Diet and Nutrition for People with Parkinson's Disease

Last Editorial Review: 10/23/2003

By Julie Carter
WebMD Live Events Transcript

Julie Carter, R.N., M.N., A.N.P., will address the most important aspects of a healthy diet for people living with Parkinson's.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Mature_Years_Mod   Hello and welcome to Health In Your Mature Years. Today's guest speaker is Julie Carter from OHSU. Ms. Carter is the Associate Director of the Parkinson's Center of Oregon as well as an Associate Professor in the Department of Neurology at OHSU. Today she will be taking your questions on Diet and Nutrition for People with Parkinson's Disease. Also if you have general diet and nutrition questions please include those as well.  Let's get started, Is it important for effective treatment of Parkinson's to have a healthy diet?

Speaker_Carter   Diet is particularly important for people who are on Sinemet Sinemet or levodopa can interact with food at two locations, gut and brain.  At the level of the stomach food can delay levodopa from being absorbed into the blood. If  levodopa is taken on a full stomach the food must first be digested before it enters the gut of intestine.  Levodopa is absorbed across the gut wall into the blood. If the absorption is delayed it might be ineffective. Our recommendation is to take levodopa or sinemet on a empty stomach.  At the level of the brain, protein can interfere with levodopa.  This happens because levodopa uses the same molecules as protein to be carried into the brain.  If all of those molecules are filled up with amino acids (parts of protein) there is no place for levodopa to hook on and get into the brain.  We recommend that people take the RDA for protein each day; this is usually less than most people consume. Next

Mature_Years_Mod   What are the benefits of a low protein diet?

Speaker_Carter   A low protein diet means a diet that meets the RDA for protein. This is .8grams/kg or .4 grams/pound.  The benefit is to reduce the interaction between levodopa and food which I just described. Next

Mature_Years_Mod  What is the value of different nutritional supplements?

  Speaker_Carter  Do you have any specific supplements in mind?

Mature_Years_Mod  Why is thiamin and Vitamin E good for you?

Speaker_Carter Vitamin E is an antioxidant. This means that it can counteract oxidative metabolism which is thought to be responsible for the damage in a number of disease processes.  In PD it was thought to delay progression but after a careful study it does not look like this is true. It most likely does not get across the blood brain barrier.  It is still good for other disease processes such as heart disease, perhaps cancer, and others. Next

Mature_Years_Mod What are some other supplements worth taking and learning more about for those sick as well as aging?

Speaker_Carter   I should first start with vitamins in general. A well balanced multivitamin is important in normal aging and any chronic illness.  Good nutrition can be harder to come by and a good vitamin is protective for nutritional deficits.  The other supplement is calcium. Women and men should both have 1200-1500mg/day.  A glass of milk has 300mg so you can start to estimate how much you get in food. Are there other supplements that come to mind?

Mature_Years_Mod   None specifically... just making sure that those that are aging are looking for the right foods which provide them the right nutrients...

Mature_Years_Mod   To submit a question please type in /ask then skip a space then type in your question and hit return.

Speaker_Carter   Let me say a word about coenzyme Q10 This nutritional supplement is being studied in PD. It is a powerful antioxidant, boosts energy, and the immune system.  In PD it is thought to repair a defect in the powerhouse of the cell (mitochondria). There is a controlled double blind clinical trial being done right now to answer this question. Next

Mature_Years_Mod  I've never heard of coenzyme Q10 how can you get it? Is it the same as Echinacea (sorry it's probably not spelled right)

Speaker_Carter   It can be found in any health food store. The concern with all of the nutritional supplements is that there are no FDA guidelines to regulate their use. Therefore, there are no rules for potency and purity.  These supplements can have minimal active ingredient. They can also be laced with toxins. I encourage my patients to call the manufacture and make sure they know what guidelines they use for production. German made supplements have very high standards because all of their supplements require a prescription to be purchased.  next

Mature_Years_Mod  Here's a question getting back to Parkinson's for a moment.....

Mature_Years_Mod   Is the timing of medication as it relates to your eating schedule important? 

Speaker_Carter   Levodopa or sinemet should be taken on an empty stomach; 20 minutes before a meal or two hours after a meal. Other anti-Parkinson meds can be taken with food. Next 

Mature_Years_Mod  Is it important to eat more often in smaller amounts than to eat 3 meals a day when you have Parkinson? If yes why?

Speaker_Carter   If a person has marked fluctuations in their mobility and they are taking their sinemet every 2 hours, it can work better to eat several small meals a day.   The other reason to eat more often is if a person is loosing weight. In PD, people have a tendency to loose weight and this is a way to get more calories in. Next

Mature_Years_Mod   Getting back to general health and nutritional questions? What do you think about the low carb diets on the market now?

Speaker_Carter  I must confess that I don't know all of the pros and cons regarding the high protein, low carb diets. I do know that for someone with cholesterol concerns this would be discouraged.  next

Mature_Years_Mod  What can you recommend to someone who is a sweets-a-holic. Is there any herbs or supplements or food alternatives that will curb the desire for sweets?

Speaker_Carter   I don't know of a specific supplement to curb the desire for sweets but I do know that trying to keep blood sugar well regulated can decrease the craving for sweets.  This is the basis of the zone diet. The zone diet maintains a constant balance of protein and carbohydrates to prevent an over secretion of insulin. This drives the blood sugar down and then people feel hungry and want carbohydrates.  next

Mature_Years_Mod   Is salt a bad thing. My mother adds salt to everything she eats, I mean everything. She went into the doctor and actually had low blood pressure how can that be?

Speaker_Carter   Salt is only bad if you have high blood pressure. Salt causes a person to retain fluid which drives up the blood pressure For some people with PD a low blood pressure is common. When this low BP causes them to be dizzy or sleepy we encourage the liberal use of salt. Next 

Mature_Years_Mod   A lot of elderly people who seem to be in good health but just are affected by their age seem to loose their appetite/ Is that okay or is there something you can recommend to increase their appetite?

Speaker_Carter   As people age they loose some of their taste buds which can decrease appetite. Also just living alone, depression, mobility problems etc can make them more at risk of malnutrition.   I think weight loss is the best guideline. If a person is losing weight poor nutrition should be explored. Again, this is one reason why I think a multivitamin is a good idea.  Next

Mature_Years_Mod   Is an over the counter one a day multivitamin enough?

Speaker_Carter   Let me give you a partial list  For men and post menopausal women:  Low-iron: Natrol, Nature Made Mature Balance, One-d-day 50 plus, Shaklee Vita-Lea  medium iron (4-10mg): Centrum Silver, Twinlab Dualtabs, Puritan's Pride OneTwinlab Allergy Multi-Caps, Your Life Central-Vite Plus.  If you are pre-menopausal I would have other recommendations Next

Mature_Years_Mod   A lot of older people complain about always being thirsty. Is that normal? Does PD increase your appetite for liquids?

Speaker_Carter  Medications for PD can cause a dry mouth which increases the desire for liquids. Next

Mature_Years_Mod  We are running out of time. Julie is there anything else you would like to add on today's topic before we say goodbye?

Speaker_Carter  Yes, I think a good source for nutrition is the Nutrition Action Health Letter   That is my last thought...thanks for the chat. 

Mature_Years_Mod   Our hour has come to an end. I would like to take this time to thank Julie Carter from OHSU for being our guest speaker today.   I hope everyone gained some knowledge today and I encourage you to check out the other live events that are coming up on WebMD's Program list. Have a great day.

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