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a carbohydrate: protein ratio of 5: 1. Such a balanced. diet in the management of PD fulfills two requirements:. the diet is nutritionally complete ...

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A balanced carbohydrate: protein diet in the management of Parkinson's diseasePage 1A balancedcarbohydrate: proteindiet in themanagement ofParkinson's diseaseArticle abstractAlthoughrestricting dietary protein is a proposed adjunct totreating Parkinson's disease (PD) the effect of carbohydrate consumption isunknown. We measured plasma levodopa and large neutral amino acid (LNAA)levels in nine PD patients treated with carbidopa/levodopa and different isocaloricmeals containing high proteinlow carbohydrate low proteinhigh carbohydrateand balanced 5:1 carbohydrate: protein mixtures. We found that levodopa levelsincreased significantly regardless of the type of diet but that plasma LNAA levelsvaried less and motor performance was superior after the balanced diet than afterthe other two meals. We conclude that PD patients can consume nutritionallyadequate meals and still maintain a stable plasma levodopa: LNAA ratio.NEUROLOGY 1991;41:12951297E.M. Berry MD FRCP; J.H. Growdon MD; J.J. Wurtman PhD; B. Caballero MD PhD;and R.J. Wurtman MDLevodopa the principal drug used in the treatment ofParkinson's disease (PD) is a large neutral amino acid(LNAA) whose passage across biological membranesdepends on the same system that transports otherLNAAs including valine leucine isoleucine tyrosinetryptophan and phenylalanine.1 Although there may besome interaction between levodopa and the LNAAs inabsorption across the intestinal mucosa competitionwith LNAAs at the bloodbrainbarrierlimitslevodopa's entry into the brain because of the low Km ofthis transport system. Two factors determine theamount oflevodopa entering the brain: the plasma concentration of levodopa and the summed concentrationsof the LNAAs. Clinical experiments confirming theimportance of the plasma levodopa: LNAA ratio in PDshowed that administration of LNAAs to PD patientsworsened motor symptoms that had been stabilized byconstant infusions of levodopa.23 Pincus and Barry4suggested that plasma levels of LNAAs in PD patie ...

Source: web.mit.edu

 

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