Parkinson’s & a plant based diet Danielle Selden Alicia Armeli

Why we chose this article....

Proof in plants • A concerning underlying problem

with our current method of treatment- its not working long term.

• Two recent studies have shown that a plant-based dietary pattern may protect against PD.

• This peer-reviewed article looks at the effectiveness of a plant-food diet in the management of PD.

Higher Quality of life

Currently there is no cure....

Quick Facts about Parkinson’s Disease (PD): • PD is a chronic progressive movement disorder in which the

neurons that produce dopamine are impaired.

• PD is characterized by slow and decreased movement, muscular rigidly, resting tremor, postural instability, and decreased dopamine transmission to the basal ganglia. Since Dopamine is not available movements can not be controlled.

• Etiology is unclear but is thought to arise from both genetic and environmental factors.

• Treatment includes medication, surgery, and other modalities to manage symptoms.

Introduction

• Preventing a high protein based diet is critical for treatment.

• Levodopa, a prodrug of dopamine (derived from the A.A tyrosine), remains the most effective treatment to alleviate motor dysfunction in PD.

• “The Protein Redistribution Diet” was formulated to avoid

the risk of nutritional deficiencies linked to extreme restriction in total protein intake.

• This intervention consists of a normoproteic diet- a pt’s main protein intake occurs in the evening meal in order to limit the negative interaction of LNAA on L-Dopa’s response at daytime, while the negative effects act up during sleep at night.

Why a plant-food diet?

• A plant-food vegan diet (PFD) is expected to raise L-Dopa availability and bring some advantage in the management of disease.

• This pilot study was designed to establish whether a PFD normoproteic protein redistribution diet can be just as effective as a protein-redistributed OD in improving motor performance in L-Dopa treated PD patients in the short term.

Subjects All 25 participants in the study were PD patients

• 12 were in the intervention group (PDi) and 13 in the control group (PDc), respectively.

• Pt’s have had a good response to levodopa in the past, with a daily dose over 350mg, under 850mg, and over 50 years of age, BMI over 18.5 and under 30.

• Pt’s were already following advices to limit total animal protein and to concentrate them in an evening meal in the context of an OD.

• Pt’s were given the choice to consume the PFD or the usual OD for a 4-week period.

Methods and Measures

• A quasi-experimental non-equivalent group design (NEGD) was utilized.

• The PD intervention (PDi) diet/vegan diet- includes plant-protein rich sources only for dinner (2/3 of total daily intake of PRO)

• The control group (PDc)/omnivorous diet- limited total animal food and concentrated them in the evening meal

• Neurological assessments were made by an experienced neurologist using the comprehensive PD measurement tool United Parkinson’s Disease rating system • Mann-Whitney • Sun Score• Hoehn and Yahr

Results

• After 4 weeks the PDi group showed a significant

reduction with respect to the PDc group in...

• Metabolic changes in the PDi group- total cholesterol, HDL cholesterol, apo-A1, and apo-B showed significant differences after 4 weeks.

PDi PDc(Mann-Whitney Test) UPDRS Total Score [P=0.008]

47.67 74.46

Sub-score III-Motor Performance [P=0.001]

25.42 46.46

Modified HY Scale [P=0.005]

1.96 3.15

Limitations

• Lack of random assignment of subjects to intervention or control groups.

• Both groups have small sample sizes.

• Short study time- 4 weeks.

• Lack of blood measurements of levodopa and dietary LNAA at the enrolment and after 4 weeks.

Conclusions

• This study showed after 4 weeks of a PFD in the PDi had a value 27 points (47.67 vs. 74.46) lower than the PDc group, a result that is clinically relevant.

• Due to its high fiber content, a PFD can potentially raise levodopa bioavailability by reducing the phenomenon of constipation.

• Consumption of a PFD is may be more effective than an OD for improving motor performances in PD pts.

• Additional studies need to be performed, especially longitudinal randomized trails of larger groups

A comprehensive plan for PD Patients

• Increase Antioxidants/ phytochemicals and mitochondrial stabilizers:• CoQ10 and Vitamin E • Vitamin D and Omega 3’s • Magnesium • Alpha lipoic acid

• Fava Beans- 3oz. Contain levodopa• Vegan diet • Acupuncture- shows reduced sxs• Massage- anecdotal evidence of reduced sxs

References Baroni L, Bonetto C, Tessan F, Goldin D, Cenci L, Magnanini P, Zuliani. Pilot dietary study with normoproteic protein-redistributed plant-food diet and motor performance in patients with Parkinson’s disease. Nutritional Neuroscience. 2011;14:1:1-9.

Mahan K L, Escott-Stump S, Raymond J L. Krause’s Food and the Nutrition Care. St. Louis, MO: Elsevier Saunders; 2012: 675-708. Parkinson’s Disease Foundation. Available at: http://www.pdf.org. Accessed May 30, 2012.

The Parkinson’s Foundation. Available at http://www.parkinson.org. Accessed May 31, 2012.

The Natural Standard. Parkinson’s Disease. Available at http://www.naturalstandard.com. Accessed May 30, 2012.