A comprehensive examination of the evidence for whole of diet patterns in Parkinson's disease: a scoping review

The Role of Diet in Parkinson’s Disease

“…A 30-year study of > 47,000 Swedish women identified a reduced risk of PD among individuals with high versus low adherence to MeDi diets in middle age (hazard ratio (HR) = 0.54 (95% CI: 0.30-0.98)) [14], while the longitudinal Dutch Rotterdam Study of 9,414 adults found a similar potential, although non-significant, association (HR = 0.89 (95% CI: 0.74-1.07)) [13]. The presumed protective properties of MeDi diets against PD may stem from the anti-inflammatory and antioxidant properties of polyphenol phytochemicals and vitamins found in fruits and vegetables, neuroprotective effects of omega-3s found in fish, and/or beneficial effects of high-fiber diets on the gut microbiome [20,23]. Japanese dietary patterns enriched in vegetables, fruits and fish were similarly associated with reduced PD risk in a case-control study of 249 PwP and 368 controls without neurodegenerative disease [24].…”

“…The role of nutrition in PD is of interest among clinicians, researchers and PwP alike, given strong epidemiological evidence implicating dietary patterns and malnutrition in the disease process [20]. However, few high-quality randomized controlled dietary intervention trials have been conducted in PD to date [20].…”

“…There is a wide range of Mediterranean (MeDi) diets, overall characterized by a predominantly plant-based diet rich in vegetables, fruits, whole grains, legumes, unsaturated fatty acids (mostly olive oil), nuts/seeds and fish/seafood, with moderate intake of poultry, and wine and low intake of red and processed meat, sweets, sugar-sweetened beverages, refined grains and saturated fatty acids [19]. Between 2020-2023 alone, several observational studies reported inverse associations between MeDi diet adherence and PD risk, age of onset and prodromal PD symptoms [20]. A single-center, crosssectional Canadian study of 167 participants with PD found a correlation between MeDi diet scores and later disease onset, of up to 8.4 years in men, specifically (p = 0.002) [18].…”

Dietary Interventions in Parkinson’s Disease

“…The ongoing trials all investigate a different dietary pattern or nutritional supplement. Considering the dietary patterns, the Mediterranean diet and ketogenic diet are popular and have been subject of previous studies, but without conclusive evidence [26,41]. Observational studies previously suggested that the Mediterranean diet is associated with a delay in disease onset [42] and a reduction in disease progression [37].…”

“…A study that would be of great interest is to evaluate the effect of offering personalized guidance by an expert dietician to people with PD, giving them individualized advice tailored to their usual food intake and diet-related symptoms or problems (e.g., obstipation, timing of protein intake). Although this type of intervention is not intended to alter the course of the disease, it could potentially have an enormous clinical effect because of the various symptomatic improvements [41].…”