Understanding the food groups

Try to base your main meals on starchy foods. These contain fibre, calcium, iron and B vitamins, and will give you healthy calories.

You should choose higher-fibre wholegrain varieties, including: wholemeal and wholegrain bread, pitta and chapatti (flatbread), wholewheat pasta, brown rice, wholegrain breakfast cereals and whole oats. Potatoes (with the skin left on), yams, noodles, cornmeal and crackers are also examples of starchy carbohydrates.

Some people think that starchy foods are fattening, but they are actually low in calories, as long as extra fat is not added to them, for example by frying potatoes in oil or buttering bread.

They are also filling, which makes you less likely to snack between meals. A third of your plate should be made up of starchy foods.

Eating wholegrain versions of starchy food, such as wholemeal bread, can keep you fuller for longer and help ease constipation. This is a common problem among people with Parkinson’s.

Try to aim for 3 servings of milk or dairy foods every day to get the calcium you need.

A serving is:

• a third of a pint of milk
• 1 small pot of yoghurt
• a small matchbox-sized portion of cheese

If you’re trying to keep your weight down, reduced fat, light and diet versions of cheese, milk and yoghurt are available.

If you don’t like dairy, there are non-dairy sources of calcium, including:

• green leafy vegetables (for example spinach)
• tinned fish with soft bones (like sardines)
• pulses like baked beans and chickpeas
• dried fruit
• nuts and seeds like tahini paste (used in hummus)

If you prefer oat, nut, rice, soya, coconut or other plant-based milks, you should check they are fortified with calcium. You should also be aware that some plant-based milks may contain lower levels of protein.

Having Parkinson’s can make your bones more fragile and increase your risk of bone fractures if you fall. Vitamin D helps to keep your bones healthy and is needed to help your body absorb calcium.

Most of the vitamin D you need comes from the effect of sunlight on your skin but what you eat can also help, especially during the winter.

Good sources of vitamin D are:

• oily fish, such as salmon, sardines and mackerel
• some breakfast cereals
• egg yolks
• meat
• some powdered milks, milk and some yoghurts
• fortified margarines and spreads

People with Parkinson’s may have lower levels of vitamin D, which may be related to reduced bone density and an increased risk of fractures. It is important to get your levels tested by your GP. So it’s important to get your levels tested by your GP. See the Vitamins, food supplements and special diets page for further details.

Fruit and vegetables are a good source of vitamins, minerals and fibre.

Try to have at least 5 portions of differently coloured fruit and vegetables each day. These can be fresh, frozen, canned or dried.

1 portion of fruit and vegetables is:

• 1 banana
• 2 satsumas, kiwis, plums or clementines
• 2 large tablespoons of fruit salad or stewed fruit
• 1 tablespoon of dried fruit
• 1 small glass of unsweetened fruit juice, vegetable juice or
  smoothie (limit the amount to a combined total of 150ml a day)
• 1 dessert bowl of salad.

Remember, potatoes are a starchy food, so don’t count towards 1 of your 5 portions of fruit and vegetables a day.

Try to have 2 to 3 servings each day of meat or fish (or vegetarian/vegan alternatives).

This is the main source of protein in your diet and will help you maintain your muscles and strength. Good sources of protein include:

• meat
• white, oily fish
• eggs
• beans,
• pulses
• nuts

Lamb, beef, eggs, beans and pulses are also good sources of iron.

A healthy diet should contain 2 portions of fish a week. 1 of these weekly portions should be ‘oily’ fish. If you don’t eat fish, you can try including linseeds, soybeans, walnuts and their oils in your diet.

One portion of protein is:

• 2-3oz (60-90g) of meat or the size of a deck of cards
• 5oz (140g) of fish or the size of a the palm of a hand
• 3 heaped tablespoons of pulses (beans, lentils, chickpeas)
• 2 eggs
• 4 tablespoons of soya or tofu or a vegetable-based meat
  alternative (such as Quorn)
• 1 tablespoon or a handful of nuts

Red meat is a good source of protein, vitamins and minerals, but you should avoid eating too much red or processed meat.

Try to reduce the amount of red meat or processed meat to no more than 70g a day. Choose leaner cuts of meat and poultry, and remove any visible fat. Try to eat a variety of other high-protein foods, such as nuts and pulses.

It is very important to drink plenty of liquid. Try to drink 6 to 8 mugs or glasses each day. Any fluid counts towards this, including water, fruit juice, milk and squash.

If you have bladder problems, it is important not to cut down on the amount of fluid you drink. It is likely to lead to other problems, such as dehydration, constipation or worsened postural hypotension.

Find out more about looking after your bladder and bowels when you have Parkinson’s

There are other ways to increase your fluid intake, including:

• eating juicy fruits, such as melon, watermelon, grapefruit, grapes and berries
• having soups, custards, jellies and ice lollies

Some people with Parkinson’s have swallowing problems and may need to thicken drinks to make the liquid move more slowly in the mouth.

Sometimes this makes it harder for people to drink enough, which can lead to dehydration. If you’re experiencing problems eating or swallowing, you should seek a referral to a speech and language therapist.

Salt

Lots of people have too much salt in their diet. Extra salt often comes from processed food, such as soups, sauces, bread and ready meals.

One way you can eat less salt is to stop adding extra salt during cooking or at the dinner table. Try using herbs and spices for flavour instead.

You can look at the labels of food to assess how much salt it contains. Per 100g:

• 0g-0.3g of salt is a low salt content
• 0.3g-1.5g is a medium salt content
• 1.5g and above is a high salt content

Some people with Parkinson’s may have problems with low blood pressure (also called hypotension). It can be a symptom of Parkinson’s or it can be a side effect of the drugs used to treat the condition.

Salt causes your body to retain water, so reducing your intake can lead to decreases in your blood pressure. So, if you have low blood pressure, reducing your salt intake may not be advisable.

If you are concerned, speak to your GP, specialist or Parkinson’s nurse.

Fatty and sugary foods

Fatty and sugary foods, such as cakes, biscuits, and pastries, contain lots of calories, fat and sugar. Try to reduce how often you eat them, especially if you are trying to lose weight.

If you have high cholesterol or are diabetic, you should seek further advice from a dietitian.

Generally, unless your GP, specialist or Parkinson’s nurse have advised you not to drink alcohol, a small amount, such as a glass of wine or a beer every now and again, should not cause any problems.

People can respond to alcohol in different ways, so talk to your medical professional if you have any concerns.

Remember to take into account any medication you are taking for other conditions. Alcohol can also cause problems with low blood pressure.

Men and women shouldn’t drink more than 14 units of alcohol a week. Keep at least 2 days each week free of alcohol and avoid binge drinking.

For more information on drinking alcohol and alcohol units, visit the NHS website.