Finally, some guidelines for a Parkinson’s Diet

Dr. Laurie Mischley, of Bastyr University,  has been tracking People with Parkinson’s (PwP’s) for several years for her “CAM Care in PD” study.  When I spoke to her at the World Parkinson’s Congress last fall, she explained that this is the only study looking at how people are living with PD now and following them to see who is having a more positive outcome and why.   Data is collected with twice annual surveys sent to the participants.  Multiple models were used to examine the association between diet, lifestyle factors, and PD severity, with Patient Reported Outcome (PRO-PD) scores used as the outcome variable. She just released an abstract published in “Oxidative Medicine and Cellular Longevity” on September 10.

I will not try to summarize the entire report.  You can read it here.  However, I will give you some of the key findings.

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The Good:

A plant- and fish-based diet, similar to a Mediterranean diet, is associated with the lowest PD severity score.  Fresh vegetables, fresh fruit, nuts and seeds, fish, olive oil, wine, coconut oil, fresh herbs, and the use of spices were all associated with statistically significant lower rates of disease progression.

The Bad:

Ice cream, cheese, and yogurt intakes were associated with higher rates of PD progression.

DIET SODA WAS ASSOCIATED WITH A FASTER RATE OF PD PROGRESSION

Consumption of canned fruits and vegetables was a strong predictor of PD progression. Stick with fresh fruits and vegetables whenever possible.

Soda, specifically diet soda, was also associated with a faster rate of PD progression.

A few other things to stay away from include meat and fried foods.

Nutritional supplements:   Only coenzyme Q10 and fish oil were associated with statistically significant reduced rates of PD progression.  The use of Melatonin for sleep produced inconclusive results.  Iron supplements increased PD progression.

And finally, organic foods were associated with a lower rate of progression.

What does this mean for us?  I have basically followed a Mediterranean diet for years, however, I am allergic to fish, so  I often each chicken instead.  I haven’t eaten red meat in years.  I never buy canned fruit and vegetables. My downfall is cheese.  I am not sure I can eliminate that completely from my diet, but I can certainly cut back on it.  I recently substituted almond milk for milk to use with coffee and cereal.  Years ago I switched to Tom’s toothpaste and deodorant to avoid the excess aluminum exposure.  The good news is that the progression of PD has been relatively slow for me.

This study will be continuing and more PwP’s are still being recruited.  If you are interested, contact Dr. Mischley at neuroresearch@bastyr.edu.

 

 

For more information on living with Parkinson’s, read   Natural Therapies for Parkinson’s Disease  by Dr. Laurie Mischley

 

Are there differences between Men and Women with Parkinson’s?

Research is beginning to prove what the medical community has long suspected: that women experience Parkinson’s differently as it relates to diagnosis, symptoms, progression, treatment complications and care

Allison Willis, M.D., M.S., co-lead of Women and PD TALK

At 10:00 pm, the husband looks at his wife and says “it’s time to go upstairs to bed.”  And he goes upstairs and gets in bed.  45 minutes later, his wife finally comes upstairs.  He asked her what took her so long.  Her response:  I had to clean the kitchen,  put the dirty clothes in the laundry, walk the dog, make sure all the doors and windows were closed, check on the kids and on and on……..

Yes, there are definitely differences in Men and Women.  Women have historically been nurturers and caregivers.   They take care of their children, their spouses, their homes.   And many of them are still working.   When diagnosed with a disease like PD, their entire support system is turned upside down.  It can be difficult to let someone else be THEIR care-giver.

In the last few months, as co-lead for the Parkinson’s Foundation’s Women and PD TALK , I have been talking to Women with Parkinson’s about issues facing them as women with a chronic illness.  As mothers, and as lifelong caregivers, many  women have never even thought to ask for help when they need it.  It often takes longer for women to receive the diagnosis of Parkinson’s Disease than it does for men.  Many are told that it is in their head.  They are often told that they are depressed, especially if they are younger.  Most women go to their doctors alone.  Many have shared that they go to therapy, alone.   They often go to support groups alone.  One woman said that she stopped going to mixed support groups because most of the women who came were care-partners and assumed that she was, too.  She felt that she could not get the support she needed from a mixed group.

 Many women with Parkinson’s seek out support systems that include other women with PD.  After all, who else would understand what they are feeling?  They need the camaraderie and friendship that Women-only groups can provide.

One thing I noticed last year when I attended the World Parkinson Congress in Portland, was that the overwhelming majority of the men with Parkinson’s were accompanied by their wives.   The number of spouses who accompanied their wives who have Parkinson’s was far fewer.  

