Effect of daytime protein restriction on nutrient intakes of free-living Parkinson's disease patients

Abstract

Studies have shown that severe daytime restriction of dietary protein improves the efficacy of L-dopa and reduces response fluctuations in some Parkinson's disease (PD) patients. This study investigated the nutritional adequacy of the daytime restricted-protein diet. Eleven free-living PD patients suffering from unpredictable response fluctuations to L-dopa were counseled to limit protein intake to approximately 10 g before 1700. Three sets of 6-d food records obtained during the 8-wk study showed that while on the test diet, mean intakes of most nutrients remained above the recommended nutrient intakes, although significant decreases occurred in protein, calcium, iron, phosphorus, riboflavin, and niacin intakes. The impact of the test diet on nutritional status as evaluated by changes in body weight and serum prealbumin was small. We conclude that healthy and highly motivated patients can maintain adequate intakes of most nutrients while restricting daytime protein intake. However, nutrient intakes might be compromised in patients whose regular diets are marginally adequate.

Protein intake and the use of levodopa in patients with Parkinson's disease

“…As in other studies with PD (7,19), our sample showed no risk of malnutrition by BMI classification. However, these patients (table 1) have a lower BMI compared with healthy elderly subjects from the same region of the country (BMI = 28.9 kg /m²) (20).Therefore, the BMI elderly rates have limitations and may not be used exclusively, since this indicator assesses only the body mass without defining its distribution (21).…”

“…In most cases, the progression of Parkinson's disease is accompanied with consequent loss of weight (1,7,11,18,19). The weight loss is continuous and may begin before the disease diagnosis (1).…”

“…However, energy consumption in the studied population is appropriate. Studies were conducted to evaluate the PD patients diet and the interference in the pharmacologic therapy (4,9,19,24,25). However, the number of different methodologies and the variety of sample populations do not provide any conclusive evidence to which is the best nutritional therapy for these patients in order to be able to relate the use of levodopa and other drugs (4,6,8,10,18).…”

Avaliação nutricional e o uso da levodopa com refeições proteicas em pacientes com doença de Parkinson do município de Macaé, Rio de Janeiro

“…An average of 21Kcal/kg of body weight per day was registered, showing that the assessed individuals consumed a reduced calorie diet. In the study by Pare et al, 31 the individuals presented an average intake of 2163 Kcal, with an average of 39 Kcal/Kg body weight per day, characterizing a high calorie diet intake. The prescription of a norm-, hypo-or hyper-calorie diet for patients with PD will depend on their nutritional status.…”

“…In the study by Fracasso et al, 9 higher protein intake during the day was also observed, with consumption between breakfast and the afternoon snack representing 70.4% of the total daily protein intake. In the study by Pare et al, 31 it was observed that, by prioritizing the majority of protein content in the diet at night, there is a reduction of the motor fluctuations that may be caused by the interaction of the protein with levodopa. Ideally protein intake should be higher at night than during the day.…”