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Nutritional Strategies for Managing Progressive Supranuclear Palsy (PSP) Symptoms

Progressive Supranuclear Palsy (PSP) is a rare neurological disorder that affects movement, control of walking (gait) and balance, speech, swallowing, vision, mood, and behavior. While it is a progressive condition with no current cure, dietary interventions and proper nutrition can play a pivotal role in managing its symptoms and ensuring the overall well-being of affected individuals. In this article, we delve deep into the potential nutritional strategies and their significance in mitigating the symptoms of PSP. 

Balanced Nutritional Intake and Progressive Supranuclear Palsy (PSP)

Adequate nutrition plays an undeniably pivotal role in overall health, and its significance is further magnified in individuals diagnosed with Progressive Supranuclear Palsy (PSP). Given the potential mobility constraints and the diminished energy levels that PSP patients often face, dietary adjustments and the inclusion of certain nutrient-rich foods can act as supportive measures to manage the condition’s symptomatic challenges.

  1. Supporting Brain Health:

    Brain health is paramount for those with Progressive Supranuclear Palsy (PSP), and certain dietary components can be pivotal in maintaining and even augmenting neural functionality: 

    • Omega-3 Fatty Acids: These essential fats are known to have neuroprotective effects. Cold-water fish such as salmon, mackerel, sardines, and trout are abundant in these fatty acids. Not only do they combat inflammation, but they also aid in preserving the integrity of the brain’s cell membranes, potentially slowing cognitive decline.
    • Antioxidants: Oxidative stress can damage neurons and accelerate degenerative processes in the brain. Incorporating foods rich in antioxidants can help neutralize harmful free radicals. In addition to blueberries and dark chocolate, consider incorporating beans, artichokes, and cranberries into the diet.
    • Leafy Greens: Rich in folate and vitamins E and K, leafy greens like kale, spinach, and collards have been associated with cognitive benefits, possibly due to their role in reducing inflammation and keeping harmful oxidation at bay.
  2. Managing Inflammation:

    Inflammation, especially when chronic, has been implicated in numerous health issues, including some neurological disorders. Dietary choices can significantly influence inflammatory responses: 

    • Curcumin in Turmeric: Curcumin, the active ingredient in turmeric, has received attention for its potent anti-inflammatory properties and its potential to cross the blood-brain barrier, directly delivering its benefits to the brain.
    • Berries: Beyond their antioxidant content, berries such as strawberries, raspberries, and blackberries contain compounds that are known to reduce inflammation.
    • Whole Grains: Foods like quinoa, barley, and oats can help regulate blood sugar and reduce inflammatory markers, offering a steady energy source while keeping inflammation in check.
    • Avoid Inflammatory Foods: Reducing the intake of processed foods, especially those rich in sugars, trans fats, and artificial additives, can diminish inflammation. Likewise, moderating alcohol consumption and avoiding fried foods can further control inflammatory responses.
  3. Aid in Mitigating Progressive Supranuclear Palsy (PSP) Symptoms:

    Diet can play a role in directly and indirectly mitigating PSP symptoms, by nourishing the brain and body and by offering protective benefits: 

    • Vitamin E: Beyond almonds, hazelnuts, and sunflower seeds, this essential vitamin can also be found in foods like kiwi, broccoli, and shrimp. It plays a role in reducing oxidative stress, potentially offering neuroprotective benefits.
    • B Vitamins: These vitamins, especially B6, B9 (folate), and B12, are crucial for brain health, aiding in the proper functioning of nerves and the synthesis of neurotransmitters. Sources include legumes, whole grains, meat, eggs, milk, and leafy greens.
    • Minerals: Essential minerals like magnesium (found in nuts, seeds, and whole grains) and zinc (found in beef, pumpkin seeds, and lentils) support neural functions and might help in managing some of the cognitive and motor symptoms associated with PSP.

Swallowing Difficulties and Nutritional Solutions for Progressive Supranuclear Palsy (PSP)

Swallowing issues, medically referred to as dysphagia, frequently emerge as challenging symptoms for individuals with PSP. With the associated dangers of weight loss, aspiration pneumonia from ingested food getting into the lungs, and malnutrition, it becomes paramount to adopt adaptive nutritional measures that guarantee both safety and nourishment for the patient.

  1. Texture-modified Diets:

    The concept behind a texture-modified diet in Progressive Supranuclear Palsy (PSP) is tailoring food consistency to match the individual’s current swallowing capability. 

    • Soft Diet: Foods in this category require minimal chewing. Examples include scrambled eggs, well-cooked pasta, and tender cuts of meat.
    • Pureed Diet: Ideal for those with pronounced difficulty in swallowing, a pureed diet consists of foods that have been blended to a smooth consistency, akin to pudding. Think mashed bananas, smooth oatmeal, and pureed vegetables.
    • Liquidized Diets: In extreme cases, where even pureed foods present a challenge, a liquidized diet may be recommended. This would involve thoroughly blending foods to achieve a drinkable consistency, ensuring that they contain all essential nutrients.
  2. Thickened Liquids:

    As ironic as it might sound, sometimes liquids pose a higher risk than solids for those with swallowing difficulties. 

