By Dr. Mercola
For newly diagnosed cases of Parkinson’s disease, new research has offered an important breakthrough that scientists say may dramatically slow progression. It may seem surprising to some, but the study indicates that intense treadmill exercise is recommended and safe. The operative word “intense” is key, because lower intensity exercise doesn’t have much of an impact, according to the randomized clinical trial published in JAMA Neurology.1 According to The New York Times (NYT):
“As most of us know, Parkinson’s disease is a progressive neurological disorder that involves problems with motor control. Symptoms like weakness, stiffness, loss of balance and falls can make exercise difficult and potentially hazardous.”2
Interestingly, the paragraph continues by stating that Parkinson’s is “currently incurable,” and easing symptoms “for a time” with drugs is the only arsenal most doctors draw from. The problem with the prescription drugs given to people with Parkinson’s disease is that they gradually become ineffective over time. That’s why researchers began searching for alternative treatment options.
Symptoms, which worsen over time, have been described by some as debilitating, including unceasing tremors, a stooped posture and a shuffling gait; later symptoms may include impaired speech, changes in personality, depression and dementia. The Parkinson’s Foundation3 lists some sobering statistics regarding this condition:
- About 1 million people in the U.S. suffer from Parkinson's disease — more than the number of people with multiple sclerosis, muscular dystrophy and Lou Gehrig's disease combined.
- More than 10 million worldwide are living with the disease.
- About 60,000 Americans are diagnosed annually — around 4 percent before the age of 50.
- Men are diagnosed with Parkinson’s about 1.5 times more often than women.
- Costs associated with the disease are estimated at $25 billion per year.
Scientists reason that if individuals with the earliest stages could put the brakes on the way the disease typically advances — as well as delay the drug protocol — with the intense exercises the study recommends, the most severe effects might modify the “arc” of the disease’s progression.
Exercise as a Treatment Option for Early Parkinson’s Disease
Researchers from a number of universities and medical centers in Pennsylvania, Colorado and Chicago participated in the research, led by Margaret Schenkman from the physical therapy program at University of Colorado in Aurora, along with Charity G. Moore from the University of Pittsburgh’s School of Health and Rehabilitation Sciences, and Wendy M. Kohrt, from the Geriatric Research Education at the Veterans Affairs Eastern Clinical Center from the University of Colorado.
Key questions the team addressed started with whether high- and moderate-intensity treadmill exercise would be safe for patients given a Parkinson’s diagnosis within the previous five years (aka “de novo” patients not yet on medication), whether or not patients could actually perform the exercises at the necessary “hypothesized adherence” three times per week and whether changes in motor symptoms would warrant further study.
For the 128 participants involved in the study, aged 40 to 80 years old, 80 percent to 85 percent exercise intensities, as well as 60 percent to 65 percent intensities, were deemed safe and feasible. High-intensity treadmill exercises were considered “nonfutile” — having enough of a benefit to warrant further testing — so an efficacy trial was set up for high-intensity, but not for moderate-intensity exercise, the study authors explained.
However, as the NYT noted, there were inconsistencies in studies on how such exercises as cycling (especially tandem biking), boxing, dancing and others benefited Parkinson’s patients, and there were also precedents:
“Animal studies already had shown that exercise reduced symptoms and slowed physical decline in a rodent version of Parkinson’s. But rodents are not people … In addition, many of these earlier studies had used many different types and amounts of exercise, and none had systematically compared different varieties of exercise head-to-head.”4
‘Treat Exercise As if It Were a Drug’
In drug trials, safety, effectiveness and other factors are tracked and weighed while at the same time ensuring outcomes can’t be skewed or manipulated, and that’s how researchers treated the different intensities of the treadmill exercises, as if they were different “doses” in a formal Phase 2 clinical trial. Phase 1 trials for drug research generally establish how safe drugs are through small-scale experiments.
