Aparna Atluru, HappyNews Staff

DECEMBER 15, 2008
Paraparaumu, New Zealand

Eric Harper of Paraparaumu, New Zealand was diagnosed with Parkinson’s disease 11 years ago. He is one of 250 Parkinson’s sufferers worldwide to take part in the medical trial of a new surgical procedure and medication.

The recent procedure consisted of a tube inserted into his small intestine, which allowed Harper to reduce his 33-tablet-a-day regimen down to one gel ampoule.

Previously, Harper was not able to walk for more than a few seconds without freezing up or entering involuntary spasms.

“I walked about four kilometers along the beach- I am over the moon,” said Harper. “It is a new lease on life for me. Miracles do happen at Christmas,” he added.

Harper is determined to work again as a gardener full-time, and got that endeavor under way my visiting the Waikanae nursery this past week, looking to plant a new garden for his wife Heidi. The nursery’s owner, Gus Evans, recognized Harper from a newspaper article, and gave him $1000 worth of plants. Mr. Harper’s dream is well on its way.

Both types of unsaturated fatty acids are contained within the membranes of nerve cells and are known to have neuroprotective characteristics, antioxidant and anti-inflammatory.

Researchers involved in the new study, published in Neurology (2005; 64:2040-2045), wanted to build on this knowledge to determine whether a product of high unsaturated fatty acids was associated with a lower risk of Parkinson's disease.

Monounsaturated fatty acids (Mufasa) have been shown to help a bad) cholesterol, lower LDL (when substituted for saturated fat. Mufasa sources include olives, oils of canola, avocados, peanuts, nuts and seeds.

One of the main forms of polyunsaturated fatty acids (PUFAs) is omega-3, commonly derived from fish, which have been proven to deliver significant benefits for cardiovascular health and cognitive function. Omega-6 is also essential for human health, found in grains, most plant-based oils, poultry and eggs.

But the modern diet is loaded more heavily towards consumption omega-6 to omega-3, an imbalance that has led to the growing reputation of the latest in fortified foods and functional in the form of the supplement.

The new study may give additional weight to the discussions in favor of the Mediterranean diet, which typically consists of foods rich in Mufasa and PUFAs since it is based while you're in olive oil, nuts, fresh fish, the Fruit and vehicles. Three separate studies published this year have highlighted the benefits for heart disease of this diet in lowering cholesterol levels, lowering the risk factors for heart disease and boosting longevity.

The new population-based study in advance of the cohort involved 5289 people aged 55 or over, all of whom were free of dementia and Parkinson's disease at the baseline.

At the start of the trial participants experienced the full charge dietician, and the incidence of Parkinson's disease was detected in the examination of the in-person and continuous monitoring by the repeated coupling of computer medical records.

The duration of the study was bad six years, during which time 51 patients were diagnosed with Parkinson's. Products of the highest total fat, of Mufasa, and PUFAs were "significantly associated" with a lower risk of developing the disease, but did not find any associations for fat, cholesterol, or transport-saturated dietary fat.

"These results suggest that high product of unsaturated fatty acids might protect against Parkinson's disease," researchers concluded.

Parkinson's disease is a progressive neurological disorder that affects about 6.3 million people from around the world. One in ten cases were diagnosed before the age of 50.

The cause is not understood but is thought to result from the combined effects of factors including aging, genetic predisposition and environmental exposures. Symptoms include tremors, stiffness, slow movement and poor coordination and balance.

A study published in the Archives of Neurology (59, pp 1541-1550) in 2002 coenzyme-Q10 which bind to delay the progressive disability caused by Parkinson's is thought to have been at least partly responsible for a surge in consumer demand for CoQ10, usually sourced from Japan, in the past three years. The prices are high, however, and the source is short, so the new research may present a viable alternative method of prevention.

By Karol Traviss, MSc, RD

Navigating the maze of nutrition information and advice available to the public is challenging, even for a healthy consumer. Add Parkinson's disease to the mix and the challenges spiral higher. The nutritional issues faced by people with PD are complex and diverse, and many of the issues do not have clear answers.

When it comes to nutrition, what matters most? Here we help you to answer that question.

Eat a balanced diet

It is difficult for a person to feel well and maintain energy when he or she is not eating properly. Eating properly involves eating regularly (no meal skipping), eating a variety of foods from all of the food groups (grains, vegetables, fruit, milk/ dairy, meat/beans) and eating prudently to maintain a healthy weight. Although this sounds like simple advice, implementing it can be a challenge, particularly if you have a hectic lifestyle or if the symptoms of Parkinson's are affecting your ability to shop, prepare food and eat.

If you are not eating as well as you should, you may wish to consult a registered dietitian who can help assess your food intake and discuss with you strategies for improving your diet. It is also helpful to seek the assistance of others for shopping and meal preparation, and to keep easy-to-eat, nutritious foods on hand. If you have any problems with depression, this can interfere with appetite; be sure to discuss the problem with your doctor.

Maintain bone health

People with Parkinson's are prone to osteoporosis, a disease caused by low bone-mineral density. Risk factors for osteoporosis include older age, low body weight, smoking, excessive alcohol intake, limited exposure to sunlight, inadequate intake of vitamin D and calcium and lack of weight-bearing exercise.

Osteoporosis can be especially worrisome to a person with Parkinson's who faces an increased risk of falling. The inevitable result is an increased risk of fractures, which are dangerous and painful and tend to be detrimental to one's quality of life. Ask your doctor about having your bone-mineral density checked. If it turns out to be low, medical treatments may be available.

To maintain bone health, make sure your diet includes plenty of calcium and vitamin D.
People who are over the age of 50 should consume 1500 mg of calcium and 800 IU of vitamin D daily. Milk and milk products are the richest dietary source of calcium. Three servings per day are recommended (one serving is one cup of milk or yogurt, or one and one-half ounces of hard cheese). Although there are other calcium-containing foods (e.g., tofu, calcium-fortified soy-based beverages, orange juice and dark leafy greens), calcium from non-dairy sources may not be well-absorbed.

You can also obtain vitamin D by getting outdoors regularly and consuming foods rich in vitamin D (e.g., vitamin D-fortified milk, yogurt or breakfast cereals and fatty fish). If you live in a region with limited sunshine and/or do not consume many vitamin D-rich foods, use of a nutritional supplement is recommended.

Supplements come in several forms. Some are easier to tolerate than others. Your pharmacist will be able to advise you on the different kinds available.

Maintain bowel regularity

Constipation is common in Parkinson's disease. While this can be an embarrassing issue to raise with your healthcare provider, prevention and treatment of constipation is critical, as severe constipation can lead to bowel obstruction, a potentially life-threatening condition.

Although the constipation observed in Parkinson's is due in large part to the disease itself, lifestyle measures can be useful for managing it. These include eating foods high in fiber (whole grain bread, bran cereals or muffins, fruits and vegetables, beans and legumes and prunes) and drinking plenty of fluid. Then there is exercise, which helps maintain bone density as well as eases constipation.

If you are not able to achieve bowel regularity through lifestyle alone, laxatives and other bowel interventions may be required. Make sure to see your doctor if constipation persists.

Balance medications and food

The medications used for Parkinson's can themselves cause nutrition-related side-effects, such as nausea and poor appetite. Typically these side-effects are most severe when a medication is first prescribed but some individuals have continuing problems with them. Taking a small snack (such as ginger ale and a few crackers) along with medications may help to control these side-effects. If nausea or poor appetite persist, contact your doctor, as these symptoms can lead to undesired weight loss.

Amino acids (from dietary protein) can interfere with the uptake of levodopa into the brain. If you find (not everyone experiences this) that eating high-protein food (such as meat, fish, poultry and dairy products) decreases the effectiveness of levodopa, keep the meat portion of your meal to about the size of a deck of cards and take your Sinemet® half an hour prior to a protein-containing meal.

Do not use a restricted-protein diet; the problem, if you find you have one, is usually with the timing of the protein intake, not its total quantity over the course of the day.

Do "wonder" foods or supplements delay progression of Parkinson's?

Supplements (both nutritional and herbal) and dietary therapies are high on the list of complementary therapies used by people with Parkinson's. In spite of compelling theories about the effectiveness of various supplements or dietary factors in delaying progression of the disease, we lack definitive, evidence-based answers. Some therapies have been studied only in test tubes or with laboratory animals. Few human trials have been done (e.g., those examining antioxidant vitamin supplements), and most have produced disappointing results. Coenzyme Q10 is one nutritional supplement that is of considerable interest to the scientific community and is under study to determine if it has any potential benefit in Parkinson's disease.

Some foods that are in the "won't hurt and might help" (at least in theory) category include coffee (several population studies have suggested that coffee may be protective against Parkinson's, particularly in men); green tea; a variety of fruits and vegetables; foods rich in vitamin E such as wheat germ; nuts and seeds; and vegetable oil. If the antioxidants present do not help with Parkinson's symptoms, they may help with some other aspect of health so there is certainly no reason not to use them.

When thinking about the potential value of using this or that supplement, consider the factors of cost, safety and effectiveness and be sure not to be "taken in" by hyped headlines. For example, a recent headline read, Vitamin B6 May Cut Risk of Parkinson's Disease. Behind the headline: this study finding, while interesting, was only observed among smokers and the study addressed only the onset, and not the progression, of Parkinson's.

However tempting it may be to seek out "wonder" foods and supplements, at this time there is not enough evidence to suggest that they play a major role.

Adjust nutritional priorities for your situation and stage of disease

Parkinson's symptoms vary from person to person and by stage of disease. Each person must set nutritional priorities based on the issues they face. In early Parkinson's, we should all emphasize eating well and maintaining a healthy weight. As the disease progresses, we should adjust our diets to manage specific new symptoms as they emerge (such as swallowing difficulties, medication side-effects, bowel issues and eating challenges). The goal of thoughtful nutrition is not just to ease PD symptoms; it is also to allow you to continue to use food as a source of pleasure in your life.

