Webinar Recap: A Healthy Diet’s Influence on Parkinson’s Disease

While there are aspects of our health that are beyond our control (i.e., genetics), what we eat is one of the key elements of our health that is under our control. Recently, Jessica Schroeder, a registered dietitian nutritionist, was our featured guest on a special episode of Dr. Gilbert Hosts to discuss how different foods can help you live your best life with Parkinson’s disease (PD) and how to make wise food choices. Jessica presented different nutritious food options, best diet tips, and recipes designed to help some common PD symptoms.

You can watch the full episode or tune in for the symptom(s) or question(s) that interests you most:

Timestamps

2:23 Foods to help with constipation
4:32 Foods to help with orthostatic hypotension
7:33 Foods to combat unintended weight loss
9:51 Food choices when managing medications and protein intake
12:27 Foods to help with gastroparesis or delayed gastric emptying

Q+A Segment

15:47 How much water do you recommend drinking in a day?
17:20 How do you balance the need to drink water and urinary symptoms?
18:32 Can you take sodium pills to increase your sodium intake?
19:42 What are your thoughts on eating meat as a protein source, or are vegetable-based proteins better?
21:27 I don’t get hungry. How do I eat when I have no appetite?
22:43 Can someone with Parkinson’s eat dairy?
25:05 How bad is sugar for someone with PD? Should I avoid it entirely?
26:59 Do you have any dietary recommendations for leg cramps?
29:37 What are your thoughts on eating gluten?
30:48 Can I drink alcohol with Parkinson’s?
31:54 Are there any diets that will help me sleep better?
33:23 Are there specific diets that you recommend, such as the Whole 30 diet? The Soul Diet? The Keto Diet?
35:21 Do you recommend any dietary supplements?
36:47 What about if you have diabetes and Parkinson’s?
38:07 What foods contain antioxidants, and are they good for people with Parkinson’s?
39:33 What are good foods to serve to someone with swallowing difficulty?
40:51 What are your thoughts on using foods to support the microbiome?
42:29 How should I arrange protein intake with medication doses?
45:42 Should I be eating ancient grains, e.g., quinoa, millet?
46:33 What are good foods to prepare easily if you are having motor difficulties or tremor?
48:18 What about foods to help fight fatigue?
49:44 Are there foods to avoid in Parkinson’s disease?

Jessica’s Expert Insights on Symptom Management Through Nutrition

During the episode, Jessica addressed five common Parkinson’s disease symptoms and shared food options and nutrition tips to help alleviate them. Below is a summary of what she shared during the program.

#1: Nutrition for Constipation

• Goals: Emphasis on fiber, water, magnesium
• Food recommendations: Snack plate with almonds, apples, dry roasted edamame, vegetables, crackers, and smoked salmon

Description: Constipation is a common non-motor symptom for people with Parkinson’s. Constipation can be managed through lifestyle in different ways such as increasing water consumption, daily movement, and consuming a variety of foods that are high in fiber. Fiber helps to bulk and soften the stool, which can help you go to the bathroom. Foods that are high in fiber include fruits, vegetables, whole grains, oats, flaxseed, beans, peas, lentils, nuts, and seeds. A good daily goal is more than 25g of fiber for women and more than 38g for men. Magnesium can also help with constipation, and you can find that in green leafy vegetables, seeds, almonds, black beans, edamame, peanut butter, yogurt, oatmeal, salmon, and avocado.

#2: Nutrition for Orthostatic Hypotension

• Goals: Emphasis on water, sodium, electrolytes, and small frequent meals
• Food recommendations: Turkey chili with cornbread and cottage cheese

Description: Orthostatic hypotension is another common complication of Parkinson’s disease as well as a common side effect of some PD medications. Orthostatic hypotension is a condition in which your body does not properly regulate your blood pressure when you change position, particularly when you go from lying or sitting to standing up. When you stand up, you may therefore have a sudden drop in blood pressure resulting in dizziness, light headedness, nausea, weakness, or fatigue. The good news is that one of the easiest and best ways to improve this symptom is through sodium intake! Jessica recommended turkey chili as an example of a way to increase sodium in a healthy way. The recipe she shared (also available below) is filled with a mix of fresh vegetables, canned tomato sauce, and canned black beans. Canned products typically contain a high sodium content.

We can’t always solve every problem with food, due to time limitations and accessibility to items, so that is where convenient electrolyte beverages can come in handy.  One of our main electrolytes is sodium which is prevalent in convenient electrolyte supplements. Electrolyte drinks such as Propel and Gatorade (among others) are sold in bottles as well as in powdered form. LMNT and salt stick tabs are also great options for boosting sodium intake.

#3: Nutrition for Unintended Weight loss

• Goals: Emphasis on healthy fats and calories
• Food recommendations: Peanut butter and jelly, with honey/maple syrup and tortilla

Description: Another possible non-motor symptom of PD is unintended weight loss, which can be related to poor appetite or poor GI motility, such as chronic constipation or delayed gastric emptying. To prevent or halt unintended weight loss, it is important to add calories to your diet, but you need to do so in a healthy way. Foods such as olive oil, avocados, honey, maple syrup, and nuts help us eat more calories in a healthy way. Jessica featured a common favorite food – a PB & J tortilla and showed how you can build your own. Add things like maple syrup, honey, and/or agave nectar. You choose!

