Bioactive Nutraceuticals and Dietary Supplements in Neurological and Brain Disease

Prevention and Therapy

Ronald Ross Watson, Victor R Preedy

• Publisher: Academic Press
• Year: 2014
• ISBN:
  9780124115293
• Topic: Technology & Engineering
• Subtopic: Food Science
• Index: Technology & Engineering

Nutritional supplement research concerning brain health and neurological disease is becoming an important focus. While nutritional supplements are very popular for general health and well being, the effectiveness of common supplements and their impact on general brain health and for the treatment or prevention of neurological disease is not clearly understood. This comprehensive introduction to bioactive nutraceuticals for brain and neurological provides a foundation review for research neuroscientists, clinical neurologists, pharmacology researchers and nutrition scientists on what we know now about these supplements and the brain and where focused research is still necessary.

• Foundational review content covering nutrition and brain and neurological health
• Reviews known nutritional supplements and impact on brain and neurological health
• Comprehensive coverage ideal for research scientists and clinical practitioners

Section VII

Seizures, Epilepsy, and Parkinson's Disease

Outline

Chapter 43. A Plant-Food Diet in the Risk and Management of Parkinson’s Disease

Chapter 44. Nutraceuticals and Other Natural Products in Parkinson's Disease Therapy

Chapter 45. Ketogenic Diet Treatment in Adults with Refractory Epilepsy

Chapter 46. Ketogenic Diets for the Treatment of Epilepsy

Chapter 47. Nutritional/Metabolic Therapies in Animal Models of Amyotrophic Lateral Sclerosis, Alzheimer’s Disease, and Seizures

Chapter 48. Metabolic Dysfunctions in Epilepsy and Novel Metabolic Treatment Approaches

Chapter 49. Vitamin D for the Prevention of Alzheimer’s Disease

Chapter 50. Is Multiple Sclerosis a Sun Deprivation Disease?

Chapter 43

A Plant-Food Diet in the Risk and Management of Parkinson’s Disease

Luciana Baroni¹, and Cristina Zuliani^{2 1}Primary Care Unit, District 4, Treviso, Italy ²Department of Neurology, Mirano General Hospital, Mirano, Italy

Abstract

Dietary protein content can reduce the effectiveness of levodopa treatment in Parkinson’s disease (PD)–affected patients, as the large neutral amino acids (LNAA) and levodopa, a prodrug of dopamine, share the same saturable carrier system. Moreover, the importance of some dietary risk factors for PD has been postulated in recent decades. A plant-food (vegan) diet, easily restricting total protein intake to the RDA while redistributing the total daily protein amount, can be effective in minimizing diet interference on levodopa treatment. This appears to be useful in the management of PD patients, improving levodopa efficacy, possibly reducing total Levodopa schedule, and optimizing neurological performance. These effects can slow the appearance of motor impairment and of the complications related to levodopa chronic therapy. Moreover, the composition of a plant-based diet can hypothetically contrast some risk factors for PD, contributing to slow the progression of the dopaminergic system degeneration underlying the disease.

Keywords

Parkinson’s disease; plant-based diet; vegan diet; dopaminergic system degeneration

Outline

Introduction 411

Epidemiology of PD 411

Physiopathology of PD 412

Etiology of PD 412

Dietary Risk Factors in PD 412

Diet and Levodopa 413

Levodopa and Dietary Protein 414

The Protein-Redistribution Diet 414

A New Strategy: Normoproteic Protein-Redistributed Plant-Food (Vegan) Diet 415

Plant-Food Diets and Comorbidity in PD 415

Normoproteic Protein-Redistributed Plant-Food (Vegan) Diet: Practical Aspects 416

Conclusion 417

Summary 418

References 418

Introduction

The role of nutrition in the field of chronic diseases is intriguing. Protective and harmful factors can act with cumulative, synergic, or antagonistic effects during a long period of time starting before the clinical onset of the disease, and Parkinson’s disease (PD) is no exception. Information on risk and protective dietary factors comes mainly from nutritional epidemiology; few intervention studies have been performed. This chapter outlines the most relevant results in the literature, and offers a key lecture to put this information into a proposed strategy of action in PD.

