Diet pattern and prodromal features of Parkinson's disease

Objective: To assess the relationship between diet pattern and prodromal Parkinson’s disease (PD) features.

Methods: These analyses include 47,679 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study. Since 1986, both cohorts have collected dietary information every four years and calculated scores for adherence to different diet patterns, including the alternate Mediterranean diet (aMED) and the Alternative Healthy Eating Index (AHEI). In 2012, participants responded to questions regarding constipation and probable rapid eye movement (REM) sleep behavior disorder. For a subset of 17,400 respondents to the 2012 questionnaire, five additional prodromal features of PD were assessed in 2014-2015. We used multinomial logistic regression to estimate the association between baseline (1986) diet pattern score quintiles and number of prodromal features (0, 1, 2, or ≥3) in 2012-2015. Additional analyses investigated the association between long-term adherence to these dietary patterns over 20 years and prodromal features suggestive of PD.

Results: Comparing extreme aMED diet quintiles, the odds ratio for ≥3 versus 0 features was 0.82 (95%CI: 0.68, 1.00, false discovery rate (FDR) adjusted p_trend=0.03) at baseline and 0.67 (95%CI: 0.54, 0.83, FDR-p_trend<0.001) for long-term diet; results were equally strong for the association with AHEI scores. Higher adherence to these diets was inversely associated with individual features, including constipation, excessive daytime sleepiness, and depression.

Conclusions: The inverse association between these diet patterns and prodromal PD features is consistent with previous findings and suggests adherence to a healthy diet may reduce the occurrence of non-motor symptoms that often precede PD diagnosis.