Credit: Hardy Jones, member PDF Creativity and Parkinson's Project
Nuts & PD
How many should you eat?
- Walnuts: five to 10 each day.
- Pistachios: a few two or three times a week.
- Macadamia nuts: a few per day.
- Cashews and Almonds: in moderation.
- Brazil nuts: no more than one or two a day.
These tips come from Dr. Heather Zwickey.
Good nutrition is essential to living well with Parkinson’s disease (PD).
While there is no prescription for a PD-specific diet, to maintain overall good health most people living with Parkinson’s should eat a variety of whole grains, vegetables, fruits, milk and dairy products, and protein-rich foods such as meat and beans. Consider also including nuts, olive oil, fish and eggs to your diet, for their beneficial fats.
In addition, you can choose foods to optimize your medications and help to ease Parkinson’s disease symptoms.
What to Know: Benefits
Paying attention to diet may help to ease certain PD symptoms.
- Digestive difficulties/constipation: drink enough water (six glasses a day) and eat fiber-rich foods, including brown rice, whole grains (breads with three grams or more of dietary fiber per slice), fruit and beans.
- Medication management and overall symptom control: take your medications with a full glass of water. It may help the medication to be broken down by the body more efficiently.
- Fatigue and sleep difficulties: limit sugar intake, alcohol and caffeine particularly before bed, as they may interrupt sleep.
- Bone thinning: Vitamin D, found in fortified milk and milk products, helps maintain bone health. Ask your doctor about taking a vitamin D supplement.
- Brain health: early research suggests that walnuts, cashews and other nuts, in small quantities (see box at right), promote brain health. Berries contain beneficial antioxidants. Foods that may have anti-inflammatory effects in the brain include salmon, tuna and dark leafy green vegetables.
What to Know: Challenges
- Food and PD medications: Diet can impact your PD medications and vice versa. Levodopa medications, such as Sinemet®, carbidopa/levodopa extended-release capsules (Rytary®) or carbidopa/levodopa/entacapone (Stalevo®), work best on an empty stomach; however for some people, the nausea caused by the drugs will make this impossible. For others, taking PD medications close to a protein-rich meal (e.g., meat, fish, eggs, dairy products, nuts and beans), may interfere with the absorption of the drug in the blood, causing it to work more slowly or less effectively. Talk to your doctor about the right option for you, whether taking the drug on an empty stomach or with a small snack, such as crackers or applesauce.
- Unintended weight loss: People with PD may eat less and lose weight because of difficulty swallowing, nausea from medications, or movement symptoms that make it difficult to eat. Address these issues, and also consider adding foods with healthy fats — nuts and nut butters, and avocado — to your diet. Try bitter greens or spicy foods to stimulate your appetite. Exercise to increase hunger.
- PD symptoms and eating: Due to Parkinson's symptoms such as tremor, stiffness or swallowing difficulties, eating certain foods may become challenging. Try eating foods that are easy to swallow. Put dishes on rubber mats to prevent them from slipping. Try weighted utensils and cups, and/or cups with lids or straws.
- Urinary Issues: Staying hydrated is important, but if drinking water leads to urinary urgency, try eating foods with a high water content in place of beverages, such as celery, butternut squash, grapefruit, strawberries and watermelon.
Tips for Getting Started
- Changing your diet can be difficult. Try making one change at a time, like eating a handful of nuts a few times a week, or avoiding white bread. Small changes can add up to big benefits.
- Consult with a registered dietician, who can help you plan menus and make shopping lists for preparing nutritious meals that you like, and that account for your individual needs and the timing of your medications.
- Consult with an occupational therapist about assistive devices, including some mentioned above, to make eating and drinking easier. (Learn more about occupational therapy here.)
- If you experience anxiety or depression, talk to your doctor. These symptoms can suppress appetite. (Learn more about these symptoms here and here respectively.)
- If swallowing issues are creating problems with eating talk to your doctor about working with a speech and language pathologist to ease those issues (Learn more about swallowing issues in PD here.)
Nutrition and PD
Resource Type: PD ExpertBriefings
Publication Date: 2015
Author: Heather Zwickey, Ph.D.
Publisher: Parkinson's Disease Foundation
Toll Free: (800) 457-6676
Associated URL: www.pdf.org/parkinsononline
Address: 1359 Broadway, Suite 1509
City: New York Zip: 10018
State: New York
This webinar discusses important issues and tips related to nutrition and Parkinson's disease.
American Dietetic Association (ADA)
Resource Type: Websites
Toll Free: (800) 877-1600
Associated URL: http://www.eatright.org/
This organization maintains a national directory of registered dietitians that a person living with PD may find helpful.