Parkinson’s Disease Foundation

PD ExpertBriefing:Nutrition and Parkinson's Disease

Led By: Heather Zwickey, Ph.D., Dean of Research and Graduate Studies and Professor of Immunology at the National College of Natural

Medicine, Portland, OR.

This session was held on: Tuesday, September 15, 2015

If you have any questions,please contact: Valerie Holt at vholt@pdf.org or call(212) 923-4700

Introduction

Robin A. Elliott, PresidentParkinson’s Disease Foundation

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Nutrition and Parkinson’s Disease

Heather Zwickey, Ph.D.Dean of Research and Graduate Studies

Professor of ImmunologyNational College of Natural Medicine

Goals for Viewers

People with PD (PWP)

• Notice differences with diet

• Sense of control or empowerment

• Balance flavor, cost, convenience, logistics

Physicians and Care Providers

• Evidence of effectiveness

• Worry about interaction with medications

• Miniscule education in nutrition

Plan

• Strategy for PD

• Medications and Food

• Nutrition for Symptoms

• Nutrition and Weight Loss/Gain

Strategy

Foods that are:

• Neuroprotective

• Anti-inflammatory

• Antioxidants

And

• Increase serum urate

Neuroprotective Foods

Nuts Herbs

Nut Ingredient Benefit

Walnuts Omega3s, Copper, Zinc Decrease dementia

Pistachios Lithium, Potassium Improves mood, and increase neurogenesis

Macadamia MUFA Increase production of neurotransmitters

Cashew Iron, Zinc, Magnesium Increase serotonin, and reduce memory loss

Almond Fiber Regulates your fuel supply

Brazil Selenium Counteracts neurotoxicity

Nuts

HerbsHerb Ingredient Potential Benefit

Tumeric Curcumin(polyphenol)

Crosses blood-brain barrierPrevents alpha synuclein from aggregatingAntioxidant

Ceylon Cinnamon Metabolized into sodium benzoate

Stops loss of Parkin and DJ-1Protects neuronsNormalizes neurotransmitter levels

Rosemary Carnosol Antioxidant and anti-inflammatoryDecreases neurotoxicity

Neuroprotection and Fat

Medium Chain Triglycerides!

Anti-inflammatory and Antioxidant

Anti-inflammatory

Help reduce inflammatory proteins in the body

Food:

Oily fishes like salmon, tuna, and mackerel

Dark leafy greens

Soy

Antioxidant

Help destroy the ‘free radicals’ that do damage to healthy cells

Food:

More colorful the better.

Think purple, red, and blue

Ingredient: Anthrocyanins

Best Evidence for PD

Increase Green Tea

Why?

1. Many epidemiological studies

2. Animal studies suggest that it is neuroprotective

3. EGCG is anti-inflammatory and antioxidant

Best Evidence for PD

Avoid dairy

Why?

1.Decreases serum uric acid – which is protective

2.Contains high levels of pesticides

Ideal Breakfast

Eat This

• Eggs

• Scrambled, Poached, Fried, Quiche, Frittata

• Nut based granolas

• Muffins made with nut and coconut flours

• Smoothies

• Berries, coconut milk, ice

• Caffeine

Avoid this

• Pastries

• Cinnamon rolls

• Donuts

• Coffee cake

• Wheat based muffins

• Processed cereals

• Pancakes

• Yogurt

Ideal Lunch & Dinner

Eat This

• Meat and vegetable

• Protein, fiber, complex carb

• Sushi

• Salad with protein

• Curry and rice

• Nuts and fruit

Avoid this

• Simple carbs

• Pasta

• Pizza

• White breads

• Cheese

• High Fructose Corn Syrup

• High fat

Organic?

