Stabilize Blood Sugar to Combat Fatigue in Parkinson’s

healthy homemade oatmeal porridge with nuts, banana, cinnamon and honey

Many people with Parkinson’s experience severe and sometimes debilitating fatigue. In fact, research shows fatigue in Parkinson’s is the single most important reason people cite when they apply for disability. Eating strategically to keep blood sugar steady throughout the day can help to keep fatigue at bay.

BLOOD SUGAR AND ENERGY LEVELS

Every cell in the human body relies on sugar (glucose) for energy. When blood sugar rises, the body produces a hormone (insulin) to ferry glucose out of the blood stream and into cells. When blood sugar drops, the body secretes different hormones to raise it. In this way, our blood-sugar and hormone levels are in constant flux, ensuring our cells’ access to glucose. But drastic swings in blood sugar levels sap us of energy, leading to lethargy and fatigue.

CARBOHYDRATE QUALITY AND THE GLYCEMIC INDEX

As we continue to learn about the role of nutrition in health, it has become clear that the quality of the nutrients we ingest – not just the amount – matters. While imperfect, the Glycemic Index can be useful for characterizing the nutritional quality of a given carbohydrate.

The Glycemic Index (GI) ranks carbohydrate-containing foods (and beverages) on a scale from 0 to 100 according to their potential to boost blood sugar. High GI foods cause sharp spikes in blood sugar and insulin levels. Foods with a low GI are generally digested and absorbed more slowly, and therefore cause a gentler rise in blood sugar and insulin. See how different carbohydrates stack up on this Glycemic Index Reference Chart.

High GI foods include starchy vegetables and highly processed carbohydrates (think: sugar-sweetened beverages, chips, white bread) – in short, the ones we already know aren’t beneficial for our health. By contrast, low GI foods tend to be fiber-rich fruits, non-starchy vegetables, legumes and minimally or un-processed whole grains.

ACTIONS YOU CAN TAKE

By making small and deliberate adjustments to your diet, you may be able to stabilize your blood sugar levels and get some of your groove back.

1. Incorporate low glycemic index foods into your diet

Reduce your intake of high GI foods in favor of whole fruits, vegetables, legumes and minimally processed grains. Try substituting brown rice for white, steel-cut oatmeal for instant and beans for potatoes. Or, if you’re having a high GI food – say, cornflakes or instant oatmeal – throw in a handful of berries to reduce its glycemic load.

2. Add protein to meals and snacks

Because protein slows the body’s absorption of carbohydrates, it helps level out blood sugar. Fish, lean meat, beans, eggs and low-fat dairy are all healthy protein sources. To incorporate more protein in your diet, top your salad with a hard-boiled egg or blend a little protein powder into your morning smoothie.

3. Be prepared

Healthy snacks help stabilize blood sugar between meals. Plan ahead to ensure you have access to healthy snacks when you need them. An apple, a handful of nuts or a cup of plain yogurt are all easy to have on hand, and portable for when you’re on the go.

Learn More About How Nutrition Affects Parkinson’s

A diet that’s rich in whole grains, lean protein, and fibrous fruits and vegetables is useful for fighting fatigue and may also reduce inflammation and oxidative stress, all of which help you live well today with Parkinson’s.

How have you found different foods affect your energy levels? Consider logging your diet and making notes about how you feel after eating and between meals. Let your experiences help guide you to make healthy modifications to your diet.

Download our Nutrition Worksheet and presentation slides about Nutrition & Parkinson’s  to stay informed.

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Comments (12)

Can’t forget to mention to be careful when incorporating protein into a Parkinson’s diet. Timing is everything. When my husband eats protein, he has to make sure it’s in the middle of each 4 hour round of meds (carb/levo). Otherwise, the protein will overtake the meds.

Thanks for commenting, Lydia. Protein consumption can affect the absorption of carbidopa/levodopa, but not any other Parkinson’s medications. However, you shouldn’t decrease your intake of protein since its essential in building muscle mass and strength. If you notice a delay in the medication delivery, try to develop a schedule of taking carbidopa/levodopa medication at least one hour before or after meals.

PD can slow digestion making the timing of protein absorption difficult to predict. My husband has great difficulty with protein blocking his meds. His solution is to delay eating protein until the evening meal.

