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.
I came to this country over 30 years ago from Mexico and have worked various jobs throughout my life to support my family. My true passion has always been music. I come from a family of musicians and have been blessed to be part of several bands here in the U.S., where I played the bajo sexto, or the Mexican 12-string guitar, and sang.
I have two daughters, a son, and two granddaughters who motivate me to face the challenges of my diagnosis. My oldest daughter noticed my early Parkinson's disease (PD) symptoms and helped me find a neurologist who gave me the official diagnosis five years ago. Since then, my daughter has made sure I stay active every day and enrolled me in Rock Steady Boxing, which has helped me feel my best.
I didn't think I was going to enjoy it, but movement has truly been like medicine for me. The Foundation says that the type of exercise you enjoy doing most, as long as it's safe, is the best exercise for you.
I also enjoy dancing with my daughters whenever I can. Music is a kind of therapy for me, and it transports me to a place of pure joy. Even my eldest daughter says that when we dance together, my balance is at its best and mobility seems to come to me easier.
I love spending time with my children and granddaughters, and I'm so grateful for their support.
When my father was diagnosed with Parkinson’s five years ago I knew I needed to find out every single thing about Parkinson’s. My father is the most hardworking and loving person I know, and I did everything in my power to help him navigate this disease.
I decided to pursue physical therapy as my career so I could give him the best care possible myself. After graduating and passing my boards I began working with Parkinson’s patients in various settings and came across the realization that movement is medicine.
During this time, I moved in with my significant other five hours away from my dad, which made it difficult to keep my dad motivated and moving. I signed him up for Rock Steady Boxing and he thrived in this class! I noticed such a positive change in his mood and physical state. It was thanks to the Parkinson’s Foundation that I was able to find these classes.
Since his diagnosis, I’ve become inspired, every day, to help people like my dad and their families. I’ve made it my mission to educate not only my patients about the importance of the Parkinson’s Foundation official exercise recommendations, but also my colleagues. Every day alongside other therapists, I try to create a space where the most up to date guidance, professional training and resources are available to everyone with PD who may come through the door.
As a first-generation Mexican-American, I also know the challenges adult children may face navigating the healthcare system in both English and Spanish. Having resources available in both languages like those the Parkinson’s Foundation provides, has been a lifesaver.
There seems to be a stigma in the Hispanic community about sharing medical hardships, and oftentimes many people with PD — like my father — feel isolated. This is why building community has been such an important part of my father’s journey, and as advocate, part of mine as well. Educating our community about Parkinson's symptoms and treatments is a job I take very seriously.
I am thankful for my siblings who always check in on Dad and for technology which helps me keep in touch with my father daily. I make the most of my monthly trips to take him to his appointments and check in on his progress in person.
I love you, Dad. You are my best friend, and I would do anything to make sure you’re happy and healthy!
Llegué a este país hace más de 30 años desde México y trabajé en varios empleos a lo largo de mi vida para mantener a mi familia. Mi verdadera pasión siempre fue la música. Vengo de una familia de músicos y tuve la bendición de poder formar parte de varias bandas aquí en Estados Unidos, donde tocaba el bajo sexto y cantaba.
Tengo dos hijas, un hijo y dos nietas que me motivan a enfrentar las dificultades de mi diagnóstico. Mi hija mayor notó mis primeros síntomas de Parkinson y me ayudó a encontrar un neurólogo que me dio el diagnóstico oficial hace 5 años. Desde entonces, mi hija se ha asegurado de que me mantenga activo todos los días y me inscribió en Rock Steady Boxing, lo cual me ha ayudado a sentirme lo mejor posible.
No pensé que iba a disfrutarlo, pero el movimiento realmente ha sido como una medicina para mí. La Fundación dice que el tipo de ejercicio que te gusta hacer, mientras que sea seguro, es el mejor ejercicio para ti.
También disfruto bailar con mis hijas cada vez que puedo. La música es una especie de terapia para mí y me transporta a un lugar de pura alegría. Hasta mi hija mayor dice que, cuando bailamos juntos, mi equilibrio está en su mejor momento y la movilidad parece más fácil.]
Me encanta pasar tiempo con mis hijos y mis nietas, y estoy muy agradecido por tener su apoyo.
Cuando a mi padre le diagnosticaron la enfermedad de Parkinson (EP) hace cinco años, supe que tenía que averiguar todo lo posible sobre el Parkinson. Mi padre es la persona más trabajadora y cariñosa que conozco e hice todo lo que estuvo a mi alcance para ayudarle a navegar por esta enfermedad.