• Environmental toxicity

• Meat vs Vegetables

– Meat Fat

– Vegetables Skin

• Clean 10 and Dirty Dozen

Medications and Food

• Food has a systemic effect on the body

• It can increase or decrease absorption of medications

• It can increase or decrease metabolism of medications

Meals and Levodopa• Vitamin B6 can reduce

the effects of levodopa

– Meat, bananas, egg yolks, lima beans, peanuts and whole grain cereals

• High fat meals can reduce the absorption of carbidopa/levodopa

– Pizza, burgers, fries, onion rings, bacon and avocado

Nutrition and Symptoms

What nutritional practices can be employed to be proactive regarding constipation, gastroparesis and other GI problems in PD?

– Increase fluids if you can• Licorice tea

– Increase fiber with fruits and vegetables • Kiwi, apples

• Prunes, dates, figs

• Radishes

• Berries

• Nuts, Beans

– Probiotics• Healthy bacteria

• Bifidobacterium (B. breve)

Nutrition and Symptoms

What is the impact of poor nutrition on symptoms for a person with PD (i.e., cognition, sleep, mood, etc.)?

Nutrition and Symptoms

What are some suggestions for managing fluid intake and incontinence/urinary urgency given that some cope by decreasing fluid intake to lessen incidences of incontinence?

• Increase foods with high water content rather than fluids

– Tomato

– Cucumber

– Radish

– Celery

– Broccoli

– Grapefruit

Nutrition and Weight Loss/Gain

• People with PD can be overweight, underweight, or weight/frame appropriate

• Individually tailoring the diet to body size, symptoms, and goals is important

• Nutritional counseling

Nutrition and Weight Loss/Gain

What tips can be employed to nutritionally manage weight loss issues in PD and loss of appetite?

• Increase calories

– Nuts

– Healthy fats (coconut, avocado)

• Foods

– Bitter greens, hot spicy

• Exercise

– Increases appetite and muscle mass

Summary

• Increase nuts, tea, berries, fatty fish, dark leafy greens, coconut…

• Decrease dairy, fried foods, high fructose corn syrup, animal fat that isn’t organic

• Cook with herbs!

Thank you!

• Thanks to the Parkinson’s Disease Foundation and Eli Pollard for the invitation to speak

• Thanks to NIH and the National College of Natural Medicine

References

1. Baer DJ, Gebauer SK, Novotny JA. Measured energy value of pistachios in the human diet. Br J Nutr. 2012;107(01):120–125.

2. Bubonja-Sonje M, Giacometti J, Abram M. Antioxidant and antilisterial activity of olive oil, cocoa and rosemary extract polyphenols. Food Chem. 2011;127(4):1821–1827.

3. Chainani-Wu N. Safety and anti-inflammatory activity of curcumin: a component of tumeric (Curcuma longa). J Altern Complement Med. 2003;9(1):161–168.

4. Curb JD, Wergowske G, Dobbs JC, Abbott RD, Huang B. Serum lipid effects of a high-monounsaturated fat diet based on macadamia nuts.; 2000.

5. Ebhardt SUEG, Rior ROLP. Concentrations of Anthocyanins in Common Foods in the United States and Estimation of Normal Consumption. 2006.

6. Garg ML, Blake RJ, Wills RBH, Clayton EH. Macadamia nut consumption modulates favourably risk factors for coronary artery disease in hypercholesterolemic subjects. Lipids. 2007;42(6):583–587.

7. Griel AE, Cao Y, Bagshaw DD, Cifelli AM, Holub B, Kris-Etherton PM. A macadamia nut-rich diet reduces total and LDL-cholesterol in mildly hypercholesterolemic men and women. J Nutr. 2008;138(4):761–767.

8. Ha AD, Jankovic J. Pain in Parkinson’s disease. Mov Disord. 2012;27(4):485–491.

9. Haider S, Batool Z, Tabassum S, et al. Effects of Walnuts (Juglans regia) on Learning and Memory Functions. Plant Foods Hum Nutr. 2011;66(4):335–340.

