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. 2020 Jul 16;12(7):2109.
doi: 10.3390/nu12072109.

Lower Energy Intake among Advanced vs. Early Parkinson's Disease Patients and Healthy Controls in a Clinical Lunch Setting: A Cross-Sectional Study

Petter Fagerberg  1 , Lisa Klingelhoefer  2 , Matteo Bottai  3 , Billy Langlet  1 , Konstantinos Kyritsis  4 , Eva Rotter  2 , Heinz Reichmann  2 , Björn Falkenburger  2 , Anastasios Delopoulos  4 , Ioannis Ioakimidis  1
Affiliations

Lower Energy Intake among Advanced vs. Early Parkinson's Disease Patients and Healthy Controls in a Clinical Lunch Setting: A Cross-Sectional Study

Petter Fagerberg et al. Nutrients. .

Abstract

Unintentional weight loss has been observed among Parkinson's disease (PD) patients. Changes in energy intake (EI) and eating behavior, potentially caused by fine motor dysfunction and eating-related symptoms, might contribute to this. The primary aim of this study was to investigate differences in objectively measured EI between groups of healthy controls (HC), early (ESPD) and advanced stage PD patients (ASPD) during a standardized lunch in a clinical setting. The secondary aim was to identify clinical features and eating behavior abnormalities that explain EI differences. All participants (n = 23 HC, n = 20 ESPD, and n = 21 ASPD) went through clinical evaluations and were eating a standardized meal (200 g sausages, 400 g potato salad, 200 g apple purée and 500 mL water) in front of two video cameras. Participants ate freely, and the food was weighed pre- and post-meal to calculate EI (kcal). Multiple linear regression was used to explain group differences in EI. ASPD had a significantly lower EI vs. HC (-162 kcal, p < 0.05) and vs. ESPD (-203 kcal, p < 0.01) when controlling for sex. The number of spoonfuls, eating problems, dysphagia and upper extremity tremor could explain most (86%) of the lower EI vs. HC, while the first three could explain ~50% vs. ESPD. Food component intake analysis revealed significantly lower potato salad and sausage intakes among ASPD vs. both HC and ESPD, while water intake was lower vs. HC. EI is an important clinical target for PD patients with an increased risk of weight loss. Our results suggest that interventions targeting upper extremity tremor, spoonfuls, dysphagia and eating problems might be clinically useful in the prevention of unintentional weight loss in PD. Since EI was lower in ASPD, EI might be a useful marker of disease progression in PD.

Keywords: Parkinson’s disease; eating behavior; energy intake; food; malnutrition; monitoring; neurodegenerative diseases; weight loss.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Standardized medical examination of upper extremity (UE) tremor.
Figure 2
Figure 2
(a,b) The clinical lunch setting, and (c) the food that was served during the lunch meal (200 g sausages, 400 g potato salad, and 200 g apple purée).
Figure 3
Figure 3
Boxplot illustrating group differences in energy intake (kcal) after sex stratification. Parkinson’s disease (PD). Each circle represents a participant with an energy intake value >1.5 × interquartile range.
Figure 4
Figure 4
Boxplot illustrating group differences in water intake (grams) after sex stratification. Parkinson’s disease (PD). The circle represents a participant with a water intake value >1.5 × interquartile range.
See this image and copyright information in PMC

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