Food and medication

If levodopa is prescribed, the doctor will give instructions on how each dose should be taken in relation to food. Most other Parkinson’s disease (PD) medications do not have specific instructions for whether they should be taken with or without food.

Some people with advanced PD with motor fluctuations may be advised to alter their protein intake (examples of foods rich in protein include meat, eggs and cheese). Protein can interfere with the uptake of levodopa into the body and the brain and, as a result, reduce the effectiveness of the medication.

Therefore, it may improve matters if the normal daily intake of protein is taken all together in one meal at the end of the day. If this is necessary, foods low in protein, e.g., bread, cereals, vegetables, fruit, clear or vegetable soups (not creamed or containing lentils or peas), spreads (honey, jam, vegemite), sweets and fats, should make up the bulk of the other daily meals.

This prevents the protein interfering with the effect of levodopa during the day. However, it does not help in all cases, and some doctors will not recommend this change in diet. Therefore, the diet should never be altered in this way before speaking to a doctor or registered dietician. Also, it should be noted that although protein may be taken at a different time of day, the total daily amount of protein should not be reduced, as it is needed by the body for repair and to fight infection.

Another way to avoid the ‘protein effect’ is to take levodopa on an empty stomach (1 hour before or after a meal), as long as this doesn’t cause nausea.

As well as protein worsening motor fluctuations, people with advanced disease may find that their dyskinesias become worse after eating foods high in carbohydrate/sugar. However, carbohydrates should not be excluded from the diet – a good overall balance of foods is still recommended, and carbohydrates are needed to maintain body weight and energy levels.