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I agree this is an excellent article, don't know who the author is, but I do have one important addition -- people should ask for a referral to a registered dietitian for help with dietary adjustments. Talking it over with the physician is not sufficient, they are not trained to perform nutrition assessments nor to manage the nutritional complications of Parkinson's disease. If not carefully managed, protein restriction can lead to hypoproteinemia, illness, hospitalization, and possibly death. Best, Kathrynne YoungPD I&R wrote: > > Does anyone know where this great article may have come from? > > Diet And Sinemet: > What's The Connection? > > Have you ever wondered why some medicines work best when taken with meals, > others when taken without any food or drink, and still others are unaffected > by what or when you eat? One reason is that different medicines are absorbed > into your bloodstream in different ways. Sinemet (carbidopa/levodopa), > unlike some other medicines, is not absorbed into the bloodstream from the > stomach. It is absorbed from the small bowel after the stomach empties its > contents there. Anything that delays the emptying of your stomach into your > small bowel can reduce the amount of Sinemet that is absorbed into your blood > and transported to your brain. Also, certain foods, such as those that are > high in protein, contain substances that actually compete with Sinemet for > entry into the brain. When less Sinemet gets to your brain, poor symptom > control results. > Because diet can reduce the effectiveness of your Sinemet therapy, doctors > sometimes suggest dietary changes that help ensure consistent levels of this > medicine in your system. The need for these changes must be evaluated along > with the need for a well-balanced diet that allows you to maintain an ideal > body weight. For example, to maintain an appropriate level of protein in > your diet but keep it from interfering with your medication, your doctor may > suggest: (1) restricting your protein intake if it is higher than the > recommended daily allowance, (2) distributing it more evenly throughout the > day, or (3) restricting it to the evening meal to make sure that you get the > full benefit of your medication during the day. > It is especially important to discuss diet with your doctor if you are > experiencing changes in the control of your symptoms throughout the day, or > if you've noticed that your ability to function seems to be affected when you > eat certain foods. These are signs that your diet is interfering with the > absorption of your medication, and some adjustments may be needed. > If you are taking Eldepryl (selegiline hydrochloride) Capsules along with > Sinemet, it's helpful to know that there are no specific dietary restrictions > associated with taking them at the recommended doses of a 5-mg capsule with > breakfast and a 5-mg capsule with lunch. Unlike some similar medicines, > Eldepryl Capsules at recommended doses work on one specific enzyme, and are > therefore rarely affected by foods that contain a substance called tyramine, > like some fermented cheeses and red wines. > > Please contact Susan Reese or Judy Wilson at the APDA Young Parkinson > Information and Referral Center at 1-800-223-9776, if you know the source of > this letter. > > Thanks -- Kathrynne Holden, MS, RD Medical nutrition therapy Author: "Eat well, stay well with Parkinson's disease" "Parkinson's disease: assessing and managing unique nutrition needs" http://www.nutritionucanlivewith.com/