title: Dietary habits and neurological features of Parkinson's disease patients: Implications for practice.
abstract: Parkinson's disease (PD) patients can benefit considerably from appropriate nutritional care, particularly from diet. However, there is limited evidence on the eating habits of PD patients and their relationship with the features of the disease.
  
  
  
  We conducted a large case-control study. Consecutive PD patients (N = 600) receiving systematic nutritional care and healthy controls (N = 600) matched (1:1) for age, gender, education, physical activity level and residence were studied using a 66-item food frequency questionnaire. The relationship between dietary habits and the following features of PD were investigated in patients: body weight, energy balance, constipation, and levodopa therapy (dose) and its related motor complications.
  
  
  
  PD patients had lower BMI and reported higher food intake than controls. BMI was found to be inversely associated with disease duration and severity, and levodopa-related motor complications, whereas energy intake was positively associated with these variables. An increase in protein intake by 10 g over physiological requirements (0.8 g/kg/day) corresponded to a mean increase in levodopa dose of 0.7 mg/kg/day. Constipation was also associated with higher levodopa requirements. Finally, protein intake and its distribution throughout the day influenced levodopa-related motor complications.
  
  
  
  The management of protein intake and the treatment of constipation should be considered to be an integral part of the care of PD patients. Attention should always be focused on energy intake also. This would result in the maintenance of nutritional status, the optimization of levodopa-therapy and the minimization of its related motor complications.
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Barichella
authors.affiliation: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: e.cereda@smatteo.pv.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Cassani
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Pinelli
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Iorio
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Ferri
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Privitera
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Pasqua
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Valentino
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Monajemi
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Caronni
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Lignola
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pusani
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Bolliri
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Samanta A
authors.initials: SA
authors.lastname: Faierman
authors.affiliation: Department of Statistical Sciences "P. Fortunati", University of Bologna, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Lubisco
authors.affiliation: Department of Parkinson Disease Rehabilitation, Moriggia-Pelascini Hospital, Gravedona ed Uniti, Fondazione Europea Ricerca Biomedica (FERB), "S.Isidoro" Hospital, Trescore Balneario, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Frazzitta
authors.affiliation: Department of Functional Rehabilitation, "Sol et Salus" Hospital, Torre Pedrera, Rimini, Italy.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Petroni
authors.affiliation: Parkinson Institute, ASST G.Pini-CTO, ex ICP, Milan, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Pezzoli
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016022:Case-Control Studies; D003248:Constipation / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D018565:Food-Drug Interactions; D006782:Hospitals, Special; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology*; D010349:Patient Compliance; D015995:Prevalence; D012306:Risk; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Body weight; Diet; Gastrointestinal dysfunction; Levodopa; Motor fluctuations; Parkinson's disease