Dietary habits and neurological features of Parkinson's disease patients: Implications for practice.

Michela Barichella, Emanuele Cereda, Erica Cassani, Giovanna Pinelli, Laura Iorio, Valentina Ferri, Giulia Privitera, Marianna Pasqua, Angela Valentino, Fatemeh Monajemi, Serena Caronni, Caterina Lignola, Chiara Pusani, Carlotta Bolliri, Samanta A Faierman, Alessandro Lubisco, Giuseppe Frazzitta, Maria L Petroni, Gianni Pezzoli

Journal: Clinical nutrition (Edinburgh, Scotland) 2018;36(4):1054-1061

PMID: 27406858

Abstract

BACKGROUND & AIMS

Parkinson's disease (PD) patients can benefit considerably from appropriate nutritional care, particularly from diet. However, there is limited evidence on the eating habits of PD patients and their relationship with the features of the disease.

METHODS

We conducted a large case-control study. Consecutive PD patients (N = 600) receiving systematic nutritional care and healthy controls (N = 600) matched (1:1) for age, gender, education, physical activity level and residence were studied using a 66-item food frequency questionnaire. The relationship between dietary habits and the following features of PD were investigated in patients: body weight, energy balance, constipation, and levodopa therapy (dose) and its related motor complications.

RESULTS

PD patients had lower BMI and reported higher food intake than controls. BMI was found to be inversely associated with disease duration and severity, and levodopa-related motor complications, whereas energy intake was positively associated with these variables. An increase in protein intake by 10 g over physiological requirements (0.8 g/kg/day) corresponded to a mean increase in levodopa dose of 0.7 mg/kg/day. Constipation was also associated with higher levodopa requirements. Finally, protein intake and its distribution throughout the day influenced levodopa-related motor complications.

CONCLUSION

The management of protein intake and the treatment of constipation should be considered to be an integral part of the care of PD patients. Attention should always be focused on energy intake also. This would result in the maintenance of nutritional status, the optimization of levodopa-therapy and the minimization of its related motor complications.

Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Address: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.; Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: [email protected].; Department of Statistical Sciences "P. Fortunati", University of Bologna, Bologna, Italy.; Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica (FERB), "S.Isidoro" Hospital, Trescore Balneario, Italy.; Department of Functional Rehabilitation, "Sol et Salus" Hospital, Torre Pedrera, Rimini, Italy.
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