Good nutrition plays a particularly critical role for individuals with Parkinson’s disease (PD). A balanced diet helps to maintain your energy, contributes to brain health, maximizes the potential of medications, and promotes wellbeing (American Parkinson Disease Association, 2009). Each individual’s needs for nutritional intake will vary, so it is prudent to consult with a healthcare professional to determine what is best. Outpatient nutrition counselling is also available at many hospitals with a referral.

Generally, a balanced diet involves eating regularly and not skipping meals, eating from a variety of food groups, and eating to maintain a healthy weight (Traviss, 2007). Following the guidelines provided in the Canadian Food Guide will ensure that you make the best decisions possible regarding your dietary choices. While the latest Canadian Food Guide has entirely removed serving numbers and sizes, its advice is broken down into four straightforward points: have plenty of vegetables and fruits, choose whole grain foods, eat protein foods, and make water your drink of choice.

While this may seem like simple advice, some people with Parkinson’s may find it challenging to ensure they are eating a balanced diet due to their lifestyle or symptoms, which may affect the ability to shop, prepare food, and eat. You may find it helpful to seek assistance from others for shopping and meal preparation (Traviss, 2007).

Parkinson’s Diet

Research has provided some evidence on the possible benefits of certain foods; currently, no singular diet has been shown to treat Parkinson’s disease or its symptoms, but a healthy and balanced diet can improve general well-being (Michael J Fox Foundation, n.d.). So, what can you eat as part of an informed diet? Look for foods that are neuroprotective, anti-inflammatory, and antioxidant-rich.

• Neuroprotective foods have been studied for their potential to improve brain health. Nuts have shown the most promise; however, they are high in calories, so your intake should be limited to a handful per day. Consider making a healthy granola for breakfast with chopped nuts and dried fruit, but skip the oatmeal and grains. If you have trouble swallowing, you can incorporate a nut butter into your diet instead. In addition to nuts, some herbs and spices have been shown to keep the brain healthy. These include turmeric, ceylon cinnamon, and rosemary. Additionally, blueberries, which are high in polyphenols (a class of compounds that are present in many plant-based foods), have also shown neuroprotective effects (Neurology Solutions).
• Anti-inflammatory foods may be useful in keeping the brain healthy. The types of fat you consume are important in reducing inflammation. One type of oil that appears to have positive benefits is coconut oil, and you can cook with it as you would with olive oil. Other foods that are considered to have anti-inflammatory properties are dark, leafy greens, such as kale, spinach, and collard greens, soy products like tofu, and oily fish like salmon, tuna, and mackerel (Zwickey, 2016).
• Antioxidants are “substances that may protect your cells against the effects of free radicals, which are molecules produced when your body breaks down food, or is exposed to tobacco smoke and radiation” (Mayo Clinic). Essentially, free radicals are toxic substances formed from stressors. When you have too many free radicals, the body is said to be under oxidative stress. A diet high in antioxidants may offset cellular damage and oxidative stress (MJFF). Look for fruits that are colourful in rich hues of purple, red or blue, such as blueberries,raspberries, and blackberries. These berries contain pigments called anthocyanins, which are well-known antioxidants (Zwickey, 2016).

Diet and Medication

Your mealtimes may affect how quickly medications are absorbed into your body. For example, some individuals who take carbidopa-levodopa (SINEMET®) may find that protein-rich foods increase the time it takes for their medication to kick in, or make it less effective (Zwickey, 2016). If you find that this is an issue for you, try taking your carbidopa-levodopa 30 minutes before your meal with a carbohydrate food, such as a cracker or biscuit (Parkinson’s UK, 2012).

However, people with Parkinson’s should not excessively limit protein intake. In fact, for optimal health, individuals with PD require at least 0.8 grams of protein per kilogram of body weight daily. When someone becomes deficient in protein, they can experience a number of adverse health outcomes, including weight and muscle loss, slow healing of wounds, and greater susceptibility to disease (American Parkinson Disease Association, 2009).

The absorption of levodopa is also influenced by dietary carbohydrates, which prompt the release of insulin, resulting in decreased blood levels of large neutral amino acids. A reduction in these amino acids can potentially improve the transportation of levodopa to the brain. Therefore, maintaining a diet where 55 to 60 percent of the calories come from carbohydrates is advisable for people with PD (American Parkinson Disease Association, 2009).

Pyridoxine, or vitamin B6, has also been found to reduce the effects of levodopa, when levodopa is taken on its own. It is recommended that if you are taking levodopa by itself, you avoid taking products containing B6 unless specifically discussed and prescribed by your doctor. Foods such as bananas, egg yolks, lima beans, meats, peanuts, and whole grain cereals contain large amounts of pyridoxine. Check with your doctor as to how much of these foods should be in your diet while taking levodopa (Mayo Clinic, 2015).

