1. DIET AND RISKS OF
PARKINSON’S DISEASE
Submitted by: Asal Sadeq
Submitted to: Dr. Salma Tokan
2. Introduction:
Parkinson’s disease (PD) also known as
idiopathic or primary parkinsonism,
hypokinetic rigid syndrome/HRS, or
paralysis agitans, is a chronic and
progressive movement disorder.
The cause is unknown, and although there
is presently no cure. But there are
medications and surgery to manage its
symptoms.
3. Parkinson’s involves the malfunction
and death of vital nerve cells in the
brain, called neurons in the an area of
the brain called the substantia nigra.
Which produce dopamine.
4.
5. Tremor or shaking
Small handwriting
Loss of smell
Trouble sleeping
Trouble moving or walking
Constipation
A soft or low voice
Dizziness or fainting
Stooping or Hunching over
Masked face
Signs of Parkinson’s disease
6. RISK FACTORS OF PARKINSON'S DISEASE
Age Gender Head
injury
Exposure
to metals
Area of
residence
Occupation
Pesticide
exposure
Solvents
and PCBs Genetic
7. AGE
About 1% of people over age
60 have Parkinson’s disease
compared with 0.001% of
people 45 or younger.
8. GENDER
Parkinson’s is more common
in men than in women and it’s
unknown whether this is due to
genetic factors, hormones, or
differences in behavior.
9. HEAD INJURY
Injury that results in amnesia or
loss of consciousness has
been associated with an
increased risk of developing
Parkinson’s years after the
injury.
13. PESTICIDE EXPOSURE
Of all chemical exposures that
have been linked to
Parkinson's, pesticides have
been reported the most
consistently.
14. SOLVENTS AND TCE
Occupational exposure to TCE
was found to be associated
with Parkinson's among
workers whose factory results
in long term exposure to the
solvent.
17. CAFFEINE
There have been several recent
studies suggesting that caffeine may
reduce the risk of Parkinson's disease.
And there is a new study suggesting
that caffeine may be a reasonable
treatment for the Parkinson's disease
motor symptoms. ( Dr. Michael S. Okun,
2012)
18. ASSOCIATIONS OF PARKINSON'S DISEASE WITH CONSUMPTION OF TEA, DECAFFEINATED COFFEE,
AND COLA DRINKS, WESTERN WASHINGTON STATE, 1992–2000
AM J EPIDEMIOL VOL. 155, NO. 8, 2002))
95% CIOR*no. of
controls
no. of
cases
Tea
(cups/day)
0.6- 1.31.0202138Almost
never
0.2-0.90.811061>0-1
0.0320.43511>= 2
19. URIC ACID OR URATE
Uric acid is a natural antioxidant that may
reduce oxidative stress, a mechanism
thought to play a role in the pathogenesis of
PD. Higher levels of serum urate may have
a neuroprotective effect. High SU levels
reduced the risk of developing PD and
correlated with slower PD progression.
Among PD patients SU level were lower as
compared with controls. (Ilana Schlesinger,
2008)
20. NICOTINE
Both retrospective and prospective
epidemiological studies have
consistently demonstrated an inverse
association between cigarette smoking
and PD, leading to theories that
smoking in general and nicotine in
particular might be neuroprotective.
(ross GW, 2011)
21. ASSOCIATIONS OF PARKINSON'S DISEASE WITH CIGARETTE SMOKING,
WESTERN WASHINGTON STATE, 1992–2000
( AM J EPIDEMIOL,2002)
95% CIOR*No. of
controls
No. of
cases
Smoking
status
1.0132112Never
smoked
0.4-0.80.521598Ever
smoked
0.1-0.70.3367Current
smoker
0.4-0.90.617991EX-
smoker
22. CHOLESTEROL LEVELS
Statins are among the most widely used
drug around the world. Beyond lowering
cholesterol they are known to fight
inflammation and oxidative stress.
When they get into your brain they likely
modify the brain’s immune system, Lessing
your risk of PD
Finding that when people on certain statins
stop taking them, their risk of developing PD
is higher. (Lee-YC, 2013)
23. VITAMIN D
Two studies of vitamin D and
Parkinson’s indicate that those with
PD have lower vitamin D blood levels
than those without PD.
