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Dietary method for reducing fluctuations in Parkinson's disease.

J H Pincus, K M Barry

    The Yale Journal of Biology and Medicine
    |March 1, 1987
    PubMed
    Summary

    Reducing dietary protein intake significantly improves Parkinson's disease management. A low-protein diet enhances carbidopa-levodopa (Sinemet) response and reduces motor fluctuations in patients.

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    Area of Science:

    • Neurology
    • Nutritional Science

    Background:

    • Motor fluctuations and diminished response to carbidopa-levodopa (Sinemet) present significant challenges in long-term Parkinson's disease (PD) management.
    • Conventional strategies like medication adjustments and drug holidays often yield limited success.
    • Previous research indicates that intravenous administration of large neutral amino acids can reverse the clinical state in stabilized PD patients.

    Purpose of the Study:

    • To investigate the hypothesis that dietary protein intake exacerbates motor oscillations and non-response to Sinemet in Parkinson's disease.
    • To evaluate the efficacy of a low-protein daytime diet in improving motor control and Sinemet responsiveness.

    Main Methods:

    • A low-protein daytime diet (7 g protein) was administered to fifteen Parkinson's disease patients.
    • Patients' clinical status, motor fluctuations, and response to Sinemet were assessed.
    • Plasma amino acid and levodopa levels were measured during both low-protein and high-protein (160 g) diet phases.

    Main Results:

    • Eighty-six percent of patients showed immediate improvement in Sinemet sensitivity on a low-protein diet.
    • While on the low-protein diet, patients exhibited predominantly choreatic movements, necessitating a dose reduction of levodopa in 8 patients.
    • Conversely, a high-protein diet resulted in immobility and elevated plasma amino acid and levodopa levels.

    Conclusions:

    • Eliminating dietary protein from breakfast and lunch offers an effective and adaptable strategy to alleviate motor fluctuations and Sinemet non-response in Parkinson's disease patients during daytime hours.
    • Dietary protein management is a crucial, non-pharmacological approach to optimizing Parkinson's disease therapy.
    • This dietary intervention can significantly enhance functional independence during waking hours for individuals with Parkinson's disease.

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