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Nutrition

Maintenance of good health through healthy nutrition is important for everyone, but it is particularly important if you have a chronic illness, such as Alzheimer’s, Multiple Sclerosis or Parkinson’s.

It is difficult for a person to feel well and maintain energy when he or she is not eating properly. Good nutrition helps provide energy, heal wounds, and fight infection.  Eating properly involves eating regularly and eating a variety of foods from all of the food groups. A healthy, low-fat diet includes plenty of grain products, vegetables, and fruits, which provide vitamins, minerals, fiber, and complex carbohydrates.

In addition to a balanced nutritional diet, there exists a role for nutritional supplements in treatment and management of neurodegenerative diseases. While this role has not been fully defined, NSCFF is in full support of further exploration.

Alzheimer's Disease

While there is no special diet for people with Alzheimer’s disease, proper nutrition is very important for maintenance of good health and quality of life. For a person with Alzheimer’s or dementia, poor nutrition may increase behavioral symptoms and cause weight loss.

In addition to eating a variety of foods, a healthy diet involves limiting foods with high saturated fat and cholesterol, cutting down on refined sugars, and limiting foods with high sodium.

During intermediate and late stages of Alzheimer’s disease, eating may become more difficult due to swallowing problems, which can lead to choking and weight loss. These difficulties may be reduced by preparing foods that aren’t hard to chew or swallow. This can be done by grinding food, cutting it into bite-sized pieces, or serving soft foods.

Maintaining a healthy weight with a good balance of diet and exercise may also become more difficult as the disease progresses and loss of appetite and weight loss become concerns. If a person has a decreased appetite, his or her caregiver can try preparing the patient’s favorite foods, increasing the patient’s physical activity, or planning for several small meals throughout the day rather than three large ones. If loss of appetite persists, your doctor may suggest supplements between meals for additional calories.
Dehydration can also become a problem for some patients. Caregivers should encourage fluids by offering small cups of water or other liquids throughout the day. Foods with high water content, such as fruit, soups, milkshakes, and smoothies can also be helpful.

Nutritional Supplements

There are a large number of nutritional supplements and herbal remedies available to Alzheimer’s patients. Many of these supplements purport to enhance memory or delay or prevent progression of the disease. While many patients feel that these supplements may have beneficial effects, rigorous studies on their safety and efficacy have not been conducted. Some common supplements used by Alzheimer’s patients are listed below:

  • Acetyl L-Carnitine has the ability to cross the blood-brain barrier and enter the brain, where it acts as a powerful antioxidant, which may help in prevention of brain cell deterioration. In addition to its potential neuroprotective properties, it may also reduce attention deficits in patients with Alzheimer’s disease after long-term treatment.
  • Caprylic acid is a “medical food” that may provide an alternative energy source for brain cells that have lost their ability to use glucose, the brain’s chief energy source, as a result of Alzheimer’s disease. Some people with Alzheimer’s disease use coconut oil as a less expensive source of Caprylic acid.
  • CDP Choline is a form of the B-vitamin choline. It is used by the body in the synthesis of cell membranes and also the production of the neurotransmitter acetylcholine, which plays a major role in signal transmission in the brain. Supplements of CDP Choline have been found to possibly help improve memory and focus and mental energy.
  • Curcumin, the principal component of the popular Indian spice turmeric, is a polyphenolic compound that has been demonstrated to have antioxidant and anti-inflammatory effects as well as effects on reducing beta-amyloid aggregation. There is growing evidence that indicates that curcumin may improve cognitive function in patients with Alzheimer’s disease.
  • Ginkgo bilboa is a plant extract containing several compounds that may have positive effects on cells within the brain and the body. It has been used for centuries in traditional Chinese medicine and Ayurvedic medicine and is currently being used in Europe to alleviate cognitive symptoms associated with a number of neurological conditions.
  • Huperzine A is a moss extract that has been used in traditional Chinese medicine for centuries. It has properties similar to those of cholinesterase inhibitors, one class of FDA-approved Alzheimer’s medications.
  • Omega-3 fatty acids are a type of polyunsaturated fatty acid. Research has linked high intake of omega-3s to a possible reduction in risk of dementia or cognitive decline.
  • Phosphatidylserine is the primary lipid component of the membranes that surround nerve cells.  The theory behind phosphatidylserine use is that it may possibly protect cells from degeneration.

All treatment decisions should be discussed with a healthcare professional. Patients must be cautious about substituting less well-studied treatments for those that have been proven to work.  An additive approach may be considered.

Multiple Sclerosis

For people with multiple sclerosis, many doctors recommend a traditional low-calorie, low-fat diet, while others promote strict limits on certain food groups or emphasize particular foods. While there is no concrete evidence that a specific diet controls MS, there are several guidelines for healthy eating.

One recommendation is cutting back on saturated fat and refined sugars. Unsaturated fat, on the other hand, is an important part of a healthy diet when consumed in moderation. Limited research has shown that certain types of polyunsaturated fats—specifically omega-3 fatty acids and omega-6 fatty acids—could actually have a positive effect on MS. Omega-3 fatty acids can be found in fatty fish like mackerel, herring, sardines, albacore tuna, and salmon. Plant sources such as soybeans, canola oil, walnuts or flaxseeds contain ALA (alpha-linolenic acid), a less potent form of omega-3. Omega-6 fats are found in safflower, sunflower, and sesame seed oils, in other seeds and nuts, and in leafy vegetables and grains.

