Major nutritional issues in the management of Parkinson's disease
Identifieur interne : 000240 ( Main/Corpus ); précédent : 000239; suivant : 000241Major nutritional issues in the management of Parkinson's disease
Auteurs : Michela Barichella ; Emanuele Cereda ; Gianni PezzoliSource :
- Movement Disorders [ 0885-3185 ] ; 2009-10-15.
English descriptors
Abstract
As with other neurodegenerative diseases, neurologic and nutritional elements may interact affecting each other in Parkinson's disease (PD). However, the long‐term effects of such interactions on prognosis and outcome have not been given much attention and are poorly addressed by current research. Factors contributing to the clinical conditions of patients with PD are not only the basic features of PD, progression of disease, and the therapeutic approach but also fiber and nutrient intakes (in terms of both energy and protein content), fluid and micronutrient balance, and pharmaconutrient interactions (protein and levodopa). During the course of PD nutritional requirements frequently change. Accordingly, both body weight gain and loss may occur and, despite controversy, it seems that both changes in energy expenditure and food intake contribute. Nonmotor symptoms play a significant role and dysphagia may be responsible for the impairment of nutritional status and fluid balance. Constipation, gastroparesis, and gastro‐oesophageal reflux significantly affect quality of life. Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). A balanced Mediterranean‐like dietary regimen should be recommended before the introduction of levodopa; afterward, patients with advanced disease may benefit considerably from protein redistribution and low‐protein regimens. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22705
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ISTEX:9A128EAE8963399EAE8E94D23EA087A5BE71DC99Le document en format XML
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However, the long‐term effects of such interactions on prognosis and outcome have not been given much attention and are poorly addressed by current research. Factors contributing to the clinical conditions of patients with PD are not only the basic features of PD, progression of disease, and the therapeutic approach but also fiber and nutrient intakes (in terms of both energy and protein content), fluid and micronutrient balance, and pharmaconutrient interactions (protein and levodopa). During the course of PD nutritional requirements frequently change. Accordingly, both body weight gain and loss may occur and, despite controversy, it seems that both changes in energy expenditure and food intake contribute. Nonmotor symptoms play a significant role and dysphagia may be responsible for the impairment of nutritional status and fluid balance. Constipation, gastroparesis, and gastro‐oesophageal reflux significantly affect quality of life. Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). A balanced Mediterranean‐like dietary regimen should be recommended before the introduction of levodopa; afterward, patients with advanced disease may benefit considerably from protein redistribution and low‐protein regimens. © 2009 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Michela Barichella MD</name><affiliations><json:string>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</json:string></affiliations></json:item><json:item><name>Emanuele Cereda MD</name><affiliations><json:string>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</json:string><json:string>International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy</json:string></affiliations></json:item><json:item><name>Gianni Pezzoli MD</name><affiliations><json:string>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>nutrition</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>gastrointestinal dysfunction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>body weight</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diet</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>levodopa</value></json:item></subject><articleId><json:string>MDS22705</json:string></articleId><language><json:string>eng</json:string></language><abstract>As with other neurodegenerative diseases, neurologic and nutritional elements may interact affecting each other in Parkinson's disease (PD). 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Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). 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Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). 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However, the long‐term effects of such interactions on prognosis and outcome have not been given much attention and are poorly addressed by current research. Factors contributing to the clinical conditions of patients with PD are not only the basic features of PD, progression of disease, and the therapeutic approach but also fiber and nutrient intakes (in terms of both energy and protein content), fluid and micronutrient balance, and pharmaconutrient interactions (protein and levodopa). During the course of PD nutritional requirements frequently change. Accordingly, both body weight gain and loss may occur and, despite controversy, it seems that both changes in energy expenditure and food intake contribute. Nonmotor symptoms play a significant role and dysphagia may be responsible for the impairment of nutritional status and fluid balance. Constipation, gastroparesis, and gastro‐oesophageal reflux significantly affect quality of life. Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). A balanced Mediterranean‐like dietary regimen should be recommended before the introduction of levodopa; afterward, patients with advanced disease may benefit considerably from protein redistribution and low‐protein regimens. © 2009 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: The authors also certify that there are no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed herein.</p></note><note xml:id="fn2" numbered="no"><p>This article is part of the journal's online CME program. The CME activity including form, can be found online at <url href="http://www.movementdisorders.org/education/journalcme/">http://www.movementdisorders.org/education/journalcme/</url></p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Major nutritional issues in the management of Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Nutritional Management of Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Major nutritional issues in the management of Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Michela</namePart><namePart type="family">Barichella</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emanuele</namePart><namePart type="family">Cereda</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</affiliation><affiliation>International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Milan, Italy</affiliation><description>Correspondence: International Center for the Assessment of Nutritional Status (ICANS), University of Milan, via Botticelli 21, 20133 Milan, Italy</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Gianni</namePart><namePart type="family">Pezzoli</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2009-10-15</dateIssued><dateCaptured encoding="w3cdtf">2008-11-21</dateCaptured><dateValid encoding="w3cdtf">2009-06-20</dateValid><copyrightDate encoding="w3cdtf">2009</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">3</extent><extent unit="references">110</extent><extent unit="words">6803</extent></physicalDescription><abstract lang="en">As with other neurodegenerative diseases, neurologic and nutritional elements may interact affecting each other in Parkinson's disease (PD). However, the long‐term effects of such interactions on prognosis and outcome have not been given much attention and are poorly addressed by current research. Factors contributing to the clinical conditions of patients with PD are not only the basic features of PD, progression of disease, and the therapeutic approach but also fiber and nutrient intakes (in terms of both energy and protein content), fluid and micronutrient balance, and pharmaconutrient interactions (protein and levodopa). During the course of PD nutritional requirements frequently change. Accordingly, both body weight gain and loss may occur and, despite controversy, it seems that both changes in energy expenditure and food intake contribute. Nonmotor symptoms play a significant role and dysphagia may be responsible for the impairment of nutritional status and fluid balance. Constipation, gastroparesis, and gastro‐oesophageal reflux significantly affect quality of life. Finally, any micronutrient deficiencies should be taken into account. Nutritional assessments should be performed routinely. Optimization of pharmacologic treatment for both motor and nonmotor symptoms is essential, but nutritional interventions and counseling could and should also be planned with regard to nutritional balance designed to prevent weight loss or gain; optimization of levodopa pharmacokinetics and avoidance of interaction with proteins; improvement in gastrointestinal dysfunction (e.g., dysphagia and constipation); prevention and treatment of nutritional deficiencies (micronutrients or vitamins). A balanced Mediterranean‐like dietary regimen should be recommended before the introduction of levodopa; afterward, patients with advanced disease may benefit considerably from protein redistribution and low‐protein regimens. © 2009 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: The authors also certify that there are no affiliations with or involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed herein.</note><note type="funding">Fondazione Grigioni per il Morbo di Parkinson</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>nutrition</topic><topic>gastrointestinal dysfunction</topic><topic>body weight</topic><topic>diet</topic><topic>levodopa</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Review</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>24</number></detail><detail type="issue"><caption>no.</caption><number>13</number></detail><extent unit="pages"><start>1881</start><end>1892</end><total>12</total></extent></part></relatedItem><identifier type="istex">9A128EAE8963399EAE8E94D23EA087A5BE71DC99</identifier><identifier type="DOI">10.1002/mds.22705</identifier><identifier type="ArticleID">MDS22705</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2009 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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