Sunday, June 28, 2009

More Food for Parkinson's Disease Thought

If you have Parkinson's disease, there may be nutrition decisions to make

Timing is everything
If you are taking levodopa meds you'll have to find the right times for protein. You need the proteins and it is difficult to avoid them from your breakfast cereals to the cheese and fruit you have for dessert.

Meat is not the only source of protein so be aware of the effect that protein has upon your dopamine before you eat eggs at 6 grams, yogurt at 8+ grams per cup, milk or soy milk at 6-10 grams, beans at 7-10 grams per 1/2 cup, a handful (1/4 cup) of nuts from pecans at 2.5 grams to pumpkin seeds at 19 grams (seeds and nuts are very important for their magnesium content). 
While most nutritionists-dietitians will tell you that vegetable protein is probably the best choice for PD patients, there are some added nutritional benefits from certain animal smaller portions.

When you eat may depend upon whether a medication has to be taken on an empty stomach or with a meal, usually to avoid nausea but also to avoid conflict with dopaminergics, i.e. levodopa.

What you eat may depend upon what medications you are taking
Although you need the full Vitamin B complex, if you are taking L-dopas, you need to know that B6 can interfere.
Some MAOIs have the pickle restrictions, while others, the MAOI-Bs, probably don't need them.
Gonna Change My Way of Thinking about food
You probably can't eat all of the things you used to eat for a variety of reasons. Limiting red meat is not just because of iron and fat, sometimes it is too tough or stringy to properly swallow, let alone digest. PD dental issues may require that veggies be cooked a bit longer. The good thing is you can compensate with well seasoned sauces.
Savory seasonings stimulate the appetite - Latin Proverb

Some other things to consider:
Dopamine synthesis: phenylalanine -> Tyrosine ->L-Dopa -> dopamine ->Norepinephrine
Synthesis of dopamine requires these nutrients:
Minerals iron, copper, magnesium, manganese, zinc
Vitamins B3, B6, folate
Serotonin synthesis: Tryptophan -> 5-Hydroxytryptophan -> Serotonin (5-Hydroxytryptamine) -> Melatonin
Glutathione (GSH) rich foods: broccoli, cauliflower, onions, brussel sprouts, tomato, carrots, spinach, turmeric, cinnamon, garlic may not provide usable GSH.  Alpha Lipoic Acid (ALA) has similar benefits and may raise GSH levels.
Remember this: Fiber can interfere with the absorption of dietary manganese - Timing is important.
High manganese foods are not the same thing as high manganese exposure so don't rule them out.

