Hi Camilla,
Your questions are excellent, but as usual, no quick, easy answers. I'll
do the best I can, though; let me know if you need more clarification

> I checked your book, and couldn't find the recommended
> amounts of vitamins C and E for PWPs

The RDAs are currently undergoing some changes. At the time I wrote the
book, for example, I knew B vitamin recommendations would be changed
somewhat, but they hadn't been issued yet. I expect to issue a revised
version of the book in about 2 years when the RDAs are completely
updated, and there is more research available about various nutrient
needs in PD.

> wondering if Peter gets enough in the supplements he takes, as I'm sure his
> diet is inadequate alone. Here are the levels:
>
> Multi-vitamin for "mature" folks:   C = 90 mg   E = 60 i.u.
> Extra supplements                        500 mg      400 i.u.
>                                _______  _______
>                                   590 mg             460 i.u.
>
> I have always been told that any *excess* C is excreted. But  also have
> heard there may be a danger in *too much* E.   Can you clarify?

As far as we know at this time, 200 mg of vitamin C appears to be the
maximum amount that we can benefit from. Unless Peter's doctor
recommends more for some reason, I generally advise against more than
200 mg. It's true that excess vitamin C is excreted (it's a
water-soluble vitamin), however, it can potentially increase iron
absorption to undesirable levels. Iron is an oxidant, and excess iron
may be implicated in cancers and heart disease, as well as other
conditions. With regard to iron deposits in the substantia nigra,
dietary iron is probably not a factor, but excessive amounts could be
undesirable for PWP.

Regarding vitamin E, most experts agree that 400 IUs is safe and some
say up to 800 IUs is safe and effective. A caution is that vitamin E has
blood-thinning properties; people using blood thinners such as aspirin
or coumadin or those with a family history of hemorrhagic stroke should
be aware of this and should consult with their doctor regarding a safe
amount of vitamin E.

> alerting me to the need to read labels for amounts
> of carbohydrates  VS  protein, so as to try to get a 7:1 ratio in regular
> meals, without having to buy the special products that are formulated that
> way.  For example, when Peter wants a chocolate Ensure, with 9 grams
> protein and 42 grams carbo., I know I must add carbo (usually fruit and
> bread) to get a total of about 63 g. carbo.

That's great; and powdered Carnation Instant Breakfast combined with
Rice Dream or soy milk will work well for most people, too, and is much
cheaper than Ensure. Note: it does contain a small amount of milk
protein; people who are very sensitive to milk protein may not be able
to use CIB, even when using a milk substitute.

> I wonder if PWPs in hospitals and nursing homes are able to watch the
> balance in this way?  Is that part of the educating you are doing, trying
> to reach hospital dieticians?

At this time, there is very little or no information available to
clinical dietitians, home health agencies, or long-term-care or
assisted-living residences. The study I completed, as well as the
professionals' manual I'm currently writing, will be available to health
professionals, and hopefully will spur further research and encourage
better meal planning. Both are designed to raise awareness and make more
information available to dietitians, nurses, aides, and physicians who
work with PWP.

I also offer a seminar for health professionals, providing more indepth
information about the special nutrition needs of PWP; and I hope to have
available audio cassette tapes by the end of next year. Although
nutrition is just one aspect of PD that needs to be addressed,
increasing awareness in one area has a "trickle-down" effect to other
areas.

My very best regards,
Kathrynne

--
Kathrynne Holden, MS, RD
"Nutrition you can live with!"
Medical nutrition therapy
http://www.nutritionucanlivewith.com/
Tel: 970-493-6532 // Fax: 970-493-6538
"If we knew what it was we were doing,
it would not be called research,
would it?" -Albert Einstein