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Swallowing and Parkinson’s Disease


People with Parkinson’s often report difficulty with chewing and swallowing. Swallowing is a complex motor activity that requires a high degree of muscle co-ordination, with a wide range of areas in the brain responsible for it.  Swallowing problems can occur with food, drink, and saliva.  Generally, swallowing troubles are part of more advanced Parkinson’s.

Difficulties with chewing and swallowing can lead to weight loss, poor nutrition and other health problems.  For many people with Parkinson’s these problems can be reduced or eliminated by changing how and what you eat.  Consulting a speech language pathologist and a dietitian for an assessment can also help.

Here are some techniques to help make swallowing easier:
• Try not to rush your meals.
• Ensure your mouth is clear before eating or talking.
• Change the consistency of your food. Solids may need to be softer (chopped or pureed); liquids may need to be thickened.

Reference 1: National Dysphagia Diet Task Force. National Dysphagia Diet: Standardization for Optimal Care, American Dietetic Association, 2002.
Images used with permission from Nestlé HealthCare Nutrition.

• Avoid or eliminate mixed consistencies (foods with both liquid and solid components e.g. cold cereal with milk).
• Divide your meals and eat several smaller meals throughout the day.
• Change your eating habits. This might include taking small mouthfuls and sips, eating slowly, avoiding speaking while eating, and eating in a calm environment.
• Improve your posture and sit upright during all eating and drinking.
• Tilt your head slightly forward, not backward, as you swallow.

NOTE: if you are having consistent choking, it is important to talk to your doctor; food can go down the wrong passage and end up in the lungs, resulting in pneumonia (lung infection).

You may also utilize nutritional supplements like juices, milkshakes or products such as Boost®, Ensure®, Carnation® Breakfast Essentials™ and Resource® 2.0.* Whey protein drinks are also a source of nutrition.

*Monitor high protein drinks if taking levodopa as combining the two may interfere with levodopa’s absorption into the brain and may have an effect on motor functioning.  If you are experiencing motor fluctuations and are thinking about adjusting the amount of protein in your diet, it is best to talk to a qualified dietician or to your doctor.

Nestlé Health Science is partnering with Parkinson Society Canada to provide important information about difficulty swallowing or dysphagia.  Download Dysphagia: A Guide to Swallowing Problems now.

Nestlé Canada has provided Parkinson Society Canada with an unrestricted grant to help educate the public about the importance of diet and nutrition in managing Parkinson’s disease.

References:
A Manual for People Living with Parkinson’s Disease, Section 7: Dealing with Speech and Swallowing Problems, Parkinson Society Canada
A Guide to the Non-Motor Symptoms of Parkinson’s Disease, Dr. Ronald Postuma 

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