Fun Foods at Random from A to W
ALMONDS - Provide Vitamin E, magnesium, potassium plus Vitamin B2 (riboflavin), manganese, copper and are high in fiber and protein.
APPLE - An apple a day may help fight constipation. Low vitamin C content, but antioxidants and flavonoids enhance the activity of vitamin C, thereby helping to lower the risks of colon cancer, heart attack & stroke.
APRICOTS - A source of Dietary Fiber and Potassium, Vitamin A and Vitamin C. I like them for adding that sweet flavor bite
ASPARAGUS - High in folic acid (folacin), fiber, Vitamins B6, A, C,Thiamine and in potassium. Low sodium, no fat or cholesterol. Asparagus also contains the antioxidant, glutathione (GSH) and rutin. 5 spears have 20 calories and have 3 grams of protein.
BANANAS - Potassium, Dietary Fiber, Vitamin C and Vitamin B6. Also a source of Magnesium required for synthesis of dopamine. But high in fat.
BEETS - A source of Vitamin C, Iron, Magnesium, Dietary Fiber, Folate, Potassium and Manganese.
BLUEBERRIES - Blue is key. Anthocyanins, the bioflavonoids of these berries elevate glutathione levels.
So have a few RED or PURPLE GRAPES, purple or RED CABBAGE as well as tart cherries. About blueberries and polyphenols - James Joseph, PhD USDA, Agricultural Research Service Research Physiologist at Tufts University found that blueberries may cause a 30% neurogenisis (new brain cells)
BROCCOLI - Protein, Vitamin E (Alpha Tocopherol), Thiamine, Riboflavin, Pantothenic Acid, Calcium, Iron, Magnesium, Phosphorus, Selenium, and a very good source of Dietary Fiber, Vitamin A, Vitamin C, Vitamin K, Vitamin B6, Folate, GSH and ALA, Potassium & Manganese.
BRUSSEL SPROUTS - Are a source of Riboflavin, Iron, Magnesium and Phosphorus, Dietary Fiber, Vitamin A, Vitamin C, Vitamin K, Thiamine, Vitamin B6, Folate, GSH, Potassium and Manganese.
CABBAGE - Contains Thiamine, Calcium, Iron, Magnesium, Phosphorus Potassium, Dietary Fiber, Vitamin C, Vitamin K, Vitamin B6, Folate, GSH and Manganese.
CANTALOUPE - A slice of Dietary Fiber, Niacin, Vitamin B6 and Folate, Vitamin A, Vitamin C and Potassium.
CARROTS - Have Thiamin, Niacin, Vitamin B6, Folate and Manganese, Dietary Fiber, Vitamin A, Vitamin C, Vitamin K, GSH and Potassium.
CAULIFLOWER - Protein, Thiamin, Riboflavin, Niacin, Magnesium, Phosphorus, Dietary Fiber, Vitamin C, Vitamin K, Vitamin B6, Folate, Pantothenic Acid, Potassium & Manganese.
Tart Cherries make such good pies. The are also helpful in lowering blood sugar and insulin levels. TART CHERRIES can also cause a decrease in cholesterol and triglyceride levels. Elements seem to be associated with relieving pain of inflammatory conditions such as arthritis. They may be a Cox-2 inhibitor but that is in research. Tart cherries are a good source of antioxidants including quercetin and melatonin, the hormone that controls the sleep-wake cycle.
COCONUT - for those medium chain triglycerides. Try cooking and baking with coconut oil or making salad dressings. Provides EFAs, essential fatty acids.
CRANBERRIES - An Excellent antioxidant with Vitamin E (Alpha Tocopherol) and Vitamin K, dietary fiber, Vitamin C and Manganese.
EGGPLANT - A source of Vitamin C, Vitamin K, Thiamin, Niacin, Vitamin B6, Pantothenic Acid, Magnesium, Phosphorus, Copper, Dietary Fiber, Folate, Potassium and Manganese.
GINGER - Vitamin C, Magnesium, Potassium, Copper and Manganese. An anti-inflammatory which also aids with nausea.
GUAVA and PAPAYA are high in vitamin C. Guava is a good fiber source. Papaya, like CANTALOUPE, MANGO and watermelon are good sources of C, A, calcium and potassium...
HUMMUS - Ok, its a dip of chickpeas/garbanzo beans, olive oil and usually tahini or sesame paste but properly's a meal. Be advised, hummus has no or low saturated fat, is high in protein. It also has iron, calcium and Vitamin C.
KIWI: Fuzzy but mighty. Kiwis are a good source of potassium, magnesium, vitamin E & fiber. The vitamin C content is twice that of an orange.
LEMONS - Vitamin B6, Iron, Potassium, Dietary Fiber and Vitamin C plus they prevent fruits in salads from oxidizing. And don't forget the bioflavonoids in the rind. You can add lemon zest to many dishes.
LIMES - Calcium, Iron, Copper, Fiber and Vitamin C.
MUSCADINE GRAPE SEED - Contain high levels of resveratrol, one of the compounds in red wine which is believed to help reduce the risk of abnormal cells and may also protect dopamine neurons against lipopolysaccharide neurotoxicity through its anti-oxidant properties. They are also high in vitamin C, ellagic acid (a polyphenol antioxidant) and contain potassium, vitamin B and trace minerals.
NUTS, SEEDS - important source of magnesium to help restore serotonin levels lost to stress
OLIVES - These tasty guys have protein, calciium, potassium as well as fiber content, traces of zinc, copper and selenium and choline. They also contain Vitamin A, E, C and K. They are high in mono-unsaturated fatty acids.
ONIONS - A source of Dietary Fiber, Vitamin B6, Folate, Potassium, GSH, Manganese & Vitamin C.
ORANGE : Sweetest medicine. Taking 2-4 oranges a day may help keep colds away, lower cholesterol, prevent & dissolve kidney stones as well as lessen the risk of colon cancer. However, they have a high sugar content so unless you are on a weight gain program...Bioflavonoids in the rind are considered to be anti-inflammatory and antioxidant. Find a way to use the rind - don't throw it away as it can be a huge asset.
Bioflavonoids include: Diosmin, hesperidin, rutin, naringin, tangeretin, diosmetin, narirutin, neohesperidin, nobiletin, and quercetin. You'll see some listed on the Vitamin C complex bottle. Perhaps juicing them...
PARSLEY is extremely nourishing to the optic system. It is supposed to help reduce inflammations of the kidneys, bladder, urethra, and genital organs. A digestive stimulant and rich in potassium, magnesium, calcium, and chlorine
PEACHES - A source of Dietary Fiber, Vitamin A, Niacin and Potassium and Vitamin C.
PINEAPPLE - Dietary Fiber, Thiamin, Vitamin B6, Copper, Vitamin C and Manganese.
PLUMS - Dietary Fiber, Vitamin A and Vitamin K and Vitamin C.
POTATOES - Red and White are very similar:  Dietary Fiber, Vitamin B6, Potassium and Manganese and Vitamin C
RASPBERRIES - Vitamin K and Magnesium, Dietary Fiber, Vitamin C & Manganese.
RED PEPPER - Thiamin, Riboflavin, Niacin, Pantothenic Acid, Magnesium, Dietary Fiber, Vitamin A, Vitamin C, Vitamin E (Alpha Tocopherol), Vitamin K, Vitamin B6, Folate, Potassium & Manganese.
SPINACH - good for the entire digestive system, and for all cells tissues, nerves, and muscles. It naturally stimulates the peristaltic action of the intestines. Spinach contains the finest quality of organic iron available. It is a source of Niacin, Zinc, Dietary Fiber, Protein, Vitamin A, Vitamin C, Vitamin E (Alpha Tocopherol), Vitamin K, Thiamin, Riboflavin, Vitamin B6, Folate, GSH, ALA, Calcium, Iron, Magnesium, Phosphorus, Potassium, Sodium, Copper and Manganese.
STRAWBERRIES - 50 calories per cup - 1 gram of protein, 3.81 grams of dietary fiber, also contain iron, magnesium. phosphorus, potassium, folate, selenium, vitamins C & A. If you're not going to use them right away, freeze unwashed strawberries in a plastic bag...for a few months. Strawberries along with blueberries and spinach contain powerful antioxidants and have been shown to relieve oxidative neuronal stress.
SWEET POTATO - A source of Dietary Fiber, Vitamin B6, Potassium, Manganese & Vitamin A
TOMATO - Contain Vitamin E (Alpha Tocopherol), Thiamin, Niacin, Vitamin B6, Folate, Magnesium, Phosphorus and Copper, DietaryFiber, Vitamin A, Vitamin C, Vitamin K, Potassium and Manganese
WALNUTS - a good antioxidant and a source of Omega 3, ellagic and gallic acids, Vitamin E. Walnut oil contains aginine, oleic acid, zinc, manganese and chrome. Both Almonds and Walnuts are high in monounsaturated fats.
"WATERMELON - it's a good fruit," said Enrico Caruso, "You eat, you drink, you wash your face." Good source of Vitamin C, Vitamin A (beta carotene the A precursor) antioxidants which "neutralize" the free radicals. Has lycopene-yes they beat out tomatoes - Vitamin B6, B1, iron, calcium, magnesium, GSH. No cholesterol or saturated fat. Most of it's 48-76 calories per cup come from sugars. Don't confuse magnesium (necessary for bone health) with manganese. However, Watermelon increases plasma concentration of arginine through citrulline, an amino acid which can metabolize to arginine. "Arginine is the nitrogenous substrate used in the synthesis of nitric oxide..." This may not be such a good thing for PD patients: we'll be discussing mitochondrial Complex I soon.

