Diet Quality is Associated with Prodromal Parkinson's Disease Features in Chinese Adults

Xinyuan Zhang; Jipo Xu; Yesong Liu; Shuohua Chen; Shouling Wu; Xiang Gao

doi:10.1002/mds.29208

Diet Quality is Associated with Prodromal Parkinson's Disease Features in Chinese Adults

Mov Disord. 2022 Dec;37(12):2367-2375. doi: 10.1002/mds.29208. Epub 2022 Sep 7.

Authors

Xinyuan Zhang^{1

2}, Jipo Xu³, Yesong Liu⁴, Shuohua Chen⁵, Shouling Wu⁵, Xiang Gao^{1

6

7}

Affiliations

¹ Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA.
² Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
³ Department of Cardiology, Tangjizhuang Hospital Affiliated to Kailuan General Hospital, Tangshan, China.
⁴ Department of Neurology, Kailuan General Hospital, Tangshan, China.
⁵ Department of Cardiology, Kailuan General Hospital, Tangshan, China.
⁶ Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China.
⁷ Key Laboratory of Public Health Safety of Ministry of Education, Institute of Nutrition, Fudan University, Shanghai, China.

PMID: 36069990
DOI: 10.1002/mds.29208

Abstract

Background: The prodromal phase of Parkinson's disease (PD) is a critical window for prevention by modifying lifestyle factors. However, there is limited knowledge on how diet quality is associated with prodromal PD symptoms in Asian populations.

Objective: To examine the association between overall diet quality and prodromal PD features.

Methods: A total of 71,640 Chinese participants who were free of PD were included in this cross-sectional study. Diet quality was assessed using the modified Alternative Healthy Eating Index (mAHEI) and alternate Mediterranean Diet (aMED). Five prodromal features including probable rapid eye movement sleep behavior disorder (pRBD), hyposmia, excessive daytime sleepiness, constipation, and depressive symptom were measured using validated questionnaires. Logistic regression was used to calculate the odds ratio (OR) for having a combination of prodromal PD symptoms (1 and 2+ symptoms vs. 0 symptoms), adjusting for age, sex, lifestyle factors, total energy intake, and other potential confounders.

Results: In the multivariable-adjusted model, the OR for having 2+ versus 0 prodromal PD features was 0.64 (95% confidence interval [CI]: 0.49, 0.85) comparing the highest versus the lowest mAHEI diet quality quartiles with a significant inverse trend (P-trend = 0.003). For individual prodromal PD features, better diet quality, as assessed by the mAHEI, was associated with lower odds of having excessive daytime sleepiness and constipation (P-trend < 0.05 for both). We observed a marginally significant association between aMED and prodromal PD features (adjusted OR comparing the extreme quartiles = 0.74; 95% CI: 0.55, 0.98; P-trend = 0.09).

Conclusion: Better diet quality, as assessed by the mAHEI and the aMED, was associated with lower probability of having prodromal PD features in Chinese adults. © 2022 International Parkinson and Movement Disorder Society.

Keywords: Alternative Healthy Eating Index; Parkinson's disease; diet quality; prodromal Parkinson's disease.

MeSH terms

Adult
Constipation
Cross-Sectional Studies
Diet, Mediterranean*
Disorders of Excessive Somnolence* / complications
East Asian People
Humans
Parkinson Disease* / complications
Parkinson Disease* / diagnosis
Prodromal Symptoms
REM Sleep Behavior Disorder* / complications