Sharing my experience with a low-protein diet (LPD)

[Michel0220]

Hello everyone,

I wanted to share my experience with a low-protein diet (LPD) and its impact on my symptoms. Following the advice from my naturopath, I've found that reducing my protein intake earlier in the day (breakfast and lunch) has made a noticeable difference in the effectiveness of my C/L medication. This approach, known as protein redistribution, helps minimise competition for absorption in the gut, allowing more levodopa to reach the brain when I need it most. Practically this approach has substantially improved my energy levels in the afternoon and has allowed me to exercise at a higher level than before.

Some studies suggest that restricting protein intake to 0.8 grams per kilogram of body weight per day can help improve motor fluctuations. I personally aim for a maximum of 10 g of protein for breakfast (fruit salad and no-dairy fruit smoothie), 10 g for lunch (no added cream vegetable soups, gluten-free bread toasties with hummus etc) and 50 g for dinner (Mediterranean style generally). One challenge, of course, is managing to maintain your weight as you follow this diet but there are ways around this.

I would love to hear from other people on this forum who have experimented with LPD (this approach may not work for everyone...). I also encourage anyone considering this to discuss it with their healthcare provider or a registered dietitian to find what’s best for you.

[BlockRuys]

This is a known potential improvement to make Levodopa be absorbed more effectively. Basically, dietary protein and Levodopa are using the same transporter to get to your brain from your gut.

If you eat too much protein, then Levodopa will be absorbed less. Therefore, it is often recommended for the Levodopa consumers to redistribute their protein intake. If you do need more protein, then it is often advised to consume that late at night.

I have read a lot about this before and it works for many people. It is also a good way to make sure you don't need more Levodopa when it is not really necessary anymore. First, focus on getting it absorbed better.

[Parkie1]

I don't have an option on this ! I have had to eat that way for a few years now, because if I eat any protein with breakfast and lunch my madopar tab will not work. Even a non protein meal slows the absorption right down, so I have a problem maintaining weight. I eat protein only with evening meals, and stick to fish mostly as it seems to digest quicker than meat. Occasionally eggs. I'm inert for 3 hours unless I time the meal with one of the controlled release Madopar that I'm supposed to take overnight.

[Michel0220 in reply to Parkie1]

Thank you very much Parkie for sharing your experience. It validates the protein redistribution strategy that I have been following and that has improved my quality of life. I used to have eggs on avocado toasts for lunch (probably 30 g protein) and this was really impacting the efficacy of my Sinemet. Like you, I now eat most protein at night for dinner and try to stay below 10 g for lunch and breakfast.

[jeffreyn in reply to Parkie1]

Hi Parkie1, I'm having trouble understanding something you wrote in your Bio.

From your Bio: "[I] now take 50 mg levadopa every 90 minutes 9 times a day."

From my neuro:

Rule 1: After taking a dose of levodopa, wait at least 30 minutes before eating.

Rule 2: After eating, wait at least 60 minutes before taking a dose of levodopa.

Your protocol seems to allow no time at all for eating, without breaking rule 1 or rule 2.

When do you eat?

[Parkie1 in reply to jeffreyn]

I don't sleep more than 5 hours on average, so I get up at 6ish, drink a herbal tea, then breakfast (muesli and fruit)around 7am .1st dose at 7:30-8 depending on activities later. Lunch is 30 mins after 4th dose, so 5th is postponed because it's delayed anyway due to having eaten, so I have a longer " off" dinner is 6 -6:30ish with controlled release Madopar 100mg which isn't affected by food, and gives me 3 hours or longer. I'm allowed only 2 c/r in evening, but sometimes swap it for the 4th or 5th dose if I'm going out for lunch. I'm on Opicapone now,starting 2 weeks ago, so I can stretch the doses out to 1 hour 45 , afternoon doses 2 hours apart. I hope you can make sense of that ! It's a challenge, but I've become used to it because I'm limited due to metabolising levadopa very quickly.

[jeffreyn in reply to Parkie1]

Thanks very much for the detailed response.

"breakfast (muesli and fruit) around 7am .1st dose at 7:30-8"

I can't see your 1st dose being very effective if it is taken so soon after breakfast (rule 2).

[Parkie1 in reply to jeffreyn]

When l said around 7 it's very around ! I fit everything round activities each day, and also breakfast and first dose depend on whether my overnight c/r is still keeping me "on" when I get up. Nothing is regimented. If I feel hungry , which is often, I eat, and take the consequences, unless I have to be "on" because I have something to do. Sometimes I can't sleep so I get up and read, then go back to bed at 5 6,7 and get a bit of sleep. That's my lifestyle......but not by choice

[india245]

how are you maintaining your weight?

