Although dopaminergic therapy, particularly the medication levodopa, can be quite effective for treating Parkinson’s Disease, the efficacy can widely vary from person to person. But a NORC grant awarded to a fellow in The UAB/Lakeshore Research Collaborative is looking to shrink that gap.
Dr. Christine Ferguson was recently awarded a pilot grant from the UAB Nutrition Obesity Research Center Pilot and Feasibility Program to study protein patterns for optimizing sleep and preservation of skeletal muscles in the management of Parkinson’s. Staying true to the mission of The Collaborative, Ferguson is bringing together skeletal muscle and movement disorder experts Dr. Anna Thalacker-Mercer, who will be new to Parkinson’s research, and Dr. Amy Amara, who will be new to dietary patterns in Parkinson’s.
“As a dietitian, I knew about this medication and that it’s effective for a lot of people – not everyone, but a lot – but I’ve also heard about this interaction with dietary protein,” Ferguson said.
Essentially, levodopa and dietary protein use the same transporter to be absorbed by the small intestine, but dietary protein is preferable, so for many who take levodopa, it gets excreted as waste, leaving them with motor fluctuations and other symptoms common to Parkinson’s.
Therefore, the typical protocol for people taking levodopa is a protein redistribution diet – less than 10 grams of protein while taking medication during the day and more than 70 grams during their evening meal.
“The thought behind that is, ‘Let’s limit our protein consumption during the day, but we want to make sure you meet your protein needs, so after your evening meal you’re going to consume all your protein,’” Ferguson said.
However, Ferguson said from her experience working with the aging population that older adults can only absorb 20-30 grams of protein per meal, which becomes a big problem with the average age of Parkinson’s patients being over 60.
“So, how does that impact their skeletal muscle, how does it impact there muscle function, their muscle strength, and all of that,” Ferguson said. “Is it a problem, or is it not? That’s what we’re trying to figure out.”
Furthermore, the grant aims to study the impact on sleep as proteins are the building blocks for amino acids, which are known to negatively impact sleep quality if disrupted. For this, the team will analyze diet and body composition records collected from a study by Dr. Amara on sleep quality in people with Parkinson’s.
The second part of the Ferguson’s grant proposal funded is a five-week study comparing a protein redistribution diet with a protein consistent diet. The first two weeks will have participants split into a control group of the redistribution diet and the other group taking the consistent diet. The third week will be a “wash-out week” in which participants resume normal habits. Then, participants will flip groups for the final two weeks – redistribution group now takes consistent diet and vice versa.
The team will monitor participants’ sleep quality, physical activity, and blood biomarkers in the metabolism. Participants will come out for four study visits.
Ferguson said because this is a pilot study, they won’t necessarily know which diet is best for which people, but she hopes this preliminary data will lay the groundwork for a larger-scale, NIH-funded study to get to the bottom of the protei patterns.
“In my experience, working with people with Parkinson’s, it can be really frustrating to take medications and to still experience all these side effects, so if there’s a way we can target this with diet, I’m hoping it can improve their quality of life."