Ensuring good nutritional status in patients with Parkinson's disease: challenges and solutions
Luciana Baroni,¹ Cristina Zuliani^2
1Primary Care Unit, Northern District, Azienda ULSS 9 Treviso, Italy; ²Department of Neurology, General Hospital, Mirano, Venice, Italy

Abstract: Nutrition is becoming an important tool in the management of the main chronic diseases, including Parkinson's disease (PD). Nutritional status has been shown to deteriorate with the progression of PD, due to motor and nonmotor complications. Dietary protein can reduce the effectiveness of levodopa treatment in PD patients, since the large neutral amino acids and levodopa share the same saturated carrier system, while fiber can improve the drug bioavailability. Moreover, nutrition seems to be directly involved in PD risk: high dietary intakes of animal fat, iron, mercury, and dairy, as well as western dietary patterns can increase it, while intake of some antioxidant compounds and plant-based dietary patterns can be protective. The means of ensuring good nutritional status in PD range from providing adequate energy and nutrients for the body, to considering in a broader perspective, the management of motor and nonmotor symptoms and chronic levodopa treatment complications, as well as pursuing potential neuroprotection. This review summarizes the most relevant results in the literature, and discusses the contribution of diet in the management of PD.

Keywords: levodopa, Mediterranean diet, plant-based diet, protein-redistribution diet, vegetarian diet