Avaliação nutricional e o uso da levodopa com refeições proteicas em pacientes com doença de Parkinson do município de Macaé, Rio de Janeiro

Abstract

Parkinson's disease (PD) is characterized by a reduction in dopamine in the central nervous system. It has a gradual progression, and is mainly known for causing tremors and difficulty in performing movements. Studies have shown that there is a significant change in the nutritional status of patients with PD. The main medication used in the treatment of patients is levodopa, and its use, without respecting the minimum intervals of 30 minutes before or one hour after meals, may diminish the pharmacological effect of the drug because of drug-nutrient interactions. The present study aimed to identify PD patients at nutritional and protein consumption risk associated with the use of levodopa in the city of Macaé. A cross-sectional quantitative and descriptive study was performed. The instruments used were the Mini Nutritional Assessment (MNA) and an estimated 3-day dietary record. The analysis was descriptive. To form the sample population a survey was performed of patients diagnosed with PD in two Department of Health programs and from the Parkinson's Association of Macaé. A total of 40 individuals were evaluated, of whom 57.5% were male. Of these, 62.5% presented a risk of malnutrition or MNA defined malnutrition, with nutritional deficit. The protein intake of the study population was 1.4 g/kg/day. The highest protein intake was during the day, including the meals between breakfast and the afternoon snack. A total of 74.7% of total protein was consumed by the population during this period. Overall, 75.0% of the elderly persons consumed their medications containing levodopa simultaneously with meals or did not follow the interval recommended by ANVISA. The study found that the total daily intake of most individuals was hyper-proteic, with proteic content being poorly distributed among meals throughout the day, and that they did not follow the recommended levodopa interval.

Nutritional status and food consumption of patients with Parkinson disease

“…In general, PD incidence does not vary with race, social class, or gender, but studies have found evidence that there is a higher prevalence in men 7,513 . In this study, the population was mainly composed of males (60%), similar to the findings by Carmo and Freire 7 , where 57.5% of the patients were male and 52.5% were over 60 years old.…”

“…As the disease progresses, food intake is affected and nutritional complications may arise, causing weight loss and, in more severe cases, malnutrition 6 . Among the causes of weight loss, the abnormal and involuntary movements such as rest tremors and dyskinesias result in an increased energy output and hypercatobolism 7 . Dyskinesias can even directly influence the quality of life of the patients, as they can negatively interfere in the physiological process of swallowing, making food intake even more difficult 8 .…”

Estado nutricional de idosos com doença de Parkinson e seus fatores associados: uma revisão integrativa

“…Malnutrition is a disorder affecting a large part of the old population 30 , also presenting a high prevalence in patients with PD. It was observed that 62.5% of the old population with PD had malnutrition or risk of malnutrition, according to the MNA 31 . In view of this high frequency, the importance of an earlier and more careful look at the nutritional condition of these patients is demonstrated.…”