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 24, 2010
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.
Summary
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.
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.
Summary
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.
Saturday, July 10, 2010
Health benefits of coffee
Lately, the list of foods that are generally considered to be healthy seems to be shrinking. In the era of trans-fat avoidance and pre-packaged health food bars, it's comforting to find out that the morning joe we've been slugging back for years might actually have some benefit to our health.
Coffee contains antioxidants. Antioxidants are also found in many fruits and vegetables and they work to neutralize unstable molecules, also known as free radicals. Free radicals damage healthy cells and are thought to contribute to cancer, as well as suppressed immune funtion, and lethargy. Both caffeinated and decaffeinated varieties of coffee contain similar levels of antioxidants, so even those sensitive to caffeine can benefit from coffee consumption in this respect.
Like cancer, Parkinson's Disease is not well understood and its cause it still a mystery to scientists. However, a study published in the Journal of the American Medical Association found that those who do not drink coffee were three times more likely to develop the disease. While this prognosis was originally attributed to coffees caffeine content, studies were unable to replicate the results when other sources of caffeine were substituted. While the jury may still be out when it comes to why coffee starves off Parkinson's, the evidence appears convincing enough to warrant its consumption.
Of all of coffees benefits, some of the most substantial evidence centers around diabetes. Coffee, as well as decaf coffee, improves insulin sensitivity and works to prevent high blood sugar. This effect is so pronounced, that a 2004 study published in the Archives of Internal Medicine, found that those who drank four cups of coffee daily were 35 percent less likely to develop type 2 diabetes. Since type 2 diabetes is approaching pandemic proportions, this is especially good news for coffee drinkers.
It is a rare event when a scientist will put his reputation on the line by making matter of fact statements. But in 2003, Professor D'Amicis, the head of Italy's Nutrition Information Unit was recorded saying "signifigant data shows us how drinking coffee could provide a real benefit to our health." Professor D'Amicis research focused on coffee in its relation to liver and gall bladder health. D'Amicis' own research, confirmed by numerous follow up studies, showed that coffee consumption provides significant reduction in both alcoholic and non-alcoholic cirrhosis related liver disease. In addition, the research showed that men who drank at least four cups of coffee a day had a 30 to 40 percent reduction in gallstone disease.
While it sometimes seems that with every published study, we are forced to once again remove something from our diets and from our cupboards; in the case of coffee, it appears that science has allowed us the freedom to enjoy our brew with a guilt free conscience. So brew a pot of your favorite grind and drink up! Your body will thank you later.
Coffee contains antioxidants. Antioxidants are also found in many fruits and vegetables and they work to neutralize unstable molecules, also known as free radicals. Free radicals damage healthy cells and are thought to contribute to cancer, as well as suppressed immune funtion, and lethargy. Both caffeinated and decaffeinated varieties of coffee contain similar levels of antioxidants, so even those sensitive to caffeine can benefit from coffee consumption in this respect.
Like cancer, Parkinson's Disease is not well understood and its cause it still a mystery to scientists. However, a study published in the Journal of the American Medical Association found that those who do not drink coffee were three times more likely to develop the disease. While this prognosis was originally attributed to coffees caffeine content, studies were unable to replicate the results when other sources of caffeine were substituted. While the jury may still be out when it comes to why coffee starves off Parkinson's, the evidence appears convincing enough to warrant its consumption.
Of all of coffees benefits, some of the most substantial evidence centers around diabetes. Coffee, as well as decaf coffee, improves insulin sensitivity and works to prevent high blood sugar. This effect is so pronounced, that a 2004 study published in the Archives of Internal Medicine, found that those who drank four cups of coffee daily were 35 percent less likely to develop type 2 diabetes. Since type 2 diabetes is approaching pandemic proportions, this is especially good news for coffee drinkers.
It is a rare event when a scientist will put his reputation on the line by making matter of fact statements. But in 2003, Professor D'Amicis, the head of Italy's Nutrition Information Unit was recorded saying "signifigant data shows us how drinking coffee could provide a real benefit to our health." Professor D'Amicis research focused on coffee in its relation to liver and gall bladder health. D'Amicis' own research, confirmed by numerous follow up studies, showed that coffee consumption provides significant reduction in both alcoholic and non-alcoholic cirrhosis related liver disease. In addition, the research showed that men who drank at least four cups of coffee a day had a 30 to 40 percent reduction in gallstone disease.
