Food and Parkinson’s: Relearning How to Eat

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by Dr. C |

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Relearning how to eat with Parkinson’s disease is more than being mindful of mouth movements. It requires careful observations of the motivations behind what food to eat, when, and how much.

Relearning how to eat required me to examine the drive to start eating and the desire to stop eating. Both are influenced by much more than being hungry. There are habits, emotions, cravings, and cultural practices that affect my food intake.

The first habit to change was not eating three big meals a day at culturally prescribed times. I can’t do big meals with Parkinson’s. I need to eat when I’m not in an “off” period. The off period puts too much stress on my body to burden it with food intake. I need smaller portions four or five times a day.

I schedule consumption of heavy protein at lunch. Sometimes my high-protein meal of the day is a late breakfast, but never dinner or my late-night meal. Those evening meals occur during my off period and need to be light, consisting mostly of grains and vegetables.

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Getting the portion size down to “fist size” for every meal took more than a year. The trick was to be mindful of that very first tickle of fullness that signals I’ve eaten enough. Surprisingly, I found myself often eating beyond this initial food satiation response.

My sense of “hunger” was influenced by habit, cravings, or an obligation to clean my plate. Portion control and meal timing help, but attention to my relationship with eating is equally important. That has taken priority over the feel-good effects that usually accompany sugar consumption (particularly ice cream, in my case).

I have a love-hate relationship with ice cream. I love it as it goes down — and hate what it does to me after. It’s 15 minutes of pleasure followed by 15 hours of discomfort due to an allergic histamine response and inflammation. My entire body rebels.

Chronic disease, like Parkinson’s, is driven by inflammation. According to an article in the Journal of the American College of Nutrition, a diet rich in colorful, nonstarchy vegetables inhibits inflammation.

An article in Aging and Disease notes that, “As one of non-motor manifestations in PD, intestinal dysfunction has the prevalence as high as 77%-81%, including constipation, small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), Helicobacter pylori (H. pylori) infection, diarrhea and inflammatory bowel disease (IBD).” All of these are signs of inflammation in Parkinson’s.

As Thomas Holland, MD, of Rush University told MedPage Today, “A higher dietary intake of flavonoids through a diet diverse in fruits and vegetables has the potential to be protective and perhaps slow disease progression.”

It’s currently understood that most, if not all, neurodegenerative disease processes involve some degree of inflammation and oxidative stress. It’s important to ensure our diets are rich in foods that have a diverse quantity and quality of nutrients and bioactive compounds, which can be found in foods like fruits, vegetables, nuts, oils, and whole grains, and that they promote good health.

It’s difficult to eliminate soda, candy, cookies, cake, and ice cream from my diet. But I found a trick that made it easier. Mrs. Dr. C makes homemade dark chocolate bars for me with nuts and dried cherries. Not only does the dark chocolate curb the sugar cravings, but it also has an added benefit of damping down the “flicker effect” at night, which disrupts my sleep.

The research on chocolate and Parkinson’s suggests positive effects. Chocolate contains phenylethylamine, which functions as a neuromodulator. Phenylethylamine increases dopamine levels, which can help patients cope with symptoms.

Of course, one must be careful of cravings during chocolate consumption. Food cravings and compulsive eating can be loud and intrusive with Parkinson’s. I work through this with a strict regimen of timing (only with meals and before bed) and limited amounts (about a quarter-cup). With meal portion size under control, my weight doesn’t expand with the increased chocolate consumption.

Trading off the feel-good effect for better meals and sitting with the new way of eating required at least 12 months to have consistent positive effects. A thorough article published in the journal Biomedicines relates the benefits of evaluating and adapting one’s diet to chronic disease and aging.

The temptation to eat whatever and whenever is constant. It’s always an effort, and I still fail occasionally.

The good news is that I am finally at a point where I can manage food intake, which helps me live better with Parkinson’s. I’ve relearned how to eat by taking the pause between to consider what, when, and how much. It is helping with weight control, my overall health, and self-management of Parkinson’s.


Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

Comments

BARRY BLOCK avatar

BARRY BLOCK

After 4 years of dealing with PD, I've found that the timing of my Sinemet CR is more important than the quantity of the food eaten. My typical day's diet. Wake up at 7AM and take Sinemet #1. Go back to bed. 8AM. Take a 1Gram salt tablet (for orthostatic hypotension. 8AM Eat 4 oz of Fage Greek yogurt with a teaspoon of peanut butter and a cup of coffee. 11 Am I take Sinemet#2. 12:30 I eat a large bowl of oatmeal with some fruit preserve, I have a glass of Gatorade G2 with 2 Citrucel tables (to prevent constipation). At 4 PM I have some fava beans (natural source of L-Dopa) at 5:30: have Sinemet#3. At 6:30 I have dinner (chicken or meat with salad or vegetables. at 9:s0 I have tea with dark chocolate or Ice cream. at 11PM I take sinemet#4 with Colace. This regimen has eliminated most off periods. This works for me.

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Tim. Myers avatar

Tim. Myers

Thank You for the helpful advice !

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Vivian avatar

Vivian

Thanks for the sharing.

Do you experience any PD symptoms while have this plan?

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Lynn avatar

Lynn

I found this article very useful, have recently been diagnosed with Parkinson’s disease and prescribed sinemet plus 3 x daily, I increased gradually and have been taking for 2 months, yesterday I had a total meltdown realised at 7pm I had taken my 1pm meds? Had palpitations, raid heart beat confusion and felt totally lost! No one had actually mentioned to me anything about food and the effects it has on my PD? I had to go to Urgencia today and they reduced my sinemet and prescribed paroxetina after reading this maybe it is my diet? Interested to hear anyone’s thoughts?

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Dr. C. avatar

Dr. C.

Our approach is to live better with the disease. Symptoms do not go away although some days are better than others. It's important, in my mind, to address a healthy lifestyle that can help manage PD. The book "Possibilities with Parkinson's: A Fresh Look" has many helpful suggestions and resources.
Thanks for reading the column!
Dr. C.

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Sveinn Áki Sverrisson avatar

Sveinn Áki Sverrisson

Hi Dr. C Thanks for the interesting articles about Levodopa and Protein and the Bacteria in the Gut. I was diagnosed with PD, in 2009 and was very lucky to get 10 years with little Parkinson's symptoms but then I started to have this "off " bad time. I had to lay down and wait until the Levodopa started to work again. I was a new man and people that saw me before and after the off couldn't believe the difference. In 2018 my Doctor ordered a DBS. I am from Iceland and the operation was done in Sweden. DBS is for me a live saver and I need just 1 tablet of Levodopa every 2 hours a day going from 2 1/2 tablets every 11/2 hours before the DBS. But my stomach problem is unsolved. I coming to be a vegetarian (global warming + PD) and take protein in small dos over the day from energy drinks for the elderly (I am 66 years old Mech. Engineer ). I can see that your passion is writing and Icecream is your friend and enemy at the same time (+15). I think we are alike. I am going to read the articles on your side.
Thangs bg. Sveinn Áki

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Dr. C. avatar

Dr. C.

Hi Ari ~ We may be kindred spirits, although we moved further south to get out of winters. How are you managing in Iceland with the temperatures there? I've gone to a mostly vegetarian diet as well. I appreciate your insight and comment on this article. I look forward to reading more of your thoughts.
Dr. C.

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Priscila Kalevar avatar

Priscila Kalevar

Thank you for your article, It is just what I’m looking for. I plan to reread it, And follow it.

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