Parkinson's in Men - A Devastating Diagnosis

Scientist's have now discovered why men seem to be more afflicted by Parkinson's disease than women.

The `SRY' gene that plays a key role in the formation of male embryos and the testes, located on the male sex chromosome is now known to be a key factor in the development of PD. It is coincidentally present in that part of the brain that is normally affected by Parkinson's. This explains why the degenerative disorder develops 1.5 times more in men than in women. It also explains why other dopamine-linked disorders such as schizophrenia or lifestyle addictions are seen more in males. (The brain cells that produce dopamine, a neuro-transmitter required for normal communication between the Brain and the controlled movement and co-ordination of the body were seen to depend on the same protein for normal male sex specific actions.)
The female hormone estrogen is now viewed as a protective agent for the brain.

Diet and Parkinson's Disease Q & A.
1.    What are the benefits of a controlled diet in Parkinson's disease?
The importance of diet and proper nutritional care cannot be overstressed in PD, both in terms of quality and quantity, especially since the amount of food consumed gradually decreases due to a lack of muscle co-ordination.

The diet chart prescribed by the doctor/dietitian will provide appropriate nutrition to help maintain overall good health.
 
2.    What kind of a diet is generally recommended?
PD patients must consume a diet that is (qualitatively) high in energy, high in protein, medium fat (low cholesterol), high in fiber, vitamin and mineral content. They must also incorporate increased amounts of fluid in their diet.     
                                      
3.    What kind of foods must I choose?
For PD patients each food group plays an important role in regulating their disease. They should choose foods that give them the maximum benefit and should consume quality rather than convenience foods.

Good quality foods to choose from-
Cereal group - Complex carbohydrates such as high fiber cereals, oats, whole grain bread, whole-wheat chappatis, whole grain pasta, bulgur and brown or wild rice are best nutritionally, as well as help relieve constipation.
Protein group - Often restricted protein diets are recommended as the protein can interfere with treatment. However, patients may find that protein helps relieve the medication side-effects. In such cases it is the timing of the protein consumed that should be adjusted. Lean meats of all types, eggs, occasionally liver, legumes/ lentils sprouted raw or cooked, and different kinds of nuts are recommended. (U.S. nih.gov)
Vegetables and fruits - Choose foods high in fiber, vitamins A, C, E as well anti oxidants. This would include plenty of fresh fruits and vegetables of all colors that can be taken in rotation. Fresh preferably unstrained fruit juice should be consumed (pulp adds fiber).
Patients should also ensure they consume foods rich in Vitamin B6 and B12 (foods such as fish, liver, eggs, whole grain cereals, spinach etc are recommended).       

Fats and oils - Avoid saturated fats and cholesterol rich foods. Use olive oil, canola and safflower oil for cooking as well on salads. Avoid pre-packaged and fried foods as they have higher sodium content as well as preservatives.
 
Dairy group - 1%-2% fat milk, yogurt, ice cream and low-fat cheese can be consumed. 1200-1500 mg of calcium and 800 IU of vitamin D a day will help.  

4.    I have problems with eating, what can I, or my family do?
As the disease progresses, the patients eating habits and digestive abilities will be lessened and as such must be addressed to ensure continued nutritional intake. Your dietician can best guide you in terms of an eating timetable and combination of foods to ensure nutritional adequacy. They will also help you address the practical issues of nausea, constipation or constant thirst that afflicts a lot of patients.

Things to keep in mind:
•    Avoid smoking, alcohol and caffeinated beverages
•    Eat smaller but more frequent meals.
•    Keep your food as moist as possible to help chewing.
•    Avoid empty calorie foods like chips, fried foods, candies and colas.
•    Reduce or avoid use of refined sugar.
•    Take plenty of fluids at least 7-8 cups a day (1& ½ -2 liters /day)
•    Nuts and dairy rich foods are especially important to prevent thinning of   
        bones as they provide calcium and magnesium.
•    Garnish your food and make it colorful and appetizing

5.    Do I need to take supplements?
A good diet will take care of all your nutrient needs; the doctor will definitely prescribe supplements if and when required.

6.    I hate going out anywhere, what should I do?
Apart from regular medication, regular exercise is a must. Whenever you go out in the sunlight your body will absorb vitamin D from the sun, which will help in maintaining bone density, as patients with PD are prone to osteoporosis. The doctor will recommend the type and amount of exercise required per day to keep the muscles as supple as possible and help in basic day-to-day activities. These exercises should be regularly followed and will help maintain the quality of life and ease constipation whenever it occurs. The earlier you start exercising and building stronger muscles, the longer you will retain your muscular co-ordination.

7.    Can diet prevent Parkinson's disease?
No, till date research has not found a way to prevent Parkinson's disease but, if as a rule a person follows a well balanced diet with major emphasis on high intake of fruits, vegetables, legumes, whole grains, poultry, and fish with light alcohol consumption, they can help ease some of the symptoms.

Foods such as these are especially rich in anti-oxidants and omega 3 fatty acids. These are important to maintain the quality of life after the onset of the disease, and help delay the more debilitating aspects of Parkinson's.

By. Viji Iyengar, Dietitian, NutritionVista.com