While it sometimes seems that with every published study, we are forced to once again remove something from our diets and from our cupboards; in the case of coffee, it appears that science has allowed us the freedom to enjoy our brew with a guilt free conscience. So brew a pot of your favorite grind and drink up! Your body will thank you later.
Tuesday, June 22, 2010
Nutrition and Parkinson's Disease
by Sandra Frank, Ed.D., RD, LDN
There is no special diet for people with Parkinson's disease. The nutritional goals include:
* Eat well-balanced meals.
* Consume adequate calories to maintain body weight within a normal range.
* Minimize food and drug interactions.
* If chewing, choking or excessive coughing becomes a problem, provide food consistency easily tolerated.
* Feeding may become difficult and a referral to an occupational therapist may be necessary for adaptive eating utensils.
Eat Well-Balanced Meals
Eat a variety of foods. Include foods rich in fiber, such as fruits, vegetables, whole grains, legumes, bran, cereals, rice and pasta. Limit intake of salt, sugar and foods high in saturated fats and cholesterol. Drink eight cups of water per day. Balance exercise and food in order to maintain your weight within a healthy range. Ask your doctor if alcohol will interfere with any of your medications.
Medication and Food Interactions
Medication used to treat Parkinson's disease may cause nausea. Let your doctor know if nausea is a problem. There are several ways to control nausea, including:
* Drink clear liquids, such as water, broth, fruit juices without pulp (apple juice, grape juice or cranberry juice), Clear sodas, sports drinks and plain gelatin.
* Avoid juices with pulp and orange and grapefruit juices.
* Eat and drink slowly.
* Beverages should be consumed between meals, not with the meal.
* Choose bland foods such as saltine crackers. Avoid greasy and fried foods.
* Eat smaller meals, more frequently throughout the day.
* Foods should be eaten cold or at room temperature.
* After eating keep your head elevated and avoid brushing your teeth.
Some medications for Parkinson's disease may cause thirst or dry mouth. Include 8 or more cups of liquid each day, unless other medical conditions require you to limit your fluid intake. Add sauces to foods to make them moister. Try sour candy or an ice pop to help increase saliva.
Malnutrition may become a problem for a person diagnosed with Parkinson's disease. This could be related to depression, nausea, difficulty feeding, problems with swallowing, chewing, coughing and/or a loss of interest in food.
Patients who experience swallowing difficulties should consult a physician. The doctor may recommend a swallow study to determine the food consistency best tolerated. If feeding becomes difficult, a referral to an occupational therapist may be necessary for adaptive eating utensils.
There is no special diet for people with Parkinson's disease. The nutritional goals include:
* Eat well-balanced meals.
* Consume adequate calories to maintain body weight within a normal range.
* Minimize food and drug interactions.
* If chewing, choking or excessive coughing becomes a problem, provide food consistency easily tolerated.
* Feeding may become difficult and a referral to an occupational therapist may be necessary for adaptive eating utensils.
Eat Well-Balanced Meals
Eat a variety of foods. Include foods rich in fiber, such as fruits, vegetables, whole grains, legumes, bran, cereals, rice and pasta. Limit intake of salt, sugar and foods high in saturated fats and cholesterol. Drink eight cups of water per day. Balance exercise and food in order to maintain your weight within a healthy range. Ask your doctor if alcohol will interfere with any of your medications.
Medication and Food Interactions
Medication used to treat Parkinson's disease may cause nausea. Let your doctor know if nausea is a problem. There are several ways to control nausea, including:
* Drink clear liquids, such as water, broth, fruit juices without pulp (apple juice, grape juice or cranberry juice), Clear sodas, sports drinks and plain gelatin.
* Avoid juices with pulp and orange and grapefruit juices.
* Eat and drink slowly.
* Beverages should be consumed between meals, not with the meal.
* Choose bland foods such as saltine crackers. Avoid greasy and fried foods.
* Eat smaller meals, more frequently throughout the day.
* Foods should be eaten cold or at room temperature.
* After eating keep your head elevated and avoid brushing your teeth.