Karol Traviss, MSc, RD is a registered dietitian on faculty at the University of British Columbia in Vancouver, Canada. She has worked collaboratively with the British Columbia Parkinson's community for many years and spoke on complementary nutritional therapies at the 2006 World Parkinson Congress.

Giancarlo Logroscino, Xiang Gao, Honglei Chen, Al Wing and Alberto Ascherio

Correspondence to Dr. Giancarlo Logroscino, Department of Neurology and Psychiatry, School of Medicine, University of Bari, Bari, Italy (e-mail: giancarlo.logroscino@neurol.uniba.it).

Received for publication March 25, 2008. Accepted for publication August 1, 2008.

Dietary iron is the most important source of iron stores. Several case-control studies have described the association of high dietary iron and Parkinson's disease, but prospective data are lacking. The authors prospectively followed 47,406 men and 76,947 women from the United States who provided information through a mailed questionnaire on their diet, medical history, and lifestyle practices between 1984 and 2000. The authors documented 422 new cases of Parkinson's disease. Total iron intake was not associated with an increased risk of Parkinson's disease (relative risk (RR) = 1.10, 95% confidence interval (CI): 0.74, 1.65; Ptrend = 0.84), but dietary nonheme iron intake from food was associated with a 30% increased risk of Parkinson's disease (RR = 1.27, 95% CI: 0.92, 1.76; Ptrend = 0.02). A secondary analysis revealed that Parkinson's disease risk was significantly increased among individuals with high nonheme iron and low vitamin C intakes (RR = 1.92, 95% CI: 1.14, 3.32; Ptrend = 0.002). Supplemental iron intake was associated with a borderline increase in Parkinson's disease risk among men. Although the authors’ prospective data did not support an association between total iron intake (dietary and supplemental) and risk of Parkinson's disease, a 30% increased risk was associated with a diet rich in nonheme iron. This increase in risk was present in those who had low vitamin C intake.

Abbreviations: CI, confidence interval; HPFS, Health Professionals Follow-up Study; NHS, Nurses’ Health Study; RR, relative risk

Sherry Baker, Health Sciences Editor

The national Neuroscience 2008 conference is underway in Washington, D.C., presenting cutting edge research on the whole spectrum of diseases impacting the brain and nervous system. Breaking news from Johns Hopkins scientists presented at the meeting suggests several natural substances could be effective in treating or preventing some of these ills. Specifically, curry spice may protect the brain from Parkinson's disease (PD) and plain table grapes appear to reduce arthritis pain and inflammation.

Researchers know inflammation and damage caused by oxidative stress are implicated in the death of brain cells associated with PD. And curcumin, derived from the curry spice turmeric, has long been known to be a powerful antioxidant with anti-inflammatory properties. So researchers at the Johns Hopkins University School of Medicine put these facts together and came up with a laboratory model of Parkinson's disease in order to see what effect curcumin has on PD. The result? The spice provided brain cells with strong protection from injury and death.

The research team tested curcumin on nerve-like cells that make a mutant form of the protein alpha-synuclein, called A53T, which binds together inside of cells, causing harmful changes that eventually lead to cell death. A53T alpha-synuclein caused half of untreated cells to die. But when A53T cells were treated with curcumin, only 19% of the cells died. What's more, additional research showed that curcumin also reduced oxidative damage to the cells.

"These results suggest that curcumin is a potential candidate for inhibiting the oxidative damage that leads to Parkinson's disease," said Wanli Smith, Ph.D., an assistant professor of psychiatry and behavioral sciences at Hopkins, in a statement to the media. "This common curry spice could be a weapon to protect the brain."

The healing power of foods was also demonstrated by a study using table grapes, a fruit known to have strong antioxidant and anti-inflammatory properties due to a high amount of flavonoids. Johns Hopkins University School of Medicine scientists say their study of powdered grapes showed the fruit reduced pain and inflammation in a rat model of arthritis. Rats were fed grape powder once a day after receiving arthritis-inducing chemical injections in their knees. A control group of animals got only sugar water. Over a period of four days after the chemical injections, the researchers tested the rats' inflammation levels by measuring knee swelling. The animals' pain responses were also measured by documenting their sensitivity to mechanical stimulation such as prodding of the rodents' paws.

The results showed the rats who were fed the grape powder could withstand stronger prodding than the sugar-fed rats. What's more, the scientists also compared the grape powder treatment with a commonly used anti-inflammatory drug, meloxicam, and found the drug alone – without the grapes – did not sufficiently reduce the animals' pain.

"I think there are two important messages here," Jasenka Borzan, Ph.D., a research associate in anesthesiology at Johns Hopkins, said in a press statement. "That consuming flavonoids through natural products like grapes can be beneficial to health in general and also specifically for reducing inflammatory pain; and that consuming natural products like grapes may also be beneficial in reducing the amount of medication necessary to reduce inflammation."