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Parkinson’s Disease and a Plant-Based Diet

Posted by Jenn on January 2, 2011


The nature of Parkinson’s disease

Parkinson’s disease (PD) afflicts about one to one and one-half million people in the United States (Tanner 1992). PD is a progressive neurological disorder that results in the death of dopamine-producing cells in the brain. Loss of dopamine affects movement, both of skeletal muscle and the smooth muscle of the gastrointestinal (GI) tract. This can result in slow, shuffling gait, resting tremor, and/or slowed peristalsis. Individuals with PD may experience frequent falls (Dolinis et al., 1997; Northrid ge et al., 1996), d ifficulty handling cooking and eating utensils, and such GI-related problems as slow stomach emptying, gastroesophageal reflux, and chronic constipation (Jost WH, 1997; Edwards et al, 1993; Edwards et al., 1994; Byrne et al., 1994).

Nutrition-related problems

Individuals with PD have been found to have a higher incidence of bone thinning and fractures than age-matched control groups (Ishizaki et al., 1993; Kao et al., 1994; Taggart, et al., 1995; Revilla et al., 1996; Koller et al., 1989; Johnell et al., 1992, Sato et al., 1997). Loss of the olfactory sense and sense of taste are frequently present (Huttenbrink, 1995; Hawkes et al., 1997), along with xerostomia (dry mouth) (Clifford and Finnerty, 1995), and sometimes loss of appetite (Starkstein SE, 1990). These, along with other factors, may contribute to the high rate of unplanned weight loss in this population (Markus et al., 1993; Davies et al., 1994; Beyer et al., 1995).

There are also indications that B vitamin deficiencies may be of concern, although the causes are not clearly understood. In 1979, Bender et al. reported the possibility that users of levodopa-carbidopa (Sinemet, Sinemet CR, a medication used to treat the symptoms of PD) could be at risk for both niacin and vitamin B6 deficiencies. Long-time users of levodopa-carbidopa have since been found to have increased levels of serum homocysteine (Kuhn et al., 1998, Muller et al., 1999), implicating vitamins B6, folate, and B12. In attempts to determine the etiology of PD, Hellenbrand et al. compared the dietary habits of patients vs. a control group; patients were found to have consumed significantly less niacin than controls (Hellenbrand et al. 1996). In a more recent Swedish study researchers note that consumption of niacin-containing foods appeared to reduce risk for PD (Fall et al., 1999). Finally, in an unpublished study, pellagra was discovered in several patients using levodopa-carbidopa (Iacono et al.). Thus, patients could have increased risk for vascular disease, pellagra, and other conditions resulting from deficiencies of B vitamins.

Constipation is very common due to the disease and/or to the medications used to treat PD (Jost, 1997; Jost and Schrank, 1998; McIntosh and Holden, 1999). Chronic constipation can raise the risk for fecal impaction (Sonnenberg et al., 1994) and colon cancer (Jacobs and White, 1998; Will et al., 1998), therefore, safe methods of controlling constipation are desirable.

Furthermore, PD brings with it a food-medication interaction that has been generally under-addressed by dietetics professionals. Levodopa, the primary medication used to treat PD, competes with the five large neutral amino acids for carriers, both in the gut and at the blood-brain barrier (Lieberman, 1992). Thus, levodopa absorption is effectively blocked if taken with meals.

How can a vegetarian or plant-based diet be of help to people with PD?

While research has failed to conclusively show a link between diet and PD, nevertheless, fiber, nutrients found particularly in plants, and protein, are excellent reasons to choose among the various vegetarian and plant-based eating plans. Animal foods are often high in protein and lack fiber. Plants in general have a high proportion of carbohydrate, with moderate amounts of protein. Plants also contain fiber and many phytochemicals, which animal products do not.

Fiber. A plant-based diet is generally richer in fiber, which can alleviate constipation, and thereby reduce risk for fecal impaction and colorectal cancer. In a pilot study, McIntosh and Holden found that while 21 out of 24 patients reported frequent constipation, analysis of three-day food diaries showed that 18 patients reported intake of fewer than 25 grams of dietary fiber daily. Education in the need for greater fiber intake, and its benefits to health, is necessary for PD patients. Additionally, a high-fiber eating plan may promote bioavailability of levodopa. Astarloa et al. found a correlation between a diet rich in insoluble fiber and plasma levodopa concentration, and postulate that the improvement of constipation may have a positive effect upon levodopa availability (Astarloa et al., 1992). While there is no research as yet on benefits of a vegetarian diet for people with PD, nevertheless, a vegetarian or plant-based diet may have special significance for people with PD.

Unplanned weight loss. To combat weight loss, patients must consume more calories. Yet delayed stomach emptying, if present, may require moderate use of fatty foods, while those using levodopa may need to control their use of protein. Such restrictions sometimes necessitate small, frequent meals and snacks, and a diet high in carbohydrates. A vegetarian diet adapts very well to such an eating plan, as it can be both high in carbohydrates and low in fat, whereas animal foods are often high in fat.

Chewing/swallowing difficulty. Patients in mid-to-late stages of PD may experience difficulty chewing food, and/or moving the tongue to position food properly for swallowing. The normal esophageal peristalsis may be slowed, resulting in choking. While a swallowing evaluation should be performed, along with education in safe swallowing techniques, it should be noted that plant foods may be easier to chew than many meats; plant foods also can be chopped, mashed, or pureed easily to provide the best consistency for the individual’s needs while retaining valuable fibers and phytochemicals.

