1. Parkinsons & a plant based diet Danielle Selden Alicia Armeli

2. Why we chose this article.... Proof in plants A concerning underlying problem with our current method of treatment- its not working long term. Two recent studies have shown that a plant-based dietary pattern may protect against PD. This peer-reviewed article looks at the effectiveness of a plant-food diet in the management of PD. Higher Quality of life

3. Currently there is no cure.... Quick Facts about Parkinsons Disease (PD): PD is a chronic progressive movement disorder in which the neurons that produce dopamine are impaired. PD is characterized by slow and decreased movement, muscular rigidly, resting tremor, postural instability, and decreased dopamine transmission to the basal ganglia. Since Dopamine is not available movements can not be controlled. Etiology is unclear but is thought to arise from both genetic and environmental factors. Treatment includes medication, surgery, and other modalities to manage symptoms.

4. Introduction Preventing a high protein based diet is critical for treatment. Levodopa, a prodrug of dopamine (derived from the A.A tyrosine), remains the most effective treatment to alleviate motor dysfunction in PD. The Protein Redistribution Diet was formulated to avoid the risk of nutritional deficiencies linked to extreme restriction in total protein intake. This intervention consists of a normoproteic diet- a pts main protein intake occurs in the evening meal in order to limit the negative interaction of LNAA on L-Dopas response at daytime, while the negative effects act up during sleep at night.

5. Why a plant-food diet? A plant-food vegan diet (PFD) is expected to raise L-Dopa availability and bring some advantage in the management of disease. This pilot study was designed to establish whether a PFD normoproteic protein redistribution diet can be just as effective as a protein-redistributed OD in improving motor performance in L- Dopa treated PD patients in the short term.

6. Subjects All 25 participants in the study were PD patients 12 were in the intervention group (PDi) and 13 in the control group (PDc), respectively. Pts have had a good response to levodopa in the past, with a daily dose over 350mg, under 850mg, and over 50 years of age, BMI over 18.5 and under 30. Pts were already following advices to limit total animal protein and to concentrate them in an evening meal in the context of an OD. Pts were given the choice to consume the PFD or the usual OD for a 4-week period.

7. Methods and Measures A quasi-experimental non-equivalent group design (NEGD) was utilized. The PD intervention (PDi) diet/vegan diet- includes plant-protein rich sources only for dinner (2/3 of total daily intake of PRO) The control group (PDc)/omnivorous diet- limited total animal food and concentrated them in the evening meal Neurological assessments were made by an experienced neurologist using the comprehensive PD measurement tool United Parkinsons Disease rating system Mann-Whitney Sun Score Hoehn and Yahr

8. Results After 4 weeks the PDi group showed a significant reduction with respect to the PDc group in... Metabolic changes in the PDi group- total cholesterol, HDL cholesterol, apo-A1, and apo-B showed significant differences after 4 weeks. PDiPDc (Mann-Whitney Test) UPDRS Total Score [P=0.008] 47.6774.46 Sub-score III- Motor Performance [P=0.001] 25.4246.46 Modified HY Scale [P=0.005] 1.963.15

9. Limitations Lack of random assignment of subjects to intervention or control groups. Both groups have small sample sizes. Short study time- 4 weeks. Lack of blood measurements of levodopa and dietary LNAA at the enrolment and after 4 weeks.

10. Conclusions This study showed after 4 weeks of a PFD in the PDi had a value 27 points (47.67 vs. 74.46) lower than the PDc group, a result that is clinically relevant. Due to its high fiber content, a PFD can potentially raise levodopa bioavailability by reducing the phenomenon of constipation. Consumption of a PFD is may be more effective than an OD for improving motor performances in PD pts. Additional studies need to be performed, especially longitudinal randomized trails of larger groups

11. A comprehensive plan for PD Patients Increase Antioxidants/ phytochemicals and mitochondrial stabilizers: CoQ10 and Vitamin E Vitamin D and Omega 3s Magnesium Alpha lipoic acid Fava Beans- 3oz. Contain levodopa Vegan diet Acupuncture- shows reduced sxs Massage- anecdotal evidence of reduced sxs

12. References Baroni L, Bonetto C, Tessan F, Goldin D, Cenci L, Magnanini P, Zuliani. Pilot dietary study with normoproteic protein-redistributed plant-food diet and motor performance in patients with Parkinsons disease. Nutritional Neuroscience. 2011;14:1:1-9. Mahan K L, Escott-Stump S, Raymond J L. Krauses Food and the Nutrition Care. St. Louis, MO: Elsevier Saunders; 2012: 675-708. Parkinsons Disease Foundation. Available at: http://www.pdf.org. Accessed May 30, 2012. The Parkinsons Foundation. Available at http://www.parkinson.org. Accessed May 31, 2012. The Natural Standard. Parkinsons Disease. Available at http://www.naturalstandard.com. Accessed May 30, 2012.