Mediterranean Diet Adherence in People With Parkinson's Disease Reduces Constipation Symptoms and Changes Fecal Microbiota After a 5-Week Single-Arm Pilot Study
Open accessAbstract
Introduction: Non-motor symptoms of Parkinson's disease (PD) such as gastrointestinal (GI) dysfunction are common, yet little is known about how modifying dietary intake impacts PD symptoms. The aim of this study in individuals with PD was to determine whether a Mediterranean diet intervention is feasible and affects GI function, intestinal permeability and fecal microbial communities. Methods: A single-arm, 5-week Mediterranean diet intervention study was conducted in eight people with PD. Daily and weekly questionnaires were administered to determine changes in GI symptoms. Urine and stool samples were collected at baseline and after 5 weeks to assess intestinal permeability and fecal microbial communities. Additionally, live-in partners of the participants with PD were matched as controls (n = 8) for baseline urine and stool samples. Results: Participants with PD increased intake of Mediterranean diet based on adherence scores from baseline to week 5 (4.4 ± 0.6 vs. 11.9 ± 0.7; P < 0.01 with >10 representing good adherence), which was linked with weight loss (77.4 kg vs. 74.9 kg, P = 0.01). Constipation syndrome scores decreased after 5 weeks (2.3 ± 0.5 vs. 1.5 ± 0.3; P = 0.04). Bilophila, was higher at baseline in PD (0.6 ± 0.1% vs. 0.2 ± 0.1% P = 0.02) and slightly decreased after the diet intervention (0.5 ± 0.1%; P = 0.01). Interestingly, the proportion of Roseburia was significantly lower in PD compared to controls (0.6 ± 0.2% vs. 1.6 ± 0.3%; P = 0.02) and increased at week 5 (0.9 ± 0.2%; P < 0.01). No differences were observed for markers of intestinal permeability between the control and PD groups or post-intervention. Conclusions: Short-term Mediterranean diet adherence is feasible in participants with PD; correlated with weight loss, improved constipation, and modified gut microbiota. Clinical Trial Registration:ClinicalTrials.gov, identifier: NCT03851861.
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The consumption of fiber and sugar has been linked to key gut pathways implicated in PD pathogenesis, including microbial diversity, SCFA synthesis, and intestinal luminal integrity.
“The consumption of fiber and sugar has been linked to key gut pathways implicated in PD pathogenesis, including microbial diversity, SCFA synthesis, and intestinal luminal integrity [183, 184].”
From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [184]
The Introduction links dietary fiber to short-chain fatty acid production and intestinal barrier function, and associates Mediterranean-diet adherence with greater microbial richness. It does not link ordinary sugar consumption to those pathways; the sugars discussed in the Methods and Discussion are administered as probes of intestinal permeability, not studied as dietary intake. The Discussion also reports no change in microbiota diversity or permeability ratios after the intervention. (LLM, conf=0.87)
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Self-citation
- Authors
- Rusch, C., Beke, M., Tucciarone, L., Nieves, C., Ukhanova, M., Tagliamonte, M. S., Mai, V., Suh, J. H., Wang, Y., Chiu, S., Patel, B., Ramirez-Zamora, A., & Langkamp-Henken, B.
- Affiliations
- University of Florida Health (US)
- University of Florida (US)
- Corresponding author
- Rusch, Carley
- ORCID
- Venue
- Frontiers in Neurology
- Publisher
- Frontiers Media SA
- Published
- 2021-12-23
- Volume
- 12
- Pages
- 794640-794640
- ISSN
- 1664-2295 (ISSN-L)
- PMC
- PMC8733603
- OpenAlex
- W4200293414
- Cited by
- 63
- References
- 58
- Citations by year
- 2026: 14 · 2025: 16 · 2024: 22 · 2023: 4 · 2022: 7
- FWCI
- 7.15
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Food and Agriculture (Hatch project FLA-FOS-005636)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- Parkinson's disease, Mediterranean diet, dietary adherence, constipation, gut microbiota, intestinal permeability, gastrointestinal dysfunction, non-motor symptoms, weight loss, Roseburia, Bilophila, dietary intervention
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