Nutritional Care of Patients with Parkinson's Disease

There has been a growing interest in the nutritional care of patients with Parkinson's disease (PD). The nutritional domain can be considerably affected by the disease, its treatment, and progression, particularly by motor symptoms and levodopa-related complications, which are responsible for important energy imbalances. However, gastrointestinal dysautonomia symptoms (sialorrhea, dysphagia, and constipation) and dysfunction are also major issues, and their evaluation and monitoring are recommended. Nutritional status, nutrition-related complications, and geriatric syndromes also play a role in disease management and prognosis. Patients can take advantage of various interventions, which can be (i) general and applicable to all, or (ii) tailored to specific conditions. Their orientation is both for treatment and prevention, focusing on the maintenance of nutritional and functional status and quality of life, avoidance of nutritional deficiencies, management of gastrointestinal dysfunction, and optimization of pharmacological treatments, particularly levodopa-based regimes. The basic principles of nutritional care for PD have here been summarized to provide a guidance paper to all clinicians dealing with these patients. Attention was focused on basic assessment procedures, evidence-based interventions, expert-based recommendations, and new potential strategies. Therefore, some spotlights on therapeutic options deserving further investigation have been provided.