Some medications for Parkinson's disease may cause thirst or dry mouth. Include 8 or more cups of liquid each day, unless other medical conditions require you to limit your fluid intake. Add sauces to foods to make them moister. Try sour candy or an ice pop to help increase saliva.
Malnutrition may become a problem for a person diagnosed with Parkinson's disease. This could be related to depression, nausea, difficulty feeding, problems with swallowing, chewing, coughing and/or a loss of interest in food.
Patients who experience swallowing difficulties should consult a physician. The doctor may recommend a swallow study to determine the food consistency best tolerated. If feeding becomes difficult, a referral to an occupational therapist may be necessary for adaptive eating utensils.
Thursday, June 10, 2010
Vitamin B6 levels low in arthritis and Parkinson’s disease
by Newsletter Editor
Vitamin B6 levels are low in the general population and in arthritis and Parkinson’s disease, according to findings from three new studies.
In the first large study of vitamin B6 in the general population, researchers measured blood plasma levels of vitamin B6 in 7,822 males and females at least one year old. Nearly 25 percent of those who did not take supplements had low levels of vitamin B6, as did 11 percent of supplement users. Four groups were more likely than most to have low vitamin B6 levels, including women of childbearing age—especially those taking or who had taken oral contraceptives—male smokers, non-Hispanic African-American men and men and women over age 65. Three in four (75 percent) of women who had taken oral contraceptives and did not take vitamin B6 supplements had very low levels (deficiency) of B6. Investigators noted that the federal government uses the same blood plasma measure to set the recommended daily allowance (RDA) for vitamin B6 and that even those who said they consumed more than the RDA had low vitamin B6 levels.
In an arthritis study of women over age 55, including 18 women with rheumatoid arthritis (RA) and 33 healthy women, researchers measured blood levels of vitamin B6, folate, fats and signs of inflammation. Participants weighed the food they ate for seven days and described their pain and ability to perform daily tasks. Compared to the healthy women, women with RA had lower levels of vitamin B6, folate and more inflammation. Because the women in both groups consumed the same amounts of nutrients, doctors theorized that those with RA do not absorb vitamin B6 as well as healthy people and may need to take supplements.
In a Parkinson’s disease (PD) study, researchers examined the diets of 5,289 healthy participants over age 55 and followed up for 10 years. Those who consumed at least 231 mcg of vitamin B6 per day were 54 percent less likely to develop PD than were those who consumed less than 185 mcg per day.
Vitamin B6 levels are low in the general population and in arthritis and Parkinson’s disease, according to findings from three new studies.
In the first large study of vitamin B6 in the general population, researchers measured blood plasma levels of vitamin B6 in 7,822 males and females at least one year old. Nearly 25 percent of those who did not take supplements had low levels of vitamin B6, as did 11 percent of supplement users. Four groups were more likely than most to have low vitamin B6 levels, including women of childbearing age—especially those taking or who had taken oral contraceptives—male smokers, non-Hispanic African-American men and men and women over age 65. Three in four (75 percent) of women who had taken oral contraceptives and did not take vitamin B6 supplements had very low levels (deficiency) of B6. Investigators noted that the federal government uses the same blood plasma measure to set the recommended daily allowance (RDA) for vitamin B6 and that even those who said they consumed more than the RDA had low vitamin B6 levels.
In an arthritis study of women over age 55, including 18 women with rheumatoid arthritis (RA) and 33 healthy women, researchers measured blood levels of vitamin B6, folate, fats and signs of inflammation. Participants weighed the food they ate for seven days and described their pain and ability to perform daily tasks. Compared to the healthy women, women with RA had lower levels of vitamin B6, folate and more inflammation. Because the women in both groups consumed the same amounts of nutrients, doctors theorized that those with RA do not absorb vitamin B6 as well as healthy people and may need to take supplements.
In a Parkinson’s disease (PD) study, researchers examined the diets of 5,289 healthy participants over age 55 and followed up for 10 years. Those who consumed at least 231 mcg of vitamin B6 per day were 54 percent less likely to develop PD than were those who consumed less than 185 mcg per day.
Wednesday, June 2, 2010
An Ibuprofen A Day Could Keep Parkinson's Disease Away
New research shows people who regularly take ibuprofen may reduce their risk of developing Parkinson's disease, according to a study released that will be presented at the American Academy of Neurology's 62nd Annual Meeting in Toronto April 10 to April 17, 2010.
