Tips on exercise, nutrition, and stress for people with Parkinson’s Lifestyle advice as medicine based on the latest insights

4 November 2025

Increasing physical activity, reducing stress, and improving nutrition can alleviate Parkinson’s symptoms and may even slow the progression of the disease. Neurologist and professor Bas Bloem from Radboudumc offers lifestyle advice for Parkinson’s based on the latest scientific findings.

Medications reduce Parkinson’s symptoms but do not stop the disease’s progression. This may be because medications target a single disease-causing process, while Parkinson’s involves multiple factors and pathways. Lifestyle changes have broader effects and are therefore an attractive option for managing Parkinson’s symptoms. A healthy lifestyle consists of more exercise, a healthy diet, reducing stress, sleeping well, having positive social relationships, and avoiding harmful substances. Exercise, nutrition and stress are the most thoroughly investigated. Neurologist and professor Bas Bloem, together with colleagues, wrote about this in The Lancet Neurology and summarizes the key recommendations.

In short:

• Exercise: move at moderate to high intensity for at least 30 minutes three times a week, ideally supplemented with strength training and balance exercises. Also increase daily physical activity.
• Nutrition: follow general healthy dietary guidelines—mostly plant-based, with plenty of vegetables, fruits, whole grains, and nuts. Avoid processed foods.
• Stress: reduce the consequences of stress through relaxation exercises, mindfulness, or yoga. Strengthen your social network to build resilience.

More exercise

People who are sedentary are more likely to develop Parkinson’s than those who are structurally physically active. While this doesn’t prove that inactivity causes the disease, it does suggest that an active lifestyle may offer benefits or protection.

For those already living with Parkinson’s, it’s been convincingly shown that exercise has a positive influence on motor  symptoms like problems with balance and walking. It also improves other issues such as fatigue, sleep quality, mood, and anxiety.

Exercise at high intensity works best, ideally three times a week for at least thirty minutes. This means activities that raise your heart rate and breathing, such as jogging, dancing, boxing, or cycling on a stationary bike. The specific activity doesn’t matter as much as doing it regularly. Moderate-intensity activities like brisk walking also help. Strength training has shown positive effects as well.

Exercising with others is beneficial: it’s fun, provides social contact and some people are better able to stick with it as a result. Group activities like climbing, boxing, Tai Chi, dancing, karate, and Pilates have proven benefits for people with Parkinson’s.

Increasing movement at home also has positive effects, for instance through household chores or gardening. There are also games, virtual reality (VR) headsets, and phone apps that encourage movement. VR has been shown to improve balance, and 'exergaming' (active gaming) reduces fall risk. A downside is, that most of these new technologies are not available to everyone yet.

No disadvantages of exercise for Parkinson’s have been found. Although people with Parkinson’s are more likely to have cardiovascular problems, no studies have reported cardiovascular incidents due to exercise. While falls are more common under people who are more active, exercise under proper guidance actually helps prevent these falls. If someone falls frequently or has balance issues, it’s wise to coordinate exercise with a specialized healthcare provider. These professionals are available throughout the Netherlands via the national ParkinsonNet and can be easily found here.

How exercise impacts Parkinson’s disease isn’t fully understood, but MRI scans show that people participating in exercise programs develop more new brain connections. This allows healthy brain areas to take over functions from damaged ones, potentially slowing Parkinson’s progression. These benefits may result from improved brain circulation, reduced inflammation, protective substances, and better gut microbiome composition.

Healthy diet

People who follow a Mediterranean diet are less likely to develop Parkinson’s than those who eat a lot of meat and processed foods. A Mediterranean diet is mostly plant-based, with lots of vegetables, whole grains, nuts, seeds and legumes. Processed foods include items with many added ingredients like sugar and salt. Examples are snacks, cookies, soft drinks, and ready-made meals.

Studies show that the Mediterranean diet positively affects bowel movements and cognitive functions in people with Parkinson’s. High-fiber foods, such as whole grain products, vegetables, and fruit, reduce constipation and stimulate digestion, improving medication absorption. Drinking enough fluids also helps, preferably unsweetened drinks like water, coffee, and tea.

Research has also looked at the ketogenic diet, which is low in carbohydrates and high in fat. So far, no convincing positive effects have been found for Parkinson’s. In addition, this diet is difficult to maintain and can lead to nutritional deficiencies. This can result in weight loss and muscle mass loss.

Proteins can interfere with the absorption of the medication levodopa. However, proteins are essential for health. It’s best to consume them, but not at the same time as taking the medication. For those needing extra protein, whey protein—a byproduct of cheese production—seems to be a safe option.

Reducing stress

Stress directly worsens the motor symptoms of Parkinson’s disease, such as tremors and involuntary movements. People with Parkinson’s have higher levels of stress hormones in their bodies than the average Dutch person, and they are more likely to have mood (one in three) or anxiety disorders (one in four).

Stress in Parkinson’s can be reduced through relaxation exercises, mindfulness, yoga, Tai Chi, or Qigong. Mindfulness and yoga have also been shown to help with anxiety and depression.

Resilience is important for mental health in Parkinson’s. A strong social network, a positive outlook on life, and good cognitive skills make people with Parkinson’s more resilient. Interestingly, resilience is not related to the severity of symptoms or the duration of the disease. Loneliness, on the other hand, may be  a risk factor for Parkinson’s.

Applying advice in practice

When people with Parkinson’s start exercising more, eating a healthier diet, and reducing stress, these three pillars reinforce each other and lead to the best results. However, changing one’s lifestyle can be challenging, especially when improvements are needed in multiple areas at once.

Support is available for this. Healthcare providers can assist with a personalized approach and help set priorities. They also provide access to an online lifestyle decision aid. This tool offers information, considers individual circumstances and preferences, and helps with making choices.

You can turn to organizations such as ParkinsonNet, a nationwide network of over four thousand Parkinson’s specialists. Additionally, more digital tools are becoming available, such as a smartphone app that acts as a digital coach. These innovations also support sustainable lifestyle changes.

About the publication

This review study was published in The Lancet Neurology: The role of lifestyle interventions in symptom management and disease modification in Parkinson's disease. Joanne Trinh, Nienke M de Vries, Piu Chan, Marieke C J Dekker, Rick C Helmich, Bastiaan R Bloem. DOI: 10.1016/S1474-4422(25)00305-900305-9.

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