Nutrition is a vital component of maintaining and preserving good health. It may be an especially important consideration when one has a disease or other health condition that may impose certain dietary requirements or restrictions. At the same time, the standard recommendations for good health still stand – heart healthy eating, weight control, adequate fluid intake, limiting alcohol consumption, and more. With Parkinson’s disease, dietary choices and habits can help alleviate some symptoms. For example, fluid and fiber intake may help with constipation, increasing fluid intake may alleviate orthostatic hypotension, the feeling of dizziness when standing up, and a high protein meal can interfere with levodopa absorption, leading to fluctuations in medication effectiveness. In this second of two episodes with Dr. John Duda, Director of the Parkinson’s Disease Research, Education and Clinical Center at the Philadelphia Veterans Affairs Medical Center and Professor of Neurology at the University of Pennsylvania, a Parkinson’s Foundation Center of Excellence, he tells what he recommends about diet and nutrition for his Parkinson’s patients, including when to look for organically grown produce.
Released: March 9, 2021
John Duda, MD is the Director of the Parkinson's Disease Research, Education and Clinical Center (PADRECC) and Co-Director of the Center for Neurotrauma, Neurodegeneration and Restoration of the Cpl. Michael J. Crescenz VA Medical Center and a Professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania. For the past 19 years, he has worked with his colleagues in Philadelphia to provide state-of-the-art care for thousands of Veterans with PD and related disorders.
His research activities have included basic science investigations into the role of Lewy pathology in the pathophysiology of Parkinson’s disease and related disorders as well as investigations into the mechanisms involved in traumatic brain injury. He has also conducted clinical research in Parkinson’s disease with studies of deep brain stimulation therapy, transcranial magnetic stimulation, the benefits of a plant-based, whole food diet, and the use of olfaction as a biomarker of disease diagnosis and progression. He has received research grants from the Department of Veterans Affairs, NIH, the Michael J. Fox Foundation for Parkinson Research, and the Department of Defense. He has been recognized as a BLR&D Senior Clinical Research Scientist and authored more than 120 scientific publications including articles in JAMA, Science, Neuron, The New England Journal of Medicine and Neurology.
A major thrust of Parkinson’s research today is exploring potential ways to slow the progression of the disease. Exercise may be one way and is recommended. Another possible approach is nutrition, although the evidence is not as solid as for exercise. Nonetheless, there is evidence that good nutrition and dietary practices can have beneficial effects for people with Parkinson’s, including lessening digestive symptoms, as well as preserving quality of life by lowering the risk of heart disease, stroke, diabetes, high blood pressure, and dementia. Improving digestive function may even improve the absorption and actions of medications. Dr. John Duda, Director of the Parkinson’s Disease Research, Education and Clinical Center at the Philadelphia Veterans Affairs Medical Center and Professor of Neurology at the University of Pennsylvania, a Parkinson’s Foundation Center of Excellence, recommends a plant-based, whole foods diet. In this podcast, the first of two with Dr. Duda, he explains what a whole foods diet is, how it differs from a standard American diet, and how people can reliably and comfortably change the way they eat.
Released: February 23, 2021
John Duda, MD is the Director of the Parkinson's Disease Research, Education and Clinical Center (PADRECC) and Co-Director of the Center for Neurotrauma, Neurodegeneration and Restoration of the Cpl. Michael J. Crescenz VA Medical Center and a Professor of Neurology at the Perelman School of Medicine at the University of Pennsylvania. For the past 19 years, he has worked with his colleagues in Philadelphia to provide state-of-the-art care for thousands of Veterans with PD and related disorders.
His research activities have included basic science investigations into the role of Lewy pathology in the pathophysiology of Parkinson’s disease and related disorders as well as investigations into the mechanisms involved in traumatic brain injury. He has also conducted clinical research in Parkinson’s disease with studies of deep brain stimulation therapy, transcranial magnetic stimulation, the benefits of a plant-based, whole food diet, and the use of olfaction as a biomarker of disease diagnosis and progression. He has received research grants from the Department of Veterans Affairs, NIH, the Michael J. Fox Foundation for Parkinson Research, and the Department of Defense. He has been recognized as a BLR&D Senior Clinical Research Scientist and authored more than 120 scientific publications including articles in JAMA, Science, Neuron, The New England Journal of Medicine and Neurology.