The research involved 136,474 people who did not have Parkinson's disease at the beginning of the research. Participants were asked about their use of non-steroid anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen and acetaminophen.After six years, 293 participants had developed Parkinson's disease.
The study found regular users of ibuprofen were 40 percent less likely to develop Parkinson's disease than people who didn't take ibuprofen.Also, people who took higher amounts of ibuprofen were less likely to develop Parkinson's disease than people who took smaller amounts of thedrug. The results were the same regardless of age, smoking and caffeine intake.
"Ibuprofen was the only NSAID linked to a lower risk of Parkinson's,"said Xiang Gao, MD, with Harvard School of Public Health in Boston."Other NSAIDs and analgesics, including aspirin and acetaminophen, did not appear to have any effect on lowering a person's risk of developing Parkinson's. More research is needed as to how and why ibuprofen appears to reduce the risk of Parkinson's disease, which affects up to one million people in the United States."
The study was supported by the National Institute of Neurological Disorders and Stroke.
Source: American Academy of Neurology (AAN)
The research involved 136,474 people who did not have Parkinson's disease at the beginning of the research. Participants were asked about their use of non-steroid anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen and acetaminophen.After six years, 293 participants had developed Parkinson's disease.
The study found regular users of ibuprofen were 40 percent less likely to develop Parkinson's disease than people who didn't take ibuprofen.Also, people who took higher amounts of ibuprofen were less likely to develop Parkinson's disease than people who took smaller amounts of thedrug. The results were the same regardless of age, smoking and caffeine intake.
"Ibuprofen was the only NSAID linked to a lower risk of Parkinson's,"said Xiang Gao, MD, with Harvard School of Public Health in Boston."Other NSAIDs and analgesics, including aspirin and acetaminophen, did not appear to have any effect on lowering a person's risk of developing Parkinson's. More research is needed as to how and why ibuprofen appears to reduce the risk of Parkinson's disease, which affects up to one million people in the United States."
The study was supported by the National Institute of Neurological Disorders and Stroke.
Source: American Academy of Neurology (AAN)
Thursday, May 27, 2010
Six once-forbidden foods that aren’t so bad for us
Care2 via Sarah Krupp, DivineCaroline
For years, nutrition advice could be summed up something like this: If you like eating or drinking (fill in the blank), it’s bad for you. Health experts blacklisted sugar, butter, chocolate, coffee, alcohol, and eggs.
The Grim Reaper, it seemed, doubled as tiramisu cake. So we abstained from these forbidden foods or flagellated ourselves while indulging in them. No longer!
Researchers have found that these foods are less sinful than we thought and, in some cases, can actually provide health benefits. Plus, eating real foods in moderation is better for you and the planet than eating processed imitations.
Find out what makes these “bad” foods not so bad after all.
1. Butter is (sometimes) better
We all know that butter isn’t good for us. But, according to the scientists at Harvard Health Publications, a little butter isn’t so bad and is actually better than stick margarines.
Margarine was thought to be heart-healthy because, unlike butter, it doesn’t contain cholesterol or saturated fat. But the common process to convert liquid oil into margarine by adding hydrogen atoms creates harmful trans fats that, like butter, increase bad cholesterol in the blood while decreasing the good kind.
The hydrogenation is essential to create the stick margarine, but many of the soft margarines in tubs are now made with fewer or no trans fats and some health experts recommend those over butter. As for the overall fat and calorie content, it’s a tie–neither will do your waistline any favors, so use them sparingly.
2. A good egg
Nutritional experts had long maligned eggs because they are high in cholesterol, but more recent research revealed that saturated fat -- not cholesterol -- poses the greatest risk. Plus, eggs provide protein, iron, and lutein, a nutrient that helps stem age-related eyesight decline. (Spinach and other leafy greens are also good sources of lutein.)
The American Dietetic Association considers eating eggs in moderation a healthy habit and suggests removing some of the egg yolks to reduce fat and cholesterol. For example, in a recipe that calls for two whole eggs, the association recommends substituting with two egg whites and one whole egg.
3. The case for coffee
Forgoing coffee was like a badge of honor in health nut circles, but not any longer. Recent studies have refuted caffeine’s link to heart disease, cancer, and high blood pressure. In addition, health experts now tell us that filling up our mugs has health benefits.
