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An Informative Interview with Retired Dietitian, Kathrynne Holden

One question that get all the time, is how to manage their diet with medications, protein, and their Parkinson’s symptoms. Today, I am thrilled to bring you someone who knows Parkinson’s disease, was a registered dietitian, has written and advised extensively on the subject of Parkinson’s and diet (I am vegetarian and some of the following recipes are my guest’s suggestion), and now, will share her knowledge with you! I am so excited to present my interview with Kathrynne Holden:

Question 1:  What pointed your focus in nutrition to Parkinson’s? Was it a personal focus for a loved one or a need that you saw that had to be addressed?

I discovered a need that had to be addressed. In university, we studied medical nutrition therapy for heart disease, cancer, diabetes, stroke, and many other conditions; also food-medication interactions, of great importance for dietitians. After graduation I offered free counseling at our senior center, and a gentleman asked if there was any special diet for Parkinson’s disease. In seven years of study I had never heard of Parkinson’s disease, so I said I would do some research and get back to him. What I learned on Medline was staggering. There was a vast array of nutritional obstacles, including a major food-medication interaction: levodopa and protein. Yet there were no nutritional guidelines, either for patients or health professionals. I determined to narrow my focus to Parkinson’s disease alone. In the process, I coauthored research, wrote two manuals for dietitians as well as books for people with Parkinson’s and their families, and contributed to two physician’s manuals on Parkinson’s. Currently several of us are petitioning our parent organization, the Academy of Nutrition and Dietetics, to include Parkinson’s Disease as a condition requiring nutrition therapy. If successful, insurance coverage might be a result as well.

Question 2: What should every person with PD know about diet and this illness?

Karl: Maybe, you can list a few suggestions. For me, I noticed that my meds efficacy and my digestion improved from being a long-time vegetarian. I discovered that my pills activated faster when I took them with caffeine and that Not until I visited Hawaii did I find out that Macadamia nuts were a natural laxative. These were helpful tidbits that I had to find on my own.

Kathrynne: Karl, you’ve hit on one of the most important points. Medication effectiveness, digestion, and constipation are concerns for almost everyone. But the solutions can be quite different from one person to the next. And no one knows you as well as you do, so it’s important to be your own detective, and learn what works best for you. But here are some points to consider.

For constipation, besides fluids and a high-fiber diet, some foods that can help include, as you note, macadamia nuts,  kiwifruit, cashew nuts, cooked prunes, beets, flax seed, whole grains, and well-soaked chia seeds. You’ll need to experiment to find what works best for you.

For those using levodopa, some people report that taking it with a carbonated drink such as seltzer water speeds its absorption.

It’s also important to take levodopa 30 minutes before meals containing protein, so it can dissolve and enter the small intestine for quick absorption. Do not take it with, or right after, meals, because the stomach hasn’t emptied and the levodopa can’t pass through to the small intestine. Also, because Parkinson’s can slow the motion of the gastrointestinal tract, it can take 90 minutes or longer for the stomach to empty. If it doesn’t seem like your levodopa is effective, it may be due to slowed stomach emptying, a question to discuss with your doctor.

Also, when timing of meals and levodopa is complicated it can help to use quick-absorbing “liquid levodopa.” The Parkinson Foundation has instructions for making it. Go to Parkinson’s Disease Medications: https://f5h3y5n7.stackpathcdn.com/sites/default/files/attachments/Medications.pdf On page 73 find the “Formula for Liquid Sinemet.”

Question 3: We are all very different in our symptoms, medicines, and stages of illness but is there a universal truth that can benefit all our diets?

Yes. It’s important to realize the value of whole foods, as opposed to vitamin and mineral supplements. Parkinson’s is a stressful condition, and stress, along with other conditions, creates “free radicals” – very reactive particles that cause damage in the body and brain. But antioxidants stabilize free radicals, making them harmless.

Foods are a much better source of antioxidants than supplements, because foods contain substances that support each other and make the antioxidant more effective. For example, a Brazil nut contains vitamin E, which you can also get from a pill. But the Brazil nut contains the entire array of tocopherols and tocotrienols that make up vitamin E, and it also contains selenium, an antioxidant mineral that works with vitamin E, forming an antioxidant combination much more powerful than either one alone.

