Ultraprocessed Food Intake Tied to Prodromal Symptoms in Parkinson Disease

Long-term consumption of ultraprocessed foods (UPFs) may increase risk for nonmotor prodromal features of Parkinson disease (PD), according to the findings of a study published in Neurology.

Mounting evidence has indicated that dietary habits may contribute to PD pathogenesis. Increased consumption of UPFs has been associated with increased risk for dementia. However, it remains unclear whether UPF consumption affects PD risk.

Researchers from Fudan University in China sourced data for this study from the Nurses’ Health Study (NHS) and the Health Professionals Follow-Up Study (HPFS) which were cohort studies conducted in the United States starting in 1976 and 1986, respectively. The subset of individuals (N=42,853; mean age, 47.8; women, 58.6%) who provided answers to questions about probable rapid eye movement sleep behavior disorder (pRBD) and constipation outcomes in 2012 and about hyposmia, color vision, daytime sleepiness, body pain, and depressive symptoms in 2015 were included in this study. The primary outcome was risk for the 7 prodromal features on the basis of UPF consumption between 1984 and 2006, assessed using the Food Frequency Questionnaire (FFQ).

When stratified by UPF consumption, individuals with higher intake were generally younger, more likely to be White, had higher body mass index (BMI), caffeine intake, and total energy intake, and had lower levels of physical activity, alcohol consumption, and a lower Alternate Healthy Eating Index 2010 (AHEI-2010) score.

A total of 16.8% in NHS and 17.2% in HPFS participants reported 3 or more prodromal PD features.

Compared with individuals in quintile 1 of cumulative average UPF consumption, the risk of having 3 or more prodromal features increased progressively across higher quintiles — Q2 (aOR, 1.27), Q3 (1.52), Q4 (2.02), and Q5 (2.47) — with a significant trend (P for trend <.0001). Trends were similar when the NHS and HPFS cohorts were analyzed separately, with the exception that quintile 2 no longer reached significance in either cohort.

Compared with individuals in quintile 1 of UPF consumption, the risk of having 3 or more prodromal features (excluding constipation) was significantly higher in quintiles 5 (aOR, 2.00) and 4 (aOR, 1.82; P <.0001). When the analysis was limited to constipation, probable REM sleep behavior disorder (pRBD), and hyposmia, the risk for this specific combination of features was elevated in quintiles 5 (aOR, 2.47) and 3 (aOR, 1.74) relative to quintile 1 (P <.0001).

When all features except constipation were evaluated, risk for 3 or more prodromal features were associated with quintiles 5 (aOR, 2.00) and 4 (aOR, 1.82) of UPF consumption relative to quintile 1 (P <.0001). When only constipation, pRBD, and hyposmia were included, risk for this combination of features was associated with quintiles 5 (aOR, 2.47) and 3 (aOR, 1.74) vs quintile 1 (P <.0001) of UPF consumption.

When only baseline UPF consumption was considered, risk for 3 or more prodromal features associated with quintiles 5 (OR, 1.50), 4 (OR, 1.29), and 3 (OR, 1.38) compared with quintile 1 (P =.0009).

Stratified by type of UPF, risk for 3 or more prodromal features increased with every additional daily serving of packaged sweets or snacks (aOR, 1.60), sweetened beverages (aOR, 1.53), condiments (aOR, 1.40), animal-based products (aOR, 1.37), dairy-based desserts (aOR, 1.27), and packaged savory snacks (aOR, 1.26) but not with ready-to-heat dishes or ultraprocessed breads or cereals.

The limitations of this study included the reliance on self-reported data and the lack of diversity in the study population.

“[W]e found that long-term UPF consumption was positively associated with both individual and combined prodromal PD features, including pRBD, constipation, excessive daytime sleepiness, and body pain,” the researchers concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.