Fiber is also an important part of a healthy diet for a person with MS. Fiber-rich foods promote good bowel function to combat constipation. Good sources of fiber include cereal grains, nuts, seeds, vegetables and fruits.

Nutritional Supplements

Although standard medical studies have had mixed results, some research has indicated that various nutritional and herbal supplements may be effective in managing symptoms MS:

  • Fish oil supplements are the richest sources of Omega-3 fatty acids. Research has shown that omega-3 fatty acids could have a positive effect on slowing disability progression and relapses for MS patients. Supplements containing one to two grams of EPA plus DHA are widely available.
  • Valerian is a flower root sometimes used as a sleep aid. People with MS may have difficulty sleeping, and difficulties with sleep may contribute to MS-related fatigue.
  • St. John’s Wort is a yellow flower that grows in many parts of the world. It is generally used as an antidepressant. Many, but not all, studies have indicated that St. John’s wort does have antidepressant effects.
  • Vitamin D is a hormone, or chemical messenger in the body. Scientific studies, both in the laboratory and in people with MS, indicate that vitamin D alters immune function in a way that may be desirable in MS. Low Vitamin D levels have been found to increase the incidence of MS and the frequency of exacerbations.
  • Antioxidants are of particular interest for people with neurodegenerative diseases, as they may protect nerve cells against nerve cell damage caused by oxidative stress associated with disease.
  • Gingko Bilboa is a plant extract, which preliminary studies suggest may improve memory or concentration among people with MS. One small study in MS indicated that ginkgo may improve fatigue, as well. It also inhibits a substance known as platelet activating factor (PA F). By inhibiting PA F, ginkgo can cause a decrease in the activity of certain immune cells.
  • Calcium is a critically important supplement for those who are at risk for osteoporosis. Many people with MS also have risk factors for osteoporosis.

All treatment decisions should be discussed with a healthcare professional. Patients must be cautious about substituting less well-studied treatments for those that have been proven to work. An additive approach may be considered.

Parkinson's Disease

In addition to eating a healthy, well-balanced diet for maintenance of good health, there are several nutritional measures that may be beneficial for people with Parkinson’s disease. Parkinson’s patients are prone to osteoporosis, a disease caused by low bone-mineral density. This can be a problem for people with Parkinson’s who have an increased risk of falling, resulting in an increased risk of bone fractures. Therefore, it is important that people with Parkinson’s maintain a diet that includes adequate amounts of calcium and vitamin D. If your diet does not involve consuming foods rich in calcium and vitamin D, use of a nutritional supplement is sometimes recommended.

Constipation is also a common effect of Parkinson’s disease that must be addressed because cases of severe constipation can lead to bowel obstruction. Nutritional measures can be used to manage constipation by eating foods that are high in fiber and drinking plenty of fluids. If you are not able to achieve bowel regularity through lifestyle alone, laxatives and other bowel interventions may be required.

Some medications for Parkinson’s disease can raise the risk for dehydration. People with Parkinson’s should drink plenty of fluids throughout the day to avoid dehydration.

Protein and Levodopa

Levodopa is currently one of the most effective medicines available for the management of Parkinson’s disease. Proteins follow the same pathway for absorption into the bloodstream as levodopa and therefore, proteins may interfere with the body’s response to levodopa. When taking levodopa, high protein diets may need to be avoided and intake of normal amounts of protein may need to be spaced equally throughout the day.

Nutritional Supplements

Although research studies have had mixed results, some people with Parkinson’s disease have found that various nutritional and herbal supplements and dietary therapies may be effective in managing symptoms or delaying progression of the disease:

  • Coenzyme Q10 is an antioxidant being studied for the treatment of Parkinson’s disease. This enzyme is important for cellular energy, which may be impaired with Parkinson’s.
  • Creatine is another supplement that likely acts through its effects on energy metabolism and may protect against nerve cell injury.
  • Glutathione is an antioxidant with effects on nerve cell metabolism. It is of particular interest to patients with Parkinson’s disease because of studies showing its promising effects in the substantia nigra, the site of major nerve cell damage in Parkinson’s disease.
  • NADH has been shown to significantly increase brain dopamine levels in Parkinson’s disease, and as a result, may produce benefits in reducing symptoms and improving brain function in people with Parkinson’s disease.
  • Other antioxidants such as Vitamin E and Vitamin C are also popular among patients with Parkinson’s disease, because they are thought to combat nerve damage caused by oxidative stress.
  • Gingko Balboa is an herbal supplement that may protect nerve cells from MPTP, a neurotoxin that leads to Parkinson’s disease. It may also be a way to treat mild memory lapses in Parkinson’s disease.

All treatment decisions should be discussed with a healthcare professional. Patients must be cautious about substituting less well-studied treatments for those that have been proven to work. An additive approach may be considered.

 

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