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Weight Loss and Parkinson’s Disease

weight loss

Dad used to tell us that he has two sets of clothes: a normal set and a set of “skinny clothes” that emerge when he gets sick.

Dad was diagnosed with ulcerative colitis in his 30s, and the illness caused him to lose a startling amount of weight. He was thin to begin with, but the disease found ways to take more away.

Ulcerative colitis became more manageable for my dad as time moved forward. He put on a healthy amount of weight and chose his food based on desire rather than necessity. With the help of my mom and his friends, he was able to nurse himself back to health.

But for the next 34 years, his two sets of clothing would hang in the corner of his bedroom closet because he never was certain when his health might change. Today, Parkinson’s disease is back to challenge this strategy. And Dad’s skinny clothes are making an appearance.

Causes of weight loss in Parkinson’s disease

Weight loss in relation to Parkinson’s disease can occur for a number of reasons. Decreased appetite, additional energy output, and changes in digestion can slow your food intake. And this ultimately can cause a shift in body weight.

It makes sense, really. Dad’s tremors cause him to expend energy 24 hours a day. That’s a substantial amount of time that is spent in motion. And the body needs fuel to maintain this motion.

Dad seems to eat about the same amount, but what he chooses to eat has changed. My little sister makes sure there’s a constant supply of densely packed foods, such as avocados. They juice every morning, squeezing the nutrients out of a shocking amount of produce.

Sometimes I giggle to see him eating a midnight bowl of ice cream or a handful of chocolate. Weight loss almost seems like an opportunity to eat his favorite treats. Dad looks thin, but his doctor seems to think his weight is stable.

Combating weight loss

In a society where weight loss ads litter social media platforms, it is easy to think that weight loss is a good thing. And it can be. But when uncontrolled, one risks becoming nutritionally deficient. And this ultimately prevents the body from using the building blocks it needs to keep healthy.

According to Parkinson’s News Today‘s Patricia Inacio, extreme weight loss can cause dementia, increased dependency care, and a shorter life expectancy. A study Inacio highlighted evaluated several Parkinson’s patients and found that weight loss might be able to point doctors toward an early PD diagnosis. Furthermore, counteracting weight loss might lessen disease-related outcomes.

Whatever doctors continue to discover, managing weight loss appears to be an important element of Parkinson’s. And it’s a common one, too!

Dad’s skinny clothes

More than six years have passed since my dad’s Parkinson’s diagnosis. The journey has been choppy, inconsistent, and filled with color. New challenges always seem to emerge. The disease never slows, but my dad is just as quick to fight back. His adaptability and determination are unmatched.

Today, his pants hang a bit loose around his skinny legs. But the muscles still ripple. His normal clothes have been collecting dust in the back of his closet for a while.

Christmas might be a time when those sizes shift completely, making skinny the new normal. But he’s strong. He spends three days of every week at Rock Steady Boxing, preparing himself to better challenge his disease.

During a recent visit to the gym, emotions bubbled to the surface. I had never seen him so committed to tackling an obstacle. And with great effort comes great change.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

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Looking at Parkinson’s Potential Links to the Gut Microbiome

microbiome

I wonder if my dad’s battle with ulcerative colitis is linked to his struggles with Parkinson’s disease. Because of a series of medical complications, he’s missing his colon, a vital part of the digestion process. This affects how he digests food and medicine, which in turn affects his intestinal microbiome.

Recent research looks at how the microbiome might be linked to Parkinson’s disease. The idea seems understandable enough: You are what you eat, right? But you are what your body can process as well. Which makes me wonder: Is he alone in having both ulcerative colitis and Parkinson’s?

How might ulcerative colitis and Parkinson’s be related?

According to one recent study, those who have ulcerative colitis had a 30 percent higher risk of Parkinson’s disease than the control group. My dad seems to fall in the 30 percent group.

Not everyone with ulcerative colitis loses the colon. But my dad did, which seems to add another layer to his relationship with Parkinson’s disease. The colon helps the body during the final stage of digestion, preparing you to dispose of waste while collecting the remaining fluids.

If someone were to lose their colon to a disease like ulcerative colitis, the loss would affect the final stages of digestion. And this process likely would affect the intestinal microbiome. So, how might the intestinal microbiome relate to Parkinson’s?

