BACK Published by permission of Kathrynne Holden, who holds the copyright


Fava Beans, Levodopa, and Parkinson's Disease

by Kathrynne Holden, MS, RD


Ms. Holden is a registered dietitian specializing in Parkinson's disease. She has published research, books, articles, and manuals on nutrition and PD, including "Eat well, stay well with PD." For more information you may call (USA) 877-565-2665, or 970-224-5066; or visit her website: http://www.nutritionucanlivewith.com/



Beans and Parkinson's disease

In the past few years, I've been increasingly asked for information about fava beans as a source of levodopa. It's clear that many people are trying fava beans without fully understanding their properties. This article is designed to answer questions that have arisen about fava and Parkinson's disease (PD). I hope this may clear up some of the confusion about the bean, and encourage people to discuss its use with their doctors and dietitians.

This bean is a legume called "fava" (fah-vuh), faba, broad bean, and horse bean. Its botanical name is "Vicia faba." There are many species of faba; however, the "faba major"is the bean of concern here. It grows in a long pod, like a giant green bean, with large, flat seeds inside. It has been eaten for thousands of years throughout the world, especially in the Mediterranean region.

How are fava beans related to PD?

Fava beans contain levodopa, the same chemical in Sinemet, Madopar, Dopar, Larodopa, and other levodopa-containing medicines used to treat PD. In fact, the entire fava plant, including leaves, stems, pods, and immature beans, contains levodopa.

The amount of levodopa can vary greatly, depending on the species of fava, the area where it's grown, soil conditions, rainfall, and other factors. It appears that the young pod and the immature (green) beans inside the pod contain the greatest amount of levodopa, and the mature, or dried bean, the least. Three ounces (about 84 grams or cup) of fresh green fava beans, or three ounces of canned green fava beans, drained, may contain about 50-100 mg of levodopa. If using the young pod as well as the beans, the amount of levodopa may be greater than that in the fresh beans alone.

What effect do fava beans have on PD?

Some small studies have shown that the levodopa in fava beans can help control the symptoms of PD, just as medications containing levodopa do. In fact, a few people report that the effects from fava last longer than the effects from medications. Some researchers believe fava beans may contain other substances besides levodopa that could be helpful.

However, although some people report good effects, others find no antiparkinson effect from fava beans at all; and still others report adverse effects, such as nausea and dyskinesia. Much more research needs to be done to determine how effective fava beans may be.

Are there any problems associated with eating fava beans?

Yes, there a number of concerns to be aware of:

Variable levodopa amounts. Because fava plants have varying amounts of levodopa, it's possible to get either too much or too little levodopa. Too little levodopa will not relieve PD symptoms; and too much levodopa can cause overmedication effects, such as dyskinesia - particularly if other PD medications are being used at the same time. Also, the levodopa can cause nausea in some people.

Allergies. Raw fava beans can produce an allergic reaction in some people, including discomfort, and occasionally, coma. Cooking may prevent allergic reactions.

Monoamine oxidase inhibitor (MAOI) use. Another consideration is the use of fava for people who take MAOIs. These include: isocarboxazid (Marplan); phenelzine (Nardil); tranylcypromine (Parnate); and selegiline (deprenyl, Carbex, Eldepryl).

MAOIs taken in combination with pressor agents (foods high in dopamine, tyramine and phenylethylamine), can bring about a dangerous, and sometimes fatal, increase in blood pressure. Levodopa in medications or in fava can convert to dopamine in the bloodstream. It should be noted that selegiline is a different type of MAOI (MAOI-type B), and in the amount normally used by people with PD (10 mg daily), it is not thought to pose a risk when used with dopamine. However, people using any MAOI should discuss foods containing pressor agents with their physicians and dietitians.

Favism (G6PD deficiency). Favism is an inherited disease in which a person lacks an enzyme called glucose-6-phosphate dehydrogenase (G6PD). When these people eat fava beans, they develop a condition called hemolytic anemia. This anemia causes red blood cells to break apart and block blood vessels. When such blockage occurs in the kidneys, it can result in kidney failure and even death. Although favism is usually detected in childhood, adults can be affected as well.

G6PD deficiency is rare, occurring mostly among people of Mediterranean, African, and Southeast Asian descent, but others can be affected as well. Your physician can perform a blood test for G6PD to determine whether you are at risk. If you find you have inherited G6PD deficiency, your dietitian can help you locate other foods that may be of concern, and can help you plan safe and healthful menus. For more information on favism, see Resources at the end of this article.

Should you eat fava beans if you have Parkinson's disease?

Many people with PD can benefit from use of fava beans. If you'd like to try them, discuss it with your physician first. Besides MAOI use and risk for favism, your doctor may want to adjust the amount and/or timing of your PD medications.

If your doctor agrees that you should try using fava beans, he or she will probably ask you to start out with a very small amount at first, to see what effect, if any, fava has for you. An ounce (about 28 grams, or two tablespoons of beans) a day is probably right for most people to begin with. After a week you should notice whether there is any effect, and if not, your doctor may suggest that you increase the amount. If the fava beans reduce PD symptoms, your doctor may want to adjust your other PD medications.

How often should I eat fava beans?

There is too little information available to give an exact answer; also, each person with PD is different, and has different medication needs. Some people report a half cup (4 ounces, 112 grams) of fava a day, or even every other day, gives good results. Begin with a small amount, increasing gradually under your doctor's supervision, until you find the combination of fava and/or PD medications that's right for you.

Even if fava beans help, you shouldn't eat too much. If you fill up on fava, you'll be too full for other foods, and will miss out on the benefits they offer. A dietitian can help you plan menus that include fava beans and will best meet your personal needs.

Where can I get fava beans?

Fresh pods and/or green fava beans are available in season at specialty produce markets and some specialty foods shops. They may also be found at Middle Eastern markets, some supermarkets, and farmers' markets. Grocery stores may be willing to special order the fresh pods or beans in season, frozen pods/beans, or canned green fava beans, such as produced by Krinos or Cortas. Be sure to specify "green fava beans," not dried or mature beans. For more information, see Resources.

Nutrient information for fava beans

Besides levodopa, fava beans are rich in valuable nutrients. Fava pods with beans are a good source of iron, magnesium, potassium, zinc, copper, selenium, and many vitamins. The beans alone are also good - 3 ounces (98 grams) of cooked fresh beans contain 56 calories, 20 grams carbohydrates, 5 grams protein, 2 grams fiber, and substantial amounts of iron, magnesium, and vitamin C.

How do I prepare fava beans?

The pods, including beans, are best eaten when very young, before a "string" forms along the side. They can be steamed or boiled until tender. Add some olive oil or butter, lemon juice, salt and pepper, and serve as a vegetable side dish, like snow peas.

To use the fresh green fava beans, shell the beans from the pods, like green peas. Then boil or steam them till tender - usually two to 10 minutes, depending on size and age. Add butter, salt and pepper, or your own favorite seasoning, and serve as a side dish. You can also add the cooked beans to salads. If the beans seem too chewy, cook for 8-10 minutes, then cool and slip off the outer skins; cook a few more minutes if needed. Some people like to eat the skins, others find them too tough.

In conclusion, fava beans are an excellent food, as well as a possible way to help fight the effects of PD. Discuss use of fava with your doctor and registered dietitian. Here's to your good health!

RESOURCES

Sources for fava beans: (Be sure to ask for green, or immature, fava beans, either the beans themselves or the entire pod. The pods may be fresh or frozen; the beans may be fresh, frozen, or canned.)

International Gourmet
32945 Casena Street, Temecula, California 92592
1 - 909 - 303 - 3836
Will ship fresh (in season), frozen green (immature), or canned green (immature) fava beans

RiceAndBean.Com
123 Lexington Ave.
New York 10016
http://www.riceandbean.com/
Tel: 212-685-3451
FAX: 212-683-8458
Email : sales@kalustyans.com
Carries Cortas green broad fava bean

Star Market Turkish Food
1680 E.Oakland Blvd.
Oakland Park, Florida-33334
http://www.starmarket2000.com/index.html
Tel/Fax: (954) 564-1757
Email : star@starmarket2000.com
Carries canned green fava beans

SHAMRA.COM
2650 University Blvd.
Wheaton, MD 20902
Maryland: (301) 942-9726
USA: (800) 880-6062
Fax: (240) 337-6468
http://www.shamra.com/
Carries:
KRINOS - Cooked Broad Beans ( also known as Green Fava Beans ) 24 OZ .
CORTAS - Cooked Green Fava Beans. To serve: Heat contents and serve with rice.
Ingredients: Broad beans, Water, Salt and citric acid. Imported from Lebanon. 30 OZ

For more information on fava beans:

The Fava Bean Project
http://www.efn.org/~rossr/index.html

Cornell University Division of Nutritional Services
http://www.nutrition.cornell.edu/nutriquest/favabean.html

For information on Favism:

Centers for Disease Control and Prevention
1600 Clifton Rd.
Atlanta, GA 30333
U.S.A
(404) 639-3311
1-800-311-3435
http://www.cdc.gov/netinfo.htm

G6PD deficiency
http://www.bioinf.org.uk/g6pd/

The Favism.Website:
http://www.rialto.com/favism/

References

  1. Burbano C, Cuadrado C, Muzquiz M, Cubero JI Variation of favism-inducing factors (vicine, convicine and L-DOPA) during pod development in Vicia faba L, Plant Foods Hum Nutr 1995 Apr;47(3):265-275.
  2. Rabey JM, Vered Y, Shabtai H, Graff E, Korczyn AD Improvement of parkinsonian features correlate with high plasma levodopa values after broad bean (Vicia faba) consumption, J Neurol Neurosurg Psychiatry 1992 Aug;55(8):725-727.
  3. Rabey JM, Vered Y, Shabtai H, Graff E, Harsat A, Korczyn AD Broad bean (Vicia faba) consumption and Parkinson's disease, Adv Neurol 1993;60:681-684.
  4. Apaydin H, Ertan S, Ozekmekci S Broad bean (Vicia faba)--a natural source of L-dopa--prolongs "on" periods in patients with Parkinson's disease who have "on-off" fluctuations, Mov Disord 2000 Jan;15(1):164-166.
  5. Food Fact Finder: nutrient data for Beans, fava, in pod, raw http://health.fortworks.com/nutdata.php3?Item=11973
  6. Fava Bean: The Vegeman Files http://www.geocities.com/NapaValley/7514/f101.html
  7. Nutritional Anemias (from Clinical Nutrition and Dietetics, 2nd ed., edited by Frances J. Zeman). Macmillan Publishing Co., NY NY, 1991. Favism, pp. 698-99.
  8. Glucose-6-Phosphate Dehydrogenase Deficiency (from Hematology, edited by W.J. Williams, E. Beutler, A.J. Erslev, and M.A. Lichtman). New York: McGraw-Hill 1990, p. 591-606.
  9. Mehta A, Mason PJ, Vulliamy TJ Glucose-6-phosphate dehydrogenase deficiency, Baillieres Best Pract Res Clin Haematol 2000 Mar;13(1):21-38.
  10. The Fava Bean Project http://www.efn.org/~rossr/index.html
  11. Cornell University Division of Nutritional Services http://www.nutrition.cornell.edu/nutriquest/favabean.html




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