title: Special low-protein foods ameliorate postprandial off in patients with advanced Parkinson's disease.
abstract: Protein intake interferes with levodopa therapy. Patients with advanced Parkinson's disease (PD) should restrict daily protein intake and shift protein intake to the evening. For further reduction of protein intake in the first part of the day, special low-protein products (LPP) should be used instead of normal food products at breakfast and lunch. We studied the efficacy of LPP on postprandial off periods, in PD patients on levodopa therapy. The methods included a randomized, cross-over, single-blind, pilot clinical trial comparing a 2-month balanced diet with a 2-month LPP diet in 18 PD patients with motor fluctuations. The off phases were significantly shorter after LPP diet than after balanced diet (postprandial off, 49 +/- 73 min vs. 79 +/- 72 min and total off, 164 +/- 148 min vs. 271 +/- 174 min, both P < 0.0001). Moreover, a reduction in total off time during LPP diet (3.3 +/- 2.7 hr vs. 4.7 +/- 3.3 hr, P < 0.0001), occurred also in the 9 patients who did not experience subjective benefit. No significant changes in hematological and biochemical variables or body composition were recorded; a slight reduction in body weight (mean, -1.8%) was observed. Consumption of LPP in the first part of the day ameliorates off periods in PD patients, but additional studies including pharmacokinetics are needed.
authors.affiliation: Clinical Nutrition Unit, Istituti Clinici di Perfezionamento, Milan, Italy. barichella@parkinson.it
authors.forename: Michela
authors.initials: M
authors.lastname: Barichella
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Marczewska
authors.forename: Roberta
authors.initials: R
authors.lastname: De Notaris
authors.forename: Antonella
authors.initials: A
authors.lastname: Vairo
authors.forename: Cinzia
authors.initials: C
authors.lastname: Baldo
authors.forename: Andrea
authors.initials: A
authors.lastname: Mauri
authors.forename: Chiara
authors.initials: C
authors.lastname: Savardi
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D018753:Diet, Protein-Restricted / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D018565:Food-Drug Interactions; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000178:diet therapy* / Q000503:physiopathology; D017060:Patient Satisfaction; D010865:Pilot Projects; D019518:Postprandial Period / Q000502:physiology; D016037:Single-Blind Method
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa