biscuits or crisps, instead of water. Red wine and dark coloured beers contains strong antioxidants called polyphenols, these work by neutralising the damaging free radicals in the system. However, drinking more than moderate amounts over a short time period may cause damage that outweighs any benefits to the heart. Juicy Juice A glass of fruit juice can add one portion to your five a day and provide a rich source of vitamins and antioxidants. Juices containing 'super' foods such as blueberries and pomegranates are becoming more popular. The high concentration of vitamins in these juices makes them an idea way to top up your vitamins intake. You are what you eat Every day we are bombarded with information from advertisers or the media and celebrity endorsed fad diets are never far from the news. It can be hard to know who to listen to when it comes to eating the right foods. Eating a healthy balanced diet is the only solution to reduce your risk of developing heart disease. Make sure you and your family eat a wide variety of foods, choosing the right amounts from each food group. The five food groups . Bread, cereals and starchy foods . Fruit and vegetables . Milk and dairy foods . Meat, fish and high protein foods Foods containing fats and sugars It is important to eat a wide range of foods from each group. Starchy foods should make up a third of your diet, fruit and vegetables another third. The remaining third should comprise of moderate amounts of dairy and protein and a small amount of foods containing fats and sugars. Eating for a healthy heart . Eat lots of starchy foods like bread, pasta, rice, potatoes and chapattis. Choose wholemeal or wholegrain options where possible. .Eat at least five portions of fruit and vegetables every day. Ideally, choose different types and colours of fruit and veg to get a full range of vitamins and minerals. . Choose low fat yoghurts, cheese, skimmed milk. . Trim all visible fat from meat and use fat-free cooking methods. . Eat oily fish twice a week. Fish contain Omega 3, which is good for your heart. Small changes Chuck out your deep fat fryer and try steaming, baking, boiling or grilling instead, so that you don't need to use oil or fat. Salt Eating too much salt raises blood pressure and this can cause heart disease and stroke. Nearly 75percent of the salt we consume is hidden in processed foods, such as cereals, ready meals, biscuits, soups and even bread. So even if you never add salt at the table or when cooking, you are probably still eating too much. Simply using fresh ingredients when cooking means you can control the amount of salt and other additives in your food. Use herbs, spices and garlic to flavour meals. prof@cardiacclinic.co.bw