Epidemiology of PD

PD is a progressive neurodegenerative disorder characterized by some major symptoms such as bradykinesia, resting tremor, rigidity, and postural instability. Its worldwide overall age-adjusted prevalence is 1%, with equal incidence in both sexes (Zhang & Roman, 1993), which increases exponentially with advancing age (Ben-Shlomo, 1997; Bower et al., 1999; Checkoway & Nelson, 1999). PD patients show an elevated mortality related mainly to the presence of severe extrapyramidal signs and to other common chronic medical conditions (Louis et al., 1997; Minami et al., 2000; Morens et al., 1996).

PD prevalence in industrialized countries has been reported to be from two to five times higher than in developing countries (Zuber & Alperovitch, 1991). In Afro-American people, rates are not different from those in Caucasian people. In contrast, Black-African and rural Chinese people that follow a prevalent plant-based diet show the lowest prevalence and incidence rates (Chen et al., 2001; Kleinhenz et al., 1990; Morens et al., 1996; Moriwaka et al., 1996; Schoenberg, 1987; Schoenberg et al., 1988; Wang et al., 1991; Zhang & Roman, 1993).

Physiopathology of PD

PD is related to the reduction of dopamine concentrations in the brain; the alteration is caused by the degeneration of dopaminergic neurons in the substantia nigra, which in turn is responsible for the lower production of the neurotransmitter. A fall in dopamine concentrations of as much as 80% causes the appearance of the main symptoms of the disease: bradykinesia, rigidity, tremor, and postural and gait alterations.

The classical and most effective pharmacologic treatment aims to restore adequate dopamine concentrations in the brain by using a prodrug of dopamine, levodopa, in different preparations. This molecule is able to reach the blood–brain barrier (BBB) in effective amounts and to cross it, by means of a specific saturable carrier, the large neutral amino acid transporter (LAT). Inside the brain, levodopa is then decarboxylated to dopamine, and the latter is the active neurotransmitter in the basal ganglia.

With time, unfortunately, the action of the drug becomes less stable and effective, owing to the progressive degeneration of nervous cells that lose the ability to store the exogenous dopamine and release it later, and to the intermittent dopaminergic stimulation of dopamine receptors that become upregulated. Dopamine effectiveness then fluctuates; a reduced effect of the drug causes motor blocks (the ‘off’ phenomenon), compromising motor abilities in relation to the stage of the disease. Despite this, when the levels of dopamine are higher or even adequate to contrast the ‘off’ periods, patients can undergo the opposite manifestation, exaggerated and noncontrolled movements, called dyskinesia. The instability of dopamine concentrations inside the brain is responsible for motor fluctuations, alternating ‘off’ periods with ‘on’ periods of normal movements or, in later stages, dyskinesia (the ‘on–off’ phenomenon). The appearance of such motor complications related to chronic levodopa treatment is written in the natural history of the disease.

Etiology of PD

Although the etiology of nigrostriatal pathway degeneration in PD is still unclear, research indicates that PD can represent the final common pathway of different conditions. It is suggested that PD can result from the combination of genetic and environmental factors that can interact in the development of the modification in the brain cells leading to the disease (Ben-Shlomo, 1996; de Rijk et al., 1997; Gasser et al., 1998; Hellenbrand et al., 1997; Jarman & Wood, 1999; Lazzarini et al., 1994; Scott et al., 2001).

Evidence deriving from epidemiological studies supports the hypothesis that environmental factors play an important role in the genesis of the disease in addition to genetic factors (Behari et al., 2001; Tanner & Goldman, 1996), as subjects belonging to same ethnic groups but living in different countries show the same incidence rates of their acquired country (Shoenberg, 1987). Epidemiological research also indicates that in developed countries PD is associated with rural residence and with well-water drinking, possibly related to herbicide, pesticide, and other neurotoxin exposure. On the contrary, a negative association between PD and smoking habits is well established. Finally, the association ...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Preface
• About the Editors
• Contributors
• Acknowledgments
• Section I. The Role of Complementary and Alternative Supplements: An Overview of Mechanisms of Action and Neurological Targets
• Section II. Role of Diets, Complementary, and Alternative Supplements in Prevention and Treatment of Neurodegenerative Diseases
• Section III. Mood and Cognition by Nutraceutical Interventions
• Section IV. Drugs and Foods and Nutraceutical Interactions During Treatment of Neurodegenerative Diseases: Toxicities
• Section V. Mechanisms of Action of Nutraceuticals and Dietary Supplements in Neurological Disease Therapy: Autoimmunity and Antioxidant Actions
• Section VI. Hypertension and Stroke
• Section VII. Seizures, Epilepsy, and Parkinson's Disease
• Index