According to the American Medical Association, regular coffee drinkers are less likely to have type II diabetes, and their caffeine habit may reduce the risk of developing colon cancer, liver disease, and Parkinson’s disease. Researchers have also seen a reduced risk of dementia among people who drink three to five cups of coffee a day.
4. Sweet sin or simply sugar?
Cane sugar earned a bad rap, sparking a move to replace it with everything from honey to concentrated fruit juice. Studies show that the substitutes are no better than the real deal. Whatever the original source, consuming too many of these sweet simple carbohydrates can cause health problems like obesity, type II diabetes, and tooth decay. Yet, cane sugar can be part of a healthful diet in reasonable quantities.
The World Health Organization recommends limiting added sugar to 10 percent of daily calorie intake. And as for the new pariah, high fructose corn syrup, the nutrition gurus say that it’s probably no better or worse than all the rest. Although food marketers are taking advantage of the public’s negative perception of high fructose corn syrup, experts say that consumers shouldn’t be fooled by the new marketing techniques.
In terms of your health, it’s the calories that count.
5. A drink a day
For a long time, science was lockstep with Puritan thinking, shunning all alcohol. But within the last few years, there has been a growing body of evidence that alcohol in small amounts is associated with better health.
Experts believe that having a few drinks a week may reduce your risk of coronary heart disease and stroke. Studies indicate that red wine in particular has positive benefits. Rich in antioxidants, including resveratrol, red wine may help prevent clogged arteries.
Be warned, though, while it’s tempting to embrace the more-is-better philosophy, three plus drinks a day will up your risk of liver, mouth, breast, and throat cancer as well as memory loss. Experts recommend one beverage a day for women and two for men.
Not exactly a night on the town, but a glass of syrah with dinner. Not bad!
6. Dispelling the chocolate myth
For ages it seems, parents and health professionals said that chocolate makes us pimply, rots our teeth, and offers no health benefits. Au contraire. Chocolate is chock full of minerals and has some of the same antioxidants found in fruits and vegetables that ward off disease, particularly heart disease.
Unlike gummy and caramel candies, chocolate doesn’t stick to your teeth causing cavities. And don’t try to blame chocolate for blemishes; researchers have found no correlation between the two. In fact, the antioxidants may improve the appearance of your skin by combating inflammation from free radicals.
Look for dark chocolate that contains at least 70 percent cocoa -- the higher the cocoa percentage, the more healthy flavanol antioxidants it contains. (Tea, grapes, blueberries, and cranberries are also high in flavanols.) The label should also say non- or lightly alkalized or non-dutch processed.
An even better way to get your flavanol fix is with natural cocoa powder; when converted into chocolate bars, the cocoa beans lose some of their antioxidants. Plus, chocolate is a mood-booster, increasing serotonin in the brain.
Now that you know the truth about these gustatory pleasures, stay calm. Resist the urge to stock up on all the goodies you have been missing. Remember that nutritionists, researchers, and doctors universally agree that moderation is the key. Drink a few cups of coffee, but don’t down the whole pot. Savor a few squares of chocolate, but try not to make eating the whole bar a habit.
And go ahead, order that piece of tiramisu every once in a while. It won’t kill you.
For years, nutrition advice could be summed up something like this: If you like eating or drinking (fill in the blank), it’s bad for you. Health experts blacklisted sugar, butter, chocolate, coffee, alcohol, and eggs.
The Grim Reaper, it seemed, doubled as tiramisu cake. So we abstained from these forbidden foods or flagellated ourselves while indulging in them. No longer!
Researchers have found that these foods are less sinful than we thought and, in some cases, can actually provide health benefits. Plus, eating real foods in moderation is better for you and the planet than eating processed imitations.
Find out what makes these “bad” foods not so bad after all.
1. Butter is (sometimes) better
We all know that butter isn’t good for us. But, according to the scientists at Harvard Health Publications, a little butter isn’t so bad and is actually better than stick margarines.
Margarine was thought to be heart-healthy because, unlike butter, it doesn’t contain cholesterol or saturated fat. But the common process to convert liquid oil into margarine by adding hydrogen atoms creates harmful trans fats that, like butter, increase bad cholesterol in the blood while decreasing the good kind.
