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Is underweightness still a major problem in Parkinson's disease patients?

European Journal of Clinical Nutrition volume 57, pages 543–547 (2003)Cite this article

Abstract

Objective: To evaluate the current rate of underweightness amongst Parkinson's disease (PD) patients at an Italian referral centre.

Design: Epidemiological study on consecutive patients presenting for the first time in a 16-month period.

Setting: Nutritional service of PD referral centre in Milan, Italy.

Subjects: Three-hundred and sixty-four PD patients diagnosed according to CAPIT criteria.

Methods: Anthropometric assessments: BMI and waist-to-hip ratio; evaluation of therapeutic physical activity (h/week).

Results: Three-hundred and sixty-four patients were included (180 female, 184 male), mean (s.d.) age 65.9 (8.9) y, mean (s.d.) duration of PD 10.6 (5.3) y; 134 patients (37%) were overweight and 92 (25%) were obese; 11 (3%) were underweight; 127 (35%) had normal BMI. No important differences in BMI according to sex and smoking status were observed. There was highly significant inverse correlation between duration of disease and BMI (P<0.001): mean (s.d.) duration of disease was 9.7 (4.7) y in overweight+obese patients, 11.1 (5.5) y in patients with normal BMI and 14.1 (7.2) y in underweight patients (P=0.0059). The waist-to-hip ratio was a cardiovascular risk factor in 47.7% of men and 73.8% of women. Mean (s.d.) therapeutic physical activity was 1.07 (1.59) h/week in overweight and obese patients vs 1.61 (2.04) h/week in patients with normal BMI (50.5% increase; P=0.03).

Conclusions: At present underweightness is uncommon in PD patients in Italy; this may be due to the increase in the prevalence of overweightness in the Italian population and to modern antiparkinsonian therapy.

Sponsorship: Fondazione Grigioni per il Morbo di Parkinson.

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References

  • Abbott, RA, Cox, M, Markus, H & Tomkins, A (1992). Diet, body size and micronutrient status in Parkinson's disease. Eur. J. Clin. Nutr., 46, 879–884.

    CAS  PubMed  Google Scholar 

  • Ahlskog, JE (2001). Parkinson's disease: medical and surgical treatment. Neurol. Clin., 19, 579–605.

    Article  CAS  Google Scholar 

  • Angeli, F (ed.) (2001). Indagine ‘Condizioni di salute e ricorso a servizi sanitari’ 1999/2000, [Investigation ‘Health conditions and usage of health services’ 1999/2000] Rome: National Institute of Statistics

    Google Scholar 

  • Beyer, PL, Palarino, MY, Michalek, D, Busenbark, K & Koller, WC (1995). Weight change and body composition in patients with Parkinson's disease. J. Am. Diet. Assoc., 95, 979–983.

    Article  CAS  Google Scholar 

  • Broussolle, E, Borson, F, Gonzalez de Suso, JM, Cayvialle, JA, Beylot, M & Chazot, G (1991). Increase of energy expenditure in Parkinson's disease. Rev. Neurol., 147, 46–51.

    CAS  PubMed  Google Scholar 

  • Durrieu, G, Llau, ME, Rascol, O, Senard, JM, Rascol, A & Montastruc, JL (1992). Parkinson's disease and weight loss: a study with anthropometric and nutritional assessment. Clin. Autonomic Res., 2, 152–157.

    Article  Google Scholar 

  • Jankovic, J, Wooten, M, Van der Linden, CH & Jansson, B (1992). Low body weight in Parkinson's disease. S. Med. J., 85, 351–354.

    Article  CAS  Google Scholar 

  • Jensen, GL, McGee, M & Binkley, J (2001). Nutrition in the elderly. Gastroenterol. Clin. N. Am., 30, 313–334.

    Article  CAS  Google Scholar 

  • Jost, WH (1997). Gastrointestinal motility problems in patients with Parkinson's disease. Drugs & Aging, 10, 249–258.

    Article  CAS  Google Scholar 

  • Langston, JW, Widner, H, Goetz, CG, Brooks, D, Fahn, S, Freeman, T & Watts, R (1992). Core assessment program for intracerebral transplantations (CAPIT). Mov. Disord., 7, 2–13.

