Food is an important part of overall health and wellness, and that’s true when you’re managing Parkinson’s disease, too. While symptoms like nausea, swallowing issues, or tremors — not to mention diet restrictions — can make meal times more challenging, eating a healthy, balanced diet might be more important for you than ever.

Specifically, a healthy diet helps your prescription medications to work optimally, keeps your bones strong, fights constipation and weight loss, and helps maintain your physical health, according to the Parkinson’s Foundation.

“Diet and nutrition don’t replace medication, but they work in tandem with it,” says Indu Subramanian, MD, a neurologist at Ronald Reagan UCLA Medical Center in Los Angeles who specializes in wellness and integrative medicine approaches. “Certainly, a healthy lifestyle, including a balanced diet, helps you feel better, whether or not you have Parkinson’s disease.”

How Does Parkinson’s Disease Change the Way You Eat?

If you’ve been diagnosed with Parkinson’s disease, you may have noticed some changes in your appetite and eating habits, says Dr. Subramanian.

For example, some of your prescription medications may work best on an empty stomach, but they may also cause nausea in some people when taken without food.

“We advise people to take their medication about an hour before meals, if possible, to avoid any protein interaction,” Subramanian says. Eating protein-rich foods like meat, fish, eggs, dairy products, nuts, and beans too close to the time you take medications can interfere with how the body processes some medications prescribed to treat Parkinson’s disease, which may cause them to work less quickly or less effectively.

If you experience nausea after taking your medication on an empty stomach, your doctor may recommend eating a small, light snack like crackers or applesauce before taking your pills.

Subramanian also notes that loss of appetite and subsequent weight loss are a major concern for people with Parkinson’s disease. This may be caused by symptoms such as difficulty swallowing, decreased ability to taste or smell, nausea side effects from medications, or movement problems (with your hands and wrists) that make it difficult to eat.

To address these issues, the Parkinson’s Foundation recommends:

-Placing dishes on rubber mats to prevent them from slipping while eating

-Using weighted utensils — for example, the “Parkinson’s spoon” — and cups

-Using cups with lids or straws to reduce spilling

-Cutting foods into smaller pieces and chewing extensively to ease swallowing

-Eating foods that are easier to swallow, such as soups and pureed dishes

-Eating bitter green vegetables like kale or spinach or spicy foods to stimulate your appetite and add taste to food

-Exercising before meals to increase hunger

How a “Parkinson’s Spoon” Can Make Eating and Drinking Easier

Parkinson’s disease symptoms like tremor, joint stiffness, or difficulty swallowing may make eating certain foods challenging. Try consulting an occupational therapist, who can recommend assistive devices that will make eating and drinking easier, says Subramanian.

One option: Use a “Parkinson’s spoon.” This popular device is designed to make mealtime easier for people with Parkinson’s disease. There are different products available, but all of them are eating utensils that have been equipped with a special design or technology that helps stabilize them as you eat.

Dietitians, Speech Pathologists, and Mental Health Experts Can Help, Too

Talking to a registered dietitian can help you make changes to your diet — for example, by learning how to use thickening liquids or soften solid foods.

If swallowing continues to be a problem, a speech-language pathologist may be able to help you find ways to make swallowing easier.

“A speech pathologist who is also a swallow therapist can do a swallow study, a test during which you try different foods and they monitor how you swallow using an X-ray machine,” Subramanian explains. “Food aspiration, or when food gets into your lungs, can be a problem with Parkinson’s disease, so the swallow study can identify problem foods and your doctors can recommend changes and diet modifications to make eating safer.”

Finally, as anxiety or depression are common in people with Parkinson’s and can suppress appetite, it’s important to recognize symptoms associated with these behavioral health conditions and seek out treatment if needed.

What Are the Best Foods to Eat for Parkinson’s Disease?

If you had a healthy diet before being diagnosed with Parkinson’s, there’s a good chance you don’t have to overhaul your eating habits very much. But there are a few additional considerations you should be aware of.

The Parkinson’s Foundation recommends eating a diet that’s full of grains like brown rice and breads; vegetables; fruits, including berries and sliced apples; and lean protein like beans. Collectively, these foods provide vitamins, minerals, fiber, and complex carbohydrates to help you lower your intake of fat and maintain a healthy weight while giving your body the nutrients it needs.

“The Mediterranean Diet has become popular in Parkinson’s disease, and we recommend it to a lot of our patients,” Subramanian says. “We also recommend the Mind Diet, which is low in salt and is designed to improve brain function. Generally, it’s best to avoid processed foods and foods with artificial or simple sugars. Try to stay as much as you can in a whole-food and plant-based diet.”