    • Gel-based Thickeners: Commercially available, these can be added to beverages to give them a gel-like consistency, which can make swallowing easier and safer.
    • Natural Thickeners: Items like pureed fruits, yogurt, or even cooked cereals can be used to increase the thickness of drinks.
  3. Upright Positioning:

    The body’s posture during meals can drastically influence swallowing efficiency. 

    • Promote Chin Tuck: Along with sitting upright, a slight chin tuck (chin-down posture) when swallowing can help direct food down the esophagus and reduce the risk of aspiration.
    • Post-meal Caution: Even after meals, it’s a good practice to keep the individual in an upright position for at least 20-30 minutes. This minimizes the risk of post-meal aspiration due to residual food in the throat.
  4. Professional Assessment:

    Seeking expert guidance can be a game-changer in managing dysphagia for Progressive Supranuclear Palsy (PSP) patients. 

    • Technique Modification: A speech-language pathologist can instruct on modified swallowing techniques that might be more effective and safer for the patient.
    • Muscle Strengthening: Believe it or not, just as muscles in the body can be strengthened with exercise, so can swallowing muscles. Targeted exercises can sometimes aid in enhancing the coordination and strength of these muscles.
    • Regular Monitoring: Given the progressive nature of PSP, what works at one stage might not be suitable later on. Regular assessments ensure that dietary modifications are updated as the disease progresses.

Maintaining Weight: The Key to Overall Health in Progressive Supranuclear Palsy (PSP) Patients

Weight management becomes an imperative aspect of care in individuals diagnosed with Progressive Supranuclear Palsy (PSP). As they grapple with swallowing difficulties and a dwindling appetite, unintentional weight loss can emerge, carrying with it a slew of additional health risks. Ensuring that PSP patients maintain a healthy weight isn’t just about preventing these complications, but it’s also about bolstering their overall health, vitality, and well-being. 

  1. High-Calorie, Nutrient-Rich Foods:

    When appetite is limited, it’s crucial to make every bite count. 

    • Avocados: A powerhouse of healthy fats, avocados are calorie-dense and can be easily integrated into meals, be it in salads, smoothies, or on toast.
    • Nut Butters: Think beyond just peanut butter. Almond, cashew, and hazelnut butters are not only delicious but also packed with nutrients. They can be spread on toast, blended into shakes, or even consumed by the spoonful.
    • Olive Oil: An excellent source of monounsaturated fats, a drizzle of olive oil can boost the calorie content of dishes. Consider adding it to cooked foods, salads, or even smoothies.
    • Whole Dairy Products: Full-fat yogurt, cream, and cheese are rich in calories and can be incorporated into various meals and snacks. 
  2. Frequent, Small Meals:

    Adopting this strategy can help in circumventing reduced appetite and potential fatigue associated with consuming larger meals. 

    • Snacking Right: Healthy snacks like trail mix, granola bars, or cheese can be kept handy. They not only stave off hunger but also provide a quick calorie boost.
    • Hydrate with Calories: Instead of just water, opt for milk, fruit smoothies, or protein shakes that hydrate and nourish simultaneously.
    • Meal Prepping: Preparing meals in advance ensures that there’s always something nutritious available to eat, reducing the likelihood of skipped meals. 
  3. Dietician Consultation:

    As the saying goes, “One size doesn’t fit all.” This holds exceptionally true in the realm of nutrition, especially for Progressive Supranuclear Palsy (PSP) patients. 

    • Personalized Meal Plans: A dietician can draft meal plans tailored to the unique nutritional needs and preferences of the Progressive Supranuclear Palsy (PSP) patient, taking into account factors like current weight, activity level, and existing health conditions.
    • Supplement Guidance: Sometimes, achieving the necessary caloric and nutrient intake through food alone can be challenging. Dieticians can recommend suitable nutritional supplements or shakes that can complement the diet.
    • Monitoring & Adjustments: A periodic review with a dietician ensures that the nutritional strategy evolves with the changing needs of the PSP patient. If weight continues to drop or if other nutritional deficiencies emerge, the dietary plan can be promptly adjusted.


While Progressive Supranuclear Palsy is a challenging condition to navigate, nutrition and dietary interventions can offer patients a degree of control over their health and quality of life. Through conscious choices, professional guidance, and a focus on individual needs, diet can become an empowering tool in the journey with PSP. 


  1. Litvan I., Agid Y., Calne D., et al. Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. 1996;47(1):1-9.
  2. Williams D.R., Lees A.J. Progressive supranuclear palsy: clinicopathological concepts and diagnostic challenges. Lancet Neurol. 2009;8(3):270-279.
  3. Swinn L., Schrag A., Viswanathan R., et al. Sweating dysfunction in Parkinson’s disease. Mov Disord. 2003;18(12):1459-1463.
  4. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). National Academy Press.
  5. Mahan L.K., Raymond J.L. Krause’s Food & the Nutrition Care Process. 14th ed. 2016.

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:August 30, 2023

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