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Hi all,

This is a transcript of a Chat held regarding Parkinson's Disease (which

is different from MSA; however, the

matters she is discussing have appeared in our group's messages), from

MSN/Webmed. What is interesting and

informative is what Ms. says about the proper way to take

Sinemet, about Vitamin E and CoQ10.

Take care, Bill Werre

***********************************************************

Diet and Nutrition for People with Parkinson's Disease

, R.N., M.N., A.N.P., will address the most important

aspects of a healthy diet for people living with

Parkinson's.

Mature_Years_Mod Hello and welcome to Health In Your Mature Years.

Today's guest speaker is from OHSU.

Ms. is the Associate Director of the Parkinson's Center of Oregon

as well as an Associate Professor in the

Department of Neurology at OHSU. Today she will be taking your questions

on Diet and Nutrition for People with

Parkinson's Disease. Also if you have general diet and nutrition

questions please include those as well. Let's get

started, Is it important for effective treatment of Parkinson's to have

a healthy diet?

Speaker_ Diet is particularly important for people who are on

Sinemet. Sinemet or levodopa can interact with

food at two locations, gut and brain. At the level of the stomach food

can delay levodopa from being absorbed into

the blood. If levodopa is taken on a full stomach the food must first be

digested before it enters the gut of

intestine. Levodopa is absorbed across the gut wall into the blood. If

the absorption is delayed it might be

ineffective. Our recommendation is to take levodopa or sinemet on a

empty stomach. At the level of the brain,

protein can interfere with levodopa. This happens because levodopa uses

the same molecules as protein to be carried

into the brain. If all of those molecules are filled up with amino acids

(parts of protein) there is no place for

levodopa to hook on and get into the brain. We recommend that people

take the RDA for protein each day; this is

usually less than most people consume. Next

Mature_Years_Mod What are the benefits of a low protein diet?

Speaker_ A low protein diet means a diet that meets the RDA for

protein. This is .8grams/kg or .4 grams/pound.

The benefit is to reduce the interaction between levodopa and food which

I just described. Next

Mature_Years_Mod What is the value of different nutritional supplements?

Speaker_ Do you have any specific supplements in mind?

Mature_Years_Mod Why is thiamin and Vitamin E good for you?

Speaker_ Vitamin E is an antioxidant. This means that it can

counteract oxidative metabolism which is thought

to be responsible for the damage in a number of disease processes. In PD

it was thought to delay progression but

after a careful study it does not look like this is true. It most likely

does not get across the blood brain

barrier. It is still good for other disease processes such as heart

disease, perhaps cancer, and others. Next

Mature_Years_Mod What are some other supplements worth taking and

learning more about for those sick as well as

aging?

Speaker_ I should first start with vitamins in general. A well

balanced multivitamin is important in normal

aging and any chronic illness. Good nutrition can be harder to come by

and a good vitamin is protective for

nutritional deficits. The other supplement is calcium. Women and men

should both have 1200-1500mg/day. A glass of

milk has 300mg so you can start to estimate how much you get in food.

Are there other supplements that come to mind?

Mature_Years_Mod None specifically... just making sure that those that

are aging are looking for the right foods

which provide them the right nutrients...

Mature_Years_Mod To submit a question please type in /ask then skip a

space then type in your question and hit

return.

Speaker_ Let me say a word about coenzyme Q10. This nutritional

supplement is being studied in PD. It is a

powerful antioxidant, boosts energy, and the immune system. In PD it is

thought to repair a defect in the powerhouse

of the cell (mitochondria). There is a controlled double blind clinical

trial being done right now to answer this

question. Next

Mature_Years_Mod I've never heard of coenzyme Q10 how can you get it? Is

it the same as Echinacea (sorry it's

probably not spelled right)

Speaker_ It can be found in any health food store. The concern

with all of the nutritional supplements is that

there are no FDA guidelines to regulate their use. Therefore, there are

no rules for potency and purity. These

supplements can have minimal active ingredient. They can also be laced

with toxins. I encourage my patients to call

the manufacture and make sure they know what guidelines they use for

production. German made supplements have very

high standards because all of their supplements require a prescription

to be purchased. next

Mature_Years_Mod Here's a question getting back to Parkinson's for a

moment.....

