Nutritional education program counseling based on the Mediterranean diet on intestinal constipation in people with Parkinson's disease: a randomized clinical trial

IntroductionIntestinal constipation (IC) is a common and early non-motor symptom in Parkinsons disease (PD), impacting patients quality of life. In this context, the Mediterranean diet plays a fundamental role in managing IC. This study aimed to evaluate the effects of a nutritional education program based on the principles of the Mediterranean diet on IC in individuals with PD. MethodsThis is a randomized, controlled, single-center, parallel-group, single-blind clinical study to evaluate the effectiveness of a nutritional education program based on the Mediterranean diet for three months, with a delayed-start design, in people with PD and IC. Participants were randomly allocated (1:1 ratio) to two groups: early-start (intervention from baseline to the third month) and delayed-start (intervention from the third to the sixth month) nutritional counseling, with an initial in-person assessment and monthly remote assessments. Bowel habits, adherence to the Mediterranean diet, and clinical variables were analyzed. ResultsAfter six months, a significant increase in the frequency of weekly bowel movements was observed (Early-start: 2.91 to 4.14; Delayed-start: 2.68 to 4.18 bowel movements/week; p < 0.001), along with changes in stool consistency and improved adherence to the Mediterranean diet over time. However, no significant differences were detected between the groups. ConclusionA nutritional education program based on the principles of the Mediterranean diet was associated with improved bowel habits and dietary adherence over time. These results support that locally adapted, low-cost dietary counseling may represent a complementary approach to the treatment of IC in individuals with PD in non-Mediterranean settings.