TY - JOUR
T1 - Amount and distribution of dietary protein affects clinical response to levodopa in parkinson’s disease
AU - Carter, J. H.
AU - Nutt, J. G.
AU - Woodward, W. R.
AU - Hatcher, L. F.
AU - Trotman, T. L.
PY - 1989/4
Y1 - 1989/4
N2 - Reducing dietary protein improves the effectiveness of levodopa (LD) but the most effective distribution of a low-protein diet (0.8 g/kg) is unclear. We compared a 1.6 g/kg protein diet, a 0.8 g/kg diet with protein evenly distributed between meals, and a 0.8 g/kg diet with protein restricted to the evening meal in 5 parkinsonian patients with motor fluctuations. We monitored clinical response, plasma LD, and plasma large amino acids (LNAAs) hourly throughout the day. Mean “on” times were 51% (1.6 g/kg diet), 67% (0.8 g/kg evenly distributed), and 77% (0.8 g/kg restricted). Hourly averages of plasma LD did not differ between the diets. The mean plasma LNAAs were 732 nmol/ml (l.6 g/kg diet), 640 (0.8 g/kg distributed), and 542 (0.8 g/kg restricted), and the diurnal pattern reflected the distribution of protein intake. In conclusion, the amount and distribution of dietary protein affect clinical response to LD. These effects are not related to LD absorption but are explained by the variation in plasma LNAAs.
AB - Reducing dietary protein improves the effectiveness of levodopa (LD) but the most effective distribution of a low-protein diet (0.8 g/kg) is unclear. We compared a 1.6 g/kg protein diet, a 0.8 g/kg diet with protein evenly distributed between meals, and a 0.8 g/kg diet with protein restricted to the evening meal in 5 parkinsonian patients with motor fluctuations. We monitored clinical response, plasma LD, and plasma large amino acids (LNAAs) hourly throughout the day. Mean “on” times were 51% (1.6 g/kg diet), 67% (0.8 g/kg evenly distributed), and 77% (0.8 g/kg restricted). Hourly averages of plasma LD did not differ between the diets. The mean plasma LNAAs were 732 nmol/ml (l.6 g/kg diet), 640 (0.8 g/kg distributed), and 542 (0.8 g/kg restricted), and the diurnal pattern reflected the distribution of protein intake. In conclusion, the amount and distribution of dietary protein affect clinical response to LD. These effects are not related to LD absorption but are explained by the variation in plasma LNAAs.
UR - http://www.scopus.com/inward/record.url?scp=0024507807&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024507807&partnerID=8YFLogxK
U2 - 10.1212/wnl.39.4.552
DO - 10.1212/wnl.39.4.552
M3 - Article
C2 - 2648188
AN - SCOPUS:0024507807
SN - 0028-3878
VL - 39
SP - 552
EP - 556
JO - Neurology
JF - Neurology
IS - 4
ER -