Ernährungsaspekte bei Morbus Parkinson: Erkrankungsrisiko, Diät und Therapie von Funktionsstörungen des Verdauungstraktes

Ilona Csoti; Christian Dresel; Björn Hauptmann; Thomas Müller; Christoph Redecker; Tobias Warnecke; Ulrich Wüllner

doi:10.1055/a-0681-6700

Fortschritte der Neurologie · Psychiatrie, Table of Contents

Fortschr Neurol Psychiatr 2018; 86(S 01): S34-S42
DOI: 10.1055/a-0681-6700

Workshop

Ernährungsaspekte bei Morbus Parkinson: Erkrankungsrisiko, Diät und Therapie von Funktionsstörungen des Verdauungstraktes

Nutritional aspects in Parkinson's disease: disease risk, dietary therapy and treatment of digestive tract dysfunction

Ilona Csoti

¹Gertrudis Klinik Biskirchen, Karl-Ferdinand-Broll Straße 2–4, 35638 Leun-Biskirchen

,

Christian Dresel

²Klinik und Poliklinik für Neurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131 Mainz

,

Björn Hauptmann

³Neurologisches Zentrum, Segeberger Kliniken, Hamdorfer Weg 3, 23795 Bad Segeberg und Department Performance, Neuroscience, Therapy and Health, Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg.

,

Thomas Müller

⁴Klinik für Neurologie, St. Joseph-Krankenhaus Berlin-Weißensee, Gartenstraße 1, 13088 Berlin

,

Christoph Redecker

⁵Klinik für Neurologie, Klinikum Lippe, Rintelner Straße 85, 32657 Lemgo

,

Tobias Warnecke

⁶Department für Neurologie, Universitätsklinikum Münster, Albert-Schweitzer Campus 1, Gebäude A1, 48149 Münster

,

Ulrich Wüllner

⁷Klinik und Poliklinik für Neurologie, Universitätsklinikum Bonn und Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE e. V., Bonn)

› Author Affiliations

Abstract

Zusammenfassung

Daten aus epidemiologischen Studien, die mögliche Assoziationen bestimmter Nahrungsmittel mit dem Risiko an der Parkinson’schen Krankheit zu erkranken untersucht haben, suggerieren, dass manche Nahrungsmittel, wie z. B. nikotinreiche Paprika, dieses modifizieren können. Auch scheinen nach der Analyse einer Reihe von Medikamenten-Zulassungsstudien positive Effekte auf den Krankheitsverlauf durch Coffein (Kaffee) und höhere Harnsäure-, sowie Gesamtcholesterinspiegel vor allem bei Männern vorhanden zu sein.

Noch ist aber ungewiss, ob eine Diät oder besondere diätetische Konzepte und eventuell auch die Auswirkungen der Mikrobiota des Darmes auf den menschlichen Stoffwechsel, eine Rolle für den Krankheitsverlauf spielen könnten. Angesichts fehlender prospektiver Ernährungsstudien können nur allgemeine Empfehlungen gegeben werden: eine „ausgewogene“ saisonal-regional frische Ernährung mit Schwerpunkten auf Gemüse, Obst, Nüssen, Fisch, wenig rotem Fleisch und wenig hochverarbeiteter Nahrung mit nur einem geringen Anteil einfacher Kohlenhydrate könnte hilfreich sein. Speziell für ältere Menschen ist eine eiweißarme Diät nicht sinnvoll. Vielmehr muss, um der Entwicklung von Sarkopenie und Malnutrition im Alter vorzubeugen, besonders auf ausreichende Eiweißzufuhr geachtet werden. Die Versorgung mit den Vitaminen B12 und D3 muss sichergestellt werden – gleichzeitig muss von der unkritischen Anwendung von Nahrungsergänzungsmitteln, insbesondere von Mikronährstoffen mit vermuteten anti-oxidativen Eigenschaften, abgeraten werden.

Abstract

Epidemiological studies suggest an association of certain foods with the risk of Parkinson's disease. Also, a number of studies revaeled positive effects on disease progression by caffeine, higher uric acid and total cholesterol levels – especially in men. However, it is not yet clear whether a specific dietary concept or the effects of the intestinal microbiota on the human metabolism could play a role in the course of the disease. Given the lack of prospective nutrition studies, only general recommendations can be given: a "balanced" seasonal regional diet with emphasis on vegetables, fruits, nuts, fish, low amount of red meat, and non-processed foods with a low level of simple carbohydrates may be helpful. Especially for the elderly, a low-protein diet should be avoided. Rather, in order to prevent the development of sarcopenia and malnutrition, particular attention must be paid to adequate protein intake. The supply of vitamins B12 and D3 must be ensured - at the same time, the non-critical use of dietary supplements, especially micronutrients with presumed anti-oxidative properties, should be discouraged.

Schlüsselwörter

DIÄT - Darm - Mikrobiota - Dysphagie - Obstipation - Sarkopenie

Key words

Diet - Parkinson - Microbiome

Full Text

References

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