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The Dietitian
Since being diagnosed with Parkinson's disease you may have been referred to see a Dietitian to discuss your eating and drinking. A Dietitian is a state registered health professional who is a specialist in food and nutrition. They can provide you with practical dietary and lifestyle advice that is up to date and evidence based.

Why do I need a Dietitian?
There are many reasons why you may have been referred to the Dietitian. You may
- have experienced weight loss and/or a loss of appetite
- have swallowing difficulties that require an altered texture diet.
- require advice on healthy eating if you have gained weight due to poor mobility
- have been recommended to try a protein redistribution diet
- want advice on vitamin and mineral supplements
- or you may have other dietary problems that the Dietitian will be happy to discuss with you.

A healthy Diet
If your weight is healthy and stable you should aim to keep it that way. Some general tips for healthy eating:

• Eat At least five portions of fruit or vegetables daily (includes fresh, frozen, tinned or dried)
• Include a starchy food at each meal – these include – bread, pasta, rice, potatoes, breakfast cereals and products made with flour. To boost nutrition and ease constipation choose wholemeal breads, wholegrain cereals and whole grain rice or pasta, leaves the skins on your potatoes and use wholemeal flour in baking.
• Keep high fat, sugar and salt foods to a minimum – many processed foods such as frozen ready meals contain high levels so aim to keep these to a minimum. Choose olive or rapeseed (vegetable) oil based spreads. Use small amounts of olive or rapeseed oils in cooking instead of butter or lard. Try healthier cooking methods such as poaching, grilling or baking.
• Eat plenty of calcium rich foods such as cheese, yoghurt, milk, milk based puddings and sauces or calcium enriched Soya products.
• Eat a few iron rich foods daily such as lean meat, fish and pulses.

Common dietary advice given in Parkinson's management

For some people with Parkinson's Disease "Healthy eating" advice isn't always appropriate. For instance if you have experienced a large weight loss, loss of appetite or require a modified texture diet. Weight loss is common in Parkinson's disease and is often due to the increased movements associated with the condition, lengthy meal times, an altered textured diet, a loss of appetite or a change in circumstances. The dietitian will advise you on ways to increase the nutritional density of you daily diet and on ways to improve your appetite to minimise any further weight loss and/or regain any lost weight. You may be advised to take some additional drinks that can be prescribed by you GP - alternatively Complan or Build up shakes are available at well stocked supermarkets and chemists.

Some people with Parkinson's disease experience weight gain. This is often due to a reduction in mobility. Healthy eating advice can help to reduce further weight gain or loose gained weight.

Constipation is also common in Parkinson's disease and could be due to decreased mobility levels and change in eating habits. Your Dietitian can advice you on the correct high fibre foods to choose and the correct amount and type of fluids to drink.

It is thought that in some people dietary Protein can interfere with the absorption of Levadopa medications from the gut and across the blood-brain barrier, leading to an increase in symptoms. Therefore a protein redistribution diet can be effective for these people. This is where the protein is restricted during the daytime and made up for in the evening. You must follow the
advice of you dietitian as if followed incorrectly the diet can be restrictive and lead to malnutrition.

Co-enzyme Q10.
This nutrient has gained a reputation of being able to slow to progression of Parkinson's disease. Unfortunately there is a lack of evidence to support this.

A healthy balanced diet will contain all the essential vitamins and minerals you require.

For more information about diet :

Download diet information sheet from the Parkinson's UK