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 Parkinson's disease 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.

• 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).

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

For some patients, levodopa may cause nausea when taken on an empty stomach. 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 drug 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.

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.

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

• Drink eight 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 dehydrated.
• Dunk or moisten breads, toast, cookies, or crackers in milk, decaffeinated 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 soft and moist. 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.

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.

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.
• 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, or bread sticks with cheese sauce.

• 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.

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 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.

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).

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