Increased consumption of vegetables, nuts, and moderate alcohol intake are each inversely associated with the odds of 3 or more prodromal features that precede Parkinson disease.
Samantha Molsberry, PhD
Analysis from participants of the Nurses’ Health Study (NHS) and the Health Professionals Follow-up Study (HPFS) which collected dietary information every 4 years suggest adherence to a healthy diet may reduce the occurrence of non-motor symptoms that often precede Parkinson disease (PD) diagnosis.1
Samantha Molsberry, PhD, postdoctoral research fellow, T.H. Chan School of Public Health, Harvard University, and colleagues used a multinomial logistic regression to estimate the association between baseline (1986) diet pattern score quintiles and number of prodromal features (0, 1, 2, or ≥3) in 2012 to 2015.
Along with aforementioned diet information collected every 4 years, the researchers calculated scores for adherence to different diet patterns, including the alternate Mediterranean diet (aMED) and the Alternative Healthy Eating Indez (AHEI). Molsberry and colleagues found that the odds ratio (OR) for ≥3 versus 0 prodromal features was 0.82 (95% CI, 0.68—1.00; false discovery rate (FDR) adjusted Ptrend = .03) at baseline and 0.67 (95% CI, 0.54—0.83; FDR Ptrend <.001) for long-term aMED diet.
Excluding moderate alcohol intake as a component of the aMED score weakened, but did not completely attenuate, the association (multivariate-adjusted OR comparing extreme quintiles: 0.86; 95% CI, 0.72—1.04; FDR adjusted P = .10 for baseline diet; long-term diet: 0.73; 95% CI, 0.59—0.91; FDR Ptrend = .002).
Results for the AHEI diet followed a similar pattern but were stronger in magnitude. The multivariable adjusted OR for ≥3 versus 0 prodromal features comparing extreme AHEI quintiles was 0.72 (95% CI, 0.59—0.87; FDR Ptrend = .002) at baseline and 0.66 (95% CI, 0.53—0.80; FDR Ptrend <.001) for long-term diet.
Pooled multivariable-adjusted analyses showed an increased aMED adherence at baseline was inversely associated with constipation, excessive daytime sleepiness, and depressive symptoms. Adherence to the aMED diet pattern at baseline or long-term was not associated with probable rapid eye movement (REM) sleep behavior disorder (pRBD), hyposmia, body pain, or impaired color vision.
Molsberry and colleagues noted that the associations were attenuated when constipation was excluded as a prodromal feature, but long-term diet associations remained significant. “Analyses of individual aMED components indicate that increased consumption of vegetables, nuts, and moderate alcohol intake are each inversely associated with the odds of 3 or more prodromal features,” they concluded.
In total, 17,400 participants (NHS: n = 11,493; NPFS: n = 5,907) included in the analysis completed all secondary screening and an additional 1,129 participants (NHS: n = 781; NPFS: n = 348) participants completed some but not all secondary screening. Cohort participants included in the analysis were under 85 years of age, did not have diagnosis of PD, and responded to questions assessing pRBD and constipation on the 2012 questionnaire as well as the baseline food frequency questionnaire. Investigators included 5 additional prodromal features assessed between 2012 to 2015.
A sensitivity analysis that assumed that the individuals who completed only a portion of secondary screening did not have any features for which they were missing data, revealed an OR for ≥3 versus 0 prodromal features comparing extreme aMED quintiles of 0.83 (95% CI, 0.69—1.00; FDR Ptrend = 0.03) at baseline and 0.70 (95% CI, 0.57­—0.86; FDR Ptrend <.001) for long-term diet.
“Sensitivity analysis results suggest that the association between diet pattern and prodromal PD features cannot be attributed solely to the effect of diet on constipation or the association between PD and alcohol intake. There was little to no evidence of heterogeneity between men and women for most of our findings,” Molsberry and colleagues concluded.
This would not be the first study to look at the impact healthy diets can have on neurological disorders. In April, analysis of Analysis of data from the Age-Related Eye Disease Study (AREDS) and AREDS2, suggested dietary factors can play a role in slowing cognitive decline. More specifically, diets that included high consumption of vegetables, whole grains, fish, and olive oil correlate with higher cognitive function.2
1. Molsberry S, Bjornevik K, Hughes KC, Healy B, Schwarzschild M, Ascherio A. Diet pattern and prodromal features of Parkinson’s disease. Neurology. Published online August 19, 2020. doi: 10.1212/WNL.0000000000010523
2. Diet may help preserve cognitive function [news release]. Bethesda, MD: National Institutes of Health; Published April 14, 2020. Accessed August 25, 2020. nih.gov/news-events/news-releases/diet-may-help-preserve-cognitive-function