Balanced Diet to Maintain Optimal Health in Parkinson’s Patients: A Nutritionist’s View

optimal diet

Parkinson’s disease has typically been classified as a neurodegenerative disease with much of treatment focused on managing symptoms. However, recent connections between the brain and gut microbiome as it is influenced by nutrition, oxidative stress, and the environment has been gaining interest.

In a 2015 article from the World Journal of Gastroenterology, the authors said: “A better understanding of the brain-gut-microbiota axis interactions should bring a new insight in the pathophysiology of [Parkinson’s and] permit an earlier diagnosis with a focus on peripheral biomarkers within the ENS [enteric nervous system]. … Dietary or pharmacological interventions should be aimed at modifying the gut microbiota composition and enhancing the intestinal epithelial barrier integrity in [Parkinson’s] patients or subjects at higher risk for the disease.”

The vast population of microorganisms, called the microbiota, live mainly within the gastrointestinal tract and vary greatly. It is widely accepted that highly diverse and stable microbiota promote overall human health.

When this balance is disrupted, changes can occur on several levels across many body systems. Excessive stimulation of the innate immune system resulting from gut dysbiosis (bacteria imbalance) and/or small intestinal bacterial overgrowth and increased intestinal permeability may induce systemic inflammation; investigating and understanding this connection may lead to new therapeutic possibilities in Parkinson’s.

Findings show that gastrointestinal dysfunction, especially constipation, is associated with a higher risk of developing Parkinson’s and may precede motor symptoms by more than a decade.

This insight into the alleged root cause of Parkinson’s is important and can offer opportunities for new preventive pathways as well as provide creative solutions for treatment, potentially inhibiting the progression of the disease.

Important interventions are probiotics, specifically Lactobacilli, Enterococci, Bifidobacteria, and prebiotics, which are non-digestible oligosaccharides (carbohydrates) that selectively stimulate the growth and activity of bacteria in the gut, producing metabolites.

Probiotics can be ingested either through supplementation or through the consumption of fermented foods such as sauerkraut, kimchi, kefir, and miso; this strategy directly introduces beneficial bacteria into the gut microbiome.

When prebiotics are metabolized by the bacteria, they produce a byproduct of short chain fatty acids (SCFAs) essential to gut integrity and immunity. One of these SCFAs is butyrate.

A 2016 article reported, “Butyrate has also been shown to interact with the ENS and to increase colonic contractility. In critically ill subjects, lower concentrations of butyrate are associated with dysmotility. Taken together, these data are compatible with the assumption that reduced concentrations of butyrate in the feces of [Parkinson’s] patients might exert relevant effects on the ENS and might contribute to gastrointestinal dysmotility, a frequent non-motor symptom in [Parkinson’s].”

Oxidative stress and inflammation have also been at the center of many proposed mechanisms underlying cell death in Parkinson’s, and therefore, much of the focus of nutritional interventions has been on antioxidants. Recently, however, anti-inflammatory compounds such as curcumin (turmeric) have been introduced as an option for regulating the gut-brain axis as well.

So when it comes to diet, here are some of my suggestions:

  • Include foods that have a high nutritional profile complete with probiotics and essential micronutrients such as folate, B vitamins, and flavonoids. These are associated with lower Parkinson’s risk as well as a decrease in functional decline and aging.
  • When thinking about the type of diet to reference, the Mediterranean diet is emerging as a potential neuroprotective alternative for Parkinson’s. This diet includes fresh fruits and vegetables, fresh fruit, nuts, seeds, non-fried fish, olive oil. coconut oil, wine, fresh herbs, and spices.
  • Foods that have been statistically significant in increasing the progression of the disease and should be avoided are canned fruits and vegetables, soda, fried foods, beef, and ice cream, cheese, and those rich in iron.
  • Supplementing with fish oil and CoQ10 has been recommended due to their anti-inflammatory and mitochondria/cellular protective properties respectively. Supplementation should always be monitored by a medical professional.

Research on microbiome-directed therapy is still being conducted, yet provides compelling arguments that these therapies may have a significant influence on the pathological progression of Parkinson’s. The combination of dietary supplementation and a low inflammatory diet may in fact prove to be a core factor in how we approach treatment in the future.


