This continues a series of posts which reframe major aspects of Parkinson’s Disease as habitual behaviours rather than symptoms. These are features of the condition which can be addressed and changed over time in order to assist with progressive symptom reduction. In this article, we consider eating and PD, but while there is a lot of literature on diets and supplements relevant to the condition, here we consider that the how and when we eat may be just as important or even more so than what we eat.
I first came across these concepts through the work of Dr Rangan Chatterjee, and this is one of the reasons why I have come to respect this doctor so much. On the topic of food and chronic conditions, he says something quite profound, yet quite obvious once stated, but which I have never heard anyone else in the medical community really say before: that is not just what we eat, but the state our nervous system is in before, during and after ingestion and digestion, which may be key.
It is well known that when our bodies are in stress states (fight, flight, or freeze), that our digestion is largely downregulated/off-lined, since the digestive gut functions are not needed for life preservation in acute stress situations. Indeed, we have covered here before how biochemical disruptions caused by a lack of specific enzymes, can be induced when our systems are chronically stressed, which in turn can cause all sorts of disease-like symptoms, especially in regards to neurotransmitter production. So, for myself, it is patently true that if we eat when our nervous system is in a stress state, no matter how "healthy" the food is, since important digestive enzymes and peptides may not be being produced/activated, the food might not get broken down properly into nutritious molecules, and toxic by-products could be created instead.
Thus eating while stressed, or in environments which put the body into stress response states, e.g. at work in front of emails, or at home in front of the television news, can negate many benefits of a healthy diet, and also promote food intolerances even for "good" food choices. Dr Chatterjee therefore recommends ensuring relaxation before eating, in order to put the nervous system in a state favourable to digestion. He recommends engaging in calming breathing exercises before a meal, or a walk outdoors in a green space, and then choosing an appropriate stress free environment in which to eat - away from the desk or a television or smart phone at least, and also making mealtimes a social time - eating with relaxed others, while socially engaged.
Dr Chatterjee says he has seen the proof of this concept in his own medical practice: patients who have severe food intolerances that implement his recommendations, and change their relationships with food, find they can suddenly eat “problem” foods with no problem. This is supported by stories from people who, having worked on recovery from chronic stress, anxiety and breathing disorders, often find that their food intolerances markedly reduce too, for example the anecdotal experience of stress reduction resulting in a rapid change of food intolerances as recounted by Veronique Mead of Chronic Illness Trauma Studies.
Building on these themes, Deanna Hansen, creator of the Block Therapy self-care system, says
"In a past book, I had a ninety day program with one week devoted to not what we eat, but how - making proper chewing and conscious breathing a component of healthy eating - I see people eating so fast that they are swallowing whole bits of food, and there is an enzyme to break down food that only exists in the mouth for this process. Talking while eating is another challenge - for health, eating should almost a meditation as opposed to a social time."
This problem with wolfing down food, and thus not activating important enzymes, as well as preventing healthy breathing, is also covered in a podcast of Dr Chatterjee with Tony Riddle of The Natural Life-stylist. Tony says one should even chew liquid foods like smoothies, and not just neck them, for these enzymatic reasons. Interestingly, Dr Chatterjee mentions that eating too fast is a problem he is struggling with himself, and is worried that he has passed this habit on to his son. I also eat very fast, and have to really concentrate hard not to. I suspect that if we were to take a survey of folks affected by PD, wolfing down food would be a very common theme. Not chewing food properly may have even more significance for people with PD, who can have problems with swallowing, and hence for whom large pieces of unchewed food represent a choking hazard.
In a podcast interview with James Nestor, author of Breath, it is also mentioned that chewing on one side and then the other is important, as this aids relaxation and digestion, whereas biting down equally on both sides is like clenching the jaw, and can put the body into a stress response. Furthermore, a lack of chewing and savouring means there is then also a lack of enjoyment from eating the food, which would otherwise normally aid relaxation and hence digestion by stimulating reward circuits. This means we are less likely to produce dopamine in response to food, which won’t help the symptoms of PD that are due to a lack of dopamine in our system. Marin McCue also recommends savouring the smell of food before eating, as part of the relaxation and enjoyment. This may be particular pertinent for people with PD, for whom loss of sense of smell can be one of the first signs, and hence it is worth trying to restore it by using it at mealtimes.
