Living With Parkinsonism: Healthy eating and nutrition.

Parkinson's disease is a disorder affecting the muscles and causes much difficulty in eating and because of this nutrition is affected considerably. It becomes necessary for the caregiver to understand the nutritional requirements, meeting deficiencies and providing a wholesome and nutritionally sufficient diet to PD patients.
The difficulties faced may be difficulty in eating due to deficient or slow movements, difficulty in swallowing and not getting a balanced diet. Special plate and glass holders, straws and special forks  help in faciltating patients to eat their own meals. Pakistan Parkinson's Society does provide good information on these issues. http://www.parkinsons.org.pk/
The US website http://www.Parkinson.org/ gives very good guidelines for keeping the nutritional balance in PD patients. Some of the points to keep in mind are:

1. The diet should carry a variety of foods like vegetables with fibre, greens, proteins like chicken, red meat, fish and plenty of grains.
2. Fresh fruits should be eaten daily in a way that caloric intake is maintained.
3. Lentils and complex carbohydrates help maintain sugar levels and reduce fat intake.
4. Fat intake should be limited and lighter oils should be used sparingly. Always try to poach, steam, bake or grill food in a way that least oil is used.
5.Water and fluid intake should be sufficient. As PD patients are at risk of dehydration more than any other , fluid intake should be in accordance to the heat and climate change. In hot humid countries like Pakistan, use fresh fruit juices, green teas, herbal teas, plenty of water, tea, coffee both warm and chilled as liked upto 12-15 cups or glasses per day.
6. If concurrent diseases like high blood pressure is present their treatment and diet with less sodium intake is essential.
7.Empty calories as in sugar-rich foods like cakes, patties etc should be avoided. Learn to prepare foods that use less empty calories as sugary foods and more complex carbohydrates and that too in moderation. Satisfy your sweet tooth with limited fresh fruit.
8. Use vitamin supplements regularly with doctor's advice in order to replace and avoid deficiencies.
9. Last but not least, make food appealing and wholesome as some may suffer from nausea. make it easily chewable and digestible. Make small frequent meals in order to avoid difficulty in larger whole meals.

The PD patients are also at risk for certain nutritional deficiencies like less calcium intake , magnesium, vitamin D and vitamin K intake.This can lead to more bone thinning also known as osteopenia and osteoporosis. This may result in fractures that do not heal easily.Regular excercise to keep the bones strong, vitamin supplements, calcium supplements under doctor's care are advised.Avoid activity in unsupervised areas where a fall and fracture may result.
Dehydration should be avoided and treated by drinking plenty of fluids.Bowel impaction should be avoided by treating constipation regularly. If unexplained weight loss is occurring a re-evaluation of the entire nutritional intake should be done and diet made with a help of a nutritionist.
Medication side effects and the protein/ levodopa interaction should be kept in mind when giving medicines.
(Sources: US Parkinson society, Internet)