Diet and supplements for Parkinson’s: what’s the research?

Many factors contribute to the development of Parkinson’s. Whilst there’s currently no known cure, research continues to help us understand how diets and supplements can help people to live well with the condition.

What’s the best diet for Parkinson’s?

Maintaining a healthy, balanced diet is important for everyone, not just people with Parkinson’s. Generally, most people would benefit from a diet that involves eating more fresh fruits and vegetables, and fewer processed foods.

While there have been some studies that start to delve a little deeper into which diets might be best for people with Parkinson’s, there’s still very little evidence that points to the benefits of one specific diet over another. Take a look at some of the research so far.

Important note

There’s lots of information about diet and supplements around, but it’s hard to know what’s best for you. We know that everyone with Parkinson’s is different, and this applies to diet and supplements too. Please always speak with your healthcare team for the most relevant information for you, before making any changes.

Mediterranean diet or MIND diet

The Mediterranean diet is a term used to describe a diet of lots of fruit and vegetables, grains (like brown rice or wholewheat bread) and healthy fats (like olive oil or avocado). It also avoids red meat, and limits foods with lots of added sugar, like processed sugary sweets.

The MIND diet is a variation of the Mediterranean diet. It stands for Mediterranean and dietary approaches to stop hypertension Intervention for Neurodegenerative Delay, and specifically advises leafy greens (like spinach or collard greens) and nuts or seeds, as well as the main principles of the Mediterranean diet.

There’s lots of anecdotal evidence that suggests that diets like these can help people with Parkinson’s manage their symptoms. However, there aren’t many studies that have been carried out to the gold standard of research (a randomised controlled trial) that look at the effect of these diets in particular.

But there is some evidence that following a healthy, balanced diet such as these could delay onset of Parkinson’s symptoms. A research study with 225 people with Parkinson’s showed that people who followed the MIND diet tended to develop symptoms of Parkinson’s later than those who didn’t follow the diet. There was a delay in onset of symptoms of as much as 17 years for women, and 8 years for men.

Read the full scientific study in the Movement Disorders journal.

Ketogenic diet

A ketogenic diet favours high amounts of healthy fats, such as olive oils, avocado and nuts. It also restricts most, if not all carbohydrates – so no bread, pastas or rice, and limits  fruits and natural sugars.

It’s often used for weight loss, but can bring on other harmful side effects if the diet isn’t managed properly. So it’s vital that anyone following a ketogenic diet is regularly monitored to check for a build up of protein in their blood or urine, which can put strain on the kidneys.

A number of short, small studies looking at the ketogenic diet have suggested that it could help manage some symptoms of Parkinson’s, such as anxiety, speech difficulties, and thinking problems. However this was often accompanied by a worsening of movement symptoms, meaning people were less likely to finish the study. This also makes it difficult to know the longer term impact of the diet. 

Read a summary of these ketogenic diet studies in the Maturitas journal.

A research study at the University of British Colombia in Canada is comparing a milder form of the ketogenic diet with the standard ketogenic diet. This could offer a safer alternative. The study will recruit 50 people who will follow one of the two for 8 weeks, then swap to the other diet for the following 8 weeks. Researchers will be looking at changes in gut inflammation, tiredness, and Parkinson’s movement symptoms. The study is due to be completed later this year.

Can supplements help?

Dietary supplements are designed to provide nutrients that might be missing or lacking in a person’s regular diet. They often come in pill, powder or liquid form.

It’s thought that supplements could have positive effects on our general health and may even help to protect brain cells. But unfortunately, current recommendations and evidence of which supplements might be helpful for people with Parkinson’s is unclear. Here are a few reasons why:

• there’s a lack of research and funding into supplements
• Parkinson’s is complex and research studying a single supplement in isolation can be tricky to draw conclusions
• people are not routinely tested for deficiencies that might be helped by supplements
• Parkinson’s affects people differently and there’s a need for a more personalised approach when it comes to treating the condition.

The NHS advises that most people don’t need to take supplements if they’re eating a healthy balanced diet. However, there’s an acknowledgement that supplements can provide a helping hand for those that have lower levels of a vitamin or an important mineral. This can be the case in certain individuals due to lifestyle factors or health conditions.

We’ve taken a look at some of the most commonly talked about supplements in Parkinson’s.

Magnesium

Magnesium plays an important role in the body, especially in the brain. And research has suggested that some people with Parkinson’s have lower levels of magnesium in their brains than people without the condition.