Vegetables, fruits, and nuts are rich in antioxidants, as well as fibers that both help prevent constipation and serve as food for our “friendly bacteria” known as the microbiome. Some good examples are berries, grapes, plums both fresh and dried (prunes), carrots, beets, blue corn, broccoli, pecans, bell peppers. Another excellent food is fatty fish, such as salmon, for omega-3 fatty acids that benefit the brain.

Here are links to recipes using some of these foods, by George Mateljian, whose work in nutrition is excellent, I’m a great fan:

Sautéed Vegetables with Cashews

http://whfoods.org/genpage.php?tname=recipe&dbid=229&utm_source=daily_click&utm_medium=email&utm_campaign=daily_email

Super Carrot Raisin Salad

http://whfoods.org/genpage.php?tname=recipe&dbid=164&utm_source=daily_click&utm_medium=email&utm_campaign=daily_email

Kiwi Salad

http://whfoods.org/genpage.php?tname=recipe&dbid=190&utm_source=daily_click&utm_medium=email&utm_campaign=daily_email

5- Minute Blueberries with Yogurt

http://whfoods.org/genpage.php?tname=recipe&dbid=286

5-Minute “Quick Broiled” Salmon


Question 4: It is believed that Parkinson’s disease begins in the gut. Have you seen diet make an impact on your client’s symptoms as well as progression?

It seems likely that PD may begin in the gut via the vagus nerve, which is a pathway from the digestive tract to the brain. In an analysis, researchers found that individuals whose vagus nerve was severed were at a much lower risk for developing PD. But scientists believe that there are likely to be other causes besides the gut-brain pathway. Some also theorize that unhealthy gut microbes may communicate to the brain by way of the vagus nerve, and that maintaining a healthy microbiome might lower risk of PD.

Regarding diet’s impact on PD, yes. Persons with PD who turn to wholesome, nourishing foods, have offered such comments as “digestion has improved,” “PD symptoms have lessened,” “depression has lifted.” It appears that with a good diet, medications can be more effective, and there is a general sense of improved well-being.

It’s possible that this could be due to nourishing the gut microbiome – the colony of microorganisms that live in our gastrointestinal tract. We now know that dietary fibers are food for these beneficial microbes, keeping them in good health. They can then communicate with our DNA to influence our health.  A healthy microbiome appears to help prevent the inflammatory bowel disease and irritable bowel syndrome that so often plague people with PD. It fights cancer, and may be a factor in preventing some types of depression. Some strains produce a dopamine byproduct that is associated with better mental health.

But they need to be fed the proper food – dietary fiber – in order to do their work. That’s why whole grains, vegetables, and fruits are so important, and why refined flour and sugar and highly-processed foods are so harmful – they leave nothing for the microbiome to feed on. I recommend eating a variety of whole grains, vegetables, and fruits, because each has different fibers, and the various types of microbes each need their own kind of fiber.


Question 5: What should we be avoiding in our diets to get the most from our food and to assist our medications?

I would avoid what I call “anti-foods” – those that are made from refined, highly-processed ingredients like white flour and sugar, hydrogenated fats, and artificial colorings and flavorings. Many of the ready-to-eat frozen meals and canned soups fall into this category.

Also, as much as possible I would avoid produce grown with herbicides and pesticides in favor of organically-grown produce. There is a growing association between pesticide and herbicide use and risk for Parkinson’s disease. Organic foods are often more expensive, but the Environmental Working Group posts a list of foods that are the most and least contaminated. See their website: https://www.ewg.org/foodnews/summary.php   Good food will never let you down.

My thanks to Kathrynne Holden for making this interview possible. I am very appreciative that she shared so much great information on diet and Parkinson’s disease with us! I hope you find this interview helpful. Eat Well!

Kathrynne Holden, MS, RD (retired)  is author of “Eat Well, Stay Well with Parkinson’s Disease,” “Cook Well, Stay Well with Parkinson’s Disease” and “Parkinson’s Disease and Constipation (CD)” See her blog at nutritionucanlivewith.com for more on nutrition for Parkinson’s disease.

It’s World Parkinson’s Disease Day!