The interesting thing is that most men fare much better than women as the disease progresses.  Is this because they have someone that will take care of them and advocate for them, even if they don’t ask for help?  Many of the women with PD that I spoke to are now care-partners for their husbands, which means that they are not getting the support they need at home.  This is unfortunate, because being a care-partner can take much more energy than these women with PD have to give.  And they suffer because of it.  Unless they can get help in their home, they often do not have the time to exercise daily and take care of their other needs.  I am sure that the stress of being a care-partner must take its toll as well.  Women who live alone have their own difficulties in accessing adequate care.

What is the solution for these women with Parkinson’s?  Are there differences in treatment?  Care?  Are their symptoms different than men’s?  Why does is take longer for women to get diagnosed?   We will be exploring these issues and more at the Parkinson’s Foundation’s Women and PD TALK   forums that will be taking place in 10 communities around the country in the next 6 months.  Stay posted for more information.

Parkinson Foundation Logo

 

 

Exercise, Exercise, Exercise

Exercise is your medicine!  Do it EVERYDAY

[re+active] physical therapy and wellness

By now, you know that I am a big fan of exercise.  It has been a daily part of my life since I was young.  Since my diagnosis with Parkinson’s, it has become not just something I enjoy, but something that I must do to keep on moving.  I am sure that many of you feel that way as well.  But for those of you who have never embarked on an exercise program, you need to speak to your Movement Disorders Specialist about how to begin.  You may think that you cannot exercise because of limited movement or pain caused by PD.  That was the prevailing theory 50 years ago.  Today,  however, we know that lack of exercise only makes things worse.  You know the old adage:  use it or lose it.

Scientists, such as Dr. Jay Alberts from the Cleveland Clinic Lerner Research Institute, have shown the benefits of forced exercise on PD.  As a result, many physical therapists and trainers work with PD patients to improve motor function using forced exercise.

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We have been told that Neuroplasticity is crucial to either change or delay the progression of PD.  And exercise is one of those activities that allows the brain to change. Exercise enables more of the dopamine in the brain to be used.  It is important to exercise outside of your comfort zone.  It increases blood flow to the brain and allows the neuroplasticity to occur.  Goal directed exercise allows for these changes in the brain to occur.  It improves the circuitry and improves the connection of the basal ganglia to the cortex.

Physical therapist, Allie Southam, from [re+active] physical therapy & wellness explained all of this in a fascinating talk last Sunday.  Briefly:

  • #1 reason for exercise:  potential to slow the progression of PD through neuroplasticiy
  • Find exercise that you love – otherwise you won’t do it
  • Goal-directed motor skill training through acquisition of skills
  • Learning a skill is hard, practice drives skill aquisition
  • Getting feedback during exercise – allows us to challenge ourselves
    and make ourselves aware ofour movements.  What used to be automatic now requires us to think about what we are doing.  It is also motivational

You can read a summary of her talk here.

Exercise for PD Handout

Tom McLaughlin, a personal trainer whose wife, Linda, has PD, has been working on a training program to improve PD symptoms.   He says that the brain is a learning machine.  Because of dopamine depletion, we have cut off the connection between the brain and our muscles.  The brain doesn’t know the connection is gone, so you have to go back and have your cognitive brain focus on motor function and motor skills.  You have to overcome the “defect” in the brain through exercise.

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Tom’s exercise program tries to activate all of the muscles, and challenge them, in order to improve neuroplasticity in the brain.  There are 16 steps to his program with the goal to work on 8 muscular functions on the top half of the body and 8 on the bottom. Those steps include working with each muscle group to move out to the side, the middle, forward and back, and to the 4 corners.   Focusing on these 16 steps will help the brain reconnect with the body to return to more normal function.

Both Allie and Tom stressed the words Focus and Learning.  To improve your PD symptoms, you must focus on your movements to make them become automatic again, and you must learn new skills to increase the neuroplasticity in your brain.

 

Some related articles:

Study: Biking Restores Brain Connectivity in Parkinson’s

Brain Connectivity

 

Computer Games as Therapy for PD????

I recently read an article from Parkinson’s News Today that explores the use of Computer Games as a non-drug therapy for Parkinson’s Disease.  Being an addictive person who spends way too much time on the computer anyway, I had to check this out.  Can I really justify the minutes – ok hours – spent playing games on my iPad as therapy for my brain? This sounds too good to be true.

The scientific study titled, “Early stage feasibility assessment of a non-pharmacological intervention for motor slowing and fatigue in Parkinson’s disease,” will be conducted by researchers from Bangor University’s School of Psychology(BUSP), the Betsi Cadwaladr University Health Board (BCUHB), and Walton Centre in Liverpool.

