Running head: NUTRITION 1

Nutrition

Name

Institution
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Nutrition

Parkinson’s disease is a condition of the central nervous system. The disorder affects

movement which includes tremors. The disease is caused by damage to the brain’s nerve cells

causing a decline in the levels of dopamine. This results in tremors in one hand, slow movement,

stiffness, and loss of balance. A study by Ball et al (2019) states that more than 50,000

Americans are diagnosed with Parkinson’s disease yearly. The incidence of this disease tends to

increase with age with about 5% of people getting diagnosed with it before the age of 50 (Ball et

al., 2019).

Role of nutrition in the prevention

Proper nutrition and a balanced diet are important for individual health and normal

functioning. People suffering from Parkinson’s disease should take a well-balanced diet and

good nutrition to control the disease’s symptoms. According to Ongun (2018), good nutrition

significantly affects the medication schedule and the absorption of medications. Since the disease

is chronic and progressive, the nutritional needs of people with the illness may change with time.

A registered nutritionist plays an important role in the prevention of the disease symptoms. A

nutritionist can design a nutrition tool that can help patients suffering from Parkinson’s disease to

follow and take the recommended diet not only to prevent the disease’s symptoms but also to

promote health.

Etiology

This disease is caused by low levels of dopamine hormone in the brain. The basal ganglia

cells produce a chemical called dopamine. When the nerve cells in the basal ganglia get

destroyed or die, there is no dopamine in the brain causing body tremors. Dopamine is a

chemical that acts as a neurotransmitter in sending signals between nerve cells. The chemical
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plays a significant role in the human ability to think and feel pleasure. When this hormone is not

a significant amount, it affects message transmission to nerve endings that produce

norepinephrine, a chemical messenger of the sympathetic nervous system (Sveinbjornsdottir,

2016). This explains the major symptoms of Parkinson’s disease.

Progression

The progression of Parkinson’s disease is usually gradual. The symptoms start as mild

and then grow to be worse with time (Venuto et al., 2016). Most of the patients that seek a

clinical diagnosis tend to believe that they have been sick for some time. When symptoms

become severe to a point of interfering with a person’s daily life, the individual decides to seek

medical attention and upon assessment, and investigation they are diagnosed with the disease.

The progression of the disease can differ from one person to another. For some, the disease may

take several years to develop while for others it takes a shorter period.

Treatment

Different medications may help manage symptoms of Parkinson’s disease. A patient may

have relief of the symptoms after taking the medication, but the drugs become less effective as

their consistency reduces. Some of the medications taken include;

 Carbidopa levodopa – This is the most effective medication that gets converted to

dopamine in the brain, controlling the disease’s symptoms

 Dopamine agonists – Medications falling in this class mimic the effects of dopamine in

the brain and thus control the symptoms.

 MAO B inhibitors – These medications inhibit the synthesis of the monoamine oxidase

enzyme in the brain. The inhibition prevents the breakdown of dopamine in the brain.
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 Anticholinergic – Medications in this class can also be taken to maintain dopamine levels

in the brain and prevent tremors and other symptoms. (Fox et al., 2018).

Recommended diet

Nutritional assessment is an integral part of the control of this disease’s symptoms. A

registered nutritionist can carry out a nutritional assessment on the patient and provide helpful

tips on the recommended type of diet to control some of the symptoms such as difficulty

swallowing weight changes, and constipation. The nutritionist can evaluate the patient’s nutrient

intake, medical history, and lifestyle. Although tremor movements are the major symptoms of

Parkinson’s disease, they may also cause problems along the gastrointestinal tract. For instance,

the patient may experience dehydration, trouble chewing, excessive salivation, and a decrease in

gastric motility (Barichella et al., 2017). Also, some medications used to manage the disease can

cause loss of appetite, increased anxiety, vomiting, and general fatigue.

A general nutritional recommendation for patients includes eating a balanced diet

consisting of proteins, carbohydrates, vegetables, fruits, and fiber. There is also a need to drink

plenty of water to prevent dehydration and take enough fiber to reduce constipation (Barichella

et al., 2017). The number of calories taken should correspond to the body’s requirements. It is

thus important that a nutritionist designs a schedule to make it easier for the patient to follow and

adhere to the recommended diet.

