Ernährung bei der Parkinson-Krankheit

Andres Ceballos-Baumann; Urban M. Fietzek

doi:10.1055/a-2512-0254

Nervenheilkunde, Table of Contents

Nervenheilkunde 2025; 44(03): 106-114
DOI: 10.1055/a-2512-0254

Schwerpunkt

Ernährung bei der Parkinson-Krankheit

Nutrition in Parkinson‘s disease

Authors

Andres Ceballos-Baumann

¹Parkinson-Fachklinik und Abt. für Neurologie und klinische Neurophysiologie, Schön Klinik München-Schwabing
Urban M. Fietzek

¹Parkinson-Fachklinik und Abt. für Neurologie und klinische Neurophysiologie, Schön Klinik München-Schwabing

Abstract

Zusammenfassung

Die Ernährung spielt eine bedeutende Rolle in der Behandlung der Parkinson-Krankheit (PK) und stößt bei Betroffenen auf großes Interesse. Levodopa bildet die Basis ihrer Pharmakotherapie und zeigt eine komplexe Interaktion mit der Ernährung. Aminosäuren können die Resorption und Wirkung von Levodopa durch kompetitive Hemmung im Dünndarm und an der Blut-Hirn-Schranke beeinträchtigen. Diäten mit eingeschränkter Proteinzufuhr am Tag haben Levodopa-Wirkungsschwankungen verbessert. Zusätzliche Faktoren wie eine verzögerte Magenentleerung, fettreiche Nahrung und ein gestörtes Darmmikrobiom können die Bioverfügbarkeit von Levodopa weiter vermindern. Obstipation ist das häufigste nicht-motorische Symptom der PK. Ernährungsansätze wie eine erhöhte Flüssigkeits- und Ballaststoffzufuhr (25–30 g/Tag) sind hilfreich. Verschiedene Ernährungsweisen können potenziell präventive und therapeutische Effekte bei der PK haben. Die MIND- und mediterrane Diäten korrelieren mit einem reduzierten Parkinson-Risiko und langsameren Krankheitsfortschritt bei schon Erkrankten.

Abstract

Nutrition plays a significant role in the treatment of Parkinson’s disease (PD) and is of great interest to those affected. Levodopa forms the cornerstone of PD pharmacotherapy but exhibits complex interactions with diet. Amino acids can impair the absorption and efficacy of levodopa through competitive inhibition in the small intestine and at the blood-brain barrier. Protein redistribution diets have shown improvements in levodopa-fluctuations. Additional factors, such as delayed gastric emptying, high-fat meals, and a disrupted gut microbiome, can further reduce levodopa bioavailability. Constipation is the most common non-motor symptom of PD. Nutritional strategies, such as increasing fluid and fiber intake (25–30 g/day), can be beneficial. Various diets also show potential preventive and therapeutic effects in PD. The MIND and Mediterranean diets are associated with a reduced risk of PD and slower disease progression.

Schlüsselwörter

Parkinson-Krankheit - Levodopa - Nahrung - Parkinson-Diät - Levodopa-Wirkungsschwankungen

Keywords

Parkinson disease - levodopa - protein redistribution - nutrition - levodopa fluctuations

Full Text

References

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