Larger groups of people are used in Phase 2 studies, looking at the safety of what’s being tested and whether it’s worth continuing with experimental protocols (nonfutile). Being a Phase 2 trial, the study involved both men and women who were not taking drugs for the condition, and none of them were exercising regularly. Using a standard numerical scale, the scientists tested the participants in three main areas:
- Aerobic capacity
- Maximum heart rates
- Disease severity
Next, the entire group was split at random into three categories of activity: high-intensity exercise, moderate-intensity exercise or control, each lasting for a month and any injuries reported, after which the volunteers were asked to continue the activities they were given on their own, but with heart monitors:
- One group was asked to continue living just as they had with no changes (although the members were put on a waitlist for exercise training later).
- The next group began exercise protocols on a gentle treadmill walking for 30 minutes four times per week. Meanwhile, the scientists manipulated the machines’ speed and incline to keep individual heart rate between 60 percent and 65 percent of what had already been deemed their maximum.
- The last third of the participants were given the same amount of time for exercises but at a more strenuous incline and pace so their heart rates would stay between 80 percent and 85 percent of their maximum.
Results of the Study’s Treadmill Exercises
After a total of six months following the start of the study subjects’ exercise programs (including the delayed onset of the exercises), the disease status of each was checked and compared to their previous statistics. The NYT reported:
“To no one’s surprise, the men and women who had continued with their previous lives showed some worsening. Their scores on the disease scale had declined on average by more than three points.
Likewise those in the moderate exercise group showed declines of around two points, meaning that, by the study’s standards, the exercise had been ‘futile’ as a Parkinson’s treatment. But the group that had worked out intensely showed almost no decline in their disease scores, meaning their exercise had been 'nonfutile.' It had helped.”5
Along with the improved disease scores, the participants agreed that the exercise regimens had been tolerable, and in fact almost all of them in the group of 128 completed six months of exercises without injuring themselves and only a few complaints of sore muscles.
Rather than being a test to see why intense exercise slowed the progression of newly diagnosed Parkinson’s disease while moderate exercises didn’t, it was designed more as a study in high-intensity doing a better job at the more beneficial bottom line — lowered disease progression, likely due to improved brain vascularity and neuronal blood supply.
According to Daniel Corcos, professor of human movement sciences at Northwestern University Feinberg School of Medicine in Chicago and one of the study leaders, scientists believe improved blood flow to the brain might help not just improve overall brain health, but slow deterioration. That hypothesis needs further testing, however.
Corcos also thinks the next step is a Phase 3 study on the merits of intense treadmill exercises for people with new cases of Parkinson’s, especially since the Phase 2 results justify it. He and his research cohort have been preparing for such a study. He advises people with relatively new cases to talk to an athletic trainer about how to incorporate intense treadmill workouts, as they’re not likely to cause harm and may in fact be helpful.6
Causes, More Studies and Therapies
In 2012, a University of Maryland study7,8 analyzed three types of exercise for patients with Parkinson’s disease: low-intensity treadmill exercise, high-intensity treadmill exercise and stretching and resistance exercise, reporting improved gait speed for the low-intensity exercise. Both high- and low-intensity exercises built up cardiovascular fitness, and as the scientists expected, Parkinson’s patients engaging in stretching and resistance exercises had increased muscle strength.
A 12-year-long Swedish study9,10 involving around 43,400 people concluded that people who engage in six hours of moderate exercise per week reduce the risk of developing Parkinson’s disease by 43 percent. Those are two more examples of the way exercise can relieve Parkinson’s symptoms and may help prevent the disease altogether.
But what causes Parkinson’s disease? While it’s known as an idiopathic disease, meaning there’s no one cause scientists can pin it on, there’s evidence that pesticides, even at low levels, may be culpable.
Other toxins, including mercury in amalgam fillings (a known neurotoxin), may have a bigger impact on this disease (and others) than many people realize. That’s why eating organic foods as much as possible is so important; not doing so increases your exposure to pesticides. In addition, studies suggest that your gut microbiome, besides being inextricably intertwined with your overall health, may also influence your vulnerability to Parkinson’s.
A study in Neurology11 contends that Parkinson’s may start in your gut and travel to your brain through your vagus nerve, the longest nerve in your body, which runs from your neck to your abdomen, distributing sensory and motor fibers, as well as influencing heart rate and digestion. A surgery known as vagotomy is a resection of the vagus nerve to reduce the amount of acid secretion, often undergone by people suffering from ulcers.
In Sweden, researchers compared people who’d had the surgery with those who hadn’t. Those who had a truncal vagotomy, in which the trunk of the nerve is removed, as opposed to a selective vagotomy, had a 40 percent lower risk of developing Parkinson’s disease.
Can Fasting Help With Parkinson’s?
It may seem odd that going on a fast could have anything to do with helping to alleviate symptoms of Parkinson’s disease, but it’s connected to immune system function. As Valter Longo, director of the USC Longevity Institute and co-author of a study that explored the beneficial effects of fasting on aging and immune system health, observed, your white blood cell count drops with prolonged fasting, and when you eat again, your white blood cells, the primary disease fighters, return.
Longo explains that when you fast, a “regenerative switch” is activated, which promotes stem cell-based regeneration of your hematopoietic system that’s involved in the production of blood. Fasting initiates the death of old, damaged immune cells and replaces them with new ones. He noted, “We could not predict that prolonged fasting would have such a remarkable effect in promoting stem cell-based regeneration of the hematopoietic system.” Medical Daily explains further:
“Fasting forces the body to store sugars, fats and ketones, and to break down a significant amount of white blood cells. Ketones are produced when the body turns fat into energy or fuel, and are a major player in weight loss. Intermittent fasting allows the body to use fat as its primary source of energy, which is why many athletes use it to hit lower body-fat percentages for competitions.
It can help speed up the metabolism and improve bowel movements by giving your digestive system a rest. Periods without food boost the metabolism to burn through calories more efficiently — in a way reminding the body how healthy digestion is done.”12
Strategies for Parkinson’s Prevention
The studies showing that intense exercise may be a way to stave off or minimize some of the more debilitating aspects of Parkinson’s disease indicate that, once again, the beneficial effects of exercise on health shouldn’t be underestimated. There are many more studies listing other health conditions exercise remediates, as well as prevents.
No matter how well you may be eating, exercise is crucial and ideally should combine strength training as well as core-strengthening exercises, stretching and high-intensity interval training, or HIIT, which is particularly helpful for aging muscles. One version, known as the Nitric Oxide Dump, can be completed in short, four-minute sequences. Regular daily nonexercise movement is also important. Other ways to help prevent Parkinson’s include:
- Adopting a ketogenic diet, which focuses on lowering your net carbohydrate intake and getting moderate amounts of good protein and high amounts of healthy fats.
- Molecular hydrogen,13 a potent and highly selective antioxidant supplement, consists of two atoms of hydrogen, the planet’s smallest molecule. It selectively targets damaging free radicals produced by radiation, such as the gamma rays, and can mitigate as much as 80 percent of the damage they cause. A randomized double-blind study showed that drinking molecular hydrogen water for 48 weeks significantly improved Parkinson’s disease symptoms, and research is ongoing to confirm the results.14
- Optimizing your vitamin D. There’s a direct link between Parkinson’s disease as well as several other serious conditions and a deficiency of vitamin D, even in areas where there’s plenty of sun. It’s involved in the biochemical function of all your cells and tissues, so when you don't have enough, your entire body struggles to function optimally.
- Eat whole, organic, unprocessed foods as much as you can, free from hydrogenated oils and other unhealthy fats and high-fructose corn syrup, and be informed regarding foods that are genetically engineered, known as GE foods. Eating as close to the earth as possible will help keep your body in balance and minimize the prevalence of disease.
Remember that, possibly more than any other factor, diet is responsible for fueling your body with what it needs to stave off disease and function at its best.