Protein Intake and Treatment of Parkinson's Disease with Levodopa

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Abstract
We studied the influence of protein ingestion on the therapeutic efficacy and metabolic effects of levodopa in Parkinson's disease. Among eight patients, differing in symptomatic control, neurologic scores (normal 0, maximal 100) on 2 g of protein per kilogram of body weight were, at 8 a.m., 27.8 ± 2.1 (mean ± S.E.M.)and at 3 p.m., 46.7 ± 2.6(p < 0.001). On 10 g of protein per day scores were 24.6 ± 2.1 at 8 a.m. and 24.1 ± 2.7 at 3 p.m. In seven patients maintained on 0.5 g of protein per kilogram of body weight per day for two months to one year, levodopa requirements diminished progressively. Measurement of growth hormone in five patients off levodopa showed low constant levels without the normal fluctuations. Near normal patterns were found in six patients on levodopa, but tended to flatten out in six patients also taking a high protein diet. Although growth hormone affects calcium metabolism, hormone levelsand total body calcium showed no correlation in 15 patients taking levodopa. Ourfindings suggest that a low protein diet benefits patients with Parkinson's disease and with moderate neurologic instability.(N Engl J Med 292:181–184,1975)