While nutrition can affect many aspects of our health, there are three things which you should be aware of. Bone health, hydration, and constipation.
Bone health:
Healthy bones are important for everyone, but as Parkinson's patients, we are at a disadvantage. Studies have shown that individuals with Parkinson's are susceptible to low bone mineral densities, putting us at an increased risk for osteoporosis and subsequent fractures.
What can we do? The main things affecting bone health are 1) calcium, 2) vitamin D, and 3) weight-bearing and muscle-strengthening activitities. You may wonder, what do you mean by weight-bearing muscle-strengthening activitities? Exercises which put stress on your bones can signal your body to strengthen your bones through a complex interaction between ostoblasts, osteoclasts, and osteocytes (bone cells). Weight-bearing activities put stresses on your bones due to gravity, while muscle-strengthening activities act on bones through tendons (which connect muscle to bone). Yet another example of the benefits of exercise!
Calcium is an extremely important mineral in our bodies. Not only is it a main component of bone, but it is also affects blood clotting, plays a huge role in neurotransmission, and also is required for muscle contraction. As such, our bodies know how to regulate calcium levels well. But this relies on having enough calcium to keep our reservoirs (bone) full! If you don't consume enough calcium, your body will use calcium from your bones for other body processes - resulting in a decreased bone mineral density.
According to the National Ostoporosis Foundation, individuals need 1000-1200 mg of calcium per day (1000 mg for women under 50 and men under 70; 1200 mg for women 51 & older, and men 71 & older)... but too much of a good thing can make it bad! Don't consume over 2000 mg per day, as this can lead to kidney stones. Main natural dietary sources of calcium are dairy products and some leafy green vegetables. Other food products may contain added calcium, and supplements can be taken if needed. Check food labels (daily values are based on 1000 mg per day), and consult with your physician or nutritionist if necessary.
Vitamin D is required for calcium and other mineral absorption, and is a vitamin that many of us are deficient in. Vitamin D can be ingested from food sources, from supplements (or foods with added vitamin D), or from skin exposure to sunlight. There are mixed views about how much vitamin D we need, but a starting point is 600 IU for those of us 70 and under, and 800 IU for 71 and up. Check out this article for more information about vitamin D dosing. Also be aware that many factors including where you live, sunscreen use, air quality, skin color, weight, and age can affect how much vitamin D you make from sunlight. Read more about this here.
In summary, make sure you exercise, assess your calcium and vitamin D intake, and adjust your diet or supplement intake as needed.
Hydration:
We all know that we should stay hydrated, and that dehydration is bad, but why is it important? For one, dehydration is a serious condition, which may start as a headache. Proper hydration can also mean that your heart does not need to work as hard to pump blood throughout your body. A simple way to check your hydration status is to look at the color of your urine. Pale yellow means you are well-hydrated. Dark yellow means you should consume more liquids! While our kidneys have an impressive mechanism to control salt and water balance (urine color is a result of how concentrated your kidneys make your urine), why make them work harder than they need to?
We've all heard that we should drink 8 glasses of water per day. This equates to approximately 2 liters of fluid. Tea, coffee, and juice, as well as foods with a high water content can also help to hydrate your body. If you have a heart or kidney condition, or take certain medications, consult with your physician about your hydration needs.
Constipation:
Sure, everyone can get constipation (less than 3 bowel movements per week), but those of us with PD may be particularly susceptible due to:
- Decreased peristalsis (rhythmic movement of food down the gastrointestinal system) due to degeneration of the nerves responsible for peristalisis
- Medication side effects, again by affecting peristalsis
- High-sugar, low-fiber diet
- Low fluid intake
It’s probably pretty clear that if constipation is an issue for you, you should address the last two points: diet and fluid intake. Maintaining a healthy exercise routine, such as following PD on the Move workouts multiple times/week, will also help to keep you regular.
How should you change your diet? It’s simple: increase your fiber intake. It’s important to know that there are two types of fiber: insoluble and soluble. You need both, but when talking about constipation, insoluble fiber is key.
Foods high in insoluble fiber include:
- Wheat bran
- All bran cereal
- Most beans
- Lentils
- Most whole grains
- Flax seed
- Certain vegetables (e.g. okra, turnip, peas)
You may be wondering what soluble fiber does. Essentially, it acts to slow down how rapidly your stomach absorbs sugar, meaning you have longer sustained energy as opposed to a spike in blood sugar. It also binds to fatty acids, meaning it has positive effects on cholesterol, by lowering LDL.
Foods high in soluble fiber include:
- Oat/oat bran
- Some beans
- Soy (e.g. tofu and edamame)
- Certain vegetables (e.g. avocado, Brussel sprouts, sweet potato, asparagus, turnip)
- Certain fruits (e.g. dried figs, prunes, oranges, fruits with edible skins)
- Flax seed
In addition to increasing your intake of high fiber foods, try to limit high sugar foods such as pastries, certain juices, sodas, and candy. If you are not used to eating foods high in fiber, such as beans or apples with skin, gradually increase the amount of fiber. If not, you may experience bloating and gas while trying to digest the increased amount of fiber. This can be remedied with over-the-counter medications, if necessary. Our recipes integrate high fiber foods such as beans, lentils, whole grains, fruits, and vegetables. Give some of them a try if you want a new high-fiber meal!
In addition to increasing your fiber intake, make sure you are hydrating properly. Drink 4-8 glasses of water. Tea, coffee, and juices also are hydrating.
These simple dietary changes may be sufficient for you to avoid constipation or the effects of chronic constipation such as: hemorrhoids, bowel impaction, and increased colorectal cancer risk.
If this is not enough, talk to your physician.
Sources and additional reading:
National Osteoporosis Foundation - Calcium/Vitamin D
Mayo Clinic - Vitamin D Dosing
Harvard - 6 Things You Should Know About Vitamin D
NPR - Coffee Myth Busting: Cup of Joe May Help Hydration And Memory
UCSF PD Center - Constipation and Dietary Needs
Health Castle - Fiber 101: Soluble Fiber vs Insoluble Fiberl