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Eat your veggies, Parkie

Diet and exercise. Diet and exercise. Those are the two prescriptions beyond medication neurologists often offer Parkinson’s patients.

Diet was the agenda topic this week at Parkinson Place. Dr. Juan Sanchez-Ramos, medical director, chose food for the weekly educational session he has with members at this model of integrated care for PWP in Sarasota. Sanchez-Ramos, a relaxed and low key USF professor, is in residence every Wednesday for his elderly students who pay nothing for the services offered at this unique facility.

His key message is that most of what is known about diet and PD comes inferentially from epidemiological studies of large populations of people. Unlike drugs, there is no financial incentive to do large scale tests of any single dietary factor, such as fruits and vegetables.

Nonetheless, he squeezed some guidance from the epidemiological research reviewed in a article in the journal “Frontiers in Aging Neuroscience.”

“A well-balanced diet rich in a variety of foods, including numerous servings of vegetables and fruits…and moderate amounts of omega-fatty acid, caffeine and wine may be neuroprotective,” the article says. Neuroprotective means limiting damage to nerves before and after the onset of disease.

Alcohol is neuroprotective in moderation (two or fewer glass of wine or the equivalent}. But in excess it can increase the risk of PD.

The low-fat Mediterranean diet is preferable to the high fat diets of northern climes. The Mediterranean is high in fish, nuts, fruits, vegetables and olive oil

Sanchez-Ramos cautioned against diets high in dairy products, which have been linked to PD. The reason may be contamination of milk with pesticides, which are thought to be possible causative agents in PD.

Foods high in antioxidants get a thumbs up. Among them are: tomatoes, red peppers, potatoes, cauliflower, cabbage, artichokes, okra, kale, bell peppers, berries, pears, apples, grapes, grains, eggs, kidney beans, lentils, pecans, walnuts, hazelnuts, anddark chocolate.

The only dietary supplement Sanchez-Ramos recommends is Omega-3 oil.

A Word of Warning About Off-Label Inosine Use

I wrote recently about promising clinical trial results for the OTC food supplement Inosine in treating PD. I was tempted to buy some and try it. I had second thoughts about this off-label usage. I consulted my neurologist Robert Hauser. He was none too thrilled. His response is worth reading:

“I do not advocate nor prescribe medications that are being evaluated for disease modification. Such agents are in clinical trials to determine whether they do or do not slow progression of disease and whether they are safe and reasonably well tolerated. If we knew they were helpful (positive benefit/harm ratio), they would not be in clinical trials. I would much prefer people participate in clinical trials, provide informed consent, participate in a program that has been approved by various institutions (FDA/NIH/IRB), and help ascertain what the efficacy and safety of the agent actually is. These institutions ensure that the risk of participating in the trial is reasonable relative to the potential benefit to society to discern the safety and efficacy of the agent.

“As you know, there have been many agents for which there was reason to hope that they might slow progression of disease that turned out not to do so when evaluated in clinical trials. If everyone simply went on agents for which there was hope and no one participated in clinical trials, we would never know which agents are actually helpful.”

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