A 2017 study in the journal npj Parkinson’s Disease discusses a link between the intestinal microbiome and disease: “Changes in the composition of intestinal bacterial populations have been associated with a wide array of conditions including neurological and neurodevelopmental disorders such as multiple sclerosis, autism, depression, schizophrenia and PD, and studies are beginning to explore some of the mechanisms that contribute to the powerful influence of the microbiota.”

If ulcerative colitis affects the intestinal microbiome, and the microbiome is linked with Parkinson’s disease, ulcerative colitis could be related to Parkinson’s.

Gut microbiome and disease prevention

If the gut microbiome is related to the development of certain illnesses, can those illnesses be prevented? According to a 2016 study in the journal Pharmacology & Therapeutics, “The interaction between the host and its gut microbiome is a complex relationship whose manipulation could prove critical to preventing or treating not only various gut disorders, like irritable bowel syndrome (IBS) and ulcerative colitis (UC), but also central nervous system (CNS) disorders, such as Alzheimer’s and Parkinson’s diseases.”

The npj Parkinson’s Disease study also raises the possibility of diagnosing Parkinson’s at an earlier stage by monitoring the bowels. Its authors noted: “Meta-analyses suggest that constipation is more than twice as common in people who develop PD compared to those who do not, and that constipated individuals are twice as likely to develop PD within 10 years of their evaluation.” By recognizing the relationship between the brain and the gut, we might be able to better understand the link between digestion and the central nervous system. This knowledge could help in developing a treatment at an earlier stage of the disease.

Additionally, we don’t know whether Parkinson’s might be a cause or an effect of the microbiome’s status. It’s possible that Parkinson’s affects the gut. Per the same study: “At this time, it is not clear whether the observed changes in microbiota in PD patients are an initial occurrence that contributes to the development of neurological dysfunction and degeneration, or if they emerge in response to PD-related pathology in the enteric and/or the CNSs that impairs peristaltic activity and induces inflammation.” But my dad had ulcerative colitis many years before the first signs of PD showed.

I’m interested in seeing what developments will occur as we begin to better understand Parkinson’s disease. Perhaps emerging science will discredit the relationship between the microbiome and Parkinson’s disease. But these statements and statistics seem to hint at a significant relationship between the digestive process and the nervous system.

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Note: Parkinson’s News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Parkinson’s News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to Parkinson’s disease.

The post Looking at Parkinson’s Potential Links to the Gut Microbiome appeared first on Parkinson’s News Today.

Gut Inflammation May Increase Risk for Parkinson’s Disease, Review Study Suggests

gut inflammation

Inflammation in the gut, a hallmark of autoimmune disorders such as inflammatory bowel disease, may contribute to an earlier risk of developing Parkinson’s disease (PD), according to a recent review of genetic, epidemiological and animal model studies.

The risk, however, is very small with only 3% to 5% of patients with IBD eventually getting a Parkinson’s diagnosis.

The review, ”Inflammatory Bowel Diseases and Parkinson’s Disease,” was published recently in the Journal of Parkinson’s Disease.

PD is characterized by a range of inflammatory processes in the brain, including the release of pro-inflammatory signaling molecules (cytokines) and infiltration of immune cells.

Increasing evidence, however, suggests that PD starts in the gastrointestinal system, with symptoms such as chronic constipation often emerging before motor symptoms develop.

“Experimental, clinical and epidemiological data suggest that intestinal inflammation contributes to the pathogenesis of PD,” the researchers wrote.

Gut infections are then thought to trigger alpha-synuclein release and subsequent aggregation, with the disease then spreading to the central nervous system (brain and spinal cord), where it promotes neurodegeneration. Alpha-synuclein is the protein that in PD becomes misfolded and forms toxic aggregates or clumps, which are the main component of Lewy bodies and greatly contribute to neurodegeneration.

“Parkinsonism is probably not just a brain disorder, but a group of diseases that may have their onset in the periphery, particularly in the gastrointestinal tract,” Tomasz Brudek, PhD, at the Copenhagen University Hospital and author of the review, said in a press release.

Inflammatory bowel disease (IBD) is triggered by prolonged inflammation of the digestive tract due to an imbalanced immune response. The two most common forms of IBD are ulcerative colitis and Chron’s disease.

Chronic inflammation of the gut is likely a predisposing factor for people to develop PD.

Genome-wide association studies (GWAS) have identified links between IBD and PD. Using GWAS, researchers analyzed the whole human genome searching for genetic changes associated with the disease. Mutations in the LRRK2 gene were found to be “a common susceptibility-factor” in both PD and Crohn’s disease, which may indicate a potential genetic link and common disease mechanisms.

