Food Habits and Intake of Nutrients in Elderly Patients with Parkinson’s Disease

Background: Weight loss is reported frequently in patients with Parkinson´s disease also early during the disease. Objective: To investigate food habits and nutrient intake in elderly Parkinson´s disease patients compared with matched controls, as well as to compare PD patients with and without weight loss. Methods: Twenty-six elderly free-living patients with PD, and 26 sex- and age-matched healthy controls, were assessed twice with one year interval between. All food consumed was recorded over 3 consecutive days. Food habits were assessed with the Food Based Concept for Classification of Eating Episodes and intakes of energy and nutrients were calculated. PD symptoms, olfaction, swallowing function, daily activities and serum concentration of different nutri ents were investigated. Results: After 1 year, the PD patients decreased their intakes of daily high quality snacks from 0.5 ± 0.7 to 0.3 ± 0.3 (p < 0.05) and their prepared complete meals from 0.8 ± 0.3 to 0.6 ± 0.3 (p < 0.05), while their daily number of prepared incomplete meals increased from 0.2 ± 0.2 to 0.3 ± 0.3 (p < 0.01). PD patients with weight loss increased their daily intakes of fat by 12 ± 34 g and their energy intake per kg body weight increased by 21 ± 31 kJ (p < 0.05), respectively, and this was higher than in those without weight loss (p < 0.01). PD patients required more help with buying and cooking food compared with the controls. Conclusions: PD patients’ food habits changed so that they consumed a lower number of prepared complete meals. PD patients with weight loss had a higher intake of fat and energy than those without weight loss, although this was obviously not sufficient to prevent weight loss. Impaired absorption of fat in PD should be discussed.

[1]  Douglas G. Altman,et al.  Practical statistics for medical research , 1990 .

[2]  G. Grimby,et al.  Assessment of physical activity, fitness and performance in 76‐year‐olds , 1994 .

[3]  S S Schiffman,et al.  Taste and smell perception affect appetite and immunity in the elderly , 2000, European journal of clinical nutrition.

[4]  AE Black,et al.  Critical evaluation of energy intake using the Goldberg cut-off for energy intake:basal metabolic rate. A practical guide to its calculation, use and limitations , 2000, International Journal of Obesity.

[5]  A. Tomkins,et al.  Increased energy expenditure in Parkinson's disease. , 1990, BMJ.

[6]  M. Unosson,et al.  Does l‐dopa treatment contribute to reduction in body weight in elderly patients with Parkinson's disease? , 2005, Acta neurologica Scandinavica.

[7]  E. Poehlman,et al.  Free-living Daily Energy Expenditure in Patients with Parkinson's Disease , 1997, Neurology.

[8]  A. Tomkins,et al.  Diet, body size and micronutrient status in Parkinson's disease. , 1992, European journal of clinical nutrition.

[9]  S. Kirk,et al.  Health and social factors affecting the food choice and nutritional intake of elderly people with restricted mobility , 1999 .

[10]  A Carlsson,et al.  'On‐off' phenomenon in Parkinson's disease , 1988, Neurology.

[11]  A. Brotherton,et al.  Principles of nutritional assessment , 2006 .

[12]  K. Kashihara Weight loss in Parkinson’s disease , 2006, Journal of Neurology.

[13]  A. Tomkins,et al.  Raised resting energy expenditure in Parkinson's disease and its relationship to muscle rigidity. , 1992, Clinical science.

[14]  Z. Wszolek,et al.  Body mass index is reduced early in Parkinson's disease. , 2005, Parkinsonism & related disorders.

[15]  E. Poehlman,et al.  Misreporting of Total Energy Intake in Older Men and Women , 1999, Journal of the American Geriatrics Society.

[16]  Torbjörn Åkerstedt,et al.  A new approach for evaluation of meal quality and meal patterns , 1993 .

[17]  K. Hellström,et al.  Outcome of protein-energy malnutrition in elderly medical patients. , 1995, The American journal of medicine.

[18]  S. Bingham,et al.  The dietary assessment of individual: methods, accuracy, new techniques and recommendations , 1987 .

[19]  P. Finglas,et al.  Relationships between micronutrient intake and biochemical indicators of nutrient adequacy in a ‘free-living’ elderly UK population , 1997, British Journal of Nutrition.

[20]  M. Unosson,et al.  Factors of importance for weight loss in elderly patients with Parkinson's disease , 2004, Acta neurologica Scandinavica.

[21]  B. Sidenvall,et al.  Case studies of food shopping, cooking and eating habits in older women with Parkinson's disease. , 2001, Journal of advanced nursing.

[22]  H. Berendse,et al.  Loss of olfaction in de novo and treated Parkinson's disease: Possible implications for early diagnosis , 2001, Movement disorders : official journal of the Movement Disorder Society.

[23]  S. Fahn Members of the UPDRS Development Committee. Unified Parkinson's Disease Rating Scale , 1987 .

[24]  C. de Graaf,et al.  Impaired sensory functioning in elders: the relation with its potential determinants and nutritional intake. , 1999, The journals of gerontology. Series A, Biological sciences and medical sciences.

[25]  W. Koller,et al.  Nutritional aspects and swallowing function of patients with Parkinson's disease. , 1990, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition.

[26]  D King,et al.  A study of the nutritional status of elderly patients with Parkinson's disease. , 1994, Age and ageing.

[27]  J. Jankovic,et al.  Low Body Weight in Parkinson's Disease , 1992, Southern medical journal.

[28]  T. Cederholm,et al.  Treatment of protein-energy malnutrition in chronic nonmalignant disorders. , 2001, The American journal of clinical nutrition.

[29]  D. King,et al.  Intestinal permeability and orocaecal transit time in elderly patients with Parkinson's disease. , 1996, Postgraduate medical journal.

[30]  D A Schoeller,et al.  How accurate is self-reported dietary energy intake? , 2009, Nutrition reviews.

[31]  E. Rothenberg,et al.  Evaluation of energy intake estimated by a diet history in three free-living 70 year old populations in Gothenburg, Sweden , 1997, European Journal of Clinical Nutrition.

[32]  A. Norberg,et al.  Aberrant eating behavior in elderly parkinsonian patients with and without dementia: analysis of video-recorded meals. , 1989, Research in nursing & health.

[33]  M. Lennernäs,et al.  Food-based Classification of Eating Episodes (FBCE) , 1999, Appetite.

[34]  M. Nydahl,et al.  Five-day food intake in elderly female outpatients with Parkinson's disease, rheumatoid arthritis or stroke. , 2004, The journal of nutrition, health & aging.