Lifestyle modifications
NUTRITION
- Persons with Parkinson disease who are old are at risk for weight loss, reduced bone health and muscle mass, and malnutrition (1)
- A healthy dietary pattern, e.g. MIND diet, may prevent or slow the progression of Parkinson disease (1)
- High intake of fiber, satisfactory fluid intake and exercise may reduce symptoms of constipation (1)
- Dietary protein restriction may be useful in patients with advanced disease where amino acids compete with L-dopa for absorption (1)
- Avoid large meals high in fats, which slow gastric emptying and interfere with medication absorption (1)
PHYSICAL ACTIVITY
- May help to slow the progression of motor symptoms of Parkinson’s disease (1)
- May improve non-motor symptoms (1)
- May reduce secondary effects of rigidity and a flexed position, such as pain in shoulders, back and hips (1)
- Focus on exercise that improve balance, strength and flexibility (1)
SOCIAL
- Social connectedness is recommended, as patients with Parkinson’s disease are at risk of loneliness and social isolation, specially in later stages of the disease (1)
- Loneliness is associated with increased PD symptoms (1)
References
1) https://www.uptodate.com/contents/nonpharmacologic-management-of-parkinson-disease
Resources
EXPLANATION TO EVIDENCE PRESENTATION

Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD font
Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE font
Evidence based on randomized controlled trials is written in PLAIN font
Evidence based on observational / cohort studies is written in CURSIVE font