Objectives: There is limited information about the dietary habits of patients with Parkinson's Disease PD , or associations of diet with clinical PD features. We report on nutritional intake in an Australian PD cohort. Methods: PD patients and 81 healthy controls HCs completed a validated, semi-quantitative food frequency questionnaire. Food and nutrient intake was quantified, with consideration of micronutrients and macronutrients energy, protein, carbohydrate, fat, fibre, and added sugar.
Participants also completed PD-validated non-motor symptom questionnaires to determine any relationships between dietary intake and clinical disease features. Increased sugar consumption was associated with an increase in non-motor symptoms, including poorer quality of life, increased constipation severity and greater daily levodopa dose requirement. Conclusions: We provide clinically important insights into the dietary habits of PD patients that may inform simple dietary modifications that could alleviate disease symptoms and severity.
The results of this study support clinician led promotion of healthy eating and careful management of patient nutrition as part of routine care. Parkinson's Disease PD is the second most common neurodegenerative disease and is associated with significant morbidity 1. It is characterised by the loss of dopaminergic neurons in the substantia nigra pars compacta, and a deficiency of dopamine in the striatum and other basal ganglia structures.
A growing body of evidence suggests that nutrition may play an important role in PD 2. PD patients are more frequently underweight 3 , 4 , have a higher risk of malnutrition 5 and tend to have a lower body mass index BMI 6 that inversely associates with disease duration, disease severity and levodopa-related motor complications 7. Furthermore, it has been suggested that lower dietary intake of poly-unsaturated fatty acids, vitamin A, vitamin E, vitamin B12, vitamin D and folic acid are associated with an increased risk of developing PD 8 , 9 , although this remains controversial.
Nevertheless, throughout the disease course, weight gain and loss may fluctuate, being influenced by both changes in food intake and energy expenditure Interestingly, PD patients are also purported to display a preference for sweet foods, such as cakes 11 , chocolate 12 , ice cream 13 , milk puddings and custards 14 , consistent with an increased consumption of carbohydrates 7 , 15 , Emerging research suggests that the complex bidirectional communication between the gut and brain is influenced by dietary patterns and may contribute to the development and progression of PD 17 , 18 , as well as levodopa metabolism Therefore, the predominance of gastrointestinal dysfunction in PD may further influence the diet of PD patients and vice versa.