 Today is special because it is about spreading awareness about Parkinson’s Disease! I am so proud and fortunate to be part of the Parkinson’s disease community and have the opportunity to share with you.
I am so grateful for all the incredible people and close friends that Parkinson’s has brought me. The strength and friendship of the community is so energizing and inspiring!
Today’s tee shirt is from the 2014 cruise to the Caribbean that my dear friends, Michael and Gretchen Church, organized and hosted! What a memorable event!

Parkinson’s Disease Awareness Month 2019

2019 Parkinsons awareness month shirt 1

Parkinson’s Disease Awareness – Together WE are ONE

The month of April is upon us and this means a month of Parkinson’s awareness! There is an array of events, fundraisers, lectures, walks, and more that are planned for April, around the world. If you or someone that you care about is looking for an event in your area, you may want to Google:  local Parkinson’s events in my area, or visit your favorite Parkinson’s organization/charity website to see what they have going on, or consult your local support groups, hospitals, clinics, to see what you might attend locally.

We have updated our events page on this website for the speaking engagements that Angela and I will be presenting this month. If you are in the Northern Virginia area and have an interest in hearing us talk, please visit the 2019 upcoming events page and see what talk you think might interest you. We look forward to seeing you at one of the events on our list of future events!

Watch for more upcoming events and updates! You may want to subscribe to our site, to get the latest post fresh off the press.


In my 30 plus years of dealing with Parkinson’s disease and attending numerous events, conferences, walks, lectures, World PD Congresses, I have amassed an extraordinary collection of Parkinson’s disease related tee shirts which I will commemorate and share with you this April. This first tee shirt is sort of a mystery, but I believe it was created by my dear friend and Parkinson’s advocate, the late James Trussell. He was a dear friend and is greatly missed. He gave so much to the Parkinson’s community!

The shirt speaks of unity and strength–what a perfect message to start Parkinson’s Disease Awareness Month!

Watch for more tee shirts from my collection, this month!

Building blocks for a future for better health!

Trust, faith, hope, and diligence are four key components to seeing your way through any health challenge. Personally, they have made my 30 years with Parkinson’s disease more than just sustainable. Living well with Parkinson’s disease takes a variety of skills that must be honed and used. Before I get to trust, let me express the essential weight that faith and hope play when facing illness.

Without faith and hope our internal drive shuts down and leaves us vulnerable to only worsen our condition. We all need to visualize a path for our future, whether it is a leap or a small step. Your path is yours alone and only you can determine the scope of your vision.

When I speak of trust, I mean the belief in oneself as well as believing in others. Trusting that if we follow our gut, listen to our inner voice, and do what we know in our head/heart is a big part of making a good decision. There is much more, though. When it comes to making an informed decision about your medical condition, it is best if you’ve done the research as well. You may want to consult those around you for their opinion.

Trusting your doctor’s decisions, his or her pharmaceutical suggestions, surgical outlook, or any other decision will require your educated consent. You have the free will to reject or accept your doctor’s suggestions. Trust can only go so far when questioning your doctor. You must weigh the pros and cons of the proposed medicines and possible procedures. Providing cogent reasons and facts for why you are adamant about going against a doctor’s wishes needs to be thought out and be thoroughly researched. Depending upon the severity of the recommendation, a second or third opinion may be needed, despite the trust.

Diligence means making use of your time and taking care of yourself. There are things that you can do for yourself that even your doctor can’t. Maintaining a healthy lifestyle and keeping a schedule take discipline but can be very helpful when structuring your day. If you take medicines every day, structure is crucial to stay on time when administering medicines.

There was a time when we didn’t question our doctor’s advice, but with greater access to information and a better understanding of therapies, nutrition, exercise, diet, meditation, reiki and more, there is real opportunity to work with your doctor. As a constant seeker of information about improving your condition, you become a resource for your doctor and are empowered with knowledge that may unveil new options for your future.

Conference Nirvana and The Real World!

In 2003, I attended my first Young-Onset Conference in Atlanta where I met some great people and made lifelong friends. In 2004, I was asked to join the planning committee right after the Minneapolis meeting. In 2005, I would help organize and arrange conferences each in a chosen city until 2008: Phoenix, Reston, Chicago, and Atlanta.  Attendance was strong, and the Conferences brought in people from all over the world. The Conference for many of us turned into a large family get together.