The recommended nutritional goals for people with the disease should focus on

improving these symptoms and preventing further health deterioration. The first recommendation

is that one should increase their fiber intake. Fiber is important to increase the motility of gastric

contents and thus reduce constipation (Mischley et al., 2017). Maintaining hydration is important

as dehydration is one of the symptoms of this disease. Patients should therefore increase their
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water and fluid intake to prevent dehydration and dry mouth. A balanced carbohydrate intake

will provide enough energy to prevent weight loss. The number of carbohydrates taken should

not exceed the body’s requirements as it may lead to weight gain and other chronic illnesses such

as obesity and diabetes. To prevent thinning of the bones, the patients should increase their

intake of food rich in vitamin D.

Foods rich in protein should be taken in small portions as they may cause more problems

due to drug interactions. Proteins consist of amino acids which can significantly interfere with

the absorption of medications such as levodopa. When drug absorption is interfered with, it

affects its effectiveness in the management of the disease. However, patients can avoid this by

taking their medications at least 1 hour before or after their meals. Also, taking proteins during

dinner rather than in the morning is recommended.

Type of nursing assessment

During the assessment of the patient, the nurse will conduct a physical examination and take

the history of the patient to obtain data about the following parameters based on the patient’s

clinical status

 How often do the patient experience trembling of hands, arms, and jaws

 If the patient experiences stiffness of the limbs and trunk

 If they have slowness of movement

 History of falls due to impaired balance and coordination

 Ability to speak properly

 Change in consciousness level

 Decreased sensation and perception level

 Presence of dehydration, dry mouth, vomiting, and constipation

Nursing interventions needed with regard to nutrition

Nurses play a significant role in promoting health and preventing illness. One of their

roles is to provide care to patients using a holistic approach. A holistic approach in the provision

of care ensures that all the realms of life are given attention to, achieve total wellbeing. People

with Parkinson’s disease require a specific diet to help prevent their symptoms. Nurses should

ensure that their patients take a well-balanced diet and good nutrition to improve their health.

Some of the interventions nurses can take regarding nutrition include

Optimizing the patient’s oral intake

Optimizing the patient’s oral intake is important to ensure that the patient is taking

enough fluids. Nurses can monitor the fluid intake of the patients and encourage them to increase

their daily intake of water to reduce dehydration.

Providing oral nutrition supplements

Nurses can provide patients with oral nutritional supplements to meet their nutritional

requirements. Since one of the symptoms of Parkinson’s disease is loss of appetite, patients may

not take enough food to meet the body’s nutritional requirements. It is thus important that nurses

provide nutritional supplements to help the patients meet their nutritional needs. In the case

where the patient needs to be fed through gastrointestinal feeding, the nurse should elevate the

patient’s head before feeding. The feeds should be administered slowly. The nurse should closely

monitor and report the excessive retained or residual feeding. This is important to monitor any

signs of constipation.
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Administering enteral and parenteral nutrition

Some patients may not be in a position to orally take nutritional feeds. In this case, nurses

should administer nutritional feeds either through parenteral or enteral routes depending on the

status of the patient. This will help the patient meet his/her nutritional needs and speed up the

recovery process.

Outline of what should be included in patient education

Maintain health with nutrition

 Advice the patient to eat a well-balanced diet with good nutrition. Eating a nutritious

balanced meal will help the patient to get all the nutrients needed for normal body

functioning and good health.

 Observe the patient for constipation and offer medication to manage it. This will help

improve the patient’s appetite as they will not be feeling fullness along the

gastrointestinal tract.

 Teach the patient to take meals in small portions to prevent the risk of vomiting. Eating

small portions of food in intervals helps prevent refluxes that may cause vomiting.

Increased vomiting can lead to dehydration and loss of important minerals in the body

such as potassium and sodium.

 Advice the patient to sit upright when eating to promote comfort and also to avoid the

risk of regurgitation. Also, teach the patient not to sleep immediately after taking meals to

prevent vomiting. The patient should go to sleep at least thirty minutes after eating to

promote motility of the gastrointestinal contents and thus prevent constipation.

 Teach patients about the dangers of a high sodium intake. Tell them to reduce their intake

of salt to prevent the risk of hypertension.

 Tell the patient to take a diet with less fat to decrease the risk of heart diseases. Food rich

in cholesterol levels may contribute to heart diseases and obesity. To maintain a healthy

weight, the patient must take food low in fat and cholesterol.

 Advice the patient to avoid alcoholic drinks as they may cause health problems. Also,

alcohol may affect the effectiveness of some medications and thus should be avoided.