Decidí dedicarme a la fisioterapia como profesión para poder darle yo misma los mejores cuidados posibles. Después de graduarme y aprobar mis certificaciones, empecé a trabajar con pacientes de Parkinson en varios entornos y me di cuenta de que el movimiento es medicina.
Durante este tiempo, me mudé con mi pareja a cinco horas de distancia de mi padre, lo que dificultó mantenerlo motivado y en movimiento. ¡Lo inscribí en Rock Steady Boxing y la clase le sentó muy bien! Noté un cambio muy positivo en su estado de ánimo y físico. Fue gracias a la Parkinson's Foundation que pude encontrar estas clases.
Desde que lo diagnosticaron, cada día me he sentido más inspirada para ayudar a personas como mi padre y a sus familias. He adoptado la misión de educar no sólo a mis pacientes acerca de la importancia de las recomendaciones oficiales de ejercicio de la Parkinson’s Foundation, sino también a mis colegas. Cada día, junto con otros terapeutas, intento crear un espacio en el que la orientación, la formación profesional y los recursos más actualizados estén al alcance de todas las personas con la EP que entren por mi puerta.
Como mexicana-estadounidense de primera generación, también conozco los desafíos a los que pueden enfrentarse los hijos adultos al navegar por el sistema de salud tanto en inglés como en español. Contar con recursos en ambos idiomas, como los que ofrece la Parkinson’s Foundation, ha sido un salvavidas.
Parece que en la comunidad hispana existe un estigma a la hora de compartir las dificultades médicas y a menudo muchas personas con la EP — como mi padre — se sienten aisladas. Por eso, crear comunidad ha sido una parte tan importante del recorrido de mi padre y, como defensora, también del mío. Educar a nuestra comunidad sobre los síntomas y tratamientos del Parkinson es un trabajo que me tomo muy en serio.
Estoy agradecida con mis hermanos, que siempre están pendientes de papá y con la tecnología, que me ayuda a mantenerme en contacto con mi padre a diario. Aprovecho al máximo mis viajes mensuales para llevarlo a sus citas y comprobar en persona sus progresos.
Te quiero, papá. Eres mi mejor amigo, ¡y haría cualquier cosa para asegurarme de que eres feliz y estás sano!
I was diagnosed with Parkinson’s disease (PD) in 2019 after my wife noticed a tremor in my left hand. Like many people, I left that initial doctor appointment with more questions than answers. For a period of time, I focused on following medical advice, maintaining my routine and not projecting too far into the future. I believed I was managing Parkinson’s, but in reality, I was largely reacting to it.
Over time, it became clear that a passive approach wasn’t neutral — it had consequences. I noticed gradual changes and realized that waiting for Parkinson’s to dictate next steps limited my options. That marked a shift in how I approached the disease. I decided to take a more active role, both in managing my own health and in contributing to broader efforts aimed at improving outcomes for people with Parkinson’s.
One of my first focus areas was exercise. As I began educating myself, the Parkinson’s Foundation resources on movement were critical. Their recommendation to incorporate four types of exercise — aerobicactivity,strengthtraining,balanceandagilitywork,andflexibility — gave me a clear, practical framework. It became the foundation of my exercise plan. I used it to structure my weekly training, build variety into my workouts and ensure I was addressing multiple aspects of movement.
From that base, I began setting goals and layering in events as a way to stay consistent and accountable.
Over the past few years, that approach led me to complete seven triathlons, eleven Spartan obstacle course races and three races up the Empire State Building stairs. These events weren’t about competition. They provided structure, measurable milestones and a reason to remain engaged over the long term. Training for events helped translate an abstract recommendation (exerciseisimportant) into a concrete, sustainable practice.
With each event, I gained confidence — not only in my physical capacity, but in my ability to influence my own trajectory. That confidence began to shape how I approached other aspects of living with Parkinson’s.
I took a broader focus on wellness. Again, Parkinson’s Foundation information played an important role, particularly around nutrition, sleep, stress management and overall lifestyle balance. None of these elements are cures, but together they help tilt the playing field in my favor. I became more intentional about what I eat, how I recover, how I manage stress and how consistently I support my body and brain. The goal wasn’t perfection; it was building habits that support resilience over time.