10. Heymsfield SB. Treatment of Parkinson disease with diet-induced hyperketonemia : A. 2005:728–730.

References11. Kay CD, Gebauer SK, West SG, Kris-Etherton PM. Pistachios increase serum antioxidants and lower serum oxidized-LDL in hypercholesterolemic adults. J Nutr. 2010;140(6):1093–1098.

12. Lee JK, Tran T, Tansey MG. Neuroinflammation in Parkinson’s disease. J Neuroimmune Pharmacol. 2009;4(4):419–429.

13. Maguire LS, O’Sullivan SM, Galvin K, O’Connor TP, O’Brien NM. Fatty acid profile, tocopherol, squalene and phytosterol content of walnuts, almonds, peanuts, hazelnuts and the macadamia nut. Int J Food Sci Nutr. 2004;55(3):171–178.

14. Malouf R, Grimley EJ, Grimley Evans J. Vitamin B6 for cognition. Cochrane Database Syst Rev. 2003:CD004393.

15. Seidl SE, Santiago J a, Bilyk H, Potashkin J a. The emerging role of nutrition in Parkinson’s disease. Front Aging Neurosci. 2014;6(March):36. doi:10.3389/fnagi.2014.00036.

16. Shaltiel-Karyo R, Davidi D, Frenkel-Pinter M, Ovadia M, Segal D, Gazit E. Differential inhibition of α-synuclein oligomeric and fibrillar assembly in parkinson’s disease model by cinnamon extract. Biochim Biophys Acta -Gen Subj. 2012;1820(10):1628–1635.

17. Simopoulos AP. Omega-3 fatty acids in wild plants, nuts and seeds. In: Asia Pacific Journal of Clinical Nutrition.Vol 11.; 2002.

18. Tan LCS. Epidemiology of parkinson’s disease. Neurol Asia. 2013;18(3):231–238.

19. Thomson CD, Chisholm A, McLachlan SK, Campbell JM. Brazil nuts: An effective way to improve selenium status. Am J Clin Nutr. 2008;87(2):379–384.

References

20. VanItallie T, Nonas C, Di Rocco A, Boyar K, Hyams K, Heymsfield S. Treatment of Parkinson disease with diet-induced hyperketonemia: A feasibility study.

21. Wu X, Beecher GR, Holden JM, Haytowitz DB, Gebhardt SE, Prior RL. Concentrations of anthocyanins in common foods in the United States and estimation of normal consumption. J Agric Food Chem. 2006. doi:10.1021/jf060300l.

22. Zuo L, Motherwell MS. The impact of reactive oxygen species and genetic mitochondrial mutations in Parkinson’s disease. Gene. 2013. doi:10.1016/j.gene.2013.07.085.

Thank You!

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“Painting has not only helped to calm the tremor in my hand, but it hasalso improved my attitude toward life and increased my energy levels.”

Still Life, Hardy JonesPDF Creativity and Parkinson’s Project

Questions and Discussion

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Resources from PDF

Parkinson’s HelpLine •Available at (800) 457-6676 or info@pdf.org•Monday through Friday•9:00 AM – 5:00 PM ET

Fact Sheets•Nutrition and Parkinson’s

PD Resource List•750 resources in the Parkinson’s community

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Upcoming PD ExpertBriefings

Cognitive Issues: Advice for Parkinson's Care PartnersIn recognition of National Family Caregivers MonthTuesday, November 10, 1:00 PM – 2:00 PM ET Rebecca Gilbert, M.D., Ph.D., Clinical Associate Professor of Neurology, Pathology and Psychiatry, NYU Langone Medical Center and NYU Langone Parkinson’s and Movement Disorder Center

Anxiety in Parkinson’s Disease Tuesday, January 5, 2016, 1:00 PM - 2:00 PM ET Joseph H. Friedman, M.D., Director, Movement Disorders Program, Butler Hospital and Professor and Chief, Division of Movement Disorders, Warren Alpert Medical School, Brown University

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