Diet Quality Leads to Lower Risk for Prodromal Parkinson Disease Features

Diet quality is associated with a lower probability of having prodromal PD features in Chinese adults.

Higher quality diets with increased fruit and vegetable intake correlate with a lower risk of developing prodromal features associated with Parkinson disease (PD) among Chinese adults, according to study findings published in Movement Disorders.

Researchers conducted a cross-sectional study, obtaining relevant data from 2 prospective cohort studies, Kailan Study I and II, which took place in Tangshan city in North China. They focused on data collected from 2014 to 2015 which incorporated dietary assessments and questions regarding prodromal symptoms of PD, identifying 71,640 eligible participants for their cross-sectional study.

Participants self-reported dietary intake using the food frequency questionnaire (FFQ) and dietary quality using the modified Alternative Healthy Eating Index (mAHEI) and the alternate Mediterranean Diet (aMED).

The researchers analyzed the correlation between diet and 5 prodromal features associated with PD. These 5 prodromal features included probable rapid eye movement sleep behavior disorder (pRBD), hyposmia, excessive daytime sleepiness, constipation, and depressive symptoms.

Eating healthily could be an important factor for PD early prevention.

Chinese adults whose diets ranked on the higher end of diet quality per the mAHEI were less likely to experience daytime sleepiness and constipation (P-trend <.05 for both). Better diet quality per the mAHEI also correlated inversely with having 2 or more prodromal PD features (odds ratio [OR], 0.64; 95% CI, 0.49-0.85), while lower quality diets correlated positively with 2 or more prodromal features. These participants were more likely to be older, women, and less likely to smoke.

Additionally, aMED scores marginally correlated with prodromal PD features (adjusted OR, 0.74; 95% CI, 0.55-0.98; P-trend =.09). Increased intake of fruits and vegetables and decreased intake of fruit juices and sugar-sweetened beverages correlated with lower risk of developing prodromal PD features.

“Better diet quality, as assessed by the mAHEI score and the aMED…was associated with a lower overall probability for having prodromal PD features, mainly pRBD, hyposmia, constipation, excessive daytime sleepiness, and body pain, in a Chinese population,” the researchers stated.

They also cautioned that prodromal symptoms do not always develop into PD.

Study limitations included the cross-sectional design, the small selection of food items and no miscellaneous dish in the Food Frequency Questionnaire, and lack of comprehensive prodromal feature screening. Additionally, results of this study are not generalizable outside of the Chinese adult population.

The researchers concluded that “Eating healthily could be an important factor for PD early prevention.”


Zhang X, Xu J, Liu Y, Chen S, Wu S, Gao X. Diet quality is associated with prodromal Parkinson’s disease features in Chinese adults. Mov Disord. Published online September 7, 2022. doi:10.1002/mds.29208