Advocacy followed. I became involved in efforts supporting the National Plan to End Parkinson’s Act, meeting with the staff of seven U.S. Senators. Three ultimately committed to supporting the legislation. That experience demonstrated how individual stories, shared clearly and persistently, can influence policy. It also reinforced my belief that advocacy isn’t limited to professionals — it’s accessible to anyone willing to engage.
At the same time, I became increasingly involved in Parkinson’s research. What began as curiosity developed into active participation. I enrolled in studies, learned directly from researchers and gained insight into how essential patient involvement is to scientific progress. Research provided clarity and purpose, and it led me to become both a Parkinson’s Foundation Ambassador and a Research Advocate — roles that enable me to help ensure patient perspectives are reflected in the work shaping future treatments.
Looking back, I realized I hadn’t just been responding to Parkinson’s. I had been building a framework for how to live well with it.
Once that became clear, I felt a responsibility to share what I had learned. It all led me to write a book, LivingParkinson’s, and to create livingparkinsons.comas a place to organize information, resources and lessons learned along the way. My goal was to document practical strategies — grounded in lived experience and supported by science — that together form the core of an actionable plan anyone can adapt. Rather than offering prescriptions or guarantees, the focus is on helping people take ownership of their disease and actively fight back in ways that fit their own circumstances.
This journey I’m on has been about agency. Parkinson’s changes life, but it doesn’t eliminate the ability to influence outcomes. Whether it’s exercise, wellness, education, advocacy or research participation, each step builds momentum.
Parkinson’s has altered my story, but it hasn’t determined its direction. My journey isn’t defined by a diagnosis — it’s defined by how I’ve chosen to respond. If sharing that perspective can help someone else take a more active role in their own journey, then the effort has been well worth it.
Help champion policy changes that make life better for people with Parkinson's. Get involved today.
For years, I lived with a secret. When you are diagnosed with Parkinson’s disease (PD), there is this common, almost overwhelming urge to hide it. Whether it’s the fear of not being accepted or the dread of people looking at you with pity, many of us fight to act “normal.” Trying to mask a diagnosis that has become a huge part of your life is exhausting. It’s hard to be your authentic self when you’re hiding.
I was diagnosed at age 51 in February 2021, right in the heart of the pandemic. At the time, I was working full-time as an educator, leading others through the trials of remote and in-person school. The diagnosis felt like a gut punch during an already impossible season. I kept my diagnosis a secret for over a year — I didn’t even tell my family. I had back surgery during the same time to relieve sciatica, which also caused me to have difficulty walking. This made it easier to hide my symptoms as the sciatic pain masked my rigidity.
Coming out of the pandemic and back into reality, the strain of hiding continued. Eventually, I began to let people in and felt a burden lift. I discovered that people are often far more supportive and less judgmental than I thought. Although I don’t tell everyone I meet that I have PD, I’m becoming more open about my journey, hoping that by sharing my story, I can help someone else live their authentic life a little easier.
Adapting and Moving
While Parkinson’s has affected my left side and made handwriting difficult, I haven't let it stop my voice. I’ve discovered that speech-to-text is a game-changer. It’s more efficient than my old way of writing, allowing my thoughts to flow quickly and freely.
I’ve also learned that movement is medicine. My mobility can feel constrained, so working out is a non-negotiable part of my day. If I skip a workout, I feel the difference. The breakthrough for me was finding a specific Parkinson’s exercise group. Not only has it greatly enhanced my physical ability to function, but it has provided me with a network of "warriors" who are on this same path.
The Power of the Tribe
What keeps me happy and hopeful? Connection. Spending time with family and friends is the best way to stay healthy, but connecting with my "PD tribe" is critical. There is a deep, unspoken understanding that exists between us. Attending the 2025 Moving Day Chicago was an uplifting experience — seeing so many people thriving and living well was the best kind of fuel for my spirit.
When I got a call to participate in the new Parkinson's Foundation PSA, I realized this was a chance to connect with even more people in the PD Tribe and help make others feel less alone.
My Advice: Find Your People
If you are new to this diagnosis, my biggest piece of advice is this: Find your people. Whether it’s an illness or any other life challenge, finding your tribe is essential. The bond you’ll form with those who truly understand your journey will give you a strength you didn't know you had.
Five years into this journey, I’ve learned that staying active — physically, mentally, socially and spiritually — makes all the difference. Don’t hide; reach out. There is so much life to live!
