Living Well Resources

“Success is not measured by what you accomplish,
but by the opposition you have encountered,
and the courage with which you have maintained the struggle against overwhelming odds.”
– Orison Swett Marden

We know that having Parkinson’s disease raises a lot of questions, and while Keith and Linda Hall walk a related path, they don’t consider themselves experts. Parkinson’s Fitness does not offer medical advice, rather, we share what we learn and encourage you to discuss all information with your physicians.

We are proud of our relationships with local and national medical communities from whom we’ve received community grants to help provide our free programs (namely, the APDA and the Parkinson’s Foundation), and with whom we partner in research studies, symposiums and special annual events – APDA Mass Chapter, Parkinson’s Foundation, Michael J. Fox Foundation, Massachusetts General Hospital Parkinson Center of Excellence, and the Boston University Medical Center Parkinson’s Disease and Movement Disorder Center. Please visit the many web sites below for excellent information about the organizations mentioned, and many more!

Remember that you are not alone, and chances are someone has been through something similar to whatever you might be experiencing or questioning. The most important things you can work toward are forming a comprehensive team in whom you have confidence, establishing realistic goals and educating yourselves on a regular basis. Take a few moments to read Keith Hall’s 25 guidelines for creating active-living goals shared from his own personal journey with Parkinson’s – Keith Hall – 25 Steps to the Goal

General Education
American Parkinson’s Disease Association- MA Chapter: https://www.apdaparkinson.org/community/massachusetts/
Parkinson’s Disease Foundation: https://www.parkinson.org/Living-with-Parkinsons/Resources-and-Support
Parkinson’s News Today: https://parkinsonsnewstoday.com
Checklist for the Newly Diagnosed –https://davisphinneyfoundation.org/resources/parkinsons-newly-diagnosed-resources/
Live Well with Parkinson’s Disease – The Davis Phinney Foundation – https://davisphinneyfoundation.org/
Living with Parkinson’s Disease: https://www.michaeljfox.org
Brain & Life Magazine – all neurological conditions – free subscription – https://www.brainandlife.org/the-magazine/
Lewy Body Dementia Association – https://www.lbda.org/10-things-you-should-know-about-lbd/

Care Partners
1) Care partner Resources – Caregiver Resources | Parkinson’s Foundation
2) Caring.com is a leading senior care resource for family caregivers seeking information and support as they care for aging parents, spouses and other loved ones. We have been featured by AARP, The Administration for Community Living, The National Legal Resource Center, and Forbes, as well as referenced by many governmental agencies and organizations across the Internet.
3) Parkinson’s Hospital Safety Guide: How to Prepare for a Hospital Stay –Hospital Safety Guide | Parkinson’s Foundation
4) Preparing for Surgery – https://www.apdaparkinson.org/surgery-complications-and-parkinsons-disease-parkinsons-disease-and-preparing-for-surgery/

Exercise to Ease Symptoms
Movement Disorder Consultation, Expertise and Care Programs: https://www.bumc.bu.edu/parkinsonsdisease/
At home exercise: https://www.apdaparkinson.org/community/wisconsin/resources-wi/exercise-at-home/
Exercise chart – Parkinson’s Foundation: parkinsons-exercise-recommendations-infographic.pdf
Exercise and Parkinson’s Disease: https://www.michaeljfox.org/understanding-parkinsons/living-with-pd/topic.php?exercise
Does Exercise Impact Parkinson’s – Exercise | Parkinson’s Foundation
Center for Balance, Mobility and Wellness at Gordon College – Center for Balance, Mobility & Wellness – Gordon College
Brian Grant Foundation – Exercise – Brian Grant Foundation
Types of Exercise for People with Parkinson’s – Best Exercises for People with Parkinson’s Disease | APDA (apdaparkinson.org)
Improving the Quality of Life for People with Parkinsons through Exercise and Nutrition – https://www.parkinfit.org/

We are so proud and grateful to have amazing, talented, creative certified instructors engaging weekly with our members, both in person and via online ZOOM classes! Click here to read an article about our Marblehead instructor, Kim Crowley!

Nutrition
Diet and Nutrition – https://www.michaeljfox.org/news/diet-nutrition
Managing Parkinson’s with Good Nutrition – Diet & Nutrition | Parkinson’s Foundation
Manage Parkinson’s with Diet and Nutrition – Diet & Exercise in Parkinson’s | APDA (apdaparkinson.org)

Nutrition’s Impact on Parkinson’s Disease – Nutrition’s Impact on Parkinson’s Disease – Today’s Dietitian Magazine (todaysdietitian.com)
The following information is an excerpt from an interesting article on the effect of proper nutrition on Parkinson’s from a past edition of Today’s Dietitian magazine, written by Matt Ruscigno, MPH, RD. To read the full article, click on the Today’s Dietitian magazine link directly above.