Episode 70: The Role of the Microbiome in PD: Part Two
Our bodies contain more than just our own human cells. We normally live in harmony with a vast array of microorganisms occupying specific spaces, or niches, on and within us. These bacteria, fungi, viruses, and protozoa form the human microbiome. The ones in the gut, mainly within the colon (large intestine), normally maintain a health balance and keep “bad” microbes from overpopulating that area of the digestive system. The normal gut organisms, consisting of around 1,000 different species of bacteria as well as other microbes, outnumber all the human cells in our bodies.
The gut microbiome acts locally and systemically, meaning it interacts with other parts of the body. Locally in the gut, the microbiome digests foods, helps to regulate the immune system, and produces vitamins that our bodies need for metabolism, nerve function, and blood clotting but that they cannot produce on their own.
There is mounting evidence that the gut microbiome also interacts with the nervous system, including the brain, in health and disease. Its effects also reach beyond the gut. Evidence points to a role for it in the faulty regulation of the immune system, leading to such diseases as rheumatoid arthritis, multiple sclerosis, diabetes, and allergies.
In this episode, Ai Huey Tan of the University of Malaya in Kuala Lumpur, Malaysia discusses what is known about the role of the gut microbiome as it affects Parkinson’s disease and its treatment and what researchers are continuing to investigate.
Released: December 17, 2019
Dr. Tan Ai Huey is a Senior Lecturer and Consultant Neurologist at the University of Malaya Medical Centre, Malaysia. She completed her specialty training in Neurology at the University of Malaya, Malaysia. Her main areas of research are in Parkinson's Disease and Movement Disorders, with a particular interest in exploring the role of gut infections and neuro-inflammation in Parkinson's Disease, and the characterization of rare/"orphan" diseases. She has numerous peer-reviewed journal publications and book chapters and has been awarded the Best Neuroscience Publication Award (UM Faculty of Medicine), and the International Scholarship Award from the American Academy of Neurology.
Dr. Tan has served as a Council Member of the Malaysian Movement Disorder Council since 2013 and was Co-Author of the National Consensus Guidelines for the treatment of Parkinson's disease. Currently, she is the Honorary Secretary of the Malaysian Society of Neurosciences (MSN), the professional body that represents Malaysian clinicians and scientists in the neurology/neuroscience field. At the international level, she serves on several committees in the International Parkinson’s and Movement Disorder Society (MDS) including the MDS Education Committee, which oversees the planning of movement disorder education programs around the world.
Episode 68: The Role of the Microbiome in PD: Part One
How and why Parkinson’s disease (PD) starts and progresses is still not exactly known, but active research points to genetics and environment, among other factors. The environment is both external and internal – external in terms of what people encounter outside their bodies and internal in terms of what is inside their bodies. Researchers studying a variety of diseases have learned the importance of the microbiome in health and disease. The microbiome consists of all those bacteria, fungi, and viruses that occupy niches on and inside of people, such as on the skin, in the nose and mouth, and in the gut. These organisms can have far reaching effects in the body, distant from their own locations. Some of these interactions can affect the brain.
Ali Keshavarzian, MD, Chief of the Division of Digestive Diseases and Nutrition at Rush University in Chicago has been studying the role of the gut microbiome and its relation to inflammation, such as in inflammatory bowel disease, in addition to more distant sites including in the brain. His research includes the role of the gut microbiome as a contributing factor to the development and progression of PD as well as the potential to manipulate it to help manage the disease. He conducts both basic science research using animal models and clinical research with people with PD.
Released: November 19, 2019
Ali Keshavarzian, MD, FRCP, FACP, MACG, AGAF the Josephine M. Dyrenforth Chair of Gastroenterology, Professor of Medicine and the Graduate College, Director of the Division of Digestive Diseases and Nutrition (1999) and Director of the Institute for Advanced Study of the Gut, Chronobiology and Inflammation (2017) at Rush University Medical Center in Chicago, Illinois has been a practicing gastroenterologist with a specialty in managing patients with inflammatory bowel disease for over 30 years.
As a clinician scientist, he has been studying the impact of environmental factors [stress, alcohol, sleep and circadian disruption] on intestinal barrier function host/microbe interaction that promote intestinal and systemic [gut-derived] inflammation leading to initiation and/or progression of inflammatory disorders including IBD, IBS, food allergy, metabolic syndrome, alcoholic cirrhosis, NASH and Parkinson’s disease. He has contributed to over 350 published articles [h-index of 77] and book chapters. His works have been supported by multiple NIH, DoD, NASA and USDA grants. He was one of the first investigators to report the key role of oxygen free radicals in tissue injury in inflammatory bowel disease and one of the first investigators to begin to focus on the role of intestinal microbiota in health and disease in alcoholism, IBD, cancer, HIV and Parkinson. He is one of the early investigators to examine the effects of circadian and sleep disruption on GI tract and to report the negative impact of sleep and circadian disruption in IBD.