An analysis of 138,511 genomes (our complete genetic “set”) from participants with European ancestry identified 17 genetic changes that occurred in both PD and autoimmune diseases, including ulcerative colitis and Crohn’s disease. Additional diseases included celiac disease, rheumatoid arthritis, type 1 diabetes, multiple sclerosis and psoriasis.

Several epidemiological studies also have shown a link between IBD and PD but with conflicting results. A meta-analysis of different population studies revealed that IBD patients had a 46% increased risk of having PD compared to controls. This association was still significant if ulcerative colitis and Chron’s disease patients were analyzed separately; those with Crohn’s had a 28% increased risk of PD, while those with ulcerative colitis had a 30% increased risk of PD when compared to healthy controls.

However, the authors noted that only a very small proportion of IBD patients will develop PD. “While IBD patients are more likely to get PD, the risk is still very small. For a given IBD patient, the probability of not getting the diagnosis is 95%–97%,” Brudek said.

The association of Parkinson’s disease with IBD may not be due to the disease specifically, but to gut inflammation in general.

“Inflammation of the gut is only one of many symptoms on the list of changes in the gut and is associated with neural structures in PD patients. Thus, IBD might be just one of many sources of intestinal inflammation,” Brudek said.

Animal studies have shown that inflammation in the gut can lead to the death of dopaminergic neurons — those that are mainly affected in Parkinson’s disease — supporting a link between gastrointestinal inflammation as a factor contributing to PD.

A recent study using a PD mouse model showed that alpha-synuclein aggregation occurred in the large intestine. This also was the case in wild-type (control) mice that were induced to develop colitis (inflammation of the gut).

When researchers induced colitis in the PD mouse model at a young age, they saw that mice went on to develop severe neurodegeneration later in life.

Several studies involving the post-mortem analysis of PD patients have reported the existence of alpha-synuclein aggregates in patients’ enteric nervous system (ENS) —  the network of nerves that innervate the gastrointestinal tract — along with the brain.

Overall, these results support the existence of “connection between the intestinal environment and the CNS, [central nervous system], the so-called ‘gut-brain axis theory’ with a bi-dircetional communication between both,” Brudek wrote.

Similar to IBD patients, the gut microbiome — the natural community of microbes living in the gut — also is altered in people with PD, with an enrichment of a pro-inflammatory microbiome signature.

“Taken together, all data, including human, animal, and microbiome studies, suggest quite strongly that individuals with an increased tendency for peripheral inflammation have a higher risk to acquire PD. Given the potentially critical role of gut pathology in the pathogenesis of PD, there is reason to suspect that IBD may impact PD risk,” Brudek said.

Brudek proposed that future studies are required to identify risk factors associated with early (prodromal) PD that will support the development of therapeutic interventions for patients at higher risk of developing the disease.

Moreover, he added, it is important that clinicians recognize early the symptoms of PD in IBD, but also in patients with other chronic inflammatory disorders.

“We should direct our focus on the immune system in all Parkinsonian disorders, and further investigate the role of systemic inflammation and the immune system as such in these neurological diseases,” he said, adding that a “clear knowledge of the mechanisms implicated in gut/immune/nervous communication could help improve the prognostic and therapeutic tools leading to better quality of life for patients, reducing the exacerbation of PD symptoms, and delaying the progression of the disease.”

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Older IBD Patients Show Increased Risk for Parkinson’s Disease, Study Suggests

IBD risk factor

Older patients with inflammatory bowel disease (IBD) are more likely to develop Parkinson’s disease than those without the condition, a meta-analysis suggests.

Whether the same association exists for younger patients — ages 59 or younger — remains to be determined, according to the researchers.

The study, “Older patients with IBD might have higher risk of Parkinson’s disease,” was published in the journal Gut.

The chronic activation of pro-inflammatory mechanisms, which occurs in autoimmune conditions, has been increasingly recognized as a critical contributor of neurodegenerative disorders.

Studies suggest that this may happen due to the “gut-brain axis” — the two-way communication between the nervous system and the intestine that monitors gut function and links certain regions of the brain to intestinal functions, such as immune activation or intestinal permeability.

In line with the findings, some studies have already reported that patients with IBD — an autoimmune condition characterized by chronic inflammation of the gut — are 22-41% more likely to develop Parkinson’s than those without IBD.

However, a case-control study that examined Medicare data from 89,790 Parkinson’s cases and 118,095 population-based controls suggested that IBD actually reduced the risk for Parkinson’s by 15%.

