Parkinson’s and nutrition: Exploring an important relationship | Dr Silke Appel Cresswell

[Melissa McConaghy]

Many thanks for the presentation and great work being done.

For any comments or questions, please add them here so that we can forward them on to the speaker.

[Suzanne McGhie]

Hi there mel,well icanget no sound . Oh boy so frustrating for me…

[Suzanne McGhie]

I just ot my sound fixed!

[Beth Urwin]

Thank you for a very useful talk. Does using a blender to make smoothies with fruit and vegetables decrease their nutritional benefits? My husband finds eating salads and some vegetables very difficult due to decreased dexterity and slowness. It would be easier for him to to drink them.

[Silke Appel-Cresswell]

Hi Beth,

Thank you for a good question, if having veggies and fruit in the form of smoothies is more feasible, then go with that. The best veggies are the ones that get actually consumed. 🙂

[Heidi Pearsall]

Great talk! One of the screens indicated that at some point, Levodopa might not kick in or be effective if pills are taken with protein or too close to eating protein. It sounded like this was not an issue when a person initially begins taking Levodopa, and I wondered at what point people typically see protein consumption interfering with the drug. Also, if you are in the group where you need to be careful of the timing of eating protein and taking drugs, is any protein okay (2 g? 3 g?) or should the person avoid all protein before and after drugs? thank you.

[Silke Appel-Cresswell]

Hi Heidi,

Yes, the protein-levodopa interaction can become an issue usually after a few years, essentially we are considering this when either the quality of ON time is reduced or it takes a long time for levodopa to kick in but not everyone develops problems with protein intake and it only requires management if it actually is an issue for the individual. There are considerable differences in regard how sensitive an individual is to protein in the diet. A few grams of protein will likely be ok but larger amounts might not be. The issue is that the protein transporter capacity will be taken up by the protein in the food and levodopa, also a protein, is not transported properly.

[Heidi Pearsall]

Thank you for replying! Best to you. 🙂

[Silke Appel-Cresswell]

PS: It is important to continue to eat enough protein in the diet, taking in too little protein can worsen muscle loss among other issues. One of the ways to achieve this is to have most of the protein in the evening with dinner, assuming that evenings are more of a low activity time at home where suboptimal ONs can more easily be dealt with than during the day. Otherwise, separating protein intake from levodopa is helpful if there is interference.

[Suzanne Dow]

Thank you very informative!

[Silke Appel-Cresswell]

Thank you, Suzanne!

[Kathy Stone]

Great talk. I wonder if the speaker has any opinion re the MIND diet in the context of PD?

[Silke Appel-Cresswell]

Thanks, Kathy! In studies that directly compared the MIND diet to other Mediterranean diets in most cases the MIND diet had the upper hand. Having said this, in our study this was true for women but not necessarily for men.

[Peter Hobday]

Very practical, just what I wanted.

I think It would help if there was a greater differentiation between when the comment was relevant for those who wanted to know how to reduce the chance of getting P and those who wanted to slow the progression.

Thank you very much

Peter

[Silke Appel-Cresswell]

Thanks, Peter! Fortunately, mostly plant-based, Mediterranean-type diets seem to be associated with a reduced risk to develop Parkinson’s as well as better outcomes once someone has developed Parkinson’s so the advice would still be the same.

[Jenny Bond]

Really good reminders about the importance of our dietary choices and I look forward to the lecture covering supplements.

[Silke Appel-Cresswell]

Thank you, Jenny!

[Veronique Venning]

Hi Jenny, just wondering about the talk on PD and supplements was. I can’t find it on the program

[Silke Appel-Cresswell]

This should be covered in Dr Laurie Mischley’s talk.

[Veronique Venning]

Thanks Silke

[Kerry Bacon]

Thanks Silky,

Clear, straight forward presentation of the facts. Thank you. I now have some work to do, but not too much, to bring our diet back to where it was a few years ago.

[Silke Appel-Cresswell]

Thanks, Kerry, I am glad it was useful :-).

[Dee]

Thank you. A great presentation. Any advice about Rasagiline & certain food intake? Thanks

[Silke Appel-Cresswell]

Thank you, Dee! There has been considerable debate and research about the question how much of a risk there is to develop high blood pressure with tyramine-containing foods when taking rasagiline, a selective MAO-B inhibitor. Both clinical studies and clinical experience support that it fortunately is not usually a concern as long as rasagiline is taken at the recommended dose (up to 1mg per day). The US labeling for rasagiline was updated to reflect that tyramine reactions are not ordinarily required at the recommended rasagiline dose. So as long as you don’t go overboard with aged cheeses and other tyramine-containing foods, you should not run into problems. And of course, always discuss questions about your medication with your physician and/or pharmacist.

[Dee]

Thank you so much for your reply. All the best, Dee

[Ken Whitson]

Thank you, a very palatable reminder of how we can be helping ourselves with minimum effort.

[Silke Appel-Cresswell]

Thanks, Ken, happy cooking!

[Anita White]

Excellent presentation Silky. Thank you.

[Silke Appel-Cresswell]

Thank you, Anita, enjoy the rest of the conference!

[Gunilla Beard]

Very good presentation! Thank you so much!

[Silke Appel-Cresswell]

Thank you, Gunilla, bon appetit!

[Ken Morrison]

A very good presentation but I was wondering what the best thing i should be doing to improve my fight against PD. Is this getting a referral to a dietitian and what info I should bring with me for the appointment

[Silke Appel-Cresswell]

Hi Ken, yes, I recommend consulting with a dietitian to review what you (and your family) are currently eating, where you might be able to optimize your diet, what potential barriers to doing this might be and how to set realistic, concrete goals and then together figuring out the steps to get there. For the dietitian to have information to work with, keeping a food diary (aka writing down what and how much you eat for each meal/snack) for a few days is very helpful.

[Sarah Black]

Thank you for a fascinating talk

[Silke Appel-Cresswell]

Thanks, Sarah, bon appetit!

[Sally Crossman]

Thanks Silke,

I have a drought or flood gut function so trying to get a balanced effective diet is a challenge. Gut inflammation rules out anything acidic including tomato and I can no longer tolerate dairy in any form so the Mediterranean diet poses some challenges. Any suggestions for alternate ?

[Silke Appel-Cresswell]

Hi Sally, it sounds like you have to be particularly thoughtful about your food. A dietitian can help you to review what you are eating now, where the challenges are for you, how to address them and how to optimize your nutrition. They have excellent information on swap outs, e.g. for dairy and specific vegetables that might not be tolerated. I recommend to consult with a dietitian and have them as a core member of your team.

[John Wood]

Thank you for a most informative and brilliantly delivered presentation Dr Silke.

[Silke Appel-Cresswell]

Thanks, John, enjoy the flavors!