Varying Protein Patterns in the Management of Parkinson’s Disease: Results of a Pilot Randomized Controlled Crossover Study

Objectives: People with Parkinson's Disease (PPD) take the drug Levodopa during the day, the absorption of which is limited by dietary protein.The aim of our study is to pilot the feasibility of a protein redistribution diet (PRD) versus protein consistent diet (PCD) on the sleep quality of PPD.Methods: A 5-week randomized crossover pilot trial was conducted with PPD to follow the PRD or PCD in random order.They followed each diet for two weeks, with a one-week washout period in the middle.PRD consisted of a low amount of protein (~10g) for breakfast and lunch and a high amount (!40g) of protein during dinner.PCD consisted an equal amount of protein in each meal.Participants received meal plans and one-on-one consultations with a registered dietitian.Participants wore Micro logger sleep watches and kept a log of sleep times every day.Participants' down time was manually marked on the Action-W 2.7.2 software using participants' sleep logs.Sleep efficiency (SE) and sleep onset latency (SOL) for each down period and participant averages were determined.Descriptive statistics and paired t tests were conducted to assess the difference in SE and SOL between two diets.A 90% confidence level and significance of p< .1 was used in this pilot study.Results: Twelve participants enrolled in the study, and 11 completed both diets and were included in the analysis.Participants were white, 63.6% male, age 65.4 AE 6.6 years, and with a mean BMI of 28.0 AE 2.8 at baseline (n11).The mean SE was 72.7% (SD14.5)during PRD and 72.6% (SD12.2) during PCD, which indicated no significant differences (p .973;CI: -3.6, 3.8).Paired t test showed a significant difference of mean SOL of 10.2 AE 7.5 minutes during PRD to 5.0 AE 4.1 minutes during PCD (p .038),with a mean change of 5.2 minutes (CI: 1.3, 9.2).Conclusions: This pilot study indicates that assessing sleep efficiency with a wearable watch during a diet trial was feasible, though, results suggest sleep efficiency may not be affected by either PRD or PCD.This finding may benefit nutrition recommendations as the diet that best suits the patients' needs can be prescribed without concern regarding sleep efficiency.More research is needed to explore the effects of diet on sleep onset latency.