Dietary intake of Parkinson's disease patients
Original author: Baert F, Matthys C, et al. (2020) (DOI: 10.3389/fnut.2020.00105)
Jr. Economist intern
December 13, 2022
Parkinson's disease is the second most prevalent neurodegenerative disorder. Often, dietary management is supplemented as adjuvant therapy. Therefore, dietary-relevant studies may grant an interesting insight into the diet of PD patients and may provide insight as to how to reduce the intensity of various symptoms, thus, improving the patient's quality of life.
In 2011, the British Dietetics Association (BDA) in partnership with Parkinson’s UK produced a best practice guideline for dieticians on the management of Parkinson's disease, emphasizing the importance of nutritional management in different stages of neurodegenerative disorder. Although no specific diet is required, different symptoms or consequences of PD should be taken into consideration. Not only nutrient composition but also the timing of consumption of meals plays a major role in PD management.
Some studies suggest the amount of dietary protein intake is important in PD, as amino acids and levodopa (the most frequently used drug in PD) are absorbed via the large-neutral amino acid transporter, both at the level of the small intestine and the blood-brain barrier. Some other studies suggest a protective effect on the intake of different vitamins and antioxidants in PD but require further investigation. A ketonic diet is also proposed as a treatment for motor dysfunction in neurological disease but lacks clinical data and the risk of adverse effects currently prevents their therapeutic use.
This paper describes the nutrient intake of Belgian PD patients, compare these intakes to the general nutritional recommendations, and further investigates their medical-taking behavior and knowledge of potential food-drug interactions.
An observational, cross-sectional study was conducted. The samples of PD patients were recruited through participation in cooking workshops, and the inclusion criteria were self-reported diagnosis of PD and self-reported intake of any type of PD medication, cross-checked by the research team and the patient's physician. The record was completed during 2 non-consecutive days in the week before the workshop and included dietary and timing of medication intake. The record of 2 non-consecutive was chosen since they are the minimum number of days needed to properly estimate an individual’s intake.
The general questionnaire was completed during the workshop which comprised multiple-choice questions about the socio-demographic characteristics, medication use, changes in the diet and their underlying reason, knowledge about food-drug interactions, and the sources of information concerning food-drug interactions.
For the determination of nutrient intake, the Belgian Food Composition Data Base was used. Based on the actual intake, the usual dietary intake was calculated using the Multiple Source Method. Later, the percentage of macronutrients of the daily total energy was calculated using Atwater factors. Also, the energy intake of participants was compared with the average requirements of men and women (aged 60-70) based on energy intake using the physical activity level (PAL) 1.4-1.8. Micronutrient intake was compared with Estimated Average Requirements (age categories 19-70+), to determine the prevalence of inadequate intake using the EAR cut-off method.
The normality of data was assessed using the Shapiro-Wilk test. If the data was not normally distributed, Mann-Whitney U-test was employed. Possible associations between categorical data of different socio-demographic characteristics were analyzed using Pearson's Chi-square test. A student's t-test was used to analyze the difference in nutrient intake according to gender.
In total, 52 men and 22 women aged 49-84 years were included in the study. Records showing incompleteness of data or non-compliance to the instructions were excluded.
Both the nutrients, that is, micro and macro, intake in this study were like the dietary pattern of the general Belgian population. However, results showed that the PD population had a high dietary fiber intake of 26.2±7.7 g/day, which was in line with the recommended intake. Most PD patients had an adequate intake of vitamin D and iron. When looking at food-drug interactions, most PD patients claimed to be aware of the interaction between dietary proteins and levodopa.
Thus, the results from the study showed that monitoring dietary intake in PD patients is important to detect possible micronutrient insufficiencies. Moreover, the knowledge of patients regarding the importance of correct medication intake should be improved.