Alex Reinhardt

Thanks for commenting, Carol. Protein can interfere with absorption of carbidopa/levodopa, but not other Parkinson’s medications. This may delay the onset of levodopa effectiveness, causing the benefits to take awhile to kick in or have a reduced effect on your motor symptoms. If you notice your medication absorption is significantly impacted, try to eat most of your protein at less active times of your day.

I’ve learned through trial and error that if I eat sugar and refined carbs I will pay for it the next day with a hollow feeling of bone-aching fatigue. I’m still learning how the GI index affects PD and my blood sugar levels. I’m usually much happier and energetic when I’m cutting out sugar from my diet.

It’s always beneficial to keep track of certain symptoms like fatigue and then going the extra mile to identify which foods/ingredients are contributors. You can keep a log of this by using our Nutrition Worksheet. We hope this helps!

I have PD — diagnosed a couple of years ago, AND most of my rectum is gone because of cancer surgery. Because of the latter, it can take a long time for me to void, requiring several trips to the toilet (docs call this “clustering”). I have noticed two things about my PD symptoms, especially tremor:

1. They seem to be worse when my rectum and/or colon just above rectum is/are full than when empty. I have tremor before voiding, then, afterwards, it seems to calm down. I have seen studies about intestinal events causing people to GET PD–that’s a big trend right now in academic neurology–but no articles about a full rectum making the IMMEDIATE SYMPTOMS worse.

2. When I eat sugary candy, or drink coca-cola, my tremor seems to get worse. Similarly, I have seen studies saying that type-2 diabetes can cause you to GET PD, but no studies saying that high blood sugar can make the IMMEDIATE SYMPTOMS WORSE.

Any comments?

Thank you, –Ted.

Hi Ted. Thank you for sharing your story with us. It sounds like you are having some success testing things that make your tremor better or worse. Food can be such powerful medicine. Here are a few articles that address the issues you mention:

https://www.ncbi.nlm.nih.gov/pubmed/27232063
https://www.ncbi.nlm.nih.gov/pubmed/27913126
https://www.movementdisorders.org/MDS/Scientific-Issues-Committee-Blog/The-Relationship-Between-Diabetes-and-Parkinsons-Disease.htm

In both instances, more studies need to be (and are being) done, but they are certainly interesting intersections to watch.

I hope that you continue to look for ways to improve your quality of life and live well with Parkinson’s.

In response to Ted’s comment, I’ve found my Parkinson’s symptoms also increase right before a bowel movement and alleviate shortly after. I’ve been chasing down the neurotoxin/Parkinson’s link when we found mold was setting off the Parkinson’s every time I inhaled it. A paper connecting olfactory and vagus nerve pathways and neurotoxins explained a lot, but again, nothing mentioned about the bowel connection. I’m theorizing it has to do with neurotoxins being reabsorbed in the bowel/colon, and triggering the symptoms all over again, and am trying Welchol to see if it helps prevent it while killing off candida overgrowth. Here’s hoping.

I’ve been struggling with hypoglycemia long before the Parkinson’s hit me. Does low dopamine lead to low blood glucose at all? Eating has been so difficult with this condition, especially with sluggish digestion. The gut/Parkinson’s link isn’t a surprise at all. There’s so much to understand just to regain health.

Hi Gabrielle – Thank you for reading. I did find something about dopamine and blood glucose level that might be helpful to you. https://www.sciencedaily.com/releases/2013/06/130610223722.htm. As you said, there is so much to understand just to regain health. It’s great that you’re working with your doctors to find the best solution for you. Cheers to living well in 2019!

Carolyn Stewart-Locke

I have had paralytic ileus since 2011, following radiation treatment for uterine cancer, and have taken Miralax twice a day since then. In August, 2018, I was hospitalized for a small bowel obstruction caused by surgical adhesions. The obstruction was resolved without surgery, but I was told I needed to be permanently on a low-fiber diet. It has been a very difficult process trying to eat somewhat healthy without including fiber. In January of this year I was diagnosed with Parkinson’s. I keep reading and hearing about the need to eat a healthy, i.e., fiber-rich diet, as a major component of managing Parkinson Disease. It’s very discouraging! Any suggestions on how to supplement my diet for optimal health?

Hi Carolyn – Thank you for reading. We have several articles on nutrition that you can find here: https://www.davisphinneyfoundation.org/?s=nutrition
Also, we’re doing a webinar all about nutrition with Dr. John Duda on Nov. 6 so be sure to register to that when we open it up. For all of our upcoming webinars, go here: https://www.davisphinneyfoundation.org/resources/webinars/

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