Vitamin D may also reduce
inflammation in the brain.
25. ANTIOXIDANTS AND MEDITERRANEAN DIET
Antioxidants “soak up” or scavenge free
radicals.
Vitamin C and E are antioxidants that fight
free radicals, and may protect brain cells.
Dietary sources include whole grains, wheat
germ, avocados, nuts and vegetable oil.
26. MEDITERRANEAN DIET
There is some evidence that the
Mediterranean diet, a diet high in
monounsaturated fats, may be
beneficial in reducing blood pressure
and cardiovascular disease.
The diet emphasizes fish, especially
those high in Omega 3 fatty acids, and
food containing antioxidant.
28. PARKINSON’S AND GASTROINTESTINAL
DIFFICULTIES
Scientists point to two explanations for
these difficulties:
The same brain changes in PD cause
stiffness and slow of movement.
PD affect the nerves that line the
digestive tract, called the enteric
nervous system.
30. DIFFICULTIES SWALLOWING
“DYSPHAGIA”
People with Parkinson's tend to
swallow less often and less
completely, and as a result some 70%
have too much saliva, which often
pools in their mouth. (Ron Pfeiffer, 2008)
32. NAUSEA
Nausea or bloating can result when
the stomach empties its content into
the small intestine too slowly, a
condition called gastroparesis. (Ron
Pfeiffer, M.D.,2008)
33. CONTROLLING NAUSEA
Avoid orange or acidic beverages
Drink beverages slowly
Avoid fried or sweet food
Eat slowly
Eat small and frequent meals
Try to eat when you feel lees nauseated
Rest after eating
Eat light, bland food
Don’t mix cold and hot food
34. CONSTIPATION
It’s defined as fewer than three bowel movements
per week, is perhaps the most widely recognized
gastrointestinal symptom of Parkinson’s disease.
In some people with PD, constipation may occur
due to the improper functioning of the autonomic
nervous system which is responsible for regulating
smooth muscle activity.
Medications used to treat Parkinson’s disease can
also cause constipation. (Ron Pfeiffer, M.D., 2008)
35. TO AVOID CONSTIPATION
Eat a well-balanced diet with plenty of fiber
Dink a plenty of water
Exercise daily
Drink warm liquids, especially in the
morning
Add fruits and vegetables to your diet
Eat whole grain food
36. BLADDER PROBLEMS
People with PD may also have bladder
problems. The most common difficulty
is a frequent and urgent need to
urinate, even when the bladder is not
full. (Ron Pfeiffer, 2008)
37. DRUGS USED TO TREAT PARKINSON'S
Carbidopa-levodopa
Dopamine agonists
MAO inhibitors
COMT inhibitors
38. LEVODOPA-CARBIDOPA
It’s converted by enzyme in the brain
to produce dopamine.
Levodopa is most frequent combined
with Carbidopa.
But levodopa has not seen to slow
disease progression. And this drug has
a side effects including: dyskinesia,
hallucinations, illusions, nausea, and
lightheadedness.
39. DOPAMINE AGONISTS
These drugs don’t convert to
dopamine in the brain, but instead
mimic the effect of dopamine on the
brain.
May cause side effects like: daytime
sleeping, hallucinations and risk taking
behavior.
40. MAO INHIBITORS
MAO Inhibitors drugs inhibit an enzyme that breaks
down Levodopa thus extending its action.
Used alone or in combination with levodopa-
carbidopa, but when added to it, the medications
increases the risk of hallucinations.
They have side effects like: the drug may have
interactions with other medications and food, blood
pressure issues must be monitored carefully, also
they may have interaction with antidepressant.
41. COMT INHIBITORS
Catechol O-methyltransferase (COMT)
inhibitors allow a larger amount of levodopa
to reach the brain, thus raising the
dopamine levels there.
Used in conjunction with levodopa-
carbidopa.
Side effects include: dyskinesia,
hallucination mainly from an enhanced
levodopa effect.
42. DIETARY GUIDELINES FOR PD
PATIENTS
Eating regularly
Try to limit sugars
Moderate use of salt
Drink 8 glasses of water per day
Diet should includes plenty of calcium
and Vitamin D
Diet should includes foods high in
fiber.
