Lifestyle choices and Parkinson’s disease. Dr. Domenico Pratico', MD, FCPP

Parkinson’s Disease (PD) is a chronic degenerative disease of the Central Nervous System that impairs primarily the motor skills and speech of the individual who is affected by.  It belongs to a group of medical conditions generally called "movement disorders".  From a clinical point of view, it is characterized by muscle rigidity, tremor at rest, a slowing of physical movement, and, in extreme cases, a loss of physical movement.

Symptoms of PD have been known since ancient times. But only in 1817 James Parkinson, a British physician, formally described its symptoms in an article he wrote and published entitled “An Essay on the Shaking Palsy”.

In 1950 the underlying biochemical changes, namely the reduction of dopamine levels in the brain of PD were identified by Arvid Carlsson, a Swedish scientist .

Dr. James Parkinson and its publication "An assay on the Sahking Palsy" considered the first clinical descritpion of the disease.

More than 70 years later, we still do not know the causes of the PD in 95% of cases (being a 5% secondary to a genetic mutation) and for this reason we do not have a cure yet. All the pharmacologic therapies available so far try to replenish dopamine levels in a specific area of the brain (called "substantia nigra") and for this reason are symptomatic and because do not target a mechanism of the disease, do not stop its progression.

Emerging evidence suggests that lifestyle changes have broad beneficial effects on brain health and are therefore an attractive option also for managing Parkinson’s symptoms.

In general, a healthy lifestyle consists of more exercise, a healthy diet, reducing stress, sleeping well, having positive social relationships, and avoiding harmful substances.

A recent paper showed that these very healthy lifestyle interventions have promise for both managing symptoms and potentially altering the course of PD since they can improve both motor and non-motor symptoms.  

Here are 3 important ones:

Physical Activity can have positive effects on symptoms as well as disease progression. In fact, regular exercise, both aerobic and resistance training, can improve motor symptoms like gait, balance, and posture, as well as non-motor symptoms such as sleep and mood. On the other hand, studies suggest it can slow the progressive motor deterioration associated with the disease. 

Dietary lifestyle and nutrition can also provide important beneficial effects in PD patients.  Studies have shown that a Mediterranean-style diet, rich in vegetables, whole grains, nuts, and seeds, can help with non-motor symptoms like constipation and improve cognitive function. Additionally, there is evidence that the same type of diet can potentially improve medication absorption and may have a beneficial effect on disease progression.

Management of stress. Like for general brain health, learning and applying techniques like mindfulness and yoga with the goal to reduce anxiety and or depression can have positive effect also on the motor symptoms besides improving overall well-being, which may ultimately influence the clinical progression of the disease.

The Compass of Health with the 4 Cardinal Points of Healthy Behavior

These findings brought back to my mind some of the things I learned during a recent trip to Kos, the birthplace of Hippocrates, the father of modern medicine. Among those, I would like to mention here what he said a while ago: “Illnesses do not come upon us out of the blue. They are developed from small daily sins against nature. When enough sins have accumulated, illnesses will suddenly appear.” This saying reflects his revolutionary belief that diseases are not punishments from the gods, but rather have natural causes related to environmental factors, diet, and lifestyle.

To echo Hippocrates teaching, I recently proposed a new idea called the “Compass of brain health”, a guideline based on the 4 Cardinal points that can be easily followed by anyone at any age to achieve or maintain healthy body and healthy mind. North is for nutrition, East is for exercise, South is for socialization and West is for wellness.

Despite these important findings, there is still work to be done. For instance, we do not know whether combining these interventions, like healthy dietary approaches with exercise, offers higher benefits than when applied alone. Another important aspect is how we encourage and make sure that the patients with PD adhere to those interventions in the long-term. Studies have shown that it is very common for many patients to shift away from the initial enthusiasm of following these changes.

To summarize, there is now ample evidence suggesting that adoption of healthy lifestyle interventions known to have beneficial effects on brain health are also excellent choices for a patient with PD. While they should not be seen as a therapy for the disease, they can bring positive results for both the motor and non-motor symptoms of PD.

And importantly, as I always say, please remember that it is never too early or never too late for anyone to follow the 4 Cardinal points of healthy behavior and experience their full benefits for the brain and the whole body!   

If you are interested in reading more of my blogs:

Check out my recent blog: The 4 Cardinal Points of Behavior Domenico Pratico', MD, FCPP 

Dr. Domenico Pratico' , MD, FCPP

Domenico Praticò, MD, holds the Scott Richards North Star Charitable Foundation Chair for Alzheimer’s Research and serves as a Professor at the Alzheimer’s Center at Temple, as well as a Professor of Neural Sciences at Lewis Katz School of Medicine at Temple University.

For more information on the research conducted by Dr. Domenico Pratico, please visit this link.

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