Nutrients. Plant foods are rich in magnesium and vitamin K, important to bone health. This should be emphasized, as PD patients, due to the nature of the disease, may be prone to falls (Ishizaki et al., 1993; Kao et al., 1994; Taggart, et al., 1995; Revilla et al., 1996; Koller et al., 1989; Johnell et al., 1992, Sato et al., 1997), and therefore more susceptible to fractures (Dolinis et al., 1997; Northridge et al., 1996). Good sources of calcium and vitamin D must be highlighted, also, as there may be a greater need for these in this population; in a controlled study, Sato et al. found increased incidence of vitamin D deficiency and reduced bone mass in individuals with PD (Sato et al., 1997).

A vegetarian or plant-based diet can provide excellent amounts of the B vitamins (with the possible exception of B12), especially folate; and education regarding need for B vitamins is important. The vegan patient may need to use a supplement of vitamin B12, and in fact, if deficiencies are suspected, a B complex may be required, at least temporarily. It should be noted that large amounts of vitamin B6 (over ten mg per day) may reverse the effects of levodopa; therefore, supplements should be taken with meals, with levodopa taken at least 30 minutes prior to meals, to avoid this food-medication interaction.

Protein-levodopa interactions. As stated before, protein breaks down in the gut to individual amino acids, with which levodopa must compete for carriers across the intestinal wall. For this reason, patients must take levodopa at least 30 minutes prior to meals or snacks. As the disease progresses, individuals often begin to experience fluctuations in their response to levodopa, resulting in the “on-off” phenomenon, a condition wherein a dose of levodopa wears off before the next dose is due. Without levodopa, the individual may be able to move only very slowly, or not at all, and is effectively disabled. Read the rest of this entry »

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Improvements in Nutrition and Lifestyle Increase Telomerase Activity

Posted by Jenn on December 21, 2010


Animation of the structure of a section of DNA...

Image via Wikipedia

(Source: Longevity Medicine Review; lmreview.com; by Lara Pizzorno, MDiv, MA, LMT)
Introduction

Telomeres, the protective DNA–protein complexes at the end of chromosomes, are required for DNA replication and to protect chromosomes from nuclease degradation, end-to-end fusion, and the initiation of cellular senescence. Since telomeres shorten with each cell division, telomere length is a key indicator of mitotic cell aging and viability.

Telomere length has emerged as a prognostic indicator of disease risk, progression, and premature mortality in humans. Shortened telomeres are a precursor to the initiation of many types of cancer and are predictive of increased risk of bladder, head and neck, lung and renal-cell cancers; poor clinical outcomes in breast and colorectal cancer; recurrence of prostate cancer in patients undergoing radical prostatectomy; and decreased survival in patients with coronary heart disease and infectious disease1 2 3 4 5 6 7 8.

However, even cells with shortened telomeres can remain genetically stable if the enzyme telomerase, which adds telomeric repeat sequences to the chromosomal DNA ends preserving telomere length and healthy cell function, is fully operational.1 9 10

The converse is also true. Decreased telomerase activity alone has been linked to increased risk of cardiovascular disease, independent of chronological age. In a study involving healthy women, telomerase activity, but not telomere length, in immune cells (specifically, peripheral blood mononuclear cells or PBMCs) was inversely associated with six major cardiovascular disease risk factors.11 Telomerase activity is also adversely affected by obesity and insulin resistance, another way in which both result in decreasing telomere length.12 Thus telomerase activity may offer an earlier prognosticator of genomic stability and long-term cellular viability than telomere length.

Can telomerase activity be increased by improvements in diet and lifestyle?

Published in the November 2008 issue of Lancet Oncology, Dr. Dean Ornish‘s latest research, a pilot study on the effects of dietary and lifestyle changes in 30 men with low risk prostate cancer, suggests the answer is a resounding “Yes!” PBMC telomerase activity in these men increased 29.84% within just 3 months of making significant, yet simple, changes in diet and lifestyle.1

Telomerase-Enhancing Diet, Supplement and Lifestyle Program

After a 3-day intensive residential retreat, the men were placed on a low-fat (10% of calories from fat), whole foods, plant-based diet, centered on vegetables, fruits, unrefined grains, and legumes. Intake of refined carbohydrates was minimized. The diet was supplemented with soy (one daily serving of tofu plus 58 grams of a fortified soy protein powdered beverage), fish oil (3 grams daily), vitamin E (100 IU daily), selenium (200 μg daily), and vitamin C (2 grams daily).

In addition, subjects participated in moderate aerobic exercise (walking 30 min/day, 6 days/week); stress management (gentle yoga-based stretching, breathing, meditation, imagery, and progressive relaxation techniques 60 min/day, 6 days/week), and a 1-hour group support session once per week. Participants also met with staff 4 hours per week and had one weekly telephone contact with a study nurse.

Compliance was excellent for both lifestyle and dietary recommendations. After 3 months, subjects reported consuming an average11.6% of calories from fat per day, exercising an average of 3.6 hours each week, and practicing stress management techniques an average of 4.5 hours each week. All medications remained unchanged throughout the 3-month trial, with the exception of participant whose statin drug dosage was decreased. Read the rest of this entry »

Posted in Aging Prevention / Anti-Aging, Cancer Prevention, Dementia, Diabetes, Exercise, Heart Disease, Parkinson's Disease, Research/Data, Telomerase | Tagged: , , , , , , , , , , , | 2 Comments »