The focus of this webinar will be to address the needs of veteran’s living with Parkinson’s disease (PD). A healthy lifestyle is an important part of living well with Parkinson’s. Physical exercise is well-established as beneficial for symptom control and possibly disease modification, and physicians regularly counsel patients to increase overall fitness. Similarly, diet and overall brain health can be another tool to fight PD. This webinar will explore how exercise, dietary choices, stress management, sleep and social connection can affect your brain health and PD care.
John Eric Duda, MD
Professor of Neurology at the Veteran's Administration Medical Center
Director, Parkinson's Disease Research, Education and Clinical Center of the Michael J. Crescenz VA Medical Center, University of Pennsylvania
Co-Director, Center for Neurotrauma, Neurodegeneration and Restoration of the Michael J. Crescenz VA Medical Center, University of Pennsylvania
James F. Morley, MD, PhD
Assistant Professor of Neurology at the Veteran's Administration Medical Center Staff Neurologist, Philadelphia VA Medical Center
Associate Director, University of Pennsylvania/PADRECC Movement Disorders Fellowship Program. Co-director, Parkinson's Disease Research, Education and Clinical Center, Crescenz VA Medical Center
Podcasts
Episode 93: Benefits of Practicing Tai Chi Chuan Exercises
Many people find that Eastern mind-body practices complement Western medicine well and produce additional benefits. One Eastern system of mind-body integration is tai chi and its martial art practice of tai chi chuan. Using continuous, flowing movements, this moving meditation addresses flexibility through stretching and involves aerobic activity and relaxation as well. Through the practice of tai chi, people can develop better awareness of movement and actions, develop better body alignment, posture, core strength, and breath support and control. Studies have shown physical benefits on balance and slowing the decline in motor control as well as mental health benefits in terms of stress management, possibly cognition, and quality of life for people with Parkinson’s and their care partners. In this episode, Dr. Pei-Fang Tang, professor of physical therapy in the School of Physical Therapy at National Taiwan University, says tai chi is based on ancient Chinese philosophy, part of which is a dynamic balance between yin and yang, which are invoked by the movements in its practice and which bring balance to one’s life.
Released: November 17, 2020
Professor Tang earned her BS degree in physical therapy from National Taiwan University, MS degree in physical therapy from University of North Carolina at Chapel Hill, and PhD degree in Exercise and Movement Science from University of Oregon. Her research interests focus on the influences of aging processes and neurologic disorders, especially stroke and degenerative ones, on the cognitive control, neuromuscular control, and brain mechanisms of motor control and motor learning. She also is interested in studying the efficacy and neural mechanisms of different forms of exercise interventions in the promotion of cognitive and motor functions, as well as neuroplasticity, and in the prevention of dementia and disability in middle-aged and older adults and in people with neurologic disorders. The primary research tools her lab uses are movement analysis, biomechanics, and neuroimaging techniques.
Episode 181: What to Know Before Taking Nutritional Supplements for Parkinson’s
People with Parkinson’s disease (PD) may hear, whether through word of mouth or the internet, about herbs or supplements that claim to ease PD symptoms. It’s important to recognize that nutritional supplements are not federally regulated, and there is limited research supporting their overall effectiveness. You should always speak with your healthcare provider before starting a new medication or supplement.
Nutritional supplements can include herbs, vitamins, or other drugs that are often available without a prescription. Since these products are not formally regulated, there is a high risk for potentially dangerous drug interactions when mixed with other medications, regardless of if they are prescribed by a doctor or available over the counter.
In this episode, we speak with Dr. Angela Hill, a pharmacist and professor at the University of South Florida, to better understand the precautions of taking supplements while living with PD. She discusses the potential side effects and risks of taking drugs without fully knowing what’s in their ingredients, as well as the warning signs to watch for. She shares tips for reading and evaluating labels and offers guidance on the type of questions to ask a pharmacist to help decide whether the supplement may be a good fit based on your specific health condition.
During the episode, Dr. Hill mentions additional resources for evaluating herbal medications and understanding medication timing. Click here to view the articles, along with her contact information for any follow-up questions.