[Michel0220 in reply to india245]

AI generated but human verified 😀

Maintaining your weight on a low-protein diet can be a bit challenging, but with careful planning, it’s definitely achievable. Here are some tips to help you:

Focus on High-Calorie, Low-Protein Foods: Incorporate foods that are calorie-dense but lower in protein, such as avocados, nuts (in moderation), seeds, oils, and certain fruits like bananas and dates.

Increase Healthy Fats: Use healthy fats to add calories without increasing protein. Olive oil, coconut oil, and nut butters can help boost your energy intake.

Choose Carbohydrate Sources Wisely: Opt for whole grains, fruits, and starchy vegetables. Foods like rice, potatoes, quinoa, and oats can provide essential calories and nutrients.

Snack Wisely: Incorporate snacks that are high in calories but low in protein. Options include trail mixes (with low-protein nuts and dried fruits), smoothies made with fruit and healthy fats, and energy bars specifically designed for low-protein diets.

Monitor Portion Sizes: Keep an eye on your portion sizes, ensuring you're eating enough to meet your caloric needs while adhering to your protein restrictions.

Stay Hydrated: Sometimes thirst can be mistaken for hunger, so make sure you're drinking enough fluids. Consider adding smoothies or juices to your diet for extra calories.

[PalmSprings]

This has been a game changer for me. I intermittent fast. My first meal is around noon with no protein. I have dinner around 6 and I enjoy some protein at that meal. I am glad you have found something that works for you.

[Michel0220 in reply to PalmSprings]

Thank you very much PS! Hopefully this can help others on this forum.

[Rebtar]

I've been doing this- protein redistribution, evening only, for a while.Yes it helps meds work better, but i worry about not getting enough protein.

[Michel0220 in reply to Rebtar]

I understand, it is a fair concern. Best to coordinate with a dietician or health consultant. Personally, I am trying to compensate for the low protein diet for breakfast and lunch with more proteins in the evening (redistribution). And I am keeping an eye on my weight.

[Boscoejean in reply to Michel0220]

is you weight remaining stable?

[Michel0220 in reply to Boscoejean]

I lost one kilo and am keeping an eye on my weight, but the positive impact of the protein redistribution on my quality of life has been substantial.

[Esperanto]

Inadequate protein intake directly contributes to muscle loss, which impacts mobility, strength, and overall health, especially in older adults. Some guidelines recommend an increased protein intake of up to 1.5 g/kg/day to maintain muscle mass, which may conflict with protein restriction strategies for PD.

In fact, you've already identified the solution, Michel. You're describing a Protein Redistribution Diet (PRD), where protein is limited during the day and consumed mainly in the evening, rather than a strict Low Protein Diet (LPD) that restricts total daily intake. I also follow PRD, although I don't have to be as strict anymore since my L/C medication is minimal currently. Nevertheless, ensuring adequate protein intake is crucial for my overall health and particularly for my peripheral neuropathy (PN), as it supports muscle mass and promotes recovery processes

[stlewy in reply to Esperanto]

I'm pre-diabetic, fighting the disease for 20 years with exercising and dieting (no diabetic meds yet). My endocrinologist (diabetic doctor) recommends that I eat proteins and healthy fats (like avocado) to slow my carb consumption. I have not taken much C/L yet, but does the protein itself temporarily worsen PD symptoms, such as increased tremors?

[Esperanto in reply to stlewy]

Based on current understanding and my own experience, dietary protein is not generally thought to directly worsen PD symptoms, such as tremors, on its own. The main concern regarding protein and symptom fluctuations in PD is how it interacts with levodopa medication.

[Payparky in reply to stlewy]

I am on the carnivore 6 months. PD 7 yrs. DBS 2.3 years ago. I have seen benefits from this diet to where I am committed to it for life. Neuropathy actually gone. C/L reduced. No digestive issues. Brain fog gone. Sleep improved as long as I get to bed by 10:30. Hair growth. Fingernails strong. I take 50/200 ER c/l morning and 2 pm. Then 1 25/100 c/l if needed overnight. My cervical dystonia is improved. This may be due to my neurologist having lengthened the DBS pulse however.

[park_bear in reply to Payparky]

ER C/L works better with food.. I use this version exclusively and eat whatever I want whenever I want.

[Payparky in reply to park_bear]

Right! I have the same experience

[gomelgo]

What an inspiration! We need more stories like yours here. Thank you so much for sharing, and for your perseverance.