We'll talk later about cooking some of the stringier veggies so that PWPs can actually swallow them and gain the nutritional value from them.

Nutritionists suggest an old style Mediterranean diet high in Omega 3.  Such a diet includes olive oil, fruits and vegetables, fish (limited red meat), and red wine.

My sister would recommend juicing as a way to be sure of getting at least a daily minimum of fruits and vegetables and I agree. For those who want to keep it simple, we've been trying V8 Fusion. Some folks might need to be aware of the sodium and potassium content if  having more than one can a day.

more reading to help you decide: mineral - nutrient chart
vitamin - nutritional chart
vegetable - nutrition chart
nuts and seeds - nutrition chart

Note: Good News - the cheese effect or tyramine warning has been removed by the FDA from Azilect, an MAO-B inhibitor since this post was written.

Addendum: magnesium is necessary for 300+ biochemical reactions in the human body.  Chocolate cravings might be a sign of magnesium deficiency.  Low levels of magnesium may also trigger lowered dopamine levels thus the desire for the pleasure-producing chocolateOf course bitter or baking chocolate has a high magnesium content, as does cocoa powder, so this isn't just an odd craving. For quick body feedback, go with the darkest chocolate bar available...if it has almonds or cashews, all the better.  Or have a cup of instant (powder) coffee.

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