Released: July 15, 2025
About Angela M. Hill, Pharm. D., CRPh
Dr. Angela M. Hill is a professor, Associate Dean of Clinical Affairs and the Project Director for WE-CARE at the Taneja College of Pharmacy at the University of South Florida. She received her doctorate in pharmacy from Florida A&M University and completed a post-graduate residency in neurology from the Neuroscience Research Foundation, Inc. of Florida. Throughout her career, she has helped patients with neurological and psychiatric disorders through her work in community and hospital pharmacy practice, specialty clinics and community boards. She has provided pharmacy services to patients being screened, treated, or involved in clinical research with Alzheimer’s disease and other dementias for the last 25+ years, and is one of the pioneering pharmacists to be involved in Memory Disorder Clinics in the State of Florida and was acknowledged by the Department of Elder Affairs and the Alzheimer’s Resource Association for her pioneering work.
Dr. Hill is the project manager for WE-CARE where she does work in clinical trial recruitment and health disparities. Dr. Hill has done research and published on a variety of topics related to her specialty areas, which include pharmacogenomic principles in psychiatric and neurological disorders. Her work and training of pharmacists, spans from the United States to other countries like Nigeria, Trinidad, Panama, and most recently Canada.
She is currently practicing at Dr. Tracy’s House, an innovative holistic health primary care practice that serves underrepresented and marginalized populations in Tampa, Florida.
Dr. Hill is the wife of Mr. Thaddeus Hill and their 10-year-old daughter, Sylvia Hill.
Exercise and staying active are essential not only for physical health but also for mental and emotional well-being, especially as a veteran living with Parkinson’s disease. This program will address how staying active can positively impact physical symptoms, mood, and overall health. Participants will learn about the benefits of exercise, discover strategies to stay active beyond traditional workouts, and explore meaningful activities that bring joy and purpose.
Hillari Olson, DPT, RYT 200
LSVT BIG®, PWR! Moves® Certified Clinician
Program Coordinator / Physical Therapist
Parkinson's Disease and Movement Disorders Program
Minneapolis VA Health Care System
Emily Hall, LCSW
Southeast PADRECC Senior Social Worker
Central Virginia VA Healthcare System
Konner Kielman, OTD, OTR/L
LSVT BIG® Certified Clinician
Occupational Therapist
Parkinson's Disease and Movement Disorders Program
Minneapolis VA Health Care System
Science News
Study Finds Potential Link Between Parkinson's and Gut Health
Inflammatory bowel disease (IBD) — conditions like Crohn's disease and ulcerative colitis — are linked to an increased risk of developing Parkinson's disease (PD), a neurodegenerative disorder affecting movement. Scientists are working to figure out why the diseases are linked, and a key player may be the community of microbes living in our gut, often referred to as the gut microbiome.
The gut microbiome is a complex ecosystem of trillions of bacteria, fungi, viruses and other microorganisms that live in our digestive system. It plays a crucial role in digestion, immunity and brain health. An imbalance in this gut microbial community, known as gut dysbiosis, can contribute to various health issues.
A recent study compared the gut microbiomes of people with Parkinson’s disease, IBD and healthy individuals. It also examined larger, publicly available microbiome data from people with Parkinson’s or IBD. This research is the first to directly compare gut microbiomes across these three groups.
Parkinson’s Foundation Scientific Advisory Board member Malú Gámez Tansey, PhD, led the study, which was published in npj Parkinson's Disease; Michael S. Okun, MD, Parkinson's Foundation National Medical Advisor, was also a study contributor. The results revealed previously unknown similarities between the gut microbiomes of people with Parkinson’s and those with IBD.
The study found a reduced number of a certain type of microbe in both people with inflammatory bowel disease and Parkinson’s, suggesting that these specific microbes may influence the risk of Parkinson’s.
Study Results
The study recruited 54 people with Parkinson’s, 24 people with IBD and 16 people without these diseases. The researchers used fecal samples and special techniques to identify the microbes that make up each participant’s microbiome. When they compared the microbes, they observed clear differences as well as certain overlaps in the species of bacteria in the guts of people with IBD and Parkinson’s compared to healthy individuals.
Additionally, in large sets of data from past studies of people with IBD or Parkinson’s, they found that even though there are unique changes in each condition, there are also specific bacteria and metabolic processes that are either more or less common in both IBD and Parkinson’s.
In people with Parkinson’s or IBD, the study found that there tended to be a decrease in the levels of certain types of bacteria known for producing short-chain fatty acids (SCFAs), which are important fuel and signaling molecules for our gut and brain. The study highlighted a few specific SCFA-producing bacteria that were lower in both the Parkinson’s and IBD groups.
