Parkinson’s disease is associated with gastrointestinal (GI) dysfunction, including constipation symptoms and abnormal intestinal permeability and inflammation. A Mediterranean diet (MediDiet) may aid in disease management. This parallel, randomized, controlled trial in people with Parkinson’s (PwP) and constipation symptoms compared a MediDiet against standard of care on change in constipation symptoms, dietary intake, and fecal zonulin and calprotectin concentrations as markers of intestinal permeability and inflammation, respectively. Participants were randomized to either standard of care for constipation (control; n = 17, 65.1 ± 2.2 years) or a MediDiet plus standard of care (n = 19, 68.8 ± 1.4 years) for 8 weeks. Constipation scores decreased with both interventions (p < 0.01), but changes from baseline were not different between groups (MediDiet, −0.5 [−1.0, 0]; control, −0.8 [−1.0, 0.2]; median [25th, 75th]; p = 0.60). The MediDiet group had a higher intake of dietary fiber at week 4 than the control group (13.1 ± 0.7 g/1000 kcal vs. 9.8 ± 0.7 g/1000 kcal; p < 0.001). No differences in fecal zonulin were observed between groups (p = 0.33); however, fecal calprotectin tended to be lower in the MediDiet group at week 8 (45.8 ± 15.1 µg/g vs. 93.9 ± 26.8 µg/g; p = 0.05). The MediDiet and standard interventions reduced constipation symptoms; however, the MediDiet provided additional benefit of increased dietary fiber intake and less intestinal inflammation.

Objective: To assess deployed Gulf War (GW) veterans for prodromal Parkinson's Disease (PD) using the REM Sleep Behavioral Disorder (RBD) Screening Questionnaire (RBDSQ). Methods: GW veterans ( n = 165) were assessed for nonmotor PD symptoms with the RBDSQ, Non-Motor Symptoms Scale, and Scales for Outcomes in Parkinson's Disease–Autonomic. Some veterans were also assessed with the University of Pennsylvania Smell Identification Test ( n = 120), neurological examinations ( n = 41), and 3T magnetic resonance imaging ( n = 16). Results: Eighty percent of veterans with PD and 73% of veterans without PD had probable RBD (ie, RBDSQ ≥5). Exploratory analysis conducted for hypothesis-generating purposes revealed that RBDSQ scores were positively associated with GW deployment–related exposures and inversely associated with brainstem volume. Conclusions: These findings suggest that veterans with GWI and high levels of deployment-related exposures are at risk for prodromal PD, possibly through RBD as a mediator.