Evidence map›Paper›PMID 37355689›Full record

ReviewNPJ Parkinson's disease2023

To restrict or not to restrict? Practical considerations for optimizing dietary protein interactions on levodopa absorption in Parkinson's disease.

C Rusch, R Flanagan, H Suh, I Subramanian

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in NPJ Parkinson's disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 27 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Lifestyle medicine for neuroprotection: evidence and implementation in Asian contexts.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  7. Article
  8. Review
  9. Plant-derived therapies in Parkinson's disease: a systematic review of clinical evidence.Journal of neural transmission (Vienna, Austria : 1996) · 2026
    Review
  10. When the Scale Drops: Pathways to Weight Loss in Parkinson's Disease and Future Directions.Movement disorders : official journal of the Movement Disorder Society · 2026
    Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Ketogenic diet and Parkinson's disease.Frontiers in molecular neuroscience · 2026
    Review
  17. Review
  18. Nutritional and dietary clinical trials for Parkinson's disease: a narrative review.Journal of neural transmission (Vienna, Austria : 1996) · 2025
    Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

C RuschFood Science and Human Nutrition Department, Center for Nutritional Sciences, University of Florida, Gainesville, FL, USA. carley.rusch@abbott.com.
R FlanaganMy Moves Matter, Dublin, Ireland.ORCID http://orcid.org/0009-0005-1049-0482
H SuhParkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, USA.
I SubramanianParkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA, USA.ORCID http://orcid.org/0000-0001-9966-0655
West Los Angeles College · USUniversity of Florida · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Administration of levodopa for Parkinson's disease (PD) has remained the most effective therapy for symptom management despite being in use for over 50 years. Advancing disease and age, changing tolerability and gastrointestinal (GI) dysfunction may result in change in dietary habits and body weight, as well as unpredictable motor fluctuations and dyskinesias. Dietary proteins which convert into amino acids after digestion are implicated as major factors that inhibit levodopa absorption. For people living with PD (PwP) who experience motor fluctuations, low protein diets (LPD) and protein redistribution diets (PRD) may be effective and are often recommended as a non-pharmacologic approach for improving levodopa bioavailability. However, there is a lack of consensus on a standard definition of these diets and appropriate treatment algorithms for usage. This may be due to the paucity of high-level evidence of LPD and PRD in PwP and whether all or specific subgroups of patients would benefit from these strategies. Managing diet and protein intake with proper education and monitoring may reduce complications associated with these diets such as dyskinesias and unintentional weight loss. Additionally, alterations to medications and GI function may alter levodopa pharmacokinetics. In this narrative review we focus on 1) mechanisms of dietary protein and levodopa absorption in the intestine and blood brain barrier, 2) dietetic approaches to manage protein and levodopa interactions and 3) practical issues for treating PwP as well as future directions to be considered.

Identifiers

PMID37355689
PMCPMC10290638
OpenAlexW4381930375

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.