NUTRITION | Dirty dozen and clean fifteen

Navigating Nutrition in young onset Parkinson’s: The Dirty Dozen, Clean Fifteen, and Becoming an MVP

Understanding why we want you to be an MVP
At the Parkinson’s Australia National Conference 2025, one of the key discussions revolved around what ‘successful people with Parkinson’s’ do in terms of diet and its role in managing Parkinson’s symptoms. Dr Laurie Mischley is a naturopathic physician, researcher, and educator focused on Parkinson’s disease and integrative medicine. She holds an ND (Doctor of Naturopathic Medicine), PhD, and MPH (Master of Public Health) and has dedicated her career to exploring disease modification strategies for Parkinson’s. Her work emphasises nutrition, lifestyle interventions, and patient-centred tracking to improve outcomes for people living with Parkinson’s.

She presented some results from The Modifiable Variables in Parkinson’s Study (The MVP Study), which aims to identify lifestyle factors that influence the rate of Parkinson’s progression.

• Over 2,500 people have enrolled in the study, providing valuable data on how diet, exercise, social engagement, and other modifiable factors impact their symptoms.
• Dr Mischley’s research is patient-driven, focusing on empowering people with Parkinson’s to take an active role in managing their condition.
• Her work challenges the traditional view that Parkinson’s is inevitably progressive, instead exploring ways to slow or even reverse symptom severity through holistic approaches.

The Modifiable Variables in Parkinsonism (MVP) Study has already provided some fascinating insights into lifestyle factors that may influence Parkinson’s progression. Here are some key findings from preliminary data:

• Diet Matters – Foods associated with slower Parkinson’s progression include fresh vegetables, fresh fruit, nuts, non-fried fish, olive oil, wine, coconut oil, fresh herbs, and spices. Conversely, canned fruits and vegetables, diet and non-diet soda, fried foods, beef, ice cream, yoghurt, and cheese were linked to faster progression.
• Social Health is Crucial – people who report loneliness rate their symptoms twice as severely as those who feel socially connected.
• Nutritional Supplements – Coenzyme Q10 and fish oil were associated with reduced Parkinson’s progression, while iron supplementation was linked to faster progression.
• Exercise & Stress – Regular physical activity and lower stress levels were correlated with better symptom management.

These findings highlight the importance of lifestyle choices in Parkinson’s management. The study continues to collect data to refine these insights further.

How to Participate

People interested in enrolling in the Modifiable Variables in Parkinsonism (MVP) Study can do so through the official MVP website https://mvp-study.com/ The study aims to identify lifestyle factors that influence Parkinson’s progression by collecting data from participants over time.

• Eligibility: Individuals with Parkinson’s disease or Parkinsonism (including Multiple System Atrophy, Progressive Supranuclear Palsy, and Dementia with Lewy Bodies) can enrol.
• Online Access Required: Participants need an email address and basic computer literacy.
• Survey Participation: Enrolled individuals complete online surveys every six months for five years, tracking their health, diet, and lifestyle choices.
• Time Commitment: Each survey takes approximately 90 minutes, with reminders sent when deadlines approach.

The study does not provide direct medical care but aims to identify patterns in disease progression and highlight factors associated with better quality of life.

A particularly insightful topic she brought up was the Dirty Dozen and Clean Fifteen lists compiled by the Environmental Working Group (EWG) to help consumers make informed choices about pesticide exposure in fruits and vegetables.

The Dirty Dozen and Clean Fifteen

The Dirty Dozen: Foods recommended to buy organic

The Dirty Dozen consists of produce with the highest pesticide residues, meaning they are best purchased organic when possible. These include:

1. Strawberries
2. Spinach
3. Kale, collard, and mustard greens
4. Nectarines
5. Apples
6. Grapes
7. Cherries
8. Peaches
9. Pears
10. Capsicums and hot peppers
11. Celery
12. Tomatoes

For people with young onset Parkinson’s, avoiding excessive or repeated pesticide exposure may be beneficial, as some studies suggest a potential link between pesticide repeated exposures and neurodegenerative diseases.

The Clean Fifteen: Foods with Minimal Pesticides

On the other hand, the Clean Fifteen includes produce with low pesticide residues, meaning they are generally safe to buy non-organic:

1. Avocados
2. Sweetcorn
3. Pineapples
4. Onions
5. Papayas
6. Sweet peas (frozen)
7. Asparagus
8. Honeydew melon
9. Kiwi
10. Cabbage
11. Mushrooms
12. Cantaloupe
13. Mangoes
14. Watermelon
15. Carrots

These foods provide essential nutrients without significant pesticide exposure, making them excellent choices for a balanced Parkinson’s-friendly diet.

If buying organic isn’t an option, washing the Dirty Dozen properly can help reduce pesticide residues.

While washing reduces surface pesticides, remember that some residues penetrate the food’s flesh—so when possible, buying organic for the Dirty Dozen is still preferable. However, here are the best methods to clean them effectively:

1. Vinegar or Baking Soda Soak
   • Mix 1 part vinegar to 3 parts water, or dissolve 1 tablespoon of baking soda in a bowl of water.
   • Soak fruits and vegetables for 15 minutes, then rinse thoroughly.
   • This helps remove pesticide residues and bacteria.
2. Salt Water Rinse
   • Mix 1 teