What is Parkinson’s disease?
Parkinson’s disease is a progressive, degenerative neurological condition that alters the control of body movements. It can cause symptoms like trembling of the hands, legs, jaw and face, or slow down body movements. As you can imagine, this disease can be extremely frustrating for the patients as it can affect the ability to perform daily activities such as getting dressed, driving and eating.
The cause of Parkinson’s disease
The symptoms occur due to inadequate levels of the dopamine being secreted from the brain. The lack of this neurotransmitter essentially causes difficulty in controlling movements and moving freely. It can also impact movements and other aspects such as sense of sense, bowel movements and mood.
What are the nutritional concerns for people with Parkinson’s disease?
- Medication side effects like constipation
- Orthostatic hypotension
- Malnutrition
Management of constipation
Constipation is diagnosed when there is:
- Excessive straining
- Incomplete evacuation
- Digital manipulation
- Rectal pressure/pain
- The stool frequency is <3/7
Treatment for the constipation:
- 25-35g of fibre a day from foods like fruits, vegetables, wholegrain breads and cereals
- Gum-based fibre supplements are preferred over supplements like psyllium husk as additional fluid is required to swallow it
- Drink lots of water
Orthostatic hypotension
This refers to the condition when a person experiences low blood pressure on standing up. Again, this is due to loss of control over a certain section of the nervous system responsible for controlling blood pressure. PD patients often experience this after eating.
This is related to the effect that digestion has on blood pressure. Normally, when a meal is ingested, it goes through the process of digestion from the stomach to the intestines. The intestines require a large amount of blood for digestion. This large blood flow causes the heart rate to increase as a result and blood vessels in other parts of the body constrict as a way of maintaining the blood pressure. In the case of patients with PD, the blood flows to the intestines as per the general population, but the usual response of the heart rate increasing and blood vessels constricting does not take place. As a result of this, the blood pressure falls.
Dietary management of orthostatic hypotension
- Reduce the amount of food at each meal
- Reduce carbohydrates as the intake of carbohydrates causes the stimulation of insulin and can influence lower the blood pressure
- Increase salt intake
- Increase fluid
- Reduce alcohol intake
Management of medication
The main medication used in PD is known as Levodopa. Levodopa is a chemical that the body uses to convert into dopamine. It is commonly used in PD patients. However, it can have side effects such as nausea and vomiting, hypotension, loss of appetite and sleep problems. The best way to take it is either at routine times during the day or on an empty stomach either 30 minutes before or 2 hours after a meal. This is so digestion and absorption of the meal does not interfere with the absorption of the medication.
Management of malnutrition
Malnutrition is the condition in which a person is not able to meet their nutritional needs. Inadequate food intake is common among PD patients as many patients experience swallowing difficulties.
Ways to counteract malnutrition are:
- Fortifying foods; for example, adding cheese to mashed potatoes
- Small frequent meals
- High energy, high protein foods such as eggs, meat and dairy products
- Oral nourishing fluids and a texture modified diet to help with swallowing difficulties
Contact us for results focused nutritional advice
This article was written by our dietitian and nutritionist Juhi Bhambhaney. If you have any questions regarding health and nutrition, make an appointment with one of our dietitians. We‘ll provide you with a simple and effective routine targeted to your concerns. Contact us today.
