Lower Energy Intake among Advanced vs. Early Parkinson's Disease Patients and Healthy Controls in a Clinical Lunch Setting: A Cross-Sectional Study.

Petter Fagerberg,Ioannis Ioakimidis,Billy Langlet,Anastasios Delopoulos,Heinz Reichmann,Lisa Klingelhoefer,Björn Falkenburger,Matteo Bottai,Eva Rotter,Konstantinos Kyritsis

doi:10.3390/nu12072109

Petter Fagerberg, Ioannis Ioakimidis + Show 8 more

Open Access

https://doi.org/10.3390/nu12072109

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Abstract

Unintentional weight loss has been observed among Parkinson’s disease (PD) patients. Changes in energy intake (EI) and eating behavior, potentially caused by fine motor dysfunction and eating-related symptoms, might contribute to this. The primary aim of this study was to investigate differences in objectively measured EI between groups of healthy controls (HC), early (ESPD) and advanced stage PD patients (ASPD) during a standardized lunch in a clinical setting. The secondary aim was to identify clinical features and eating behavior abnormalities that explain EI differences. All participants (n = 23 HC, n = 20 ESPD, and n = 21 ASPD) went through clinical evaluations and were eating a standardized meal (200 g sausages, 400 g potato salad, 200 g apple purée and 500 mL water) in front of two video cameras. Participants ate freely, and the food was weighed pre- and post-meal to calculate EI (kcal). Multiple linear regression was used to explain group differences in EI. ASPD had a significantly lower EI vs. HC (−162 kcal, p < 0.05) and vs. ESPD (−203 kcal, p < 0.01) when controlling for sex. The number of spoonfuls, eating problems, dysphagia and upper extremity tremor could explain most (86%) of the lower EI vs. HC, while the first three could explain ~50% vs. ESPD. Food component intake analysis revealed significantly lower potato salad and sausage intakes among ASPD vs. both HC and ESPD, while water intake was lower vs. HC. EI is an important clinical target for PD patients with an increased risk of weight loss. Our results suggest that interventions targeting upper extremity tremor, spoonfuls, dysphagia and eating problems might be clinically useful in the prevention of unintentional weight loss in PD. Since EI was lower in ASPD, EI might be a useful marker of disease progression in PD.

Highlights

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the cardinal motor symptoms of rest tremor, brady-/hypokinesia and rigidity next to a PD-specific non-motor profile [1,2,3]
Upper extremity. (UE). * = significant difference vs. early PD patients when controlling for sex. † = significant difference vs. healthy controls when controlling for sex
PD12,patients had a significantly lower energy intake (−162 kcal) compared to19healthy controls when controlling for sex (Table 3)

Summary

Introduction

Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the cardinal motor symptoms of rest tremor, brady-/hypokinesia and rigidity next to a PD-specific non-motor profile [1,2,3]. More focus has been given to non-motor symptoms (NMS), which have been included in the diagnostic criteria for PD [1,2]. Important and common NMS of PD with respect to nutrition are dysphagia and constipation [5], olfactory and taste impairment [6], depression [7], weight loss and malnutrition [8]. These NMS together with the PD-specific motor symptoms potentially have an effect on eating behavior [9,10]. Weight loss and malnutrition might further worsen the progression of the disease and they have been implicated as potential novel targets for PD interventions [11]

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