Diet & Gut Health

Overview: It’s no secret that a “healthy” diet can slow the progression of or improve quality of life with Parkinson’s. There is also an increasing body of research exploring the connection between gut health and brain health. This indicates some exciting possibilities for the prevention of Parkinson’s. 

Diet – Many people prescribe to the Mediterranean Diet, but the general consensus is that a diet that includes a variety of vegetables, fruits, protein-rich foods, and whole grains can improve health. Nuts, olive oil, fish, and eggs – all associated with the Mediterranean Diet, are also great additions to improve health. 

● Brightly-colored vegetables and darkly-colored fruits are higher in good vitamins and antioxidants. 

● Nuts are considered excellent for brain health (and almonds relieve constipation).

● Vitamin D can be absorbed through fortified milk, egg yolks, and fish.

● Try to reduce salt and limit sugar/alcohol. Sugar intake is associated with confusion. 

Medication & Diet – Parkinson’s medications interact with the food you eat in a number of ways. For many people, it’s best to take carbidopa-levodopa on an empty stomach. For others, the medication causes nausea, in which case crackers or applesauce may help. Eating a protein rich meal alongside your medication may lessen the efficacy of the medication. That’s because protein and carbidopa-levodopa are absorbed at the same place in the small intestine (the jejunum). 

Appetite – People with Parkinson’s often report a loss of appetite or find themselves eating less and losing weight. This can be caused by difficulty swallowing, by nausea from medications, or from exhaustion and various other movement symptoms. To stimulate appetite consider: 

● Eating foods with healthy fats, like nuts, nut butters, and avocado. 

● Stimulate your appetite with spicy foods or bitter greens. 

● Plan meals that are easy to swallow. 

● Adjust eating schedule to have smaller, more frequent meals. 

● Eat foods with high water content to maintain hydration: celery, watermelon, squash…

● Speech Therapy and exercise can also help stimulate appetite.

Gut Health & PD – Gastrointestinal dysfunction is a common non-movement Parkinson’s symptom; up to 70% of people with Parkinson’s are affected by constipation, and it’s one of the earliest symptoms that appear in an eventual Parkinson’s diagnosis. Research indicates that what happens in the brain impacts the gut via the gut-brain axis, a biochemical communication between the gastrointestinal tract and the central nervous system. Research into PD and gut health is relatively new, but early research suggests the gut microbiome of people with Parkinson’s differs from those without. 

● Alpha-synuclein proteins (which misfold and form clumps in the Parkinson’s brain) have been found in the GI tract of people with Parkinson's. The “Gut First” hypothesis, proposed in 2003 by German anatomist Heiko Braak, suggests that Parkinson’s begins as misfolded proteins in the nerves of the gastrointestinal tract. 

● Some beneficial bacteria that commonly exist in the gut are reduced in people with Parkinson’s. 

● Zonulin, a protein marker for intestinal absorbency, is found in inflammatory conditions like celiac, IBD, diabetes, and some autoimmune diseases and is also significantly elevated in people with Parkinson’s. 

Leaky Gut – One theory suggests that intestinal permeability, ie “leaky gut” or a decrease in the strength of the intestinal barrier, sets off inflammation and potentially leads to diseases like Parkinson’s. Mucosal damage is a risk factor for Parkinson’s – a study involving 9,350 patients with no history of Parkinson’s who had an endoscopy between 2000 and 2005 found that mucosal damage (erosion, break, or sore in the mucous lining of the gastrointestinal tract) as associated with a 76% greater risk of developing Parkinson’s in the 15-year follow-up period of the study. This damage could include esophagitis, ulcer, or peptic injury. 

More Reading: 

● PARKINSON’S MAY BEGIN IN THE GUT, STUDY SAYS, ADDING TO GROWING EVIDENCE. The Washington Post, Oct 10, 2024 

● VITAMIN B DEFICIENCY IN GUT LINKED TO PARKINSON’S. Neuroscience News, June 18, 2024