Diet with LPP for renal patients increases daily energy expenditure and improves motor function in Parkinsonian patients with motor fluctuations

Abstract

Objective:T oestablish whether adiet based on the usage of low-protein products for renal patients (LPP) is associated with higher energy expenditure (EE) than afree low-protein diet (NO-LPP) by calculating 24 hEEbyindirect calorimetryusing an electronic armband monitor.Design:R andomized, cross-over, single-blind, pilot clinical trial performed comparing two different low-proteind ietary regimens.Subjects:Forty-two days with LPP and 42 days with NO-LPP regimen in six patients with Parkinson'sdisease with levodopa. Methods:Monitoring patient response to twodifferent nutritional schemes through indirect calorimetry(armband), BMI, Patient Global Improvement Scale.Results:Mean total EE was 1731^265 kcal/daywith NO-LPP vs.1 903^265 kcal/day with LPP ( p ¼ 0.02).Conclusions:The usage of LPP increases EE and improves motor function in PD patients to agreater extent than NO-LPP dietaryregimen. Calorie intake should be increased to prevent malnutrition in the long-term.Sponsorship:F ondazione Grigioni per il Morbo di Parkinson.

Controlled-protein dietary regimens for Parkinson's disease

“…However, protein redistribution (and restriction compared to previous habits) appears to determine a~50% reduction in total daily 'off' periods. 24,26,28,30,31 However, individual responses, due to low acceptability, logistic difficulties or lower palatability, varied considerably and were sometimes poor. 22,24,28,29 Moreover, the extent of correction of levodopa dosages was not clear.…”

“…These analogues were designed for chronic renal failure patients, in whom a low-protein diet delays end-stage renal disease. 30,31 At present, their effectiveness has been tested in two small, randomized, cross-over, single-blind, clinical trials carried out in 18 and 6 patients and Parkinson's disease out-patients, respectively. A daily protein distribution of 2.1% at breakfast, 12.6% with the midday meal and 85.3% with the evening meal resulted in significantly shorter postprandial and total 'off' phases and longer postprandial 'on' phases.…”

“…Most of the studies reported, on average, significant shortening of 'off' phases and improvement in 'on' phases. [24][25][26][27][28][29][30][31] Studies are markedly heterogeneous and data cannot be meta-analysed. However, protein redistribution (and restriction compared to previous habits) appears to determine a~50% reduction in total daily 'off' periods.…”

Sumario de recomendaciones nutricionales basadas en la evidencia de la Guía de Prácti ca Clínica para el manejo de pacientes con enfermedad de Parkinson

“…Tras la primera criba se obtuvieron 22 artículos potencialmente de interés, de los cuales se excluyeron 20 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37), indicándose sus razones en la tabla III. En consecuencia, 2 artículos fueron incluidos para la elaboración de recomendaciones (17,38).…”

Potential Influences of Complementary Therapy on Motor and Non-Motor Complications in Parkinsonʼs Disease

“…The observed change in bodyweight led the same group to perform a follow-up, small, randomized, single-blind, crossover study of six patients with PD who were taking levodopa. [14] A diet including LPP for renal patients was compared with a free 0.8 g/kg protein (control) diet for 42 days each. Mean total energy expenditure was 1903 kcal/day with the LPP diet and 1731 kcal/day with the control diet (p = 0.02), and the mean time spent in physical activity was longer with the LPP diet (1.8 vs 1.4 hours/day, p = 0.05).…”