Saying grace/practising gratitude before each meal may also help to relax the body and prepare the body for digestion. In the above mentioned podcast, Tony Riddle relates that his family not only do three minutes of relaxing breathing before a meal, they also focus on feeling gratitude for the food on the plate and for the plants which provided it. Science is increasingly showing that gratitude practices, and kindness practices more generally, have a significant beneficial impact on health and wellbeing, and using meal times as reminder is an effective way to incorporate them in to the day.
Returning to the social element of meals, this may a factor dependent on cultural eating patterns too. Deanna mentions above the problems with eating and talking at the same time. The issue here may be the time taken for meals, where even if each mouthful is properly chewed, the food is being eaten one mouthful after another without pause or one course after another without pause, because the allotted time for the meal is (too) short. Indeed, Dr Chatterjee often mentions the "French Paradox" - that people in France seem to be able to consume large amounts of "unhealthy" foods without so much affect. One possible reason for this may be the time taken over meals in France, with plenty of time for socializing between mouthfuls, and time to digest between courses.
As well as taking some relaxing breaths before eating, we also need to be mindful about how we are breathing during a meal. If we are stressed while eating we are more likely to be breathing through the mouth, from the chest, and hyperventilating. Many of us suffering with PD have breathing disorders, such that we are unconsciously breathing poorly like this most of the time. The first issue with such breathing patterns is that chewing food properly is problematic while mouth breathing, and so we are more likely to wolf down food to prevent feelings of suffocation. This results in larger pieces of food being swallowed, meaning the need for more energy to digest the food properly or else the food only being partially processed in the gut, as well as risk of choking. Chest rather than abdominal breathing will also mean the diaphragm is not working to rhythmically to create motility in the digestive organs. As noted above, this may be compounded by a deficit of the signals to the system to make digestive enzymes in the mouth and stomach which rigorous chewing would generate. The connection between unhealthy breathing and eating too fast in his own background was also made by Anders Olsson author of Conscious Breathing, who now recommends only taking food in to the mouth while exhaling as a way to slow down.
However, the links between food intolerance and breathing disorder may run even deeper. According to the book Recognizing and Treating Breathing Disorders by Leon Chaitow and co-workers:
"Emotional arousal gives rise to conditionable changes in breathing, and it appears that the connection between the emotions and breathing is a reciprocative relationship, in which changes in one lead to corresponding changes in the other. Feelings of anxiety may predispose to hyperventilation, which behaviour then reinforces the feelings of anxiety, forming a potentially destructive cycle."
I believe we can add eating as a third element to these reciprocative relationships and negative feedback cycles. "Pre-food tension" or food anxiety will likely exacerbate disordered breathing before a meal, and then food in the mouth may increase feelings of shortness of breath, creating further anxiety signals, and adding to an unhealthy emotional relationship with mealtimes.
Actually, the book has a number of interesting things to say about the relationships to food and breathing:
"Food allergy is an immunological event, involving immunoglobulin E (IgE), whereas food intolerance involves adverse physiological reactions of unknown origin, without immune mediation. Food intolerance may involve food toxicity or idiosyncratic reactions to foods, sometimes related to enzyme deficiency."
Food intolerances of this type are common in people with PD.
"Many experts hold to the opinion that the symptoms that are associated with food and environmental intolerances are more likely a response to anxiety rather than true chemical reactions."
Anecdotally, when I first went on a prolonged programme of elimination diets to determine my own food intolerances, after years of being in a toxic relationship, I was surprised to find that the list of intolerances I discovered matched almost perfectly the staple foodstuffs we had been cooking and eating regularly when I had been in that relationship. In hindsight, I am no longer surprised by these subconscious links between negative emotional states and foods associated with the failed relationship, and that these fed the anxiety-disordered breathing-food intolerance cycles.
The book also links specific foods which can have direct negative impact on disordered breathing and anxiety, including lactate, caffeine, alcohol, and glucose levels, as well as stating that anxiety and breathing dysregulations can affect the working and permeability of the gut lining.
In conclusion, while there may not be a cure for Parkinson’s Disease, there are features of the condition that we can address through changes in lifestyle, habits and behaviours which will help with symptom reduction. I believe that changing eating habits and improving relationships with food and mealtimes is a low hanging fruit in this regard. For myself, the proof has been in the eating. Like many people with PD, I have a problem keeping weight on, and no matter how much or what I ate, I just couldn’t maintain a healthy weight. However, since adopting many of the above recommendations, without changing my diet at all, I have steadily been gaining weight. The regularity and consistency of my bowel movement has also improved, which is very important since constipation is a major impact factor for PD symptoms. I am also getting a lot more pleasure and enjoyment from food.