Summary:
This study is a narrative review that examined evidence on dietary patterns and nutritional supplements in Parkinson’s disease (PD). Nutrition may influence disease risk, progression, symptom severity, and quality of life. PD can affect appetite, food intake, and nutrient status, and around one-third of people with PD are at risk of malnutrition. The strongest evidence supports plant-rich dietary patterns, particularly the Mediterranean and MIND diets, which emphasize vegetables, fruits, legumes, whole grains, nuts, seeds, fish, lean meats, and healthy fats while limiting processed foods and added sugars. Greater adherence to these diets was associated with a lower risk of developing PD, slower disease progression, later disease onset, and improved survival. This study also reviewed ketogenic diets, which may help address impaired energy metabolism in PD. Some randomized controlled trials reported improvements in cognition, anxiety, voice function, and other non-motor symptoms. Higher dairy intake was associated with increased PD risk, although findings were inconsistent across different dairy products. Evidence regarding alcohol was inconclusive. Caffeine-containing beverages were associated with reduced PD risk and slower progression in observational studies, but caffeine supplements alone did not demonstrate clinical benefits. Higher consumption of fried foods, processed foods, soft drinks, and sweets was associated with faster disease progression. Among nutritional supplements, the strongest evidence was for omega-3 fatty acids combined with vitamin E, which improved symptoms, reduced inflammation, and increased antioxidant capacity in randomized controlled trials. Probiotics also showed promising effects on motor symptoms, non-motor symptoms, depression, and gastrointestinal function. Overall, this study concluded that nutrition is an important component of PD management, and the most consistent evidence supports high-quality, fiber-rich dietary patterns. However, while several nutritional strategies and supplements appear promising, high-quality randomized controlled trials remain limited.
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Abstract:
The aim of this review is to examine the intersection of Parkinson’s disease (PD) with nutrition, to identify best nutritional practices based on current evidence, and to identify gaps in the evidence and suggest future directions. Epidemiological work has linked various dietary patterns and food groups to changes in PD risk; however, fewer studies have evaluated the role of various diets, dietary components, and supplements in the management of established PD. There is substantial interest in exploring the role of diet-related interventions in both symptomatic management and potential disease modification. In this paper, we evaluate the utility of several dietary patterns, including the Mediterranean (MeDi), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND), Alternative Healthy Eating Index (AHEI), vegan/vegetarian, and ketogenic diet in persons with PD. Additionally, we provide an overview of the evidence relating several individual food groups and nutritional supplements to PD risk, symptoms and progression.
Article Publication Date: 13/08/2024
DOI: 10.3233/JPD-230264