In addition, following the guidelines established by the US Department of Agriculture MyPlate program will enable you to have a balanced diet that provides your body with the energy, protein, vitamins, minerals, and fiber it needs for good health. For example, eating meals rich in calcium, magnesium, and vitamins D and K can help strengthen bones, which is especially important given that Parkinson’s disease can increase your risk of bone-thinning.

Foods that are excellent sources of bone-strengthening nutrients, says Subramanian, include:

-Salmon

-Milk

-Eggs

-Spinach
-Certain nuts, like almonds

And because vitamin D deficiency is common in people who have Parkinson’s disease, talk to your doctor about whether you need to increase your intake of the important nutrient for bone and gut (and perhaps brain) health, Subramanian suggests. Fortified milk and milk products, egg yolks, and fatty fish like salmon are excellent sources of vitamin D, she adds.

How Do Antioxidant-Rich Foods Help Parkinson’s?

Antioxidants help fight free radicals, which are harmful molecules that are produced by our bodies (particularly when we’re stressed or injured). Because free radicals can cause oxidative stress, or damage, to nerve cells, some researchers think there may be a link between this damage and Parkinson’s disease, according to the Parkinson’s Foundation. However, the organization points out, so far, there’s no good evidence that shows antioxidant supplements can treat Parkinson’s.

A diet rich in antioxidants — including brightly colored and dark fruits, like berries, and leafy green vegetables — can help you maintain overall brain health, says Subramanian. Plus, she says, certain nuts have also been linked with improved brain health.

According to a landmark study published in 2010 in the Nutrition Journal that catalogued the antioxidant content of more than 3,000 foods, some foods that are highest in antioxidants include:

-Dried apples

-Blackberries

-Apricots

-Artichokes

-Dried mangos

-Raspberries

-Dried plums

-Strawberries

Is Green Tea Good for Parkinson’s?

Interestingly, some studies have observed that green tea, which is also high in antioxidants, helps slow the progression of Parkinson’s disease and other neurodegenerative disorders, according to a review published in March 2016 in the journal CNS Neurological Disorders-Drug Targets. However, how the drink works to prevent these conditions and what constitutes the safest and most effective “dose” of green tea hasn’t been determined.

Constipation and Hydration in Parkinson’s Disease

As Parkinson’s disease can cause constipation, the Parkinson’s Foundation recommends a diet featuring 20 to 25 grams of daily fiber to maintain bowel health.

“It’s really important for overall health to keep bowels moving,” Subramanian says. “We recommend a diet with a lot of vegetables and as much fiber as you can take. Foods that are high in prebiotics, including fermented foods like sauerkraut and kimchee, can also help.”

Some Parkinson’s disease medications don’t work as well when taken with fermented foods, however, so check with your doctor before incorporating them into your diet.

Proper hydration is also important for everyone, including people who have Parkinson’s disease. Try to drink six to eight glasses of water a day and take your medications with a full glass of water, the Parkinson’s Foundation notes. It may help your body break down the medication more efficiently.

“Hydration helps with blood pressure and constipation,” Subramanian notes. “We recommend our Parkinson’s patients drink 40 ounces of water a day. That’s just water, not coffee or tea or other drinks. This can also help improve digestion.”

If drinking water leads to urinary urgency, try eating foods with a high water content like celery, butternut squash, grapefruit, strawberries, and watermelon instead.

Foods to Avoid in a Parkinson’s Disease Diet

If your goal is to maintain overall health with Parkinson’s disease — and it should be — you should avoid or reduce your intake of some of the same potentially harmful foods as people without the condition.

For example, a diet with lots of sugar can add too many calories and provide your body with too few nutrients. It can also contribute to tooth decay and increase your risk of diabetes.

In addition, foods high in salt and sodium content can increase the risk of high blood pressure, heart attack, and stroke. According to the American Heart Association, some of the saltiest foods in typical diets include:

-Breads and rolls

-Pizza

-Sandwiches

-Cold cuts and cured meats

-Soup

-Burritos and tacos

“Most of our patients have problems with low blood pressure, due to issues with autonomic nervous system function in Parkinson’s disease,” Subramanian adds. “So in some cases, we recommend a little extra salt in the diet, or even energy drinks, to boost blood pressure.”

Either way, you should check with your doctor about taking appropriate dietary steps to manage blood pressure along with Parkinson’s disease.

Also limit foods high in calories and fat, particularly saturated and trans fat, which can increase your risk of heart problems as well as certain types of cancer and make it more difficult for you maintain a healthy weight.

It’s important to balance what you eat with your level of physical activity — meaning: if you don’t exercise much because of your Parkinson’s disease symptoms, you need to watch how many calories you’re consuming.

Speaking of calories, alcoholic beverages add a lot, while providing your body with few (if any) nutrients. Plus, drinking alcohol can increase your risk of accidents and falls. Best to avoid alcohol altogether, but if you do choose to imbibe, first check with your doctor about possible interactions between liquor and your medications.