The missing piece of the puzzle – The key role of the dietitian in the management of Parkinson’s disease

Dietitians provide medical nutrition therapy (MNT) to help manage various diseases by conducting assessments, interventions, and monitoring. MNT is crucial in chronic disease management like cancer, heart disease, and diabetes, but little focus has been given to its role in Parkinson’s disease (PD), where lifestyle interventions have traditionally emphasized exercise. However, MNT could play a vital role in managing PD symptoms and slowing disease progression, especially when combined with exercise. Research highlights the benefits of a healthy diet for potentially delaying PD onset and slowing progression. There’s a misconception that nutrition is only important in later PD stages, but evidence suggests that nutritional support can benefit people with PD (PwP) from diagnosis onward. Guidelines from organizations like the British Dietetic Association and the European Society for Clinical Nutrition recommend regular nutrition assessments for PwP at all stages of the disease. Still, dietitians are often not included in PD care teams. Incorporating dietitians into the multidisciplinary team (MDT) could enhance patient care, as dietitians provide personalized nutrition plans and counsel patients on managing motor and non-motor symptoms through diet. Non-motor symptoms (NMS), which affect most PwP, can worsen quality of life more than motor symptoms and include gastrointestinal issues, weight changes, osteoporosis, hydration challenges, and drug-nutrient interactions, all of which dietitians are uniquely equipped to address. Despite their importance, dietitians are rarely accessible to PwP. Studies show that most PwP have limited or no access to dietitian services, and only a small percentage of patients are asked about diet during routine care. There’s also a lack of PD-specific training for dietitians and other health professionals, and insufficient research on diet’s role in PD. In conclusion, greater inclusion of dietitians and targeted nutritional research could improve outcomes and quality of life for PwP across all disease stages. It is essential to develop and fund resources that integrate nutrition expertise into the MDT for PD, alongside advocating for more specialized dietetic training in PD care.