Nutrition Guidelines for Patients
Once a Parkinson’s disease diagnosis is made, proper nutrition is important for minimizing associated symptoms and delaying disease progression. Heather Zwickey, PhD, dean of research and a professor of immunology at the National College of Natural Medicine, has a three-part strategy for developing a healthful diet protective against Parkinson’s. She says food choices should be neuroprotective, anti-inflammatory, and antioxidant rich. Nuts like walnuts, pistachios, and Brazil nuts are especially neuroprotective, Zwickey says. Recommended anti-inflammatory foods include leafy greens and soy products. Antioxidants are found in the most colorful plant foods, such as berries.

Antioxidant-rich and caffeine-containing green tea is recommended for patients with Parkinson’s disease. There’s some evidence that green tea also may be protective in the development of Parkinson’s. Interestingly, fava beans contain levodopa, a precursor to dopamine in the brain, in a significant enough amount to be beneficial for those with Parkinson’s. Fava beans also contain beneficial antioxidants and fiber; the importance of the latter is discussed below. Dairy products should be reduced or eliminated because they decrease uric acid. If patients are accustomed to consuming dairy products, dietitians can recommend nut-based alternatives for milk, cheese, and ice cream.

Addressing Symptoms
According to the Academy of Nutrition and Dietetics, the goals for patients are to reduce constipation, maintain hydration status, assess for dysphagia and gastrointestinal (GI) problems, provide adequate energy, and prevent bone thinning and vitamin D deficiency.

Fiber Intake and Reducing Constipation
Parkinson’s disease can impact all bodily movements, including the GI tract. Insoluble fiber can help move food along the GI tract and reduce constipation. Whole grains such as brown rice, rye, barley, and quinoa are excellent sources of insoluble fiber and also contain vitamin E, which has antioxidant activity. Starchy vegetables and legumes, especially lima beans and lentils, are good sources, as are berries. These foods should be added to the diet slowly to give the GI tract time to adjust to the effects of fiber.

Hydration Status
Drinking enough fluid is independently important and will additionally alleviate constipation. Some patients may experience decreased thirst and should develop a plan to maintain adequate fluid intake. Carrying a water bottle and setting daily, specific goals for water drinking can help. Fruits and vegetables also are hydrating and can be a source for water-averse patients.

Dysphagia
Some patients may have trouble swallowing due to involuntary muscle movements that make food consumption difficult. Since swallowing is compromised, food or liquid can get into the lungs and may cause aspiration pneumonia, the leading cause of death in Parkinson’s disease. It’s imperative to recognize changes early in swallowing ability so a patient’s diet can be adjusted accordingly to avoid aspiration pneumonia and malnutrition. RDs can work with a patient’s medical team, specifically a speech-language pathologist, if available, to create a nutrition plan that works within a patient’s limitations. In some cases, enteral feeding may become a necessity.

Weight Loss and Weight Gain
Patients with Parkinson’s may be underweight because of eating difficulties or overweight due to the inability to exercise. Dietitians can provide nutrition counseling to help patients lose or maintain a healthful weight. Fruits, vegetables, whole grains, and legumes are nutrient-dense and can aid in weight loss by increasing satiety with fewer calories. Nuts and nut-based foods are calorically dense and palatable and can be recommended for underweight patients. Although engaging in physical activity may be difficult, modifications can be made for individuals as a tool in weight maintenance. In addition, exercise, as tolerated, can play a substantial role in improving patients’ quality of life. Some research shows that vigorous exercise can have a neuroprotective effect and has pharmacological benefits independent of weight loss or cardiovascular benefits.26

Bone Thinning and Vitamin D Deficiency
Limited exercise and a low-quality diet can lead to poor vitamin D status and decreased bone density in patients with Parkinson’s disease. Dietitians must check for adequate calcium consumption. Green leafy vegetables contain calcium, fiber, and beneficial antioxidants. A supplement for calcium and vitamin D may be indicated. Weight-bearing exercise is also important for bone health. Patients may have a physical therapist on their health care team who can determine which exercises are appropriate. If they don’t, dietitians can recommend they consult with one.

Drug-Nutrient Interaction and Protein Timing
The main medication prescribed to patients with Parkinson’s disease is levodopa, a protein building block that competes for absorption with other proteins. It’s recommended that protein be limited throughout the day to reduce interaction with levodopa. Carbohydrate-rich snacks may be necessary with levodopa to prevent nausea. At dinnertime, more protein-rich foods can be added to ensure adequate intake.

There are many unknowns concerning the prevention and treatment of Parkinson’s disease, but this shouldn’t dissuade dietitians from utilizing good nutrition practices. While there’s no guarantee that eating a diet high in fiber and antioxidant-rich plant foods is effective in relieving constipation or reducing symptoms of Parkinson’s, there are virtually no negative side effects of introducing them. A patient with Parkinson’s may be unaware of nutrition’s role in their treatment plan, which gives the RD an excellent opportunity for providing nutrition education. Preventing malnutrition and aspiration pneumonia should be a priority, and an interdisciplinary approach may be necessary.”