    Article  CAS  Google Scholar 

  • Levi, S, Cox, M, Lugon, M, Hodkinson, M & Tomkins, A (1990). Increased energy expenditure in Parkinson's Disease. Br. Med. J., 301, 1256–1257.

    Article  CAS  Google Scholar 

  • Markus, HS, Cox, M & Tomkins, AM (1992). Raised resting energy expenditure in Parkinson's disease and its relationship to muscle rigidity. Clin. Sci., 83, 199–204.

    Article  CAS  Google Scholar 

  • Markus, HS, Tomkins, AM & Stern, GM (1993). Increased prevalence of undernutrition in Parkinson's disease and its relationship to clinical disease parameters. J. Neur. Transm., [P-D Sect]5, 117–125.

    Article  CAS  Google Scholar 

  • Mayeux, R, Denaro, J, Hemenegildo, N, Marder, K, Tang, MX, Cote, LJ & Stern, Y (1992). A population-based investigation of Parkinson's disease with and without dementia. Relationship to age and gender. Arch. Neurol., 49, 492–497.

    Article  CAS  Google Scholar 

  • Nozaki, S, Saito, T, Matsumura, T, Mitai, I & Kang, J (1999). Relationship between weight loss and dysphagia in patients with Parkinson's disease. Clin. Neurol., 39, 1010–1014.

    CAS  Google Scholar 

  • Perissinotto, E, Pisent, C, Sergi, G, Grigoletto, F & Enzi, G for the ILSA Working Group (2002). Anthropometric measurements in the elderly: age and gender differences. Br. J. Nutr., 87, 177–186.

    Article  CAS  Google Scholar 

  • Quinn, N (1995). Parkinsonism—recognition and differential diagnosis. Br. Med. J., 310, 447–452.

    Article  CAS  Google Scholar 

  • Richard, IH & Kurlan, R and the Parkinson Study Group (1997). A survey of antidepressant drug use in Parkinson's disease. Neurology, 49, 1168–1170.

    Article  CAS  Google Scholar 

  • Riley, D & Lang, AE (1988). Practical application of a low protein diet for Parkinson's disease. Neurology, 387, 1026–1031.

    Article  Google Scholar 

  • Schapira, AHV (1999). Parkinson's disease. Br. Med. J., 318, 311–314.

    Article  CAS  Google Scholar 

  • Scherer, TB, Betarbet, R & Greenamyre, JT (2001). The pathogenesis of Parkinson's disease. Curr. Opin. Invest. Drugs, 2, 657–662.

    Google Scholar 

  • Toth, MJ, Fishman, PS & Poehlman, ET (1997). Free-living daily expenditure in patients with Parkinson's disease. Neurology, 48, 88–91.

    Article  CAS  Google Scholar 

  • WHO (1995). Physical status: the use and interpretation of anthropometry, WHO technical report series no 854 Geneva: WHO

  • WHO (1998). Obesity: preventing and managing the global epidemic, WHO: Geneva

  • Zhang, ZX & Roman, GC (1993). Worldwide occurrence of Parkinson's disease: a review. Neuroepidemiology, 12, 195–208.

    Article  CAS  Google Scholar 

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Acknowledgements

We wish to thank Jennifer Hartwig, MD for drafting the manuscript.

Author information

Authors and Affiliations

  1. Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy

    M Barichella, A Marczewska, A Vairo, M Canesi & G Pezzoli

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  1. M Barichella
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  2. A Marczewska
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  3. A Vairo
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  4. M Canesi
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  5. G Pezzoli
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Contributions

Guarantor: M Barichella.

Contributors: BM and MA designed the study. PG critically reviewed the protocol and manuscript. BM and MA were the experts in clinical nutrition responsible for anthropometric assessments, recruitment of patients, data management and statistical analysis. VA was the dietician responsible for the collection of dietary data. CM was the neurologist responsible for the diagnosis of PD and neurological information.

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Correspondence to G Pezzoli.

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Barichella, M., Marczewska, A., Vairo, A. et al. Is underweightness still a major problem in Parkinson's disease patients?. Eur J Clin Nutr 57, 543–547 (2003). https://doi.org/10.1038/sj.ejcn.1601581

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  • DOI: https://doi.org/10.1038/sj.ejcn.1601581

Keywords

  • Parkinson's disease
  • nutritional status
  • BMI
  • anthropometry

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