Press release Parkinson's patients: nutrition may ease symptoms
Food as medicine.
There is some evidence that modified diets have beneficial effects on the treatment of Parkinson's. In vitro tests on stool samples show that certain dietary fibers, such as inulin from vegetables and beta-glucans from mushrooms, can boost butyric acid production in patients' intestines, which then improves the composition of gut microbiota. There appears to be a link between that composition and an alleviation of the patient's motor symptoms, such as tremors.
Doctoral researcher Florence Baert continued the ILVO work on swallowing problems and the loss of taste and smell in Parkinson's patients. "With a deep knowledge of food composition and processing, these problems can also be mitigated. If we provide the patient's daily diet with an adapted texture, and above all with alternative taste enhancers, we see interesting effects happening." Additional research and clinical trials should further develop this research track.
On 26 May 2021 Florence Baert defended her doctoral thesis, “The potential role of a customized diet as an adjuvant therapy in Parkinson’s disease”. Promotors are Prof.dr.ir. C. Matthys of KU Leuven and Dr. ir. G. Vlaemynck of ILVO.
Parkinson's makes it hard to eat (well)
Parkinson's disease is an incurable brain disease that manifests as a series of movement and other disorders. The most commonly known symptom is hand tremors, but there are also sensory symptoms such as loss of taste and smell and various gastrointestinal complaints, including swallowing problems, constipation and nausea. Treatment of these problems with eating and digesting can greatly improve patients' quality of life. Dietary modification can also become part of a multidisciplinary approach to the disease. Indeed, it was recently suggested that the gut microbiome - the set of microorganisms in the gut - plays a role in the pathology of Parkinson's. Florence Baert, researcher at ILVO in collaboration with the KU Leuven, therefore studied the role of adapted nutrition as a supporting treatment in Parkinson's disease. She specifically examined taste, aroma and texture modifications on taste perception (taste tests) and the effect of fiber intake from vegetables and from fiber supplements on butyric acid production in the colon (in vitro). The need for such research was clearly demonstrated by a survey of patients: in more than half of the cases patients adapted their eating habits because of constipation and swallowing problems, among other things. The results also showed that the knowledge of possible interactions between food and medication needs to be improved.
Dietary fiber for better gut health? Initial results are promising.
Florence Baert's PhD includes an in-depth study of the effects of dietary fiber on the bacteria in the colon of Parkinson's patients. The impetus for that research was the medical observation that the gut microbiome of Parkinson's patients differs from that of healthy volunteers, with a notable decrease in the amount of butyric acid-producing bacteria. And that is an important fact in the search for treatments, because experimental animal studies suggest that higher butyric acid production could improve motor symptoms and inflammation in Parkinson's patients. It is known that certain dietary fibers can increase butyric acid production in the colon, but this had not yet been evaluated in Parkinson's patients. This study therefore examined the effect of different fiber supplements and of the fiber fraction of various vegetables (chicory roots, salsify, chicory roots, mushrooms) on short chain fatty acid production in Parkinson's patients and healthy volunteers of the same age.
The study was not done on the patients and volunteers themselves, but rather from their stool samples that were treated in the lab. Both certain supplements tested and certain fiber fractions from vegetables were able to effectively boost butyric acid production in patients. However, this remained lower than was the case in the samples from healthy volunteers, and butyric acid production also started more slowly in their samples. "Despite this, the intake of additional dietary fiber could be a promising application in the treatment of symptoms in Parkinson's disease. Further research with patients is needed to evaluate the (indirect) effects of this increased fiber intake on motor symptoms," says co-promoter Geertrui Vlaemynck (ILVO).
Making food for patients taste better? Development of alternative thickeners, aroma boosters and recognizable scents offers some perspective.
The majority of all Parkinson's patients develop severe swallowing problems. In this case, to avoid problems when eating, texture is adjusted, by softening or liquefying solid foods and thickening liquids. Often, however, patients find this less palatable, as some clinical thickeners reduce the flavor and aroma intensity of food. As a result, patients often stop using this approach, which poses risks of choking as well as malnutrition due to decreased appetite. "However, the problem can be solved," says Florence Baert. "For example, our tests with broccoli soup showed that potato starch and quinoa flour as alternatives to the clinical gum-based thickener led to higher flavor and aroma intensity." Further fine-tuning with flavor enhancement techniques such as aroma boosters and starch-based and amylase-resistant thickeners may further enhance the flavor and acceptability of thickeners for Parkinson's patients.
Loss of smell occurs in 70 to 90% of all Parkinson's patients. Impaired taste perception is also common. This affects their taste perception, with sometimes pernicious consequences for appetite and food intake. It is therefore important to include strong and recognizable aromas as much as possible in the adapted diet of patients. In "sniffing tests" with both patients and healthy volunteers, it was investigated which herbs and spices are best recognized. This of course depends on the range of herbs that each test subject uses in their own preparations, but one scent clearly stood out in the study: garlic. This can be explained by familiarity with garlic, but also by the fact that people are very sensitive in detecting the volatile sulfur odorants present in garlic. "Garlic is therefore a good basis for the development of aroma boosters," states Florence Baert.
Nutrition as a pillar of treatment
Florence Baert's research clearly shows that there is a greater role for nutrition in various aspects of Parkinson's treatment than has been the case to date. "Therefore, we advocate the inclusion of nutritional advice in standard Parkinson's care, with a focus on both sensory aspects such as taste and smell perception and gastrointestinal symptoms such as swallowing problems. Nutritional counseling may lead to more and better eating and perhaps even symptom relief, which could improve their quality of life. However, further research is needed to develop scientifically based nutritional guidelines," concludes promotor Christophe Matthys (KU Leuven).