Dopamine agonists usually do not have any dietary restrictions associated with their use, as they do not compete for absorption with protein in the way levodopa does. However, these drugs can cause nausea, so your doctor may suggest you take your medication with food (Michael J Fox Foundation, n.d.). Another class of drugs used for Parkinson’s disease called MAO-B inhibitors require dietary modifications due to the fact they raise levels of tyramine, a naturally-occurring substance found in foods like alcohol, aged cheese, and fermented foods. Combining these foods with MAO-B inhibitors can increase tyramine levels beyond what is safe, resulting in raised blood pressure (Michael J Fox Foundation, n.d.).

Constipation

Constipation occurs when stools are hard and difficult to pass, or when a person has infrequent bowel movements. It is a common symptom of PD and may cause poor absorption of medication (Parkinson’s UK, 2013). While you may feel that this is a difficult or embarrassing issue to raise, it is critical to discuss it with your healthcare provider, as severe constipation can lead to bowel obstruction, a potentially life-threatening condition. There are, however, some steps you can take to help relieve constipation:

• Incorporate more fibre-rich foods into your diet. Foods such as whole grain bread, pasta, brown rice, fruits and vegetables, and breakfast cereals containing wheat bran or oats, will absorb fluid and form a soft stool that can be passed more easily. Although you may think it is an easy fix to add loose extra bran to your food, it is not recommended, as this can lead to bloating and reduced absorption of vitamins and minerals.
• Drink more fluids. It is recommended that you drink eight to 10 cups of water every day. You can count any fluid intake from healthy fruit juices, milk, and tea towards this amount. Try to avoid carbonated drinks, as they cause some people to feel bloated (Parkinson’s UK, 2012). Additionally, alcohol and caffeine are diuretics, which means they cause you to urinate more frequently. Enjoy both in moderation.
• Exercise to improve regularity. Anything that gets you out and moving can help you maintain a healthy digestive tract.
• Consider taking probiotic supplements, though be sure to check with your doctor if you have any questions.

Bone Health

Osteoporosis is caused by a low bone-mineral density. Risk factors include old age, low body weight, smoking, excessive alcohol consumption, limited exposure to sunlight, adequate intake of vitamin D and calcium, and lack of weight-bearing exercise.

Calcium can be obtained from a wide variety of foods, including nuts and seeds, legumes, dark leafy greens, starchy foods, or dairy/dairy alternative products. Vitamin D is primarily obtained from sun exposure, and present in fatty fish, and fortified food products like milk, yogurt, or breakfast cereals. Due to the fact that individuals with Parkinson’s disease are at an increased risk of falling, having osteoporosis can be particularly worrisome. Talk to your doctor about having your bone-mineral density checked, as medical treatments may be available (Traviss, 2007).

The information contained in this helpsheet is for general information purposes only. Any changes to your treatment or course of therapy, including dietary additions or restrictions, should be made in consultation with a physician or other qualified healthcare professional.

Additional Resources

Dietician Services | HealthLink BC | www.healthlinkbc.ca/dietitian-services | 8-1-1

Canada’s Food Guide (2023) | www.food-guide.canada.ca

Dieticians of Canada | www.dietitians.ca 

Osteoporosis Society of Canada | www.osteoporosis.ca

Sources

American Parkinson Disease Association (APDA). (2009). Good Nutrition and Parkinson’s Disease. www.apdaparkinson.org/uploads/files/Good-Nutrition-book-iEQ.pdf

Mayo Clinic. (2015). Carbidopa and Levodopa (Oral Route): Proper Use. www.mayoclinic.org/drugs-supplements/carbidopa-and-levodopa-oral-route/proper-use/drg-20095211

Mayo Clinic. (n.d.). Antioxidants: Why are they important? www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/multimedia/antioxidants/sls-20076428

Michael J. Fox Foundation (MJFF). (n.d.). Good Nutrition for Parkinson’s Patients. www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?nutrition

Neurology Solutions (n.d.). DASH Diet Recommended for People with Parkinson’s. www.neurologysolutions.com/dash-diet-recommended-for-people-with-parkinsons

Parkinson’s UK. (2012). Diet and Parkinson’s. www.parkinsons.org.uk/information-and-support/diet

Parkinson’s UK. (2013). How to manage bladder and bowel problems in Parkinson’s. www.parkinsons.org.uk/information-and-support/your-magazine/spotlight/how-manage-bladder-and-bowel-problems-parkinsons

Traviss, Karol. (2007). Nutrition and Parkinson’s Disease: What Matters Most? http://www.pdf.org/en/winter06_07_Nutrition_and_Parkinson

Zwickey, H. (2016). Nutritional Strategies for Living With Parkinson’s. www.pdf.org/winter16_nutrition

Last updated: August 23, 2023