The hydrogenation is essential to create the stick margarine, but many of the soft margarines in tubs are now made with fewer or no trans fats and some health experts recommend those over butter. As for the overall fat and calorie content, it’s a tie–neither will do your waistline any favors, so use them sparingly.
2. A good egg
Nutritional experts had long maligned eggs because they are high in cholesterol, but more recent research revealed that saturated fat -- not cholesterol -- poses the greatest risk. Plus, eggs provide protein, iron, and lutein, a nutrient that helps stem age-related eyesight decline. (Spinach and other leafy greens are also good sources of lutein.)
The American Dietetic Association considers eating eggs in moderation a healthy habit and suggests removing some of the egg yolks to reduce fat and cholesterol. For example, in a recipe that calls for two whole eggs, the association recommends substituting with two egg whites and one whole egg.
3. The case for coffee
Forgoing coffee was like a badge of honor in health nut circles, but not any longer. Recent studies have refuted caffeine’s link to heart disease, cancer, and high blood pressure. In addition, health experts now tell us that filling up our mugs has health benefits.
According to the American Medical Association, regular coffee drinkers are less likely to have type II diabetes, and their caffeine habit may reduce the risk of developing colon cancer, liver disease, and Parkinson’s disease. Researchers have also seen a reduced risk of dementia among people who drink three to five cups of coffee a day.
4. Sweet sin or simply sugar?
Cane sugar earned a bad rap, sparking a move to replace it with everything from honey to concentrated fruit juice. Studies show that the substitutes are no better than the real deal. Whatever the original source, consuming too many of these sweet simple carbohydrates can cause health problems like obesity, type II diabetes, and tooth decay. Yet, cane sugar can be part of a healthful diet in reasonable quantities.
The World Health Organization recommends limiting added sugar to 10 percent of daily calorie intake. And as for the new pariah, high fructose corn syrup, the nutrition gurus say that it’s probably no better or worse than all the rest. Although food marketers are taking advantage of the public’s negative perception of high fructose corn syrup, experts say that consumers shouldn’t be fooled by the new marketing techniques.
In terms of your health, it’s the calories that count.
5. A drink a day
For a long time, science was lockstep with Puritan thinking, shunning all alcohol. But within the last few years, there has been a growing body of evidence that alcohol in small amounts is associated with better health.
Experts believe that having a few drinks a week may reduce your risk of coronary heart disease and stroke. Studies indicate that red wine in particular has positive benefits. Rich in antioxidants, including resveratrol, red wine may help prevent clogged arteries.
Be warned, though, while it’s tempting to embrace the more-is-better philosophy, three plus drinks a day will up your risk of liver, mouth, breast, and throat cancer as well as memory loss. Experts recommend one beverage a day for women and two for men.
Not exactly a night on the town, but a glass of syrah with dinner. Not bad!
6. Dispelling the chocolate myth
For ages it seems, parents and health professionals said that chocolate makes us pimply, rots our teeth, and offers no health benefits. Au contraire. Chocolate is chock full of minerals and has some of the same antioxidants found in fruits and vegetables that ward off disease, particularly heart disease.
Unlike gummy and caramel candies, chocolate doesn’t stick to your teeth causing cavities. And don’t try to blame chocolate for blemishes; researchers have found no correlation between the two. In fact, the antioxidants may improve the appearance of your skin by combating inflammation from free radicals.
Look for dark chocolate that contains at least 70 percent cocoa -- the higher the cocoa percentage, the more healthy flavanol antioxidants it contains. (Tea, grapes, blueberries, and cranberries are also high in flavanols.) The label should also say non- or lightly alkalized or non-dutch processed.
An even better way to get your flavanol fix is with natural cocoa powder; when converted into chocolate bars, the cocoa beans lose some of their antioxidants. Plus, chocolate is a mood-booster, increasing serotonin in the brain.
Now that you know the truth about these gustatory pleasures, stay calm. Resist the urge to stock up on all the goodies you have been missing. Remember that nutritionists, researchers, and doctors universally agree that moderation is the key. Drink a few cups of coffee, but don’t down the whole pot. Savor a few squares of chocolate, but try not to make eating the whole bar a habit.
And go ahead, order that piece of tiramisu every once in a while. It won’t kill you.
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