The Sunday Telegraph

Could a healthy diet keep Parkinson’s at bay?

Triggers for the neurologic­al condition may be hidden in the gut, says Professor David Dexter

- Professor David Dexter is associate director of research at Parkinson’s UK Informatio­n: parkinsons.org.uk

Can changing your diet cut your chances of developing Parkinson’s? Research from Harvard seems to suggest so. The findings, published in the journal Neurology, claim that eating a healthy, Mediterran­eanstyle diet – high in fruit, veg, whole grains, nuts and legumes and low in red meat – can affect early symptoms associated with an increased risk of developing the disease.

For the study, every four years more than 47,000 people were asked about their diet, starting in the 1980s when they were middle-aged. It is part of wider research into the connection­s between diet and this progressiv­e neurologic­al condition, for which there is still no cure.

Parkinson’s develops when nerve cells in the brain stop working properly and are lost over time. Some brain cells produce a chemical called dopamine, which allows messages to be sent to the parts of the brain that coordinate movement. Without enough dopamine-producing cells, messages cannot get through and mild physical symptoms of Parkinson’s, such as tremor (shaking), slowness of movement and rigidity (muscle stiffness), appear.

But the loss of other cells using different chemical trigger symptoms, such as constipati­on, depression and sleep problems, can occur before these movement problems. Parkinson’s has more than 40 symptoms, each of which can affect people differentl­y.

About 145,000 people live with Parkinson’s in the UK, but more than one million people are affected – either by living with the condition or as a friend, colleague or family member of someone who is. So finding anything that can help control the effects is crucial.

There are a variety of pharmaceut­ical treatments that can increase the amount of dopamine in the brain, act as a dopamine substitute and stimulate the parts of the brain where it operates, or block the action of other factors (enzymes) that break it down. But not all these drugs suit everyone, and many may work only for a while. Some can have severe side-effects, such as compulsive behaviour. The most well-known, levodopa, increases the amount of dopamine in the brain – but needs to be given in increasing doses as dopamine-producing brain cells are lost.

That’s why looking at lifestyle interventi­ons, such as diet, is important – and this research is very interestin­g. What it shows is that eating a diet full of antioxidan­ts and foods that are known to have an antiinflam­matory effect and are found in a Mediterran­ean-style diet can decrease the risk of developing early symptoms.

In 2012, the participan­ts were asked whether they had two conditions common in people later diagnosed with Parkinson’s disease: constipati­on and REM (rapid eye movement) sleep behaviour disorder, which includes physically acting out dreams during sleep.

Around two years later, 17,400 of the participan­ts were asked about five more symptoms that can precede the disease: loss of sense of smell, impaired colour vision, excessive daytime sleepiness, body pain and depression.

The more closely participan­ts kept to a Mediterran­ean-style diet, the less likely they were to show the early symptoms of sleep disturbanc­es, constipati­on, loss of sense of smell and excessive daytime fatigue.

Those in the highest group for adherence were 33 per cent less likely to have three or more preceding symptoms than those in the lowest group, after researcher­s adjusted for factors such as physical activity, smoking and BMI.

With Parkinson’s, cell loss follows a pattern: it begins in the lower brainstem – which is why sensory and gut symptoms show up first, as this is where the relevant neurologic­al connection­s occur – before moving higher up the brain structure.

So does the Mediterran­ean diet simply protect the brain cells directly, or is there an effect via the gut? We’re not sure yet. But research – some funded by Parkinson’s UK

– has shown us some parts of the picture: we know that Parkinson’s is associated with gut bacteria that can trigger inflammati­on, and that these bad bacteria are inhibited by food found in a Mediterran­ean-style diet. We’re funding clinical trials that will tell us whether getting rid of bad bacteria in the gut will slow the progressio­n of the condition in people with diagnosed Parkinson’s.

A Mediterran­ean diet with emphasis on fibrous vegetables such as onions and asparagus can foster the right kind of gut bacteria. You can also supplement your diet with naturally occurring antioxidan­ts and anti-inflammato­ry agents. Flavonoids, found in foods such as turmeric, which I take myself every day, are a good example.

You also need to ditch the sugary, high-fat foods – just as you would to lower your risk of heart disease. Too much sugar can cause type 2 diabetes – another risk factor for Parkinson’s.

In addition, the high cholestero­l that furs up the arteries in your chest, is doing the same thing in your brain and restrictin­g oxygen supply. A good rule of thumb is that if something in your diet is not heart-healthy, it is not good for your brain either.

The next question is when to change your diet to decrease the risk of Parkinson’s. This is tricky. If you show symptoms – such as a tremor

– in your sixties, the processes that cause the condition may have been triggered 10 to 15 years earlier. So to steal a march on the condition altogether, changes to your diet should be made from your thirties.

But that doesn’t mean it’s too late to improve your diet if you’re older, or even once you have the condition. Reducing inflammati­on and protecting the brain with antioxidan­ts could potentiall­y slow progressio­n, but it will be a while before results from clinical trials confirm this.

While much of Parkinson’s is still a puzzle, and your genes also count, following a healthy diet as early as you can is a good place to start.

If a food isn’t hearthealt­hy, it’s not good for your brain, either

 ??  ?? Healthy start: a Mediterran­eanstyle diet could help to stave off Parkinson’s, says Professor David Dexter, far left
Healthy start: a Mediterran­eanstyle diet could help to stave off Parkinson’s, says Professor David Dexter, far left
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