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Low-protein and protein-redistribution diets for Parkinson's disease patients with motor fluctuations: a systematic review.
Mov Disord. 2010 Oct 15; 25(13):2021-34.MD

Abstract

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).

Authors+Show Affiliations

Department of Neuroscience, Parkinson Institute, Istituti Clinici di Perfezionamento, Milano, Italy. emanuele.cereda@virgilio.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

20669318

Citation

Cereda, Emanuele, et al. "Low-protein and Protein-redistribution Diets for Parkinson's Disease Patients With Motor Fluctuations: a Systematic Review." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 25, no. 13, 2010, pp. 2021-34.
Cereda E, Barichella M, Pedrolli C, et al. Low-protein and protein-redistribution diets for Parkinson's disease patients with motor fluctuations: a systematic review. Mov Disord. 2010;25(13):2021-34.
Cereda, E., Barichella, M., Pedrolli, C., & Pezzoli, G. (2010). Low-protein and protein-redistribution diets for Parkinson's disease patients with motor fluctuations: a systematic review. Movement Disorders : Official Journal of the Movement Disorder Society, 25(13), 2021-34. https://doi.org/10.1002/mds.23226
Cereda E, et al. Low-protein and Protein-redistribution Diets for Parkinson's Disease Patients With Motor Fluctuations: a Systematic Review. Mov Disord. 2010 Oct 15;25(13):2021-34. PubMed PMID: 20669318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-protein and protein-redistribution diets for Parkinson's disease patients with motor fluctuations: a systematic review. AU - Cereda,Emanuele, AU - Barichella,Michela, AU - Pedrolli,Carlo, AU - Pezzoli,Gianni, PY - 2010/7/30/entrez PY - 2010/7/30/pubmed PY - 2011/1/28/medline SP - 2021 EP - 34 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 25 IS - 13 N2 - 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). SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/20669318/Low_protein_and_protein_redistribution_diets_for_Parkinson's_disease_patients_with_motor_fluctuations:_a_systematic_review_ L2 - https://doi.org/10.1002/mds.23226 DB - PRIME DP - Unbound Medicine ER -