A study in animals with Parkinson’s-like symptoms showed that giving a supplement of magnesium, called magnesium L-threonate, may increase the amount of magnesium in the liquid surrounding the brain and spinal cord (CSF), and reduce some symptoms.

But it’s not clear cut. Another review of magnesium in Parkinson's suggests that a careful balance is needed, as some studies have shown that high levels of magnesium can actually make the movement symptoms of the condition worse. There’s also some evidence from a small trial of 35 people with Parkinson’s that the magnesium oxide supplement can prevent levodopa medication working properly.

More research is now needed in people with Parkinson's to confirm any potential benefits or side effects of taking magnesium.

Vitamin B1

Vitamin B1, or thiamine, can’t be stored in the body, so you need it in your diet every day. Unfortunately, research into whether vitamin B1 is beneficial for Parkinson’s is very limited.

One of the studies was published in 2013. It involved 3 people with Parkinson’s who were treated with vitamin B1 supplements and described promising improvements in symptoms. It is important to note that the sample size of 3 was very small.

Another study involved taking a high-dose of vitamin B1. Results suggested that it did lead to improvements in symptoms. However, this study was open-label, which means that the researchers and the participants knew who was receiving vitamin B1, so the results could have been impacted by the ‘placebo-effect’. This means that they could have thought they were feeling different, even though there were no clinical benefits.

At the moment, there is not enough research evidence to support recommending people take vitamin B1 as a supplement for Parkinson's.

Vitamin B3

As the body cannot store this vitamin, having a healthy diet that contains adequate vitamin B3 is essential. Fortunately, it is found in many different foods, including turkey, tuna, cereal, mushrooms and peanuts. But researchers think taking an extra dose of certain forms of this vitamin may have beneficial effects for some people with Parkinson’s.

Research in the lab has shown that vitamin B3 may boost energy in nerve cells and help prevent them being lost in Parkinson’s. It did this by boosting levels of a compound called NAD that is used to generate energy inside cells.

The latest results come from a phase 1 clinical trial in 20 people with Parkinson’s showing further promise for this vitamin. A phase 2 study is also already underway to explore this further.

Read about the phase 1 trial in our news story.

Vitamin D 

Vitamin D helps to keep our bones healthy and helps our body absorb calcium. The body naturally makes vitamin D when the skin is exposed to sunlight. But what you eat can also help, especially during the winter. Good sources of vitamin D include oily fish (such as salmon and mackerel), red meat, eggs and dairy products.

Research has shown that people with Parkinson’s are more likely to have low levels of vitamin D. Low vitamin D in people with Parkinson’s could also contribute to making balance or thinking and memory problems worse. A study of over 900 older adults in France showed that preventing low vitamin D levels slowed down the progression of thinking and memory problems in people with Alzheimer's or dementia.

Read a summary of these results on the Alzheimer's Association website.

A few research studies that vitamin D supplements can be useful for managing symptoms, but so far research looking at the benefit of vitamin D for slowing down progression of Parkinson's is unclear. A large trial monitoring involving many people with Parkinson's, to study the effects of vitamin D, would help us understand its potential going forward.

Ginger

Ginger is a common household spice, but recent evidence suggests it could do more than flavour your cooking. It helps encourage healthy digestion, and reduces excessive inflammation, a process kickstarted in response to injury or infection but which can cause damage to the body if it’s not controlled. Ginger also increases levels of a hormone called ghrelin which helps support gut health. Research has shown that people with or at a high risk of developing Parkinson’s have lower levels of ghrelin.

We’re funding Dr Caroline Williams-Gray at the University of Cambridge to run a study looking at the potential benefits of ginger for treating gut problems in Parkinson’s. The study will involve people with Parkinson’s and people with a sleep disorder that’s linked to a high likelihood of developing Parkinson’s. Participants will be asked to take ginger root extract capsules for 12 weeks, and the researchers will measure changes in gut function and inflammation, as well as Parkinson’s symptoms.

“Gut symptoms are a major issue for many people with Parkinson’s and may be linked to the condition getting worse over time. 

This new study will allow us to test whether ginger supplements can impact on both gut health and inflammation in Parkinson’s.” 

- Dr Caroline Williams-Gray

More research needed

It’s encouraging to see more research in this area that could help us determine which diets and supplements might be best for people at different stages of their Parkinson’s journey.

As always, please speak to your healthcare professionals about what might work best for you before making any changes to your diet or lifestyle. You can also find out more information about diet on our information and support pages.

Read our diet support page.