#4: Nutrition for Dietary Protein Interaction with Medication Absorption

• Goals: Emphasis on timing of protein intake, not the elimination of protein
• Food recommendations: Oatmeal, berries, two eggs, and chicken sausage (to be consumed 1.5 hours after medication)

Description: Protein is one of the main macronutrients in our diet. It is made up of building blocks called amino acids which are used by our bodies to make hormones and enzymes as well as to help build and maintain our muscles. Muscle helps to maintain stature, give strength, and protect our bones. Protein is therefore a key element in preventing falls and preventing fractures in the event of a fall.  

However, for some people, intake of dietary protein can decrease the absorption of levodopa, the mainstay medication for the treatment of PD motor symptoms. This is known as the “protein effect” which you can read more about in a blog dedicated to this topic. If protein is affecting the absorption of your levodopa, it can be tricky to time your medications, but here is one potential solution to ingesting enough protein without it interfering with your medication absorption:

Start with your medication schedule and work your food around that

Foods ingested close to your medication can be non-protein, and then ingest the protein a bit later.

Here is a sample daily routine:

• 6:30am: Wake up, take meds with water
• 7am: Oatmeal with berries (non-protein breakfast)
• 8:30am: Eggs with chicken sausage (protein breakfast)
• 10am: 2^nd dose of meds with water
• 10:30am: Apple and crackers (non-protein snack)
• 12pm: 4-5oz meat with 1-2 cups veggies (protein lunch)
• 2pm: 3^rd dose of meds with water
• 2:30pm: Crackers or toast with butter (non-protein snack)
• 4pm: PB & J tortilla (protein snack)
• 6pm: 4^th dose of meds with water
• 7pm:  Veggie sticks (non-protein snack)
• 8pm: Turkey chili (protein dinner)

Another way to handle the protein effect is to ingest your daily protein at the end of the day, so that you do not have the protein effect during the day when you need to be most active.

#5: Nutrition for Delayed Gastric Emptying/Gastroparesis

• Goals: Emphasis on smaller meals, and/or ground up/liquid meals for easier digestion
• Food recommendations: Pumpkin soup and chicken bites

Description: Gastroparesis, or delayed gastric emptying, is a condition that affects the normal spontaneous movement of the muscles in your stomach. When these muscle contractions slow down preventing the stomach from emptying properly, the resulting symptoms can be vomiting, nausea, abdominal bloating and pain, weight loss, and malnutrition. To help ease these symptoms, focus on smaller meals to help the body digest more easily. Eating ground-up foods with added liquid can help digestibility. Jessica shared a favorite fall recipe that is easy to make – pumpkin soup! (see below for the recipe). Chicken bites can be purchased pre-grilled and diced at your local grocery store, making this meal not only fast and easy to make but also easier to digest.

Recipes from Dr. Gilbert Hosts: Nutrition & Parkinson’s Disease

Instant Pot Veggie-Loaded Turkey Chili

Pot Veggie-Loaded Turkey Chili, a hearty dish that aligns with a nutrition-conscious approach to managing Parkinson’s disease.

Ingredients:

·         1 lb. ground turkey (may sub beef or chicken)
·         1 tbsp olive oil or avocado oil
·         3 large garlic cloves, minced
·         ½ medium onion, diced
·         1 bell pepper, diced
·         1 small zucchini, diced
·         1 medium carrot, diced
·         2 tbsp. chili powder
·         1 tbsp. ground cumin
·         1 tsp. dried oregano
·         1 (15-ounce) can tomato sauce and 1 can of water or broth
·         1 (10-ounce) can diced tomatoes with green chiles (or 15 oz. can fire-roasted tomatoes)
·         1 (15-ounce) can black beans, drained and rinsed
·         1 cup corn, frozen
·         Salt and pepper, to taste

Optional toppings: Diced avocado, chopped cilantro, green onion, shredded cheese, sour cream or Greek yogurt and/or lime wedges for serving

Instructions:

1. Select ‘Saute’ on the Instant Pot and add the oil. Once the oil is hot, add ground beef, garlic, onions, bell pepper, zucchini, and carrots and sauté for 7-9 minutes or until meat is cooked and no longer pink.
2. Add chili powder, cumin, oregano, tomato sauce, water or broth, diced tomatoes, black beans, and corn. Stir to combine. Lock lid into place and flip valve to sealing position.
3. Cook on high pressure for 8 minutes. Allow for 10-15 minutes of natural pressure release before flipping value to venting position to release any remaining pressure.
4. Serve with toppings of choice.

Pumpkin Soup

Nourish your body with a bowl of delectable Pumpkin Soup thoughtfully prepared to complement the dietary needs of individuals managing Parkinson’s disease.

Ingredients:

• 1 can (15oz) unflavored pumpkin puree
• 1 tbsp honey
• 1 tbsp unsalted butter
• 1 cup chicken bone broth
• 2 tbsp topping of choice such as hazelnut, almonds, pistachios, pepitas
• 1 tbsp topping of choice such as chives, green onions or other

Directions:

1. Combine pumpkin, honey, butter, and broth in a medium saucepan and heat the mixture on low until completely warmed through. Add salt and pepper to taste.
2. Top with desired amount of toppings.
3. Serve warm.
4. Enjoy!

Tips and Takeaways

• Diet can be an important component in managing certain PD symptoms.
• Watch the entire episode of Dr. Gilbert Hosts: Nutrition & Parkinson’s Disease with Jessica Schroeder, RDN.
• To learn more about nutrition and PD, read our fact sheet, or check out this blog post about MIND and Mediterranean diets for people with PD.