They say that the project will record Parkinson’s disease patients’ movement ability before and after playing touch screen “spatial reasoning games” to assess motor function and potential improvements.

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Sudoku

That sounds great, but shouldn’t there also be a study looking at complex reasoning tasks and cognitive ability in games such as Sudoku and Word Brain, where the puzzles get more and more challenging as you progress?  I have been playing these games for a while, and can judge how well I am doing cognitively by how well I do on the games on any given day.  Being able to solve the most difficult Sudoku games is an accomplishment and a measure of cognitive ability.  Some days, I have no problems solving the games.  On those days, I feel that my brain is working the way it should.  Other days, it is just plain difficult and I have to work harder to achieve my goals.

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Word Brain is a word search puzzle, which starts out very easy with a    2 X 2 puzzle and progresses through 20 levels 0f 20 games each, most of which are 6 X 6.  The difficulty increases with each level.  Like Sudoku and other games, it requires  higher and higher levels of problem solving as you progress.

 

Do you have a favorite computer game that stimulates your brain?  Please share it here:

Much Ado about Parkinson’s

As we celebrate the 200th anniversary of Dr. James Parkinson’s groundbreaking essay of “The Shaking Palsy”, there seems to be a flurry of announcements of possible breakthroughs in diagnosis and treatment of Parkinson’s.  Eight years ago, when I was first diagnosed with Parkinson’s, the prevailing theories all stated that PD was a disease that started with “dopamine-producing cell death in the brain.”  Sometimes the cause was genetic.  Other times exposure to pesticides or other chemicals were to blame.  But most of the time, there was no apparent cause.  Just 6 months ago, at the World Parkinson’s Congress, we began to hear about  different ways of looking at PD.

We have known for years, that Parkinson’s is a designer disease.  The progression can be very different for each person.  But now doctors and researchers are looking at PD as a group of syndromes, not just a single neurological condition that caused movement disorders.   Many other symptoms and diseases not typically considered Parkinson’s were now seen as part of PD.    There have been a lot of studies of possible treatments that seemed promising, but the hope for a cure still seemed elusive.  In fact, one of the speakers at the WPC, whom I believe was Tom Isaacs, quipped that the cure was always 5 years away, no matter what the research said.

But something has changed since then.  In the last few months, researchers are coming out with reports that Parkinson’s does not start in the brain, but may actually start in the gut.  Many say the culprit in some cases may be microbiomes in the gut. WOW!  If this is true, scientists at Caltech say it may mean that PD can be detected much earlier and drug treatments can be designed to remove those nasty little bacteria that are causing problems in our gut and our brain.  This treatment may also be more effective because medications

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Credit:  Caltech

can easily be absorbed in the gut, unlike treatments for the brain, which is protected by the blood brain barrier.  There has been much written about this, and it is probably confusing for most of us who are not researchers.   I am not a biologist, or a scientist, but I do understand that treating the cause much earlier, if it is in fact in the gut, is much easier that treating the damaged neurons in the brain, especially since symptoms don’t appear until it is way too late to reverse the damage.

Here is a quick look at some of the other announcements over the last few weeks:

  • Biomarkers  can be used to used to define disease subtypes.  “This precision-medicine approach will likely yield smaller, but well-defined, subsets of [Parkinson’s disease] amenable to successful neuroprotection.” according to Alberto Espay, MD, who conducted a study titled “Precision Medicine For Disease Modification In Parkinson Disease.
  • Last week the FDA approved Xadago   (Safinamide) for people with Parkinson’s disease (PD) who are taking levodopa but experiencing “off” episodes.
  •  Also last week, researchers from the University of New Brunswick    found that an extract from the brown seaweed Alaria esculenta can prevent this conversion and, therefore, could be useful in avoiding the onset of the disease or delaying its progress.”  Ok.  Does this mean we should eat more sushi?
  • A new study published in the Annals of Neurology suggests that redheads may carry a gene variant that increases the risk of both Parkinson’s disease (PD) and melanoma. Researchers have long known that having either PD or melanoma heightens the chances of developing the other condition, but it’s been unclear exactly why.  What if you are blonde and have had both, like I have???  I think this means I am in trouble….
  • The Food and Drug Administration finally gave approval for 23andMe to sell to consumers genetic tests and their accompanying health risk reports for up to 10 diseases, including late-onset Alzheimer’s and Parkinson’s.
  • And finally, the New York Times declared that exercise is good for us old people.

All kidding aside, it seems that the big breakthrough may just come in less than 5 years, which would make all of us very happy.