Is underweightness still a major problem in Parkinson's disease patients?

Abstract

Objective: To evaluate the current rate of underweightness amongst Parkinson's disease (PD) patients at an Italian referral centre. Design: Epidemiological study on consecutive patients presenting for the first time in a 16-month period. Setting: Nutritional service of PD referral centre in Milan, Italy. Subjects: Three-hundred and sixty-four PD patients diagnosed according to CAPIT criteria. Methods: Anthropometric assessments: BMI and waist-to-hip ratio; evaluation of therapeutic physical activity (h=week). Results: Three-hundred and sixty-four patients were included (180 female, 184 male), mean (s.d.) age 65.9 (8.9) y, mean (s.d.) duration of PD 10.6 (5.3) y; 134 patients (37%) were overweight and 92 (25%) were obese; 11 (3%) were underweight; 127 (35%) had normal BMI. No important differences in BMI according to sex and smoking status were observed. There was highly significant inverse correlation between duration of disease and BMI (P < 0.001): mean (s.d.) duration of disease was 9.7 (4.7) y in overweight þ obese patients, 11.1 (5.5) y in patients with normal BMI and 14.1 (7.2) y in underweight patients (P ¼ 0.0059). The waist-to-hip ratio was a cardiovascular risk factor in 47.7% of men and 73.8% of women. Mean (s.d.) therapeutic physical activity was 1.07 (1.59) h=week in overweight and obese patients vs 1.61 (2.04) h=week in patients with normal BMI (50.5% increase; P ¼ 0.03). Conclusions: At present underweightness is uncommon in PD patients in Italy; this may be due to the increase in the prevalence of overweightness in the Italian population and to modern antiparkinsonian therapy. Sponsorship: Fondazione Grigioni per il Morbo di Parkinson.

Reduced Risk Factors for Vascular Disorders in Parkinson Disease Patients

“…Furthermore a study on IPD patients in our catchment area (Region of Lombardy) found no evidence of BMI differences between Parkinsonians and the normal population. 13 The main findings of our study are plausibly explained by the reduced sympathetic activity amply documented in IPD. The sympathetic nervous system is permanently active in maintaining homeostasis, and is further activated during stress, physical activity, and whenever the body is stimulated.…”

Reduced Serum Levels of Triglyceride, Very Low Density Lipoprotein Cholesterol and Apolipoprotein B in Parkinson’s Disease Patients

“…Van der Marck et al have concluded that PD patients have a significantly lower body mass index (BMI) than controls in a meta-analysis [28], but Barichella et al have reported that nutrition is generally normal in PD patients [29]. So it needs further research to explore the relationship between nutrition and the changes of lipids and lipoproteins in PD patients.…”

Mechanisms of Body Weight Fluctuations in Parkinson’s Disease

“…Today, in spite of a decreased average BMI, individual PD patients may be overweight (75). In fact, prevalence of overweight in PD was reported to be about 60% in Italy (105) and 50% in Germany (80). In France and USA, more than 50% of the patients selected for DBS, i.e., patients with advanced disease suffering from motor complications presented an overweight with a BMI >25 kg/m 2 (106–108).…”