Alana Kessler, MS RD

Alana Kessler, MS, RD, CDN, E-RYT, is a registered dietitian, nutritionist, weight management expert, and an accredited member of the CDR (Commission on Dietetic Registration) and the American Dietetic Association. She is also a yoga and meditation teacher, Ayurveda specialist, and the founder of the New York City-based fully integrated mind, body, and spirit urban sanctuary, BE WELL. Alana’s BE WELL ARC System and Method Mapping technique is a holistic multidisciplinary approach to health and wellness that blends Eastern and clinical Western diet and lifestyle support to effect long-lasting behavior change.

A graduate of NYU with a BA and MS in clinical nutrition, Alana is dedicated to helping others learn how to nourish themselves, create balance, and understand their true nature through nutrition, yoga, and inner wellness. She leads Yin Yoga workshops and trainings as well as wellness retreats at international locations. Her health, fitness, and lifestyle expertise has been featured in,,,, Redbook,, and Vogue. For more information, visit her website at

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Eradication of Helicobacter pylori Infections Could Ease Gut Symptoms, Motor Dysfunction in Parkinson’s Patients, Study Suggests

Eradicating Helicobacter pylori infections could improve motor function, ease gut symptoms and increase levodopa’s effectiveness in Parkinson’s patients, according to a review study.
The research, “Stomaching the Possibility of a Pathogenic Role for Helicobacter pylori in Parkinson’s Disease,” was published in the Journal of Parkinson’s Disease.
While a small subset of Parkinson’s cases have genetic causes, most cases are sporadic, with unknown environmental causes. Gastrointestinal symptoms such as constipation precede motor complications, suggesting that the disease might start in the gut and subsequently spread to the brain along the brain-gut axis.
This has been observed in rats, where injection of alpha-synuclein fibrils — the major component of Parkinson’s characteristic Lewy bodies — into the gut induced Parkinson’s-related pathology.
Chronic infections with H. pylori affect half the world’s population and may cause gastritis, ulcers, and stomach cancer, as well as various gastrointestinal symptoms. A greater occurrence of ulcers in patients with Parkinson’s was first reported in 1961. More recently, a link between H. pylori and Parkinson’s has been shown, with consistent reports of higher risk for Parkinson’s in people infected with this type of bacteria.
The research team reviewed all major studies that discussed the possible link between H. pylori and Parkinson’s, which led to four key findings:

Having Parkinson’s increases by 1.5 to 3 times the risk of H. pylori infection.
H. pylori infection worsens motor function in Parkinson’s patients.
Eradication of H. pylori with triple therapy improved motor function in Parkinson’s patients compared to infected patients in clinical studies.
Eradication of H. pylori improved gut absorption and increased plasma levels of Parkinson’s gold-standard treatment levodopa in patients. Research had shown that H. pylori binds to levodopa, preventing it from reaching the brain and reducing its effectiveness

As for pathways linking this bacterial infection with Parkinson’s, the researchers provided three possible explanations besides impaired levodopa effectiveness. One explanation is that bacterial toxins produced by H. pylori or alterations to the body’s own molecules such as cholesterol can damage neurons.
The infection can also cause a massive inflammatory response in the stomach, which would become systemic, cross the blood-brain barrier (BBB) — a semipermeable barrier that protects the brain — and worsen Parkinson’s symptoms and pathology. H. pylori could also reach the brain by colonizing immune cells that cross the BBB themselves.
Finally, H. pylori may disrupt the normal gut microbial population, or microbiota, altering inflammatory mediators that predispose a person to Parkinson’s disease.
“Our conclusion is that there is a strong enough link between the H. pylori and Parkinson’s disease that additional studies are warranted to determine the possible causal relationship,” David J. McGee, PhD, the study’s lead author and a professor at the Department of Microbiology and Immunology, LSU Health Sciences Center-Shreveport, said in a press release.
Although current evidence suggests that “eradication of H. pylori or return of the gut microflora to the proper balance in [Parkinson’s] patients may ameliorate gut symptoms, L-dopa malabsorption, and motor dysfunction,” scientists still have little information on whether H. pylori infection “is a predisposing factor, disease progression modifier, or even a direct cause of [Parkinson’s]”, the authors wrote.
Specifically, future studies should explore the interactions of H. pylori with neurons and levodopa, the role of H. pylori toxins, how inflammatory responses to H. pylori may

Source: Parkinson's News Today