The Mediterranean diet has been linked to a number of health benefits, including lower incidence of cardiovascular disease, slower decline in physical function in older adults and reduced risk of developing mild cognitive impairment and Alzheimer’s. But what about Parkinson’s? Is there a potential place for the Mediterranean diet and could following this plant-based pattern of eating improve your Parkinson’s symptoms or slow the progression of your condition? Before looking at the evidence, let’s first take a closer look at the Mediterranean diet.
What is the Mediterranean diet?
The Mediterranean diet is a way of eating based on the traditional cuisine of countries bordering the Mediterranean Sea. Food is celebrated as part of the Mediterranean lifestyle with an emphasise on plant foods, sharing meals with family and friends and being physically active.
What foods are eaten as part of the diet?
The Mediterranean diet emphasises eating primarily plant-based foods including a wide range of colourful fruits and vegetables, wholegrains, legumes, nuts, seeds and extra virgin olive oil. The dietary pattern also encourages intake of fish and seafood and low to moderate amounts of poultry, eggs, red meat and dairy. Herbs and spices are encouraged to add flavour to foods with the option of drinking a small amount of wine during a meal. Overall, the Mediterranean diet is high in unsaturated fats, antioxidants and fibre.
The Mediterranean diet and Parkinson’s risk
Several studies have shown an association between Parkinson’s risk and the Mediterranean dietary pattern.
Study – Gao et al.
A study published in 2007 which followed 2 large groups, the Health Professionals Follow-Up Study and the Nurses’ Health Study, showed an inverse association between adherence to a Mediterranean diet and risk of Parkinson’s. Participants who adhered to a Mediterranean diet the most showed a 25% reduction in the risk of Parkinson’s compared to those who adhered to the diet the least.
Study – Alcalay et al.
A study published in 2012 showed lower adherence to a Mediterranean diet was associated with Parkinson’s. In this study, higher adherence to the diet was associated with reduced odds of having Parkinson’s and for each additional Mediterranean diet scoring point, the odds of having Parkinson’s were lower by 14%. Among Parkinson’s participants, greater diet adherence was associated with later Parkinson’s disease age-at-onset. This finding suggests that dietary behaviour may be associated with the age-at-onset of Parkinson’s.
Study – Maraki et al.
A population‐based study published in 2019 of older adults showed adherence to a Mediterranean diet was associated with a lower probability of developing prodromal Parkinson’s. Participants with the highest adherence to the diet had around a 21% lower probability of developing prodromal Parkinson’s. In this study, results were driven mostly by non-motor markers of prodromal Parkinson’s including depression, constipation, urinary dysfunction, and daytime somnolence. This finding may suggest that following a Mediterranean diet could delay the onset of Parkinson’s.
Study – Lin et al.
Recently a large population‐based study of more than 47,000 Swedish women observed higher adherence to a Mediterranean dietary pattern at middle age was associated with a lower risk for Parkinson’s later in life. The association was particularly noticeable among women aged 65 years or older. In this study a one-unit increase in the dietary adherence score was associated with a 29% lower risk for Parkinson’s for those aged 65 years and over.
Incidence and progression of parkinsonism
Study – Agarwal et al.
A study published in 2018 examined the relationship of dietary patterns with the incidence and progression of parkinsonism in older adults. 706 older adults participated in this study which involved annual assessments for the presence of four parkinsonian signs (bradykinesia, parkinsonian gait, rigidity and tremors). Participants were followed for an average of 4.6 years. While it was the MIND diet that was significantly associated with lower rates of developing parkinsonism, and with slower progression of parkinsonian signs, researchers observed more moderate protective associations for the Mediterranean diet.
The Mediterranean diet is a healthy way of eating with an emphasise on plant-based foods that has been associated with a decreased risk of Parkinson’s and research looks promising in the area of reducing parkinsonism progression. Further research is required including randomised diet intervention trials to confirm causality.
In the meantime, with its many positive health outcomes and emphasis on nutrient-dense, plant-based foods and unsaturated fats, the Mediterranean diet is a sensible pattern of eating for people with Parkinson’s to follow and is a lifestyle that the whole family can enjoy and benefit from.
Trichopoulou A., Martínez-González MA., Tong TY., et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med 12, 112 (2014).
Milaneschi Y., Bandinelli S., Corsi AM., Lauretani F., Paolisso G., Dominguez LJ., Semba RD., Tanaka T., Abbatecola AM., Talegawkar SA., et al. Mediterranean diet and mobility decline in older persons. Exp Gerontol 2011, 46(4):303–308.
Shahar DR., Houston DK., Hue TF., Lee JS., Sahyoun NR., Tylavsky FA., Geva D., Vardi H., Harris TB., Adherence to Mediterranean diet and decline in walking speed over 8 years in community-dwelling older adults. J Am Geriatr Soc 2012, 60(10):1881–1888.
Singh B., Parsaik AK., Mielke MM., et al. Association of Mediterranean diet with mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis. Journal of Alzheimer’s Disease. 2014;39:271–282.
Gao X., Chen H., Fung T., et al. Prospective study of dietary pattern and risk of Parkinson disease. Am J Clin Nutr. 2007 Nov; 86(5): 1486-1494.
Alcalay R., Gu Y., Mejia-Santana H., et al. The association between Mediterranean diet adherence and Parkinson’s disease. Mov Disord. 2012 May; 27(6): 771-4.
Maraki MI., Yannakoulia M., Stamelou M., Stefanis L., Xiromerisiou G., Kosmidis MH., et al. Mediterranean diet adherence is related to reduced probability of prodromal Parkinson’s disease. Mov Disord. 2019;34(1):48-57.
Yin, W., Löf, M., Pedersen, N.L., Sandin, S. and Fang, F. (2020), Mediterranean Dietary Pattern at Middle Age and Risk of Parkinson’s Disease: A Swedish Cohort Study. Mov Disord.
Agarwal P., Wang Y., Buchman AS., Holland., TM., Bennett DA., Morris MC., MIND Diet Associated with Reduced Incidence and Delayed Progression of Parkinsonism in Old Age. The journal of nutrition, health & aging, 2018, 22(10), 1211–1215.
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