Healthy Lifestyle Choices and Parkinson’s Disease

Its cause is unknown and there’s no known cure

But healthy lifestyle choices may help you avoid Parkinson’s disease

Parkinson’s disease (PD) is a neurodegenerative condition that appears mostly in older people. The incidence of PD has increased over the past several decades, especially in seniors over age 70. The cause of PD is unknown and no effective treatment exists to cure PD once it’s diagnosed. Nevertheless, recent research suggests that healthy lifestyle choices, especially Keep Moving and Eat Better, may help persons with PD live longer, or delay the onset of PD, or slow its progression.

A group of Chinese researchers conducted a systematic review and meta-analysis of longitudinal studies to determine if physical activity predicted lower risk of developing Parkinson's disease. The analysis included eight studies with a total of 544,336 Euro-American participants followed over a median of 12 years. Compared to participants in the lowest quintile of total or moderate to vigorous physical activity, those in the highest quintiles had significant 21 and 29 percent lower risks, respectively, of developing PD. The benefit arose entirely from moderate or vigorous physical activity.

Each increase in 10 metabolic-equivalent task-hours (2.5 hours of brisk walking) per week of physical activity predicted a 10 percent reduction in PD risk in men but not in women. Given the profound physical and mental effects of PD on quality of life, not to mention the myriad health benefits of Keep Moving, devoting a half-hour per day to Keep Moving would be a terrific investment.

A recent randomized clinical trial with newly diagnosed Parkinson’s disease patients showed that an in-person, supervised, high-intensity treadmill walking intervention reduced motor-related PD symptoms. A more recent study that used data from 130 patients with mild PD extended the previous work using an intervention with unsupervised, home-based, high-intensity exercise bicycle training. A control group performed stretching, flexibility, and relaxation exercises. Both study groups were instructed to exercise for 30-45 minutes three days per week for six months.

Both groups had access to electronic virtual reality software and real-life videos to increase participant retention and adherence to the study protocols. After six months and compared to the control group, the exercise bicycle training group showed statistically and clinically significantly lower increase in motor scores (1.3 versus 5.6 units, higher is worse). The intervention and control group participants reported seven and four adverse events, respectively. Strenuous aerobic exercise may slow the decline in PD motor symptoms. But even if exercise didn’t improve PD prospects, it would probably improve other aspects of healthy living.

A recent narrative review by Australian researchers identified several lifestyle factors that might slow the progression of Parkinson’s disease. Examples include eating foods with anti-oxidative and anti-inflammatory properties, including flavonoids (fruits and vegetables), caffeine (coffee and tea), being physically active, and engaging in mind-body practices. But several large prospective studies show that higher intake of dairy products predicts higher risk of developing PD. Randomized trials show that tai chi, quigong, therapeutic singing and music therapy produce beneficial short-term effects on motor and non-motor PD symptoms. Both aerobic and strength-building exercises create beneficial effects over the near term. The beneficial effects of physical activity probably depend on continuing exercise indefinitely.

Might healthy lifestyle choices increase longevity of persons with PD or slow the rate of cognitive decline? Researchers at UCLA recruited 360 PD patients (average of 67 years at PD diagnosis) living in rural central California within three years of diagnosis. All patients were followed from 2001-2016. Over an average follow-up of 5.3 years, ever drinking caffeinated coffee or tea, beer, wine, liquor, or engaging in competitive sports predicted significantly lower risk of death. On the other hand, never drinking caffeinated coffee or tea, beer, liquor, formerly smoking predicted significantly higher risk of death.

With respect to cognitive decline, ever drinking caffeinated coffee, liquor, or engaging in competitive sports predicted significantly lower risk. Contrarily, never drinking caffeinated coffee, or liquor, or currently smoking predicted significantly higher risk. Ever drinking liquor, or competing in competitive sports, or engaging in more than the median level of physical activity predicted slower decline from stage 2 to stage 3 PD. Finally, never drinking caffeinated coffee, or liquor, or drinking more than the median daily amount of liquor predicted significantly faster time to decline from stage 2 to stage 3. Drinking caffeinated coffee or tea, or moderate amounts of beer or liquor, and participating in competitive sports might help PD patients live longer. Drinking caffeinated coffee, engaging in competitive sports, and otherwise getting lots of exercise might slow PD progression.

A new study supports the idea that physical activity predicts reduces risk of Parkinson's disease mortality. The study included 10,699 participants (average age 69 years) with diagnosed Parkinson's disease in the Korean National Health Insurance System. Compared to physically inactive individuals, those who were physically active had significantly lower risk of dying over an average follow-up of 4.5 years after adjusting for confounding factors. Specifically, participants who engaged in light, moderate, or strenuous physical activity had significant 24, 51, and 34 percent lower risks of mortality, respectively. Individuals who were physically active at baseline and continued to be physically active during follow-up, regardless of exercise intensity, had significantly lower risk of dying during follow-up compared to individuals who became physically inactive. Happily, participants who were physically inactive at baseline but became physically active during follow-up had lower risk of dying compared to their consistently physically inactive counterparts. Finally, risk of dying declined in a step-wise manner with increased physical activity intensity. People with Parkinson's disease may live better and longer if they embrace a physically active lifestyle.

Some readers might be surprised to learn that low to moderate alcohol consumption predicts better multiple health outcomes. Evidently, this protective effect includes Parkinson’s disease. Researchers in China conducted a meta-analysis of 11 prospective studies relating alcohol consumption to risk of PD. Overall, daily intake of 26-35 grams of alcohol predicted a significant 19 percent lower risk of PD. To put this in perspective, a 12-ounce of beer with 5 percent alcohol contains 14 grams of alcohol. A significant relationship held for Asian but not American or European studies. Furthermore, a significant relationship existed only for beer but not liquor or wine. Drinking a can of beer every day might modestly decrease your risk of developing PD.

Overall, these studies suggest that older people who make better lifestyle choices, especially Keep Moving and Eat Better, may reduce their risk of developing Parkinson’s disease and slow its progression.

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