Plant-Based Diet and Vitamin B2 Might Help in Managing Parkinson Disease

Back in Novem­ber 2009, I wrote a blog post about a study that sug­gest­ed that a hered­i­tary prob­lem in the metab­o­lism of riboflavin (vit­a­min B2) and the heavy con­sump­tion of red meat could both con­tribute to the cause of Parkin­son dis­ease. The researchers did blood tests for riboflavin for 31 con­sec­u­tive Parkin­son patients who entered their clin­ic. Every sin­gle one of them had abnor­mal­ly low blood lev­els of riboflavin. In com­par­i­son, only a few of the patients with oth­er neu­ro­log­ic dis­eases had low riboflavin lev­els. The Parkin­son patients also tend­ed to be heavy con­sumers of red meat. After the riboflavin defi­cien­cy was cor­rect­ed and the Parkin­son patients stopped eat­ing red meat, their motor skills improved dra­mat­i­cal­ly.

I thought that this study was impor­tant. It sug­gest­ed that cheap and gen­er­al­ly ben­e­fi­cial inter­ven­tions could pro­vide sig­nif­i­cant ben­e­fits for peo­ple with Parkin­son dis­ease. It should have been fol­lowed up with larg­er stud­ies. Keep in mind that Parkin­son dis­ease is a major cause of dis­abil­i­ty among elder­ly Amer­i­cans and ranks 14th among caus­es of death in the Unit­ed States.

Since then, I’ve seen a few stud­ies in which inves­ti­ga­tors assess riboflavin sta­tus by ask­ing peo­ple what they’ve been eat­ing, instead of doing a blood test! This is a big mis­take because the Parkin­son patients in the 2003 study had riboflavin defi­cien­cy even though they were eat­ing nor­mal amounts of riboflavin. Their bod­ies just weren’t han­dling the riboflavin effi­cient­ly. We need more research to show whether Parkin­son patients should rou­tine­ly be screened for riboflavin defi­cien­cy. Of course, if you or a loved one has Parkin­son dis­ease, you can just ask for the riboflavin lev­el to be test­ed. If a patient has a vit­a­min defi­cien­cy, it should be cor­rect­ed, shouldn’t it?

Anoth­er study, pub­lished in Jan­u­ary of 2011, found that Parkin­son patients improved when they switched to a plant-based diet. This came as no sur­prise to me because sim­ply eat­ing less pro­tein, espe­cial­ly dur­ing the day­time, can dra­mat­i­cal­ly improve the patient’s response to L-dopa, which is the drug of choice for treat­ing Parkin­son dis­ease.

Red Meat, Vitamin B2 Deficiency, and Parkinson Disease

Recent­ly, some­one in my fam­i­ly got a diag­no­sis of Parkin­son dis­ease, which is the same dis­ease that Michael J. Fox has. So nat­u­ral­ly I searched the med­ical lit­er­a­ture to see if there was a dietary angle to the dis­ease. There is, and it’s very excit­ing! Remov­ing red meat from the diet and cor­rect­ing a vit­a­min B2 defi­cien­cy might pre­vent Parkin­son dis­ease, and it might even help reverse some of the effects of the dis­ease. This would actu­al­ly change the course of the dis­ease, where­as all doc­tors can do at present is treat its symp­toms.

How I Searched the Medical Literature

I went to and clicked on MeSH Data­base. Then I typed Parkin­son dis­ease in the search box and clicked on Go. One of the results was Parkin­son dis­ease. I clicked on that and select­ed the sub­head­ing “diet ther­a­py” and added that to the search box. Then I clicked on Search PubMed.

What I Found

One of the arti­cles that I found point­ed out that Parkin­son dis­ease is far more com­mon in elder­ly peo­ple in Europe and North Amer­i­ca than it is in elder­ly sub-Saha­ran Black African, rur­al Chi­nese, and Japan­ese peo­ple. In oth­er words, it’s far more com­mon in peo­ple who eat a lot of meat than in peo­ple who eat a heav­i­ly plant-based diet.

Anoth­er inter­est­ing arti­cle sug­gest­ed that Parkin­son dis­ease might result from two sep­a­rate prob­lems relat­ed to diet and nutri­tion (High dos­es of riboflavin and the elim­i­na­tion of dietary red meat pro­mote the recov­ery of some motor func­tions in Parkinson’s dis­ease patients. C.G. Coim­bra and V.B.C. Jun­queira. Brazil­ian Jour­nal of Med­ical and Bio­log­i­cal Research, 36: 1409–1417, 2003). The first prob­lem is an over­load of iron from eat­ing too much red meat. The sec­ond is some prob­lem in the way the body han­dles riboflavin (vit­a­min B2). To put these ideas to the test, the researchers test­ed 31 con­sec­u­tive Parkin­son dis­ease patients who entered their clin­ic. Every sin­gle one of them had abnor­mal­ly low lev­els of vit­a­min B2 in their blood­stream, even though they were eat­ing food that should have pro­vid­ed enough vit­a­min B2. In com­par­i­son, only 3 out of 10 patients with oth­er neu­rode­gen­er­a­tive dis­eases had a vit­a­min B2 defi­cien­cy. The Parkin­son patients were also big red meat eaters. The researchers told the Parkin­son dis­ease patients to stop eat­ing red meat and to take 30 mg of riboflavin three times a day.

The patients who fol­lowed this advice regained some of their lost motor skills. Mild­ly afflict­ed patients became com­plete­ly asymp­to­matic, and even some of the more severe­ly afflict­ed patients improved a lot. These find­ings were dra­mat­ic and excit­ing, and this arti­cle should have lit a fire under the researchers who are study­ing Parkin­son dis­ease. Here was a sim­ple, cheap, and safe dietary mod­i­fi­ca­tion that addressed the actu­al cause of the dis­ease, and could even reverse some of its effects.

Unfor­tu­nate­ly, peo­ple tend to dis­card the results of dietary stud­ies out of hand, part­ly because these stud­ies can’t fol­low the same for­mat as a drug tri­al. For exam­ple, you can’t “blind” peo­ple to what they’re eat­ing, so there’s nev­er a “place­bo con­trol.” Also, some peo­ple become total­ly unhinged if they hear that the foods they like aren’t good for them. Pre­dictably, some­one wrote in a tru­ly idi­ot­ic cri­tique of the study (Com­ments of H.B. Fer­raz et al. ) The authors’ response was with­er­ing. They said things like “By search­ing the cur­rent med­ical lit­er­a­ture, Fer­raz and asso­ciates might read­i­ly become famil­iar with count­less pre­lim­i­nary stud­ies which have been sub­se­quent­ly con­firmed by larg­er and bet­ter con­trolled research” and “The cita­tions made by Fer­raz and asso­ciates demon­strate that they have com­plete­ly missed our point, even though it was clear­ly empha­sized even in the title of our study.” What a smack-down!

Fer­raz and cowork­ers were wor­ried that if peo­ple stopped eat­ing red meat, they might end up with a pro­tein defi­cien­cy. Well, where do goril­las get their pro­tein? If a diet with­out red meat pro­vides enough pro­tein for a 500-pound sil­ver­back male goril­la, it should pro­vide enough for a human being. And what would be the harm in test­ing Parkin­son dis­ease patients for riboflavin defi­cien­cy? Why aren’t Fer­raz and cowork­ers wor­ried about the pos­si­bil­i­ty that we’re miss­ing an oppor­tu­ni­ty to stop Parkin­son dis­ease in its tracks?