Swallowing Disorder in Parkinson’s Disease

How can you modify your diet to make swallowing easier?

1. Choose moist and soft foods that are easier to eat:

· smooth texture soups
· Omelet
· well-cooked meat in sauces
· Casseroles
· macaroni (not spaghetti)
· Puree
· Custard creams
· Jelly
· yogurt
· ice cream

2. Eat whole grain bread instead of white (it’s less likely to get stuck around your mouth)
3. Try pasta or noodles instead of bread as carbohydrates during meals.
4. Foods with an appetizing smell and taste are generally easier to swallow as they stimulate saliva production.
5. Thick drinks (milkshakes and smoothies) may be easier to swallow than thinner liquids. Thickeners can be added.
6. A semi-solid diet will ease swallowing, but it’s important to maintain overall calorie intake, so sometimes a doctor may recommend special drinks to provide nutrients (protein shakes)

Avoid the following products:

· Dry, crumbly, or hard food that is more difficult to swallow and more likely to cause choking
· Soups and other products with mixed consistency (i.e., solid and liquid at the same time, such as watery soup with separate ingredients). Choose thick, creamy soups rather than thin, watery soups
· Foods that stick to the roof of the mouth or around the mouth (tomatoes with skin, cookies, bran flakes, and boiled eggs
· Nuts, grains, and seeds
· Tough, fibrous fruits and vegetables

Drinking Recommendations

· Regularly sip water during meals
· Take a break between sips to completely empty your mouth
· Try to fill the glass when it is half empty (so you don’t have to tilt your head back too far when drinking)
· Use a special cup so you can drink without tilting your head.

Dietary Recommendations

· Try eating small portions, but more frequently.
· Use a metal teaspoon instead of a plastic dessert spoon to feel the sensation of a teaspoon in your mouth.
· Relax and enjoy your food. If you are relaxed, the muscles in your throat will also be relaxed, making swallowing easier.
· You can relax the muscles of the oropharynx by yawning while eating.
· Try sitting upright for 10 minutes before eating, during the meal, and for 30 minutes afterward. Good posture aids in eating, swallowing, and digestion.
· Do not tilt your head back while eating, as it makes swallowing more difficult and less safe.
· Try to eat in a state of “engagement”
· Try not to eat when you are tired.
· Minimize distractions during meals – turn off the TV.
· Ensure that dental prostheses fit well and do not interfere with chewing.
· Brush your teeth at least three times a day, checking for food particles on the sides of your mouth.
· Engage your friends and family – make sure they are aware of the issues you are facing and the need to take your time.

These recommendations will help avoid choking and other swallowing disorders in Parkinson’s disease.

Akhmadeeva Gulnara Nailevna, neurologist specializing in Parkinson’s disease
V.S. Buzaev International Medical Centre