Additional information

WEIGHT GAIN

Although studies more commonly report weight loss, before diagnosis and in the advanced stages of Parkinson’s, some people may be overweight and may have metabolic diseases such as hypertension, hypercholesterolemia and diabetes.

The effect of weight changes on the prognosis and progression of Parkinson’s is still unknown.

WEIGHT LOSS

Weight loss is a common problem in people who have had Parkinson’s for a long time. Many studies, however, show that weight loss often precedes motor symptoms. Unfortunately, the cause of weight loss is still unclear but it is thought to be related to:

  • Increase in energy expenditure related to involuntary movements and muscle stiffness
  • Loss of appetite due to nausea, poor coordination in getting food into the mouth, chewing and swallowing difficulties
  • Reduced intestinal movement
  • Some prescribed therapies

SWALLOWING DIFFICULTIES

Swallowing is a complex action that includes a number of highly coordinated phases, in order to push the food from the mouth to the stomach.

In Parkinson’s, difficulty in swallowing (dysphagia) is more pronounced when consuming solid foods than liquid ones.

Foods to help with swallowing difficulties

It is important to avoid meals that combine different consistencies of food (soups with pasta or croutons, jelly containing pieces of fruit, minced meat in broth, milk with cereals) and foods broken down into small pieces such as rice. Instead, choose foods that form a compact bolus and combine these with sauces (such as meatballs in sauce).

Easy chewing and swallowing

Fluids

Bread and cereals

Dairy products

Meat and fish

Vegetables

Fruit
Permitted Dangerous
  • Sorbets, milkshakes, jelly, liquids containing thickening agents
  • Bread, cooked cereals, toast, pancakes
  • Butter, margarine, yogurt, ice-cream
  • Stewed meatballs or meatloaf in sauce, tender meat or fish without bones
  • Puréed vegetables, boiled or mashed potatoes with sauce
  • Peeled, pitted canned fruit, mature bananas, fruit in jelly, thick purées
  • Water, light juices, milk, tea, coffee
  • Crackers, puffed rice, cereals, bread containing seeds, dry cakes, biscuits
  • Melted grated cheese
  • Dry meat or fish with bones
  • Elongated fresh vegetables that need to be chewed
  • Fresh fruit

CONSTIPATION

Changes in bowel function often occur in Parkinson’s.

Constipation is a common symptom, often linked to the use of anticholinergic drugs and dopamine agonists, and reduced mobility. About half of people with Parkinson’s say they have a bowel movement less than once a day, with a hardening of faeces and increasingly frequent use of enemas or laxatives.

It is therefore important to increase fibre intake by eating cooked fruit and vegetables. If necessary, supplements containing lactulose and psyllium may be used. Unless you are on a fluid restriction regime, it is recommended that you drink at least 1.5 L of water per day and eat low-residue foods such as rice and potatoes occasionally.

These suggestions are guidelines only. You should consult with your doctor before changing your diet, particularly with regards to the effects of diet on medication.