Maintaining good nutritional status may protect Parkinson’s patients from greater motor impairments associated with weight loss, according to new research.
The study, “Untangling the relationship between fat distribution, nutritional status and Parkinson’s disease severity,” was published in the journal Aging Clinical and Experimental Research.
Malnutrition may be a contributing factor for weight loss in Parkinson’s, as a significant proportion of these patients are at risk of developing an inadequate nutritional status. Malnutrition may aggravate motor symptoms, which then may be associated with other complications, such as depression or cognitive decline.
A team of international researchers explored the link between Parkinson’s severity and obesity, focusing on whether excess fat was deposited at the hip and thigh areas (gynoid), or at the abdominal region (android). The investigators also assessed if nutritional status might alter the association between disease severity and fat distribution.
A total of 195 Parkinson’s patients (mean age 73.6, 124 men) were included, all admitted to a geriatric day hospital in Rome from January 2012 to December 2015. The participants underwent dual-energy X-ray absorptiometry to assess body composition, as well as determinations of body weight, height, and BMI.
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Total abdominal and gynoid fat were evaluated, as were patients’ nutritional status, severity of motor symptoms, cognition, functional ability, and depressive symptoms.
The findings revealed that patients with better motor function were more likely men, more educated and had better cognitive function, mood, functional status, and nutritional status. Also, improved motor scores (as determined by the Unified Parkinson’s Disease Rating Scale part III ((UPDRS III)) correlated with higher total body fat, percentage of abdominal fat, trunk-leg and trunk-limb fat ratios, as well as abdominal-gynoid fat ratio.
However, after accounting for nutritional status, only the percentage of abdominal fat and trunk-leg fat ratio were still associated with UPDRS III scores. Further analysis revealed that a greater abdominal fat distribution was linked with less severe motor impairment, but only with patients with a Mini-Nutritional Assessment score lower than 23.5, which indicates risk for malnutrition or overt malnutrition.
“In other words, a good nutritional status might protect [Parkinson’s] patients from weight loss associated with disease severity,” researchers wrote.
At the same time, higher percentage of gynoid fat was associated with worse motor function in patients with a MNA score not lower than 23.5.
“The main result of our study is that nutritional status drives the association between total and regional adiposity [fat storage] and disease severity in Parkinson’s disease patients,” the team commented. “In this regard, the early detection of malnutrition or risk of malnutrition in subjects with [Parkinson’s] is warranted.”