Carlos Jordão wrote:
> I had received a msg about the benefits of "fava beans" in PD, but I had a problem with my PC and this msg disapear.
> It it possible somebody send it again.
Carlos, here is the article, it's from the National Parkinson Foundation
website:
we have had numberous questions about fava beans. The following was
adapted from an article that appeared in the Journal Movement Disorders,
the official journal of the Movement Disorders Society
Fava Beans, A Natural Source of Levodopa - Prolongs “On”
Periods
in Patients with
Parkinson Disease
Adapted from an article by Hulya Apaydin, Sibel Ertan, Sibel
Ozekmekci
Istanbul University, Department of Neurology, Istanbul, Turkey
Appearing in Movement Disorders volume 15, page 164, 2000
Introduction
In 1913, Guggenheim identified the chemical levodopa in the
seedlings,
pods, and beans of Vicia
faba, commonly known as “broad bean” or fava bean. Fava beans are a
widely
cultivated vegetable
in the Mediterranean region. Its fresh green pods in the spring and also
dry seeds throughout the year
are consumed in Mediterranean cuisine. They are prepared by cooking
with
olive oil and traditionally
eaten after the main meal. Fava beans are regarded as being delicious,
especially when eaten with
yogurt.
Recently, in our practice in our Movement Disorders Clinic, several
patients with Parkinson
disease (PD) who have fluctuations described to us the beneficial effect
of
ingesting cooked fava
beans on their symptoms. These levodopa responsive patients reported
that
their “on” period was
prolonged after consuming a fava bean meal and stated that its effect
was
similar to that of Sinemet
(Merck Sharp and Dohme) or Madopar (Roche) (levodopa and benserazide).
There is precedent for this effect on Parkinson symptoms. Spengos
and
Cassilopoulos described
the antiparkinson effect of fava beans and others have corroborated this
finding. Rabey et al.
documented a substantial increase in levodopa plasma levels following
fava
bean ingestion that
correlated with substantial improvement in motor performance. In view of
our patients’ observations,
we elected to assess their responses to fava bean through an out
patient
open-label clinical trial.
Methods
The eight patients who previously had reported favorable effects
from
fava bean ingestion agreed
to participate in our trial. They were asked to ingest one standard
portion (approximately 250 grams
or 9 ounces ) of cooked fava bean at least twice a day without otherwise
altering their dietary habits.
The medical treatment was kept constant. Their predominant problems were
disabling motor
fluctuations and dyskinesia, despite appropriate treatment with levodopa
combined with other
dopamine drugs. These patients with PD were asked to complete a daily
diary recording the times
and durations of “on” and ”off” times during the 5-7 days of baseline
assessment (without fava bean
supplementation) and again corresponding to the 1-3 months during fava
bean administration.
Discussion
We observed a beneficial effect of fava beans in our patients
manifested
by strikingly prolonged “on”
time and shortened “off” time. Previously all these patients had been
administered higher doses of
levodopa up to 800-1000 mg per day, which failed to optimize their “on”
time and resulted in
dyskinesia. We were surprised by the reported magnitude of our patients’
responses given the fact
that previous trials of higher doses of levodopa seemed to provide no
further benefit.
These observations are not readily explained by assuming that fava beans
are simply a source of
levodopa. For example, one patient was able to experience a sustained
response from fava bean
meals ingested on alternate days. This is reminiscent of the
“long-duration
response” of synthetic
levodopa. Also, surprisingly, another patient experienced decreased
dyskinesia with the addition of
fava bean supplementation and reduction of levodopa. This patient had
previously failed to respond
satisfactorily to levodopa adjustments which would have accomplished the
same result if this was
simply a levodopa effect. A placebo effect may have contributed in this
trial but the magnitude of the
reported responses raises the possibility of other mechanisms. For
example,
the amino acid milieu
generated from broad bean administrations may favor the selective
transport
of levodopa across the
blood-brain barrier. Alternatively other products derived from fava
bean
may complement the
antiparkinson effect.
Our experience with fava beans complements that of Rabey who described
the acute responses
following a single administration of fava bean to six patients with PD.
Rabey noted motor
improvement of the same magnitude as seen following single doses of
levodopa. Rabey also
documented substantially increased plasma levodopa concentrations
following
fava bean
administration and the motor response tended to mirror these plasma
levodopa levels. In contrast to
Rabey we assessed the effect of prolonged fava bean meal
supplementation
as opposed to a single
administration. Elevation of plasma levodopa following fava bean
administration has also been
confirmed by Vered. Vered noted that 40 grams (1.5 ounces) of freshly
chopped fava bean
contained approximately 125 mg of levodopa.
Our patients ingested their broad bean meals garnished with yogurt,
which
is rich in protein. It is well
known that as a large neutral amino acid, levodopa competes with dietary
protein amino acid
breakdown products in crossing the brain-blood barrier: this competition
potentially results in reduced
levodopa motor effects. Nonetheless, our patients still experienced a
favorable motor response.
Some of our patients reported trying to cook and eat the dry seeds of
fava
beans but did not
experience any benefit. Burbano . showed that only the fresh green pods
of
broad bean were rich in
levodopa content, in contrast to that of dry matter, apparently
explaining
the observations of our
patients.
Comment
Reports from many, but not all, people, document the beneficial
effects of fava beans.
There’s a question about how much fava beans to eat. Vered documented
that 40 grams of fava
beans (1.5 ounces) is the equivalent of 125 mg of levodopa
(approximately
the same as one Sinemet
25/100 tablet). Yet the Turkish doctors advocated 250 grams of fava
beans (almost 9 ounces)
twice a day, the equivalent of 12 Sinemet (25/100) tablets. The reason
for the difference may have
to do with variations in the levodopa content of fava beans, differences
in
the way the fava beans are
prepared, and other factors we do not yet know. Our own recommendation
is
to use 3 ounces of
fava beans (110 grams) every other day. In addition to the levodopa
content, fava beans contain
fiber which helps with constipation.
We welcome comments.
================================================================
--
Kathrynne Holden, MS, RD
Author: "Eat well, stay well with Parkinson's disease"
"Constipation and Parkinson's" -- audiocassette & guidebook
"Guidelines for Medical Nutrition Therapy for Parkinson's
disease" & Risk Assessment Tools
"Risk for malnutrition and bone fracture in Parkinson's
disease," J Nutr Elderly. V18:3;1999.
http://www.nutritionucanlivewith.com/
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