Constipation, urinary tract infections (UTIs), thinning bones, and unexplained weight loss are all common in persons with Parkinson’s Disease (PD). Preventing or managing these conditions can be accomplished through proper hydration and nutritional intake.

Proper hydration, which is achieved by drinking plenty of fluids, is important in the prevention of constipation and UTIs. Fluid replacement is important, especially when participating in physical activity. Be sure to drink fluids throughout the day, ideally water. Consuming fruits and vegetables, foods which are naturally high in water content, can also increase daily fluid intake. Side effects of anti-Parkinson medications or anticholinergic agents (i.e., Cogentin, Artane) may include dry mouth, feelings of thirst, thick or sticky saliva, dry eyes, constipation, and taste alterations. It is important to consume adequate fluids; again, preferably water, when taking medications. Aim for eight glasses per day of water in addition to any other fluids normally consumed within the course of the day (such as juice, milk, or coffee). Carrying a water bottle around each day can aid as a reminder and help to track how much water has been consumed. Remember to include adequate fiber in any healthy diet and be sure to consume adequate water when increasing your fiber intake in order to further prevent risk of constipation.

Medications affecting taste sensations can vary in symptoms, from loss of taste to a more pronounced taste sensation. Avoiding the use of metallic utensils in exchange for plastic and substituting poultry, pork, or other lean proteins for red meat may help to prevent food aversions. Swallowing difficulties can also occur and compromise food intake. If having trouble swallowing, the consistency of foods and beverages can be altered to reduce the risk of food and liquid from entering into the lungs. Individuals struggling with acid reflux may find relief from eating smaller, more frequent meals and reducing consumption of acidic foods (i.e., alcohol, coffee, red and black pepper).

Persons with PD are also at risk for thinning bones and need to consider adequate nutritional intake to promote strengthening of bones and maintenance of bone density. This intake should include foods containing micronutrients such as calcium, magnesium, vitamin D, and vitamin K. Continue to consume a variety of foods, and incorporate foods high in the aforementioned micronutrients, such as dairy products (i.e., low-fat versions of milk, cheese, and/or yogurt). Vitamin D maintains calcium blood levels in the body within normal limits, and is crucial for adequate absorption of calcium from the blood stream. If adequate calcium is not available, the body begins to break down bone in order to supply the needed nutrient. Often, vitamin D needs are not met by dietary methods alone. Recent research indicates that limited exposure to the sun during the spring, summer, and fall of 5 to 15 minutes per day (between 10 a.m. and 3 p.m.) will provide the body with the current recommended amount of vitamin D. Allow some sun exposure to hands, arms, and face for a few minutes each day to total 60 minutes per week. In the absence of any sun exposure, be sure to increase daily intake of vitamin D-fortified foods such as milk and orange juice (products fortified in vitamin D indicate this message on their containers). Foods that naturally contain vitamin D include liver, eggs, and fatty fish (i.e., salmon). Healthy sun exposure and adequate nutritional intake may maximize a person’s vitamin D status to promote good health. In addition to healthy sun exposure and consumption of foods high in vitamin D, persons with PD may want to speak with a primary care physician about taking a supplement.

Unexplained weight loss may also occur and may be considered a nutritional risk factor if weight loss of 10% or more of usual body weight occurs. Fatigue and tremors are possible side-effects of Parkinson’s that can contribute to weight loss by effecting feeding abilities. Providing feeding assistance and using adapted utensils (i.e., weighted knives or nonslip bowls) are ways to help encourage food intake. Also adjusting the kitchen environment to improve accessibility can help to prevent weight loss by saving time and energy when preparing meals. For more information on assisted kitchen tools and adapted cooking utensils, check out the NCHPAD article titled, “Putting Your Best Assistive Fork Forward.” For more information on adequate weight gain, go to NCHPAD documents titled, “Are You at Nutritional Risk?” and “Sometimes it’s Necessary to Gain Weight.“

Healthy Salmon without the Grill

Ingredients

• 4 salmon fillets
• 1/3-cup low-fat mayonnaise (or plain yogurt)
• 2 Tbs Dijon mustard (or whole grain mustard)
• 1 Tbs liquid honey
• 1 tsp grainy mustard
• 1 tsp water
• 1/2 tsp chili powder
• Pinch of cayenne pepper
• 1 tsp lemon juice

Directions

1. Pre-heat oven to 425˚ F.
2. Place fillets on foil-lined baking sheet.
3. Mix together mayonnaise, mustards, honey, water, chili powder, and pepper.
4. Stir in lemon juice and brush mixture on salmon.
5. Bake for 12 minutes or until fish flakes apart when tested with a fork.

Spring Bean Salad

Ingredients

• 1 can garbanzo beans (15 ounces), drained
• 1 cup chopped tomatoes
• 3/4 cup cucumber, chopped
• 3/4 Tbs diced onions
• 1 small avocado (pitted), diced
• 1/2 cup plain low-fat yogurt
• 1/4 cup skim milk

Directions

1. In a large bowl, toss together beans, tomatoes, cucumber, and onion.
2. In a small bowl, mix avocado and yogurt to make dressing. If dressing seems too thick, add some milk.
3. Stir into the bean mixture and chill.
4. Serve topped with shredded lettuce and whole-wheat tortilla chips.

References:

1. Academy of Nutrition and Dietetics. (2010). Parkinson’s Disease. Retrieved from https://www-nutritioncaremanual-org.ezproxy.samford.edu/topic.cfm?ncm_toc_id=145152#
2. Holick, M. (2005). The Vitamin D Epidemic and its Health Consequences. The Journal of Nutrition; 135:2739S-48S.
3. Nahikian-Nelms, M. (2015). Nutrition therapy and pathophysiology (3rd ed.). Boston, MA: Cengage.