December 11, 2025

@michaelokun

Are there metabolic signals of shrinking fat stores in Parkinson’s? Spoiler alert: YES. Metabolic refers to the chemical processes that allow cells to generate and use energy. Atsuhiro Higashi and colleagues describe in a new paper that just dropped in the Journal of Neurology Neurosurgery and Psychiatry that folks w/ Parkinson’s show a striking metabolic signature when they begin to lose body fat. Key Points: - Reduced glycolysis in Parkinson’s lowers lactic acid and succinic acid suggesting impaired carbohydrate energy pathways. - Increased ketone bodies and amino acid breakdown markers point to a shift toward lipid and amino acid utilization. - Lower body mass index (BMI) is tightly linked to higher ketone levels, reinforcing that fat loss is tied to this metabolic shift. My take: In my clinic, I am a broken record when 'advising people to stay 5lbs heavier rather than 5lbs lighter,' if you have Parkinson’s. The weight loss in Parkinson’s is an important challenge. Here are 5 points that resonated w/ me about this paper: 1- Weight decline in Parkinson’s frequently reflects fat loss rather than muscle loss. 2- A metabolic shift toward burning fats appears to emerge as the brain and body struggle to use glucose efficiently. 3- Higher ketone levels may be a sign that the body is compensating for impaired energy pathways. 4- Tracking metabolic markers may help identify folks at risk for nutritional trouble earlier in the disease. 5- Nutrition strategies that stabilize energy balance could one day be paired w/ therapies aimed at restoring metabolic health. https://jnnp.bmj.com/content/early/2025/11/30/jnnp-2025-336929 #parkinson #fixelinstitute #michaelokun