Healthy diet and exercise improve outcomes in patients with Parkinson's disease: JAMA

USA: An active lifestyle and a good diet are linked to a decreased all-cause death rate in people with Parkinson's disease states a study published in JAMA Network Open. 

The chance of acquiring Parkinson's disease (PD), the second most common neurodegenerative disease, has been linked to lifestyle choices like food and exercise. Limited prospective studies have evaluated the impact of food and exercise on all-cause mortality, and none of these research explicitly targeted people with Parkinson's disease.

There is limited data available that existing medications reduce the increased neuronal loss, despite advancements in the therapeutic management of the motor symptoms of PD. There are no widely accepted recommendations for supplementary, disease-modifying lifestyle practices, which may be partially due to a paucity of data from prospective studies and randomized clinical trials.

The authors asserted that higher levels of physical exercise and improved nutritional quality work both separately and together to improve PD survival. 

The researchers looked at the relationship between overall diet quality and physical activity before and after diagnosis with all-cause mortality among people from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study, the two sizable US cohorts that included people with PD.

For this purpose, 652 male subjects in the Health Professionals Follow-up Study from 1986 to 2012 and 599 female subjects in the Nurses' Health Study from 1984 to 2012 were examined in the population-based cohort study comprising of 1251 participants. Inclusion criteria comprised participants with PD diagnoses and full baseline dietary evaluation data. Between January 2021 and February 2022, data was examined. The main exposures of relevance to reduce reverse causation were pre diagnosis food quality, measured by the Alternative Healthy Eating Index (AHEI), and activity level, measured by metabolic equivalent task (MET) hours per week reported on questionnaires. In order to quantify the relationship between diet and exercise and mortality, both separately and together, Cox proportional hazards regression models were employed. Age, total caloric intake, caffeine consumption, and other lifestyle risk variables were taken into account in the models.

Key findings of the study:

 In pre diagnosis studies, the adjusted hazard ratio (HR) between the highest and lowest AHEI quartiles was 0.69, while in post diagnosis analyses, it was 0.57.

 For mortality related to people with Parkinson's disease, the inverse relationship persisted (postdiagnosis AHEI: HR, 0.52; postdiagnosis physical activity: HR, 0.37).

 For people in the greatest vs least tertiles for both variables in the joint analysis of diet quality and physical activity before the PD diagnosis, the adjusted HR was 0.51.

 Following the diagnosis, the HR for both diet quality and exercise was 0.35.

"We did not discover a statistically significant interaction between total weekly MET hours and diet quality scores, indicating that diet and exercise may be separate determinants in PD mortality", the authors added.

The study's authors came to the conclusion that people with Parkinson's disease had a decreased rate of all-cause death when they followed an active lifestyle and ate well.

REFERENCE

Zhang X, Molsberry SA, Schwarzschild MA, Ascherio A, Gao X. Association of Diet and Physical Activity With All-Cause Mortality Among Adults With Parkinson Disease. JAMA Netw Open. 2022;5(8):e2227738. doi:10.1001/jamanetworkopen.2022.27738