The Mediterranean Diet and Parkinson’s Disease

Written by: Elena Smith, UF Dietetic Intern, Carley Rusch, MS, RDN, LDN & Matthew Beke, MS, RDN, LDN

If you or someone you know has Parkinson’s disease (PD), you may have wondered what the best diet is for a person with PD. The 2015-2020 USDA Dietary Guidelines for Americans considers a Mediterranean diet as a healthy eating pattern that may support healthy weight management and reduce risk of chronic disease. This has people asking – is this diet beneficial for people with PD?

Diet & Parkinson’s Disease

There are many research studies that show how healthy a Mediterranean diet can be for heart health, blood sugar levels, and even weight management. Additionally, there are numerous studies that suggest eating a Mediterranean diet can reduce your risk of neurodegenerative disease, including PD.^1-3 A Mediterranean diet may help manage non-motor symptoms like constipation, and might play a positive role in memory function and reducing inflammation.

What is the Mediterranean Diet?

The Mediterranean diet is considered to be^4-6:

• High in fruits, vegetables, whole grains, beans, nuts, and seeds.
• Low in red and processed meat, with an emphasis on seafood and poultry.
• Low to moderate amounts of dairy products, eggs, and poultry.
• Minimal intake of processed foods including hydrogenated or trans-fats, refined grains, and foods and beverages containing added sugars.
• Olive oil as the primary fat source.

Health Benefits of the Mediterranean Diet

Following a healthy dietary pattern like the Mediterranean diet may help promote wellness and manage some of the non-motor symptoms of PD.

Constipation Management

Constipation is a common and debilitating non-motor symptom of PD that affects 54-90% of people with PD.Increasing your intake of dietary fiber is often helpful to produce frequent, satisfying, and complete bowel movements. The Mediterranean diet encourages high consumption of legumes (ie. beans, peas, lentils), whole grains, vegetables, and fruits- all foods that can contain a considerable amount of dietary fiber. It is recommended that you get 25-35 gram of fiber per day.⁹

Memory Function

Some PD patients may develop mild cognitive impairment or dementia.¹⁰ Evidence suggests there may be an association with improved memory and decreased risk of dementia in people who are more adherent to a Mediterranean diet.^{11, 12} These benefits could likely be due to unsaturated fatty acids (ie. olive oil and oil fish) as well as the antioxidants (ie. vitamin E, vitamin C, and flavonoids) that can be found in fruits, vegetables, and wine. More studies are needed to confirm these findings.

Heart-Healthy

There are a range of heart-healthy benefits that have been found from consuming a Mediterranean diet. People following a Mediterranean diet have been found to have a lower rate of major cardiovascular events (heart attacks, stroke, and death from cardiovascular causes).¹⁵ The American Heart Association agrees that those who adhere greater to the Mediterranean dietary pattern are associated with reductions in coronary heart disease risk and reduced risk of a stroke.⁶

Talk to your physician or dietitian about any specific questions you have about nutrition and PD. If you are a patient of the Norman Fixel Neurological Institute at UF Health, please call (352) 294-5400 to make an appointment.

References

1. Maraki MI, Yannakoulia M, Stamelou M, et al. Mediterranean diet adherence is related to reduced probability of prodromal Parkinson’s disease. Mov Disord. 2019;34(1):48‐57. doi:10.1002/mds.27489
2. Mahlknecht P, Seppi K, Poewe W. The Concept of Prodromal Parkinson’s Disease. J Parkinsons Dis. 2015;5(4):681‐697. doi:10.3233/JPD-150685
3. Gao X, Chen H, Fung TT, et al. Prospective study of dietary pattern and risk of Parkinson disease. Am J Clin Nutr. 2007;86(5):1486‐1494. doi:10.1093/ajcn/86.5.1486
4. Francis HM, Stevenson RJ. Potential for diet to prevent and remediate cognitive deficits in neurological disorders. Nutr Rev. 2018;76(3):204‐217. doi:10.1093/nutrit/nux073
5. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. Published December 2015. Available at https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-4/. Accessed June 2020.
6. American Heart Association. What is the Mediterranean Diet? Website. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/mediterranean-diet. Published January 2020. Accessed June 2020.
7. Estruch R, Ros E, Salas-Salvadó J, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. N Engl J Med. 2018;378(25):e34. doi:10.1056/NEJMoa1800389
8. Oldways. Mediterranean Diet. Website. https://oldwayspt.org/resources. Accessed June 2020.
9. U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015 – 2020 Dietary Guidelines for Americans. 8th Edition. Published December 2015. Available at https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/appendix-7/. Accessed July 2020.
10. Galtier I, Nieto A, Lorenzo JN, Barroso J. Mild cognitive impairment in Parkinson’s disease: Diagnosis and progression to dementia. J Clin Exp Neuropsychol. 2016;38(1):40‐50. doi:10.1080/13803395.2015.1087465. 
11. Cao L, Tan L, Wang HF, Jiang T, Zhu XC, Lu H, Tan MS, Yu JT. Dietary patterns and risk of dementia: a systematic review and meta-analysis of cohort studies. Mol Neurobiol. 2016;53(9):6144–54.
12. Loughrey DG, Lavecchia S, Brennan S, Lawlor BA, Kelly ME. The impact of the Mediterranean diet on the cognitive functioning of healthy older adults: a systematic review and meta-analysis. Adv Nutr. 2017;8(4):571–86.

Images:

1. https://dynaimage.cdn.cnn.com/cnn/c_fill,g_auto,w_1200,h_675,ar_16:9/https%3A%2F%2Fcdn.cnn.com%2Fcnnnext%2Fdam%2Fassets%2F170717104105-mediterranean-diet-stock.jpg
2. https://womenlikethat.co.uk/health-and-fitness/5-benefits-of-healthy-eating/