Publication details

Title
Nutrition et maladie de Parkinson. [Nutrition in Parkinson's disease].
Authors
Desport,J. -C;Jesus,P.;Fayemendy,P.;Pouchard,L.
Publication Year
2013
Abstract
About 143,000 patients suffered from Parkinson's disease (PD) in France in 2005. The main nutritional issues are undernutrition, the need of adaptation of protein intakes and the weight gain after deep brain stimulation. Malnutrition is linked to the disease itself and treatments. Handicap, psychological troubles, swallowing disorders, taste and smell disorders, gastroparesis and constipation are the main causes of dietary intake insufficiency. Malnutrition care is not specific. Energy expenditure is probably enhanced by hypertony and abnormal movements, and depends on patient responses to treatments. One out of four PD patients can be undernourished, thus an early screening of undernutrition is mandatory. Body Mass Index (BMI), weight variation and Mini Nutritional Assessment(registered trademark) (MNA(registered trademark)) are the tools usually used in PD. Except for protein intakes, nutritional care has no specificity. Indeed, several aminoacids and levodopa compete for intestinal absorption and transport across blood-brain barrier. When treatments have a low efficiency, or if disease worsens, protein intake has to be increased for dinner and limited for other meals, levodopa has to be taken 20 to 30minutes before meals, and in front of severe neurological troubles, daily protein intake can be decreased. Deep brain stimulation is rapidly followed by an increase in weight, sometimes complicated with dyslipidemia or diabetes. Obesity may increase the handicap. Swallowing disorders are the main cause of mortality. When enteral nutrition is mandatory, the gastrostomy has not to be early discussed. (copyright) 2013 Elsevier Masson SAS.
Journals
Nutr Clin Metab.
Volume
27
Issue
2
Startpage
87-
Endpage
91
Booktitle
Editors
City
Publisher
Issnisbn
Reflist
0
Doi
doi:10.1016/j.nupar.2013.04.001
Pmid
Keywords
levodopa;brain depth stimulation;clinical assessment tool;constipation;diabetes mellitus;disability;drug absorption;dyslipidemia;dysphagia;energy expenditure;enteric feeding;food drug interaction;gastrostomy;human;malnutrition;mental disease;motor dysfunc????
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