Mature_Years_Mod Is the timing of medication as it relates to your

eating schedule important?

Speaker_ Levodopa or sinemet should be taken on an empty stomach;

20 minutes before a meal or two hours after

a meal. Other anti-Parkinson meds can be taken with food. Next

Mature_Years_Mod Is it important to eat more often in smaller amounts

than to eat 3 meals a day when you have

Parkinson? If yes why?

Speaker_ If a person has marked fluctuations in their mobility and

they are taking their sinemet every 2

hours, it can work better to eat several small meals a day. The other

reason to eat more often is if a person is

loosing weight. In PD, people have a tendency to loose weight and this

is a way to get more calories in. Next

Mature_Years_Mod Getting back to general health and nutritional

questions? What do you think about the low carb

diets on the market now?

Speaker_ I must confess that I don't know all of the pros and cons

regarding the high protein, low carb diets.

I do know that for someone with cholesterol concerns this would be

discouraged. next

Mature_Years_Mod What can you recommend to someone who is a

sweets-a-holic. Is there any herbs or supplements or

food alternatives that will curb the desire for sweets?

Speaker_ I don't know of a specific supplement to curb the desire

for sweets but I do know that trying to keep

blood sugar well regulated can decrease the craving for sweets. This is

the basis of the zone diet. The zone diet

maintains a constant balance of protein and carbohydrates to prevent an

over secretion of insulin. This drives the

blood sugar down and then people feel hungry and want carbohydrates.

next

Mature_Years_Mod Is salt a bad thing. My mother adds salt to everything

she eats, I mean everything. She went into

the doctor and actually had low blood pressure how can that be?

Speaker_ Salt is only bad if you have high blood pressure. Salt

causes a person to retain fluid which drives

up the blood pressure. For some people with PD a low blood pressure is

common. When this low BP causes them to be

dizzy or sleepy we encourage the liberal use of salt. Next

Mature_Years_Mod A lot of elderly people who seem to be in good health

but just are affected by their age seem to

loose their appetite/ Is that okay or is there something you can

recommend to increase their appetite?

Speaker_ As people age they loose some of their taste buds which

can decrease appetite. Also just living

alone, depression, mobility problems etc can make them more at risk of

malnutrition. I think weight loss is the best

guideline. If a person is losing weight poor nutrition should be

explored. Again, this is one reason why I think a

multivitamin is a good idea. Next

Mature_Years_Mod Is an over the counter one a day multivitamin enough?

Speaker_ Let me give you a partial list For men and post

menopausal women: Low-iron: Natrol, Nature Made

Mature Balance, One-d-day 50 plus, Shaklee Vita-Lea medium iron

(4-10mg): Centrum Silver, Twinlab Dualtabs,

Puritan's Pride OneTwinlab Allergy Multi-Caps, Your Life Central-Vite

Plus. If you are pre-menopausal I would have

other recommendations Next

Mature_Years_Mod A lot of older people complain about always being

thirsty. Is that normal? Does PD increase your

appetite for liquids?

Speaker_ Medications for PD can cause a dry mouth which increases

the desire for liquids. Next

Mature_Years_Mod We are running out of time. is there anything

else you would like to add on today's topic

before we say goodbye?

Speaker_ Yes, I think a good source for nutrition is the Nutrition

Action Health Letter web:www.cspinet.org

That is my last thought...thanks for the chat.

Mature_Years_Mod Our hour has come to an end. I would like to take this

time to thank from OHSU for

being our guest speaker today. I hope everyone gained some knowledge

today and I encourage you to check out the

other live events that are coming up on WebMD's Program list. Have a

great day.

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