To clarify this association, a team at Sichuan University in China reviewed all studies investigating the link between IBD and risk of Parkinson’s. Five studies met the inclusion criteria defined by the team, including a total of 9,174,766 participants.

Overall, IBD patients did not have a significantly higher risk of Parkinson’s than reference individuals, nor did patients with ulcerative colitis or Crohn’s disease — the two main forms of IBD — when examined individually.

However, patients 60 years or older were found to have a 32% higher risk of developing Parkinson’s. Patients 50 years or younger did not show this association, the researchers said.

“Our meta-analysis showed that patients with IBD did not have an increased risk of PD; however, subgroup analysis with cohort studies showed that they might be associated with increased risk of PD,” the researchers wrote.

“Age has been regarded as an important risk factor for Parkinson’s disease,” they added, but the findings suggest that “age at IBD diagnosis might be a risk factor of Parkinson’s disease.”

Interestingly, the team found that some studies reported medication-related side effects in the IBD population that resembled parkinsonism in the older population.

“It is necessary to take it into consideration whether older people will take more medications, and whether these medications lead to a higher risk of Parkinson’s also needs further studies to verify in the future,” they said.

Additional well-designed observational studies are still warranted to further explore the risk of Parkinson’s disease within the younger IBD population, the team noted.

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Inflammatory Bowel Disease Linked to Risk of Parkinson’s in Large Review Study

People with inflammatory bowel disease (IBD), an umbrella name for disorders marked by prolonged inflammation of the digestive tract, are at a higher-than-usual risk for Parkinson’s disease, a review study involving 8.9 million IBD patients suggests.
The study, “The risk of Parkinson’s disease in inflammatory bowel disease: A systematic review and meta-analysis,” was published in the journal Digestive and Liver Disease.
Inflammatory bowel disease (IBD) is a term that includes two main disorders — ulcerative colitis and Crohn’s disease — and is characterized by an imbalanced immune response that triggers prolonged inflammation of the digestive tract.
Inflammation in ulcerative colitis is confined to the colon (large intestine), while in Crohn’s disease it can involve any part of the digestive system. But inflammation in Crohn’s is most common at the end of the ileum (the last section of the small intestine) or the colon.
Several studies have reported that some of the inflammatory pathways impaired in Parkinson’s are also found in IBD. Certain population-based studies have also reported an increased prevalence of Parkinson’s among IBD patients, but the link between both disorders remains controversial. Another follow-up study failed to confirm those initial findings.
Researchers in China conducted a meta-analysis of published literature focusing on Parkinson’s risk in IBD using two databases, PubMed and Embase, and including in their search the keywords “ulcerative colitis” and “Crohn’s disease.” For the meta-analysis, they included cohort or case-control studies with patients diagnosed with IBD, either ulcerative colitis and Crohn’s disease, and whose main outcome was Parkinson’s.
Out of an initial pool of 172 studies, four studies accounting for a total of more than 8.9 million patients were included in the meta-analysis. (A meta-analysis is a statistical technique used to summarize in a quantitative manner the findings of multiple studies.)
Performed in the United States, Denmark, Sweden and Taiwan, these four studies assessed the incidence rate of Parkinson’s in IBD patients, specifically those with Crohn’s and ulcerative colitis. Three had been conducted in 2018, and one in 2016.
“To our knowledge, this is the first MA [meta-analysis] to focus on the risk of PD [Parkinson’s] in IBD patients,” the research team wrote. “Despite the small number of studies included, the patient numbers were large due to the population-based nature of the included studies.”
Pooled results of all studies suggested that an IBD diagnosis was associated with a 41% increased risk of developing Parkinson’s.
Assessing the risk of ulcerative colitis and Crohn’s disease separately, researchers found that both disease subtypes were linked to a higher Parkinson’s risk compared with age- and sex-matched controls — Crohn’s patients had a 28% higher risk of Parkinson’s, and those with ulcerative colitis a 30% increased risk, the study reported.
Among the IBD patients, the risk for Parkinson’s was not affected by gender, with similar rates seen in male and female patients, or by age.
Overall, this meta-analysis “identified an increased risk of PD in IBD patients,” the reseachers wrote, which “remained significant when separately analysing CD [Crohn’s disease] and UC [ulcerative colitis] subgroups.”
“More comprehensive and detailed MA using a larger number of studies are required to validate our

Source: Parkinson's News Today