Furthermore, researchers also found a reduction in the biological machinery responsible for producing the bacteria in both conditions. As SCFAs play a role in maintaining gut health and may have neuroprotective effects, these findings suggest that the depletion of SCFA-producing bacteria in people with IBD might increase their susceptibility to developing Parkinson's disease. A lack of these beneficial compounds could potentially impact brain health over time.
This research underscores the connection between our gut and our brain — often referred to as the gut-brain axis. It suggests that a healthy and diverse gut microbiome may be important for brain and gut health, and a lack of these beneficial bacteria could potentially impact brain health over time. However, more studies are needed to show whether interventions to change diet or microbiome could help with IBD or Parkinson’s.
Highlights
The study recruited 54 people with Parkinson’s, 24 people with IBD and 16 people without these diseases. The researchers used special techniques to identify the microbes that make up each participant’s microbiome. They also analyzed publicly available data from past studies of people with IBD or Parkinson’s.
They found previously unknown overlap between the gut microbiomes of people with Parkinson’s and people with IBD.
They found a decrease in the amount of certain types of bacteria known for producing short-chain fatty acids (SCFAs), which are important fuel and signaling molecules for our gut and brain, in both people with Parkinson’s and IBD.
Their findings suggest that the depletion of these important bacteria in individuals with IBD might contribute to an environment that increases their susceptibility to developing Parkinson's disease.
What does this mean?
This study has identified new shared features between the microbiomes of people with PD and IBD. Because there is a link between these two conditions, improving our understanding of the specific microbes involved in both diseases may potentially lead to new therapies.
While this research provides insights into the potential link between gut dysbiosis, IBD, and Parkinson's disease, more studies with larger sample sizes are needed to fully understand the complex mechanisms at play and whether any interventions could help.
What do these findings mean to the people with PD right now?
About 80% of people with Parkinson's experience gastrointestinal (GI) issues. These issues can develop up to 10-20 years before a PD diagnosis. Therefore, the gut microbiome is a ripe target for future treatments that could potentially stop or slow PD progression at an early stage.
However, the gut microbiome is very complex and unique to each person. If you are suffering from gastrointestinal issues, try eating more fiber-rich foods and less starchy ones, drinking more fluids and increasing exercise. Speak to your doctor before trying pro- or pre-biotic supplements that alter your gut microbiome, since they may affect people differently.
PD-related gastroparesis (the impaired ability to empty the contents of the stomach) and other GI issues can impact how medications are absorbed. People with gut issues may find PD medications such as carbidopa/levodopa take longer to take effect or seem less effective. Additionally, the medications themselves can alter the structure of your gut microbiome. Bring up any GI issues to your PD doctor who might refer you to a gastroenterologist, a doctor specializing in GI issues.
Learn More
The Parkinson’s Foundation believes in empowering the Parkinson’s community through education. Learn more about PD and the topics in this article through our below resources, or by calling our free Helpline at 1-800-4PD-INFO (1-800-473-4636) for answers to your Parkinson’s questions.
In 2016, I was diagnosed with Parkinson's disease (PD) at the age of 31. To say this diagnosis was difficult would be an understatement. In that moment, I realized that the life I had always envisioned for myself was no longer a possibility. Instead of living my life as I saw fit, I now had to live my life according to what I could plan out.
Does my job offer disability insurance? How should I approach building a family? Would my spouse even want to build a family knowing what is in store? How long do I have to save, and how much, before I can't work anymore? These are all questions that anyone diagnosed with a chronic illness must face. It took me 3 years to realize that the life I envisioned can still happen, it would just look a little different.
Since that time, I have dedicated myself to spreading awareness and helping raise funds for Parkinson's. I've worked as a member of the Parkinson’s Foundation People with Parkinson’s Advisory Council, and most recently I have summited mountains I never thought achievable. After all, Ali once said "it's not the mountain ahead that wears you down, but the pebble in your shoe." I take this quote literally and will continue to push myself to new heights. In 2026, on the 10-year anniversary of my diagnosis, I will be attempting to summit Mera Peak in Nepal. This 21,000 ft mountain will represent my journey with PD. While the journey will always be difficult, and often times I will want to break down, but I can't.
To those living with Parkinson's, I challenge each of you to enjoy what makes me happy, and what gives me hope. Challenge yourself every day. I see where I'm at in my life, and I look at where I can be. I want to be able to tell my daughter that you can do anything you put your mind to, and I want to mean that, and lead by example. I want to show that no matter the news, you can find your inspiration and life, and you can ALWAYS find your meaning. No matter where you are in your journey, you can always look up and see the mark you are leaving on this world. Challenge yourself, not only for yourself, but those around you.
