Parkinson’s Disease: The Brain Gut Connection  

By: Erika Bennett, PT, DPT 

Recent research has shifted from the brain to the gut and studies have found that the microbiome influences the brain through a neural network via vagus nerve. Metabolites made by gut microbes, including psychoactive metabolites, can transit from the gut across the blood-brain barrier and into the brain, where they can potentially impact mood and behavior and regulate immune cells in the brain. Alpha-synuclein, is a protein that scientists believe to be one of the key mediators of the death of dopamine that is associated with Parkinson’s Disease (PD). When this protein is misfolded groups of these proteins travel through the vagal nerve up to the brain.  - This is nerd speak for, abnormal molecules from gut microbes impact the brain’s response to regulate the immune system and dopamine system.  

Researchers believe it is possible that PD starts in the gut and regulating the gut microbiome may impact disease progression. We still need more evidence-based studies on a diet’s influence to slow the advancement of PD but there are some promising studies that suggest a healthy diet can help. 

Let us explore how people with PD can maximize nutrition by restructuring the gut microbiome and decreasing inflammation.  

Researchers hypothesize that a high-fiber, predominantly vegetarian diet shows good promise. Until more research is established, a general healthy diet that works for everyone regardless of PD diagnosis supports overall health. The Mediterranean diet is a well-founded diet that incorporates a variety of fresh whole foods that are nutrient dense to support gut health.  

Diet Do’s : 

  • Eat lots of fruit and vegetables!  

  • Eat 2 to 3 servings of fruit and four or more servings of vegetables each day. One serving of fruit equals a medium piece of whole fruit or one cup of chopped. One serving of vegetables equals two cups of leafy produce, one cup of raw veggies, or half a cup of cooked vegetables. 

  • Eat lots of whole grains!  

  • Switch to whole-grain bread, cereal and pasta. You also can try other whole grains, such as bulgur, barley and farro. If you eat about 2,000 calories a day, aim to have at least 3 ounces of whole grains. You can get 1 ounce from a slice of bread, a cup of ready-made cereal, or half a cup of cooked rice or pasta. Read the Nutrition Facts label to find out how much is in one serving. 

  • Drink lots of water! 

  • Nuts, seeds!  

  • Aim to eat four servings of raw, unsalted nuts. One serving is a quarter of a cup. 

  • Olive oil or oils with unsaturated fat  

  • Replace butter with olive, canola, or safflower or sunflower oil in cooking or at the table. And instead of putting butter or margarine on bread, you could use nut or seed spreads on toast or on an apple 

Diet Don’ts:  

  • Eat sugary foods! 

  • Consume saturated fat! 

  • Consume alcohol!  

  • Eat a lot of processed foods 

  • Eat a lot of iron rich foods (slows the absorption of PD medications) 

  • Eat high citrus foods (orange juice, lemons, etc) 

  • High salt foods 

  • Substitute herbs and spice mixes to boost flavor 

  • Choose low sodium labeled foods  

  • Large amounts of protein (especially animal proteins) 

  • Substitute fish, poultry, or beans for red meats 

(Look below for a link for further guidance on the Mediterranean diet.) 

In addition to eating a healthy diet we also have strong evidence-based studies that demonstrate the benefit of high intensity exercise to help slow the progression of PD. If you have not added a PD exercise program to your health program, contact us to schedule an appointment with one of our physical or occupational therapists who are PD movement specialists that will help you fight back against Parkinson’s.