Improve Parkinson’s disease Symptoms

 Advice the patient to drink plenty of water daily to prevent dehydration. Taking enough

water will also decrease the risk of constipation.

 Tel the patient to take enough water when taking medications. This is important in

breaking down your medication and improving the absorption rate.

 Tell the patient to incorporate nuts and cashew nuts to improve the health of the brain.

Also, increase intake of foods that have an anti-inflammatory effect on the brain. These

foods include leafy green vegetables and salmon.

Two strategies to help ensure adherence to the recommended diet

Achieving dietary adherence can be challenging especially where the patient’s lifestyle

revolves around unhealthy food. Patients do struggle to implement a recommended diet and this

results in not achieving their dietary goals. Interventions to ensure adherence to the

recommended diet are important as they form the cornerstone to healthy living. Some of the

symptoms exhibited among patients with Parkinson’s disease mainly affect the gastrointestinal

tract. It is thus important that clear strategies are designed to ensure that patients adhere to the
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recommended diet. The designed strategies should be explained to the patient and the family

members to ensure understanding and give room for clarification.

Designing a nutritional tool

One of the strategies that will help in ensuring that patients adhere to the recommended

diet is designing a nutritional tool. The nutritional tool will help the patient to remember what

type of foods they are supposed to take and in what quantities. Also, the nutritional tool will help

the patient to take well-balanced meals, supplying the body cells with enough nutrient contents

based on body requirements. A nutritional tool consists of all the types of foods that should be

taken and their amounts to meet the body’s nutritional requirement. Also, using a designed

nutritional tool will help to determine the specific time certain meals should be taken to promote

health. A designed nutritional tool should be explained to the patient and the family members to

help them understand the contents and how to implement them. Also, making the patient

understand the nutritional tool will help them seek clarification on alternative meals in case the

stated ones cannot be accessed.

Fostering social support

Another strategy that can be used to ensure adherence to the recommended diet is

fostering social support. This can be achieved through offering group sessions to help the patient

connect with others who are having the same condition. The members will connect over a

common dietary goal that will help them manage their condition (Cassani et al., 2017). Such a

community will help patients to help each other in adhering to their dietary recommendations.

Being in a social support group is important because the members are focusing on eating healthy

to help them control the disease symptoms. Since all the members in the group are suffering

from a similar condition, it is easier for them to advise each other on the kind of diet that will
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help in managing the illness. Also, members will be able to remind each other to live a healthy

lifestyle. Individual testimonies from the members will give others in the circle the motivation to

keep on to the recommended diet to also achieve better results that promote health.
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References

Ball, N., Teo, W. P., Chandra, S., & Chapman, J. (2019). Parkinson's disease and the

environment. Frontiers in neurology, 10, 218.

Barichella, M., Cereda, E., Cassani, E., Pinelli, G., Iorio, L., Ferri, V., ... & Pezzoli, G. (2017).

Dietary habits and neurological features of Parkinson's disease patients: implications for

practice. Clinical nutrition, 36(4), 1054-1061.

Cassani, E., Barichella, M., Ferri, V., Pinelli, G., Iorio, L., Bolliri, C., ... & Pezzoli, G. (2017).

Dietary habits in Parkinson's disease: adherence to Mediterranean diet. Parkinsonism &

related disorders, 42, 40-46.

Fox, S. H., Katzenschlager, R., Lim, S. Y., Barton, B., De Bie, R. M., Seppi, K., ... & Movement

Disorder Society Evidence-Based Medicine Committee. (2018). International Parkinson

and movement disorder society evidence-based medicine review: Update on treatments

for the motor symptoms of Parkinson's disease. Movement Disorders, 33(8).

Mischley, L. K., Lau, R. C., & Bennett, R. D. (2017). Role of diet and nutritional supplements in

Parkinson’s disease progression. Oxidative medicine and cellular longevity, 2017.

Ongun, N. (2018). Does nutritional status affect Parkinson's Disease features and quality of life?.

PloS one, 13(10), e0205100.

Sveinbjornsdottir, S. (2016). The clinical symptoms of Parkinson's disease. Journal of

neurochemistry, 139, 318-324.

Venuto, C. S., Potter, N. B., Dorsey, E. R., & Kieburtz, K. (2016). A review of disease

progression models of Parkinson's disease and applications in clinical trials. Movement

disorders: official journal of the Movement Disorder Society, 31(7), 947.