clinical focus
Diet and Parkinson’s disease
Maintaining a healthy diet can
be difficult for people with this
debilitating disorder, but the
following strategies can help.
By Samantha Ling
R
esearch estimates that more than 110,000 Australians may
be living with Parkinson’s disease, a neurodegenerative
disorder characterised by reduced control of fine motor
skills, tremors, slowness of movements, impaired mobility,
swallowing issues and impaired speech. As a result, staying
nourished and maintaining healthy eating habits can be
challenging for those living with Parkinson’s disease.
MAINTAIN A HEALTHY WEIGHT
Preventing unwanted weight gain plays an important role in
maintaining mobility and independence with everyday tasks,
particularly if balance and coordination is affected. Similarly,
preventing unwanted weight loss and muscle wasting is
fundamental to maintaining muscle strength, balance and
therefore mobility.
Under the guidance of an accredited practising dietitian
(APD), oral nutrition supplements for weight gain and weight
maintenance may be required. For some Parkinson’s medications
such as levodopa, absorption can be affected by the presence of
protein in the diet. This interference between protein and levodopa
does not affect everyone with Parkinson’s disease. It is therefore
important to monitor ‘on/off’ symptoms and adjust the timing of
meals and supplements with Parkinson’s medication. Generally,
administration of Parkinson’s medication is encouraged at least 30
minutes prior to meals to maximise absorption.
NAUSEA
Nausea is a common side-effect levodopa. This normally
subsides once the body adjusts to the medication. If nausea is
experienced, the following strategies can be tried:
• In the beginning, taking medication with food.
• Consume smaller, more frequent meals.
24 agedcareinsite.com.au
• Minimise aromatic foods if the smell is nauseating.
• Some evidence supports the consumption of ginger-based
products to alleviate nausea.
• Avoid taking anti-nausea medications like Maxolon which block
the effectiveness of levodopa. Always talk to your pharmacist or
medical specialist before starting new medication.
FATIGUE AND REDUCED APPETITE
If fatigue is a factor in meal preparation, patients can cook meals
in bulk when energy levels are best and freeze for later, utilise
meal services, or enlist the help of a friend or family member.
If fatigue is affecting the ability to eat, try cooking softer foods
that require less effort to chew, finger foods, or swapping the
main meal to a time of day when energy levels are best.
TREMORS AND INVOLUNTARY MOVEMENTS
A common side effect of levodopa is involuntary movements
(dyskinesia). These movements burn energy (kilojoules) the same
way exercising would and therefore require an increase in oral
intake if weight loss is not desired.
An APD can provide support and may recommend oral protein
supplements and/or fortifying meals with additional toppings,
sauces, gravy or protein powder.
For severe dyskinesia, it may be worthwhile monitoring
symptoms with medication timings so that the specialist can
fine-tune medication regimens.
Repetitive movements such as feeding, chopping or whisking
may also be hindered. An occupational therapist can discuss
options for modified equipment, such as double-handled mugs,
modified cutlery, plate guards and so on.
SWALLOWING ISSUES
Fatigue and incoordination of movements may affect a
patient’s ability to chew food. Likewise, slowing of the muscles
that control swallowing may lead to delayed swallowing and
increased risk of food particles reaching the lungs. This slowing
of the muscles is known as a condition called bradykinesia.
Consulting a speech pathologist is recommended if there
are issues with chewing or swallowing ability. The speech
pathologist may recommend a change in diet texture or
fluid thickness.