The events were not only planned by the committee, but each member would present at the Conference as well. We were encouraged to live by example and to motivate the crowd. Our dynamic group of people with Parkinson’s covered an array of topics of how to live well with the disease.

When you bring hundreds of people together with Parkinson’s disease (PD) in one place, everything Parkinson’s seems normal and the world outside our hotel seemed odd. A peace came over us, where explaining ourselves to why we were doing what we were doing wasn’t necessary. Parkinson’s was the normal for this closed and safe environment and we all understood one another. A symptom of the illness or a drug side effect needed no explanation, but if it did it wasn’t drudgery to relate.  An overwhelming feeling of belonging and being part of something that was changing people’s lives provided us an amazing opportunity. When the final day of the event came around, parting was hard for us all.

The medical information was helpful, but the living knowledge provided to us was empowering. What really made the difference in most of our lives was the freedom that we felt inside those walls and the relationships that we would take away. It takes a special event to recall so many joyous encounters around what could have been a maudlin event—but it was not.

The unity of these participants was unlike any other that I had ever seen. The newly diagnosed were being encouraged by those who had a little more experience with the illness. For many of the attendees this was there first conference devoted to Parkinson’s as well as the first time meeting another person with the disease. This was an important moment for thousands of people with Parkinson’s disease.

This was an event sponsored by a large foundation, organized largely by a committee of 7 or 8 Parkinson’s patients, which focused on educating, empowering, and enriching those diagnosed with PD. Most of the lectures were from those living with the disease and not those attempting to treat this disease. Who better to advise on how to live with an illness than those living with the experience?

There is a place for medical conferences where the program is filled with medical expertise and experts related to the illness of choice. Far too often, I see conferences about living well or living better, but the conference organizers neglect to include the ones who are living with the condition. The ones who are living well with the disease are the experts, in my opinion.

A doctor can tell you about research, medications, studies, and possible medical procedures, but they can’t tell you what it is to live inside our bodies. They can speculate and imagine, but it just isn’t the same. A conference for people with a specific illness, like PD, ought to be planned by the ones who understand it the most.

Expression Choices

Expression and making our voice heard is hard enough but if you throw in a neurological wrench like Parkinson’s disease, a whole host of challenges can arise. Some of us speak softly while others may find it difficult to form words or sentences. Our words are often judged be it vocabulary or elocution. But, real expression goes beyond the boundary of words as the transcendence of understanding relates to us through the mediums of photography, oils, pencil, music, film, video, and a host of other outlets.

How we interact with the world is only limited by our imagination. Through the medium of painting, viewers and appreciators experience the work at a gallery or museum, but this is limited access. Paintings gather deep and powerful feelings and yet limit a very particular sector of the overall population. Whether you are a viewer or creator of art, our understanding of the medium and the message make a difference in the impact. There is no doubt that the artistic personality of anyone stifled by illness is at a loss without the therapeutic reward of a creative medium.

Just as a dancer feels the urge to leap and twirl, those with limited mobility and restricted movement may need to express themselves in a manner beyond their media of choice. Bottled creativity may be wasted and untapped. The frustration and built up anxiety of sustaining our message or messages, only adds to feeding the powder keg. When done right, awareness and understanding can come about, through our expressions. Finding an outlet for any sensory message and making one’s “voice” heard is a human necessity, like breathing.

Photography, for over 40 years, besides the written word, has been a favorite medium of choice. Every photo that you see on this site, for the past 10 years was taken by me. Capturing a moment in my life or nature through photography is gratifying and almost Zen-like. When I find myself in a mountain valley or a sun-drenched beach, my focus becomes nothing but the beauty around me.

Those of us with limited options for expression must delve into exploratory mode to uncover the medium that we think fulfills the message that we mean to convey. This is art therapy. Offering creative solutions or even simple solutions can make a difference in a life.

 

Who is paying the price?

I found this quote that I wrote a year ago or so. I had put it aside to use for a later date, and now is the time to release it:

Adversity can bring us together, but it is love that can unite us.

