In a case-control study, we compared the past dietary habits of 342 Parkinson's disease (PD) patients recruited from nine German clinics with those of 342 controls from the same neighborhood or region. Data were gathered with a structured interview and a self-administered food-frequency questionnaire. Nutrient intakes were calculated from the reported food intakes through linkage with the German Federal Food Code and analyzed using multivariate conditional logistic regression to control for total energy intake, educational status, and cigarette smoking. At the macronutrient level, patients reported higher carbohydrate intake than controls after adjustment for total energy intake, smoking, and educational status (OR = 2.74, 95% confidence interval [CI]: 1.30-6.07, for the highest versus lowest quartile, p trend = 0.02). This was reflected in higher monosaccharide and disaccharide intakes at the nutrient level. There was no difference between patients and controls in protein and fat intake after adjustment for energy intake. We found an inverse association between the intakes of beta-carotene (OR = 0.67, 95% CI: 0.37-1.19, p trend = 0.06) and ascorbic acid (OR = 0.60, 95% CI: 0.33-1.09, p trend = 0.04) by patients, although only the trend for ascorbic acid intake reached statistical significance. There was no difference between groups for alpha-tocopherol intake after adjustment for energy intake. We also found that patients reported a significantly lower intake of niacin than controls (OR = 0.15, 95% CI: 0.07-0.33, p trend< 0.00005). Our results suggest that if antioxidants play a protective role in this disease, the amounts provided by diet alone are insufficient. Although the interpretation of the inverse association between niacin intake and PD is complicated by the high niacin content in coffee and alcoholic beverages, which were also inversely associated with PD in this study, the strength of this association and its biologic plausibility warrant further investigation.

In a case-control study, we compared the past dietary habits of 342 Parkinson's disease (PD) patients recruited from nine German clinics with those of 342 controls from the same neighborhood or region. Data were gathered with a structured interview and a self-administered food-frequency questionnaire, and analyzed using multivariate conditional logistic regression to control for educational status and cigarette smoking. There was no significant difference between cases and controls in the consumption of fruits and vegetables, although there was a negative trend for the consumption of raw vegetables. Controls reported a higher potato consumption than patients (OR = 0.43, 95% confidence interval [CI]: 0.24-0.74, highest versus lowest quartile). Patients reported eating significantly larger quantities of sweet foods as well as having more snacks than controls. This may, however, be the result of an illness-related change in dietary habits leading to a selective recall effect, since sweet foods may enhance the transport of L-dopa across the blood-brain barrier. We also found that patients consumed less beer (OR = 0.26, 95% CI: 0.14-0.49) and spirits (OR = 0.56, 95% CI: 0.36-0.86), but not wine, and they consumed less coffee (OR = 0.27, 95% CI: 0.14-0.52, highest versus lowest quartile), but not tea, than controls. This may relate to a possible interaction between dopaminergic activity and the intake of ethanol or caffeine. Significantly more patients than controls reported ever consuming raw meat (OR = 1.78, 95% CI: 1.21-2.63). These results suggest that the intake of certain foods may be associated with the development of PD.

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