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Protein Intake and Treatment of Parkinson's Disease with Levodopa

List of authors.
  • Ismael Mena, M.D.,
  • and George C. Cotzias, M.D.

Abstract

We studied the influence of protein ingestion on the therapeutic efficacy and metabolic effects of levodopa in Parkinson's disease. Among eight patients, differing in symptomatic control, neurologic scores (normal 0, maximal 100) on 2 g of protein per kilogram of body weight were, at 8 a.m., 27.8 ± 2.1 (mean ± S.E.M.)and at 3 p.m., 46.7 ± 2.6(p < 0.001). On 10 g of protein per day scores were 24.6 ± 2.1 at 8 a.m. and 24.1 ± 2.7 at 3 p.m. In seven patients maintained on 0.5 g of protein per kilogram of body weight per day for two months to one year, levodopa requirements diminished progressively. Measurement of growth hormone in five patients off levodopa showed low constant levels without the normal fluctuations. Near normal patterns were found in six patients on levodopa, but tended to flatten out in six patients also taking a high protein diet. Although growth hormone affects calcium metabolism, hormone levelsand total body calcium showed no correlation in 15 patients taking levodopa. Ourfindings suggest that a low protein diet benefits patients with Parkinson's disease and with moderate neurologic instability.(N Engl J Med 292:181–184,1975)

Funding and Disclosures

Supported primarily by the U.S. Atomic Energy Commission, the National Institutes of Health (Project NS 11131–01) and the National Institute for Occupational Safety and Health, Public Service, U.S. Department of Health. Education, and Welfare (Grant OH 00313–10), co-ordinated by the American Health Organization (Project AMRO-4618); it was supported in part by The Charles E. Merrill Trust and the American Parkinson's Disease Association. A preliminary report was given at the Princeton Conference on Parkinson's Disease, April 11–13,1973.

* The effects of protein restriction were demonstrated by Rosemary Gellene, M.D., while she was at Brookhaven.

We are indebted to P.S. Papavasiliou, M.D., Jorge S. Mendez, M.D., and Simone Düby, M.D. for care of the patients, to S.H. Cohn, Ph.D., for total-body calcium measurements, to Keith Thompson and Howard Pate for statistical analyses, to Margaret Bell-Midura, R.N., for assistance with the scoring of the neurologic symptoms, to Geraldine Callister for assistance with compiling of the data, to Mrs. Margaret Dienes for assistance and to Frances Brown and Samuel T. Miller for determinations of growth hormone.

Author Affiliations

From the Medical Research Center, Brookhaven National Laboratory, Upton, L.I., NY 11973, where reprint requests should be addressed to Dr. Cotzias.

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