Aerobic Exercise and Healthy Nutrition as Neuroprotective Agents for Brain Health in Patients with Parkinson's Disease: A Critical Review of the Literature.

Davide Maria Cammisuli,Jonathan Fusi,Ubaldo Bonuccelli,Claudia Martini,Simona Daniele,Ferdinando Franzoni

doi:10.3390/antiox9050380

Abstract

Parkinson’s disease (PD) is characterized by motor and nonmotor features that have an influence on patients’ quality of life at different levels. To date, some evidences have arisen on the effectiveness of physical trainings and nutrients intake in ameliorating functional and cognitive outcomes in PD patients. Physical activity is effective in improving both motor and nonmotor features and recent epidemiological investigations have revealed the pivotal role that dietary patterns may play in reducing the risk of PD highlighting the pathogenesis of the neurodegeneration. Specifically, aerobic exercise shows beneficial effects in improving motor functions and executive control in PD patients, as well as proper nutrition may help in improving neuroprotective agents counteracting neurodegeneration and allows patients to better interact with the medication. Our narrative review critically focused on aerobic exercise and nutrition in PD in order to point out the best prescriptions for brain health of affected patients. Implications for a therapeutic plan and rehabilitation for these patients are also discussed.

Highlights

Parkinson’s disease (PD) is characterized by motor and nonmotor features that have an influence on patients’ quality of life at different levels
PD diagnosis relies on the cardinal motor features, but the disease may be associated with different nonmotor symptoms that compromise patients’ clinical status, negatively impacting on quality of life (QoL) and are significantly associated with reduced wellbeing [8]
Some researchers have carefully explained the role of physical exercise in PD [24,25,26], whereas that played by nutrition appears less investigated in the literature. Starting from this assumption and in line with the fact that a multidimensional treatment constitutes the best way to counteract the aging process and related neurological conditions, the authors of the present study have focused both on aerobic exercise and healthy nutrition as the most relevant factors influencing brain health

Summary

PD and Aerobic Exercise

Aerobic exercise (AE) as the activity using large muscle groups, rhythmic in nature (e.g., cycling, dancing, hiking, jogging, running, swimming, and walking) per se [27] may help in preventing cardiovascular disease, reducing high-density lipoprotein cholesterol (i.e., HDL-C) and adipose tissue distribution, increasing insulin sensitivity, improving executive functions, enhancing response to psychosocial stressors, and even exerting a detrimental effect on depression [28]. Ciulla et al [59] showed that some molecules and natural compounds may have different beneficial effects in PD patients, such as (i) antioxidant ones (i.e., coenzyme Q10, lipoid acid, N-acetyl-cysteine, vitamin E, carvacrol, curcumin, omega-3, whey protein, vitamin D3 , creatine, melatonin, niacin, vitamin C, 6-shogaol, beta-carotene, lycopene), (ii) anti-inflammatory ones (i.e., lipoid acid, carvacrol, curcumin, fatty acids, 6-shogaol, quercetin), (iii) of neuroprotection (i.e., coenzyme Q10, lipoid acid, N-acetyl-cysteine, curcumin, vitamin D3 , creatine, vitamin B3 , 6-shogaol, epigallocatechin-3-gallate), and (iv) of neuromodulation (i.e., ginkgo biloba extract, carvacrol) In this context, good nutrition provided by the Mediterranean diet has been established as a powerful tool to modulate the systemic inflammatory balance by slowing down the age- and neurodegeneration-related increase in the production of inflammatory molecules and by favoring an adaptive anti-inflammatory response [60].

Neuroprotective Effects of Aerobic Exercise and Balanced Diet in PD

Implications for PD Therapeutic Plan and Rehabilitation

Findings

Conclusions