Parkinson's Disease


Parkinson’s Disease (PD) is a progressive neurologic disorder that involves the destruction of neurons that typically leads to tremors, stiffness, and poor coordination related to degeneration of the basal ganglia in the brain and a decrease in the neurotransmitter dopamine.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Read & Watch
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Overview


Estimates on the prevalence of Parkinson’s Disease (PD) in the U.S. are approximately 0.3%.1 It primarily affects older adults, and in about 25% of the cases, it may involve dementia. Other symptoms may be part of PD, including:

  • Slow physical movement
  • Poor balance
  • Physical rigidity/stiffness
  • Difficulty walking
  • Resting tremor
  • Slow thinking
  • Fatigue
  • Disturbed sleep
  • Decrease in dexterity
  • Depression
  • Constipation

The exact cause of PD is unknown. Genetics may play a small role, but environmental factors seem to play a stronger role. Many factors have been associated with an increased risk, such as heavy metal and chemical exposures, especially pesticides.2 Also, studies have shown a correlation with PD risk and being sedentary, overweight, having high cholesterol, eating fewer vegetables and fruits and too many animal products, and eating excessive amounts of iron (such as from red meat). One theory for why eating more animal products leads to a higher risk is that there is more exposure to chemicals or heavy metals, as these are more concentrated in animal products, but the risk of more oxidative stress to the brain from low intake of protective nutrients found primarily in vegetables and fruits may also contribute to this risk.

 
References
  1. Strickland D, Bertoni JM. Parkinson's prevalence estimated by a state registry. Mov Disord 2004, 19:318-323.
  2. van der Mark M, Brouwer M, Kromhout H, et al. Is pesticide use related to Parkinson disease? Some clues to heterogeneity in study results. Environ Health Perspect 2012, 120:340-347.

Action Plan


Diet

  • Increased dietary intake of phytonutrients, such as with a Nutritarian eating style, may be protective and lower the risk of developing Parkinson’s Disease (PD),1,2 and may even help slow the progression of PD in those already with the disease.
  • Phytochemical-rich foods, such as greens, berries, and nuts are linked to better brain health, largely because carotenoids, flavonoids, cruciferous-derived isothiocyanates, and other phytochemicals have antioxidant, anti-inflammatory, and other effects that protect the brain. Oxidative stress and neuroinflammation are thought to contribute to neurodegenerative disorders, such as Parkinson’s disease.3-8
  • Eating foods that are organically grown as part of an effort to reduce pesticide and other chemical exposures may be an important strategy.
  • Reducing animal products as part of the Nutritarian eating style is also an important strategy, as this further reduces pollutant and heavy metal exposure, as well as lowers oxidative stress and inflammation.

Supplements

  • Dr. Fuhrman’s general supplement protocol for adults (see Vitamin Advisor for details) includes:
  • Additional notes:
    • Sufficient intake of omega-3 fatty acids (DHA and EPA) is important for maintaining brain health with aging.9,10 Taking in sufficient amounts of omega-3 fats regularly may be particularly important in reducing the risk of PD, as an omega-3 deficiency reduces the ability of the brain to tolerate oxidation, leading to worse brain cell damage.2,11 Taking algae-derived supplemental omega-3 DHA and EPA allows for a reduction in contaminated fish in the diet in order to reduce pollutant exposures.

Exercise

  • Regular exercise is recommended and has been shown to help mobility, balance, and overall quality of life, and also cognition in those with PD.12,13

Other Considerations

  • Avoid household pesticide or herbicide chemicals.
  • Use filtered water, especially if drinking well water.

Read

Find additional help

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References
  1. Okubo H, Miyake Y, Sasaki S, et al. Dietary patterns and risk of Parkinson's disease: a case-control study in Japan. Eur J Neurol 2012, 19:681-688. doi: 10.1111/j.1468-1331.2011.03600.x

  2. Seidl SE, Santiago JA, Bilyk H, Potashkin JA. The emerging role of nutrition in Parkinson's disease. Front Aging Neurosci 2014, 6:36. doi: 10.3389/fnagi.2014.00036

  3. Spencer JP. Flavonoids and brain health: multiple effects underpinned by common mechanisms. Genes Nutr 2009, 4:243-250. doi: 10.1007/s12263-009-0136-3

  4. Liu Z, Zhou T, Ziegler AC, et al. Oxidative Stress in Neurodegenerative Diseases: From Molecular Mechanisms to Clinical Applications. Oxid Med Cell Longev 2017, 2017:2525967. doi: 10.1155/2017/2525967

  5. Davinelli S, Maes M, Corbi G, et al. Dietary phytochemicals and neuro-inflammaging: from mechanistic insights to translational challenges. Immun Ageing 2016, 13:16. doi: 10.1186/s12979-016-0070-3

  6. Sun Y, Yang T, Mao L, Zhang F. Sulforaphane Protects against Brain Diseases: Roles of Cytoprotective Enzymes. Austin J Cerebrovasc Dis Stroke 2017, 4. doi: 10.26420/austinjcerebrovascdisstroke.2017.1054

  7. Stringham JM, Johnson EJ, Hammond BR. Lutein across the Lifespan: From Childhood Cognitive Performance to the Aging Eye and Brain. Curr Dev Nutr 2019, 3:nzz066. doi: 10.1093/cdn/nzz066

  8. O'Brien J, Okereke O, Devore E, et al. Long-term intake of nuts in relation to cognitive function in older women. J Nutr Health Aging 2014, 18:496-502. doi: 10.1007/s12603-014-0014-6

  9. Pottala JV, Yaffe K, Robinson JG, et al. Higher RBC EPA + DHA corresponds with larger total brain and hippocampal volumes: WHIMS-MRI study. Neurology 2014, 82:435-442. doi: 10.1212/WNL.0000000000000080

  10. Tan ZS, Harris WS, Beiser AS, et al. Red blood cell omega-3 fatty acid levels and markers of accelerated brain aging. Neurology 2012, 78:658-664. doi: 10.1212/WNL.0b013e318249f6a9

  11. Cardoso HD, dos Santos Junior EF, de Santana DF, et al. Omega-3 deficiency and neurodegeneration in the substantia nigra: involvement of increased nitric oxide production and reduced BDNF expression. Biochim Biophys Acta 2014, 1840:1902-1912. doi: 10.1016/j.bbagen.2013.12.023

  12. Grazina R, Massano J. Physical exercise and Parkinson's disease: influence on symptoms, disease course and prevention. Rev Neurosci 2013, 24:139-152. doi: 10.1515/revneuro-2012-0087

  13. Murray DK, Sacheli MA, Eng JJ, Stoessl AJ. The effects of exercise on cognition in Parkinson's disease: a systematic review. Transl Neurodegener 2014, 3:5. doi: 10.1186/2047-9158-3-5

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

Are the causes of Parkinson’s disease genetic, environmental, or diet related? If they are genetic, then is it just a roll of the dice as to who gets them?

A.

Most diseases involve both genetic and environmental causes. Some interaction between genetics and the environment are present in Parkinson’s. Parkinson’s has some link with chemical or pesticide exposure, and it is possible that a genetic sensitivity to that exposure and multiple chemicals could promote the defect.

 
Q.

I read your article on the DHA/Parkinson’s connection. My 62-year-old brother is hardly the model for healthy eating, and he does have Parkinson’s, but he also does eat a lot of fish (which I have understood to be the best source of DHA). So, why then does he have Parkinson’s? Is DHA a successful form of treatment once people are diagnosed with Parkinson’s? Is eating lots of fish an acceptable way for some people to get the necessary DHA? Also, what causes these toxins that lead to Parkinson’s?

A.

Parkinson’s is not caused by DHA deficiency, but DHA deficiency makes one more susceptible to the toxins that do cause it. So, just because your DHA stores are normal doesn’t mean you can’t get it. Nobody knows the precise causes of Parkinson’s, but there are some studies that implicate certain toxins and pesticides.

Your brother should eat right and take DHA. Keep in mind, however, that this will not cure it but may slow the worsening of his symptoms. Most fish do not have much DHA and EPA, though wild salmon and sardines are rich. I do not recommend people eat much fish because of the pollution and mercury issues. Eating some wild, low-mercury fish once or twice a week is an option, as is taking a little supplemental DHA. He still needs to adhere to a Nutritarian diet to prolong his life and reduce his chances of this getting worse.

 
Q.

Have Parkinson’s disease patients been treated at your facility? Can you say something about how they do on your plan? Thanks.

A.

Over the years, many patients with Parkinson’s disease have been helped here. Research has shown that diet has a profound influence on our nervous system and neuronal function. Phytochemicals within a Nutritarian diet have been found to modulate inflammation and oxidation in the brain. Patients with Parkinson’s have excessive amounts of both, so, the hope is that by providing sufficient nutrients to diminish further neuronal injury and eliminating foods that are pro-inflammatory, people with neuro-degenerative illness will have decreased progression and maybe improved function.

We see people at various stages of Parkinson’s. The best time to institute the dietary changes is early on in the course of the illness. Nevertheless, even for people who have had Parkinson's for a while, this dietary style will be beneficial on many levels.

Also, certain supplements are being studied and may be useful such as CoQ10, riboflavin, curcumin, resveratrol, and EPA and DHA.