Objective: To assess the effects of diet and dietary supplements on motor/non-motor symptoms, and disease progression in Parkinson disease (PD).

Background: Diet has generally played a limited role in PD management where pharmacological treatment is the primary focus. Retrospective studies have investigated the effects of diets and supplements in PD, but confounders like genetics and exposure to environmental toxins make it difficult to determine dietary effects. With growing interest in diet and holistic therapies, we review current knowledge of diet in PD and the potential therapeutic implications.

Method: A PubMed literature review was conducted using keywords Parkinson, diet, vitamin, and supplement, yielding 3,804 results. Animal studies, review articles, case studies and studies of PD risk/prevalence/incidence were excluded. A total of 30 studies were included in the final review.

Results: Diet: a) MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) and Mediterranean diet alone showed slower disease progression, cognitive benefits, and less constipation, but no effect on motor symptoms, b) Ketogenic diet showed improved endurance, and improved motor and non-motor symptoms, c) Protein redistribution diet (PRD) reduces motor fluctuations, but adding amino acid or whey protein supplements did not show any difference in outcomes.  Soybean showed motor benefit with longer on-periods. (Table 1.1)

Vitamins and Supplements: a) Vitamin D stabilized nonmotor symptoms but had no effect on motor symptoms, b) Vitamin E did not show a difference but in combination with omega-3 improved Total UPDRS, c) Probiotics improved nonmotor symptoms (constipation, depression, anxiety) and one study showed motor benefits, d) Coenzyme Q10: high doses may improve daily function, but overall evidence is mixed. (Table 1.2)

Conclusion: MIND, Mediterranean, and Ketogenic diets show promising results with improved cognition, increased endurance, and slower disease progression. PRD reduces fluctuations in advanced PD. Probiotics reduce nonmotor symptoms, particularly constipation. Current evidence suggests the benefits of dietary interventions are under-recognized in PD and the need for development of evidence-based dietary clinical guidelines.

Table 1.1 Diet/supplements effects on PD.

Table 1.2 Diet/supplements effects on PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beyond-medication-the-potential-of-diet-in-parkinsons-management/