Is underweightness still a major problem in Parkinson's disease patients?

Design: Epidemiological study on consecutive patients presenting for the first time in a 16-month period. Setting: Nutritional service of PD referral centre in Milan, Italy. Subjects: Three-hundred and sixty-four PD patients diagnosed according to CAPIT criteria. Methods: Anthropometric assessments: BMI and waist-to-hip ratio; evaluation of therapeutic physical activity (h/week). Results: Three-hundred and sixty-four patients were included (180 female, 184 male), mean (s.d.) age 65.9 (8.9)y, mean (s.d.) duration of PD 10.6 (5.3)y; 134 patients (37%) were overweight and 92 (25%) were obese; 11 (3%) were underweight; 127 (35%) had normal BMI. No important differences in BMI according to sex and smoking status were observed. There was highly significant inverse correlation between duration of disease and BMI (P < 0.001): mean (s.d.) duration of disease was 9.7 (4.7)y in overweight+ obese patients, 11.1 (5.5)y in patients with normal BMI and 14.1 (7.2)y in underweight patients (P=0.0059). The waist-to-hip ratio was a cardiovascular risk factor in 47.7% of men and 73.8% of women. Mean (s.d.) therapeutic physical activity was 1.07 (1.59) h/week in overweight and obese patients vs 1.61 (2.04) h/week in patients with normal BMI (50.5% increase; P = 0.03). Conclusions: At present underweightness is uncommon in PD patients in Italy; this may be due to the increase in the prevalence of overweightness in the Italian population and to modern anti parkinsonian therapy. Sponsorship: Fonclazione Grigioni per il Morbo di Parkinson.