Transcript PARKINSON’S DISEASE : NUTRITION MATTERS

PARKINSON’S
DISEASE :
NUTRITION MATTERS
SUSAN BERKOW, PH.D. CNS
PRESIDENT SEB ASSOCIATES
ADJ PROF GEORGE MASON UNIVERISITY
1211 Tatum Drive
Alexandria, VA 22307
[email protected]
www.susanberkow.com
P/F 703 660 6556
Why is nutrition so
important?
• Swallowing problems
• Weight loss, loss of appetite
• Constipation
• Bone thinning
• Dehydration
• Slows stomach emptying and slows gastrointestinal
tract – medication
• Medication interaction
Swallowing problems
• Adequate nutrition
• Weight loss
• Taste, smell, texture may be compromised
• Increased risk for malnutrition
• Recommended Dietary Allowances (RDA)
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1800 Kcal
3 servings each fruits and vegetables
6 servings grain
3 servings dairy
Approximately 5 ounces protein
Unplanned weight loss
• Nausea, loss of appetite, depression, slowed
movement
• Can lead to: weakened immune system,
muscle wasting, loss of vital nutrients and risk
for other diseases
• Loss of 5-10% of normal adult weight – for
example, a 150 pound man loses 15 pounds
(10%) he will be at increased risk for illness and
(death)
Bowel Impaction
• Slowing of colon
• Fiber – 25g/day
• Dry hard feces that are impossible to pass
normally
Bone Thinning
• Men and women
• Malnutrition
• Increased risk of falls
• Calcium, magnesium, vit D and vit K
• Exposure to sunlight
• Supplements: 1200mg Calcium, 800 IU vit D.
• Dairy foods, green leafy vegetables, broccoli
• Weight-bearing exercise
Dehydration
• Medications can raise risk
• Can lead to confusion, weakness, balance
problems, respiratory failure, kidney failure
and death.
• At least 8- 8 ounce glasses water/day
Medications
• Polypharmacy – many medications, some for
other conditions
• Nausea
• Appetite loss
• Edema (fluid retention)
• Compulsive eating and weight gain
levodopa
• Sinemet, Sinemet CR, Madopar, Dopar, Larodopa, Prolopa, Syndopa
• If you take with meal, may take a long time for need to be absorbed
because the stomach takes 1 to 3 hours to empty
• Fat takes even longer to clear the stomach
• Protein from the meal is broken down to amino acids in the intestine..
They have to cross across the intestinal wall to get to the blood. Then
they have to cross the “blood-brain” barrier to get into the brain.
• PD meds (levodopa) use the same carrier system as the amino acids –
competition
• May be necessary to take care with timing of meds and proteincontaining foods.
• Preferably at least 60 minutes before or after a meal
• Nausea
• Ginger tea
• Ginger ale
• Graham crackers
• Controlled release?
• So it can be taken with a meal; however it requires
more time to become effective – recommend also
taking about 60 minutes before meal.
• Therefore, a meal high in protein
combined with Sinemet can seriously
interfere with levodopa absorption,
particularly at the level of the brain
receptors. Research indicates that many
people who experience "on-off" fluctuations can benefit by adjusting their
protein intake.
Protein
• Calculate about ½ gram of protein per pound
of body weight. For example is you weigh 150
pounds, that will be about 75 grams of protein
per day.
• Divide it into three meals and two to three
small snacks. Try for about 20-25 grams of
food for each meal and 5 grams in your snack.
DON’T worry about every single gram. It will
work out over a week.
• Amounts of protein in common foods
• Food
Grams Protein (approximate)
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Bread: 1 slice
3 grams
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Meat ,poultry, fish: 1 ounce
7 grams
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Vegetables: 1/2 cup
2 grams
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Fruit: 1/2 cup
0 grams
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Milk: 8 ounces
8 grams
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Yogurt: 8 ounces
9 grams
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Egg: one large
6 grams
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Cheese: 1 ounce
7 grams
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Cooked dried beans, peas
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Lentils 1 cup
20 grams
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Peanut butter: 1 tablespoon
4 grams
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Nuts: 4 tablespoons (1 ounce)
4 grams