Healthy diet, physical activity linked to lower mortality rate in adults with PD
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Healthy dietary habits and an active lifestyle were associated with a lower rate of all-cause mortality in adults with Parkinson’s disease, according to a study published in JAMA Network Open.
“Lifestyle behaviors, including diet and physical activity, have been associated with the risk of developing Parkinson’s disease, the second most common neurodegenerative disease,” Xinyuan Zhang, PhD, of the department of nutritional sciences at Penn State University, and colleagues wrote. “Few prospective studies have assessed the combined outcome of diet and physical activity associated with all-cause mortality, and none of these studies specifically focused on individuals with PD.”
Seeking to examine this association in adults with PD, researchers analyzed 652 male participants (median age at diagnosis, 73.4 years) in the Health Professionals Follow-up Study from 1986 to 2012 and 599 female participants (median age, 71.9 years) in the Nurses’ Health Study from 1984 to 2012. Researchers measured pre-diagnosis diet quality using the Alternative Healthy Eating Index (AHEI) and physical activity via metabolic equivalent task (MET) hours per week, using data from questionnaires administered every 2 to 4 years.
The primary outcome was mortality through 2018. Researchers used Cox proportional hazards regression models to estimate the association of diet and physical activity with mortality individually and jointly, adjusting for age, total energy intake, caffeine intake and other lifestyle risk factors.
According to results, 942 participants (529 men) died during 32 to 34 years of follow-up. Researchers reported an inverse association between pre- and post-diagnosis diet and mortality risk, with a 0.69 adjusted HR of the highest AHEI quartile (95% CI, 0.56- 0.85) for pre-diagnosis analyses and 0.57 (95% CI, 0.42-0.78) for postdiagnosis analyses. Similarly, the HR for cumulative mean MET hours per week in the pre-diagnosis analyses was 0.71 (95% CI, 0.57-0.87) and 0.47 for postdiagnosis analyses (95% CI, 0.35-0.63).
An inverse association also was reported for PD-specific mortality (postdiagnosis AHEI: HR, 0.52 [95% CI, 0.33-0.8]; postdiagnosis physical activity: HR, 0.37 [95% CI, 0.25-0.55]). Further, participants who adhered to a healthy diet and engaged in more physical activity before PD diagnosis had a 49% lower risk for mortality (HR, 0.51; 95% CI, 0.36-0.73), with similar findings reported after diagnosis (HR, 0.35; 95% CI, 0.23-0.52).
“Consuming a high diet quality and engaging in physical activity could be targets for improved PD outcome,” Zhang and colleagues wrote.
In a related editorial, Beate R. Ritz, MD, PhD, and Kimberly C. Paul, PhD, of the David Geffen School of Medicine at the University of California, Los Angeles, wrote that results of this study, “not only reinforce the public health recommendations to engage in these behaviors for staying healthy in general but also add to a growing body of evidence of such behaviors providing protection against PD-related neurodegeneration specifically.”
Citing guidance from the Parkinson Study Group 2022 meeting, they continued, “There is no reason for neurologists and primary care practitioners to hesitate about providing information and recommendations on diet and lifestyle that may be beneficial for PD-specific symptoms and promote healthy aging in general.
“Such professional guidance has the added advantage of giving many patients with PD a measure of control over their lives by engaging in activities that improve not only their disease outcome but also their quality of life and life expectancy.”
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