Eating properly is essential, but sometimes a challenge, for the person with Parkinson’s. There is no specific “diet” for people with Parkinson’s disease. Good nutrition helps to support the body’s ability to remain as healthy as possible and to provide enough energy to meet the body’s needs. In the early to middle stages of Parkinson’s, most people can continue eating favorite foods with few changes (except to healthier choices, if appropriate). As Parkinson’s progresses to affect the muscles of the face, mouth, and throat, the mechanics of eating become more challenging. Chewing foods such as meats and fresh, raw vegetables can become difficult. Cutting these foods into small pieces and cooking them until they are tender make them easier to manage and less of a choking hazard.
In the later stages of Parkinson’s disease the timing of medications and meals becomes essential. Dietary protein interferes with the absorption of levodopa, the primary anti-parkinson’s medication. In the early stages of levodopa therapy it is possible to take a larger dosage than the brain needs, knowing that some will be lost, so the levodopa can be taken with food to mitigate the nausea that is a common side effect of its use. As the loss of DOPAMINERGIC NEURONS in the SUBSTANTIA nigra continues, the brain needs greater amounts of levodopa to replace the diminishing levels of DOPAMINE.
The dosage soon reaches the maximal tolerable dosage of levodopa; at that time it becomes important to make the best possible use of that dosage. No longer is there the luxury to “waste” any part of the dosage by cushioning its side effects with food. It becomes necessary to adjust meals and medications to take levodopa doses on an empty stomach (or with just a light, protein-free snack such as crackers if nausea is a problem) and to limit the amount of protein in meals. Protein is necessary for tissue health and many body functions as it supplies the amino acids the body needs for cell activity and repair. It is important to eat enough protein to meet the body’s requirement, which for a typical adult is about 40 to 60 grams a day.
Many people who are experiencing fluctuating phenomenon in response to levodopa therapy shift nearly the full amount of their daily protein needs to the evening meal, when their levodopa dosage is the smallest; most people take higher dosages during the day to relieve symptoms during the times they prefer to be active. This method helps to meet nutritional needs and to obtain the maximal benefit from levodopa therapy. Maintaining adequate nutrition in the late stages of Parkinson’s disease becomes difficult as the challenges of eating increase. A nutritionist can help plan meals that meet nutritional needs that the person can consume.