Document Detail

Low-protein and protein-redistribution diets for Parkinson's disease patients with motor fluctuations: a systematic review.
MedLine Citation:
PMID:  20669318     Owner:  NLM     Status:  MEDLINE    
The American Academy of Neurology suggests advising the redistribution of daily protein meal content to every Parkinson's disease (PD) patient with motor fluctuations during levodopa treatment. However, no comprehensive evaluation of this complementary therapy has been performed. A systematic review of intervention studies investigating the neurologic outcome of low-protein (<0.8 g/kg of ideal weight/day) and protein-redistribution diets in patients with PD experiencing motor fluctuations during levodopa treatment. All studies (uncontrolled or randomized) investigating a low-protein and/or a protein-redistribution diet (LPD and PRD) and involving patients with PD with motor fluctuations were included, provided that sufficient information on dietary protein content and neurologic outcome measures was available. We identified 16 eligible studies, but they were markedly heterogeneous. There was not enough evidence to support the use of LPD. Response to PRD seemed very good. Acceptability appeared high upon introduction, but it seemed to progressively decrease over time. On average, PRD resulted in improved motor function, but also complications occurred. At the beginning, drop-outs were due to levodopa side effects rather than unsatisfactory benefits. Long-term adherence was more affected by changes in dietary habits than by diet-related side effects. Efficacy and benefits appeared to be higher when the intervention was proposed to subjects in the early stages of PD. PRD can be safely advised to fluctuating patients with PD, but those in whom benefits override the possible inconveniences still need to be identified. The long-term effects of PRD on nutritional status should be evaluated and true effectiveness in clinical practice should be reassessed, given the changes in levodopa formulations and the introduction of several adjuvants (levodopa degradation inhibitors and/or dopamine agonists).
Emanuele Cereda; Michela Barichella; Carlo Pedrolli; Gianni Pezzoli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  25     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-08     Completed Date:  2011-01-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2021-34     Citation Subset:  IM    
Department of Neuroscience, Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy.
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MeSH Terms
Dietary Proteins / administration & dosage*
Dopamine Agents / therapeutic use
Levodopa / adverse effects
Motor Activity / drug effects,  physiology*
Outcome Assessment (Health Care)
Parkinson Disease / metabolism*,  physiopathology*,  therapy*
Proteins / metabolism*
PubMed / statistics & numerical data
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Dietary Proteins; 0/Dopamine Agents; 0/Levodopa; 0/Proteins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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