1. Eat a balanced diet. Read Canada’s Food Guideand select foods from each of the four food groups each day, including vegetables and fruits, whole grains, milk and milk alternatives and meat and meat alternatives. Using the Food Guide as your base, you’ll be well on the way to making sure your body gets the nutrients it needs. The Guide will also tell you about the number of servings required and serving sizes and provides additional information on a healthy diet.
2. Enjoy your food. Eat the foods you love in the company of family and friends. Take your time eating and limit distractions. Take small bites and clear your mouth fully before taking the next mouthful. Try to schedule your meals for when you have some energy. Your sense of smell, and likewise taste, may be reduced; so tempt your appetite by using more herbs, spices, condiments and sauces.   
3. Try to eat at least seven vegetables or fruits a day. Choose brightly coloured vegetables and fruits; they contain the most nutrients and anti-oxidants. Purchase them fresh, frozen or canned and eat them raw, cooked, cut up, mashed, pureed or juiced – anyway you like them.
4. Stay hydrated. Drink plenty of fluids. Aim for six to eight glasses of fluids each day. Alcohol and caffeine are fine in moderation (one alcoholic drink and two cups of coffee per day), but can be dehydrating in greater quantities. Check with your doctor about any further restrictions for alcohol or caffeine consumption in terms of other conditions and medications. Limit fluid intake in the hours before bed to reduce trips to the bathroom at night.
5. To ease constipation. Eat a diet rich in fibre. Legumes (peas, beans and lentils), other vegetables, fruits and whole grains are all good sources of fibre. But you also need more fluids, especially water, if they are going to help you relieve constipation. Take note that legumes are also high in protein and can interfere with levodopa absorption if taken at the same time (see #7.) Increase fibre and fluid consumption gradually. Additional information onrelieving constipation, a common symptom of Parkinson’s disease, is available on Parkinson Society Canada’s website.
6. To relieve nausea. Some people may experience nausea when they start taking a new medication. Try eating your food cold, or at room temperature. Hot foods have more odours. Try taking your medications with a small snack, like some ginger ale, fruit and soda crackers, if permitted. Eventually, it is best to take levodopa 30 minutes before eating or two hours afterwards (see #7.)
7. Maximize the effectiveness of levodopa by timing your protein consumption. Protein and levodopa compete for absorption. If taken together, protein always wins. For most people, taking levodopa at least 30 minutes before eating, or two hours afterwards, allows for optimum effectiveness of the medication.  For a few others, usually those who take medication every two or three hours, a protein re-distribution diet, in which most protein is consumed late in the day, may improve the effectiveness of levodopa. This type of diet requires some education and it is best to consult with your physician and/or a dietitian for advice and assistance. You can find more information on this diet on the Live Well with Parkinson’s website.
8. Maintain your weight. Weight loss occurs in up to 70 per cent of people living with Parkinson’s, most often in the later stages of the disease. Many of the symptoms of Parkinson’s (tremors, constipation, reduced sense of smell, depression, trouble preparing, chewing and swallowing food, etc.) may contribute to weight loss. Try having more frequent meals and snacks and more higher-calorie foods.
   • Some people with Parkinson’s may be overweight and this can adversely affect mobility and cause other health concerns. Try to stabilize your weight by eating nutritious meals, controlling portions and being as active as possible.
   • Compulsive eating (binge eating) can be a side effect of particularParkinson medications . If you are experiencing this behaviour, tell your neurologist or doctor. Your medication can be adjusted to reduce or control the behaviour.
9. Drooling, chewing and swallowing issues. Drooling is a common symptom of Parkinson’s. This is not the result of more saliva, but less frequent mouth movements and swallowing. Chewing gum or sucking on hard candy may help, reminding you to swallow.  There are drug treatments available, including atropine and botulinum neurotoxin (Botox). If chewing and swallowing become a problem, discuss it with your physician. You may be referred to a speech language pathologist for a swallowing assessment and to recommend strategies for your chewing and swallowing (dysphagia) issues.
10. Ask for help. Consider a consultation with a dietitian for an eating plan and strategies. Ask family members for the assistance you need in preparing food, from shopping and cooking to cutting and pouring at the table. Consider prepared foods or cook foods in larger quantities when you have the time and energy and freeze in smaller batches to reheat later.  For more detailed information, visit the Living with Parkinson’s section of the Parkinson.ca website and read the Guide to the Non-Motor Symptoms of Parkinson’s Disease.

Health care professionals looking for more information about the Canadian Guidelines on Parkinson’s Disease and related topics, can contact Grace Ferrari, National Manager, Professional and Public Education at Parkinson Society Canada.