Without love and compassion, there is no sealed deal. When both parties are empathetic of the other, there is understanding. Common ground and communication may commence when both parties identify a shared outcome. If one party is incapable of having empathy for the other party’s condition, negotiation becomes far more complicated.

There is far too much hate, anger, cruelty, pettiness, ignorance, violence, and greed in the world. Most of the world wants the same, or at least similar hopes for their future:

  •   Provide a safe place to live and maintain a household.
  •   Access to clean air, fresh water, good nutrition, health, education, and an opportunity to sustain those necessities.
  •   To provide for one’s family and feed, clothe, and educate them.

Some leaders and celebrities exposed to power find it intoxicating and become engulfed in the overwhelming high that comes with authority. At what cost and sacrifice do we make excuses for anyone in public who condones the torrent of hurt being inflicted on government workers, who are just trying to do their job? Our government is famous for negotiation, compromise, and making policy. A government shutdown is a breakdown in everything that the United States of America is based upon. Our mission has always been to try to be a model for the rest of the planet.

Hurting the poor, the sick, the elderly, and those workers living paycheck to paycheck only weakens our government and divides us even more. Creating controversy and misdirection hurts innocent families, be it democrat or republican, is a petty and a desperate act. I have yet to hear any understanding, compassion, or caring words to ease this humanitarian crisis.

 Love thy neighbor got lost somewhere and it is time to locate it quickly.

Health Union’s Living With podcast features Karl and Angela Robb

Angela and I have been contributing articles to ParkinsonsDisease.net for almost two years. Health Union (HU)’s mission is to inspire people to live better with challenging health conditions. The HU Living With podcast this week is from an interview we did last year at their headquarters.

You can find the podcast on:
Health Union Living With podcast

Health Union’s Living With podcast

In this podcast, we discuss relationships, living well with Parkinson’s disease, and a few tidbits that we have learned. Angela and Karl Robb have been married over 20 years and Karl has had Parkinson’s disease for over 30 years. Hear their outlook on illness and keeping positive.

It’s The Little Things That Aren’t So Little!

I had a conversation the other day with a good friend who had a hard time seeing eye to eye with me about this tragic government shutdown. I say tragic because during this time, those who are living paycheck to paycheck and those in need of medical care, families trying to pay their rent or mortgage, those who are unsure whether they can pay this month’s heating bill or pay their cat’s vet bill are struggling to get by only because our politicians are unable to relate to the families that they are hurting . For anyone just trying to put food on the table, the shutdown can only make life harder.

Appreciating those calm moments of the day, a good laugh, or even a brief nap, may seem simple daily occurrences that are the good stuff of life that we too often take for granted. Too often, we are waiting for something big to land in our lap, but while we are waiting, we miss some of the crunchy goodness. Simple pleasures are often the best.

Playing with your dog in the first snowfall of the season or watching a seagull soar are just two of the magical moments to savor, treasure, and truly appreciate. These are moments that cost nothing and are beyond any kind of currency.

There is a great deal of kindness out there out but much of it gets silenced by louder voices. Many of the soft voices may not get heard, at first, but in time, with commitment, can lead positive change. Loud and noisy can only do so much, but one soft voice only needs to spark one other person to go viral. When the mission is right, everything can fall into place. Kindness isn’t in short supply, it just may need to be cultivated.

Hardships, shocks, tragedies, disasters, illness, deaths, and life tests will be with the human race as long as we occupy the planet Earth. The question for all of us is how often do you take the time to recognize those not so little moments of your life? It’s so easy to get caught up in daily life and forget to be grateful for those simple and little things. Practice gratitude today!

Messages to Ponder for 2019

Inspiration can come in many forms, be it words, photos, audio, or video. In the coming year, this site will incorporate a wider use of these tools to add to the informational and entertainment aspects of this site. I truly hope that if you or someone you know is seeking information, support, inspiration, or a fresh perspective on Parkinson’s disease  and other chronic conditions, that you might consider sharing this website with those looking for articles on living with illness. The archives on this site contains nearly 400 articles to read on Parkinson’s and living with illness. If you are seeking more content, check out my recent articles on ParkinsonsDisease.net.

The following is a condensed video of many of my messages from my 12 Days of Christmas. I hope that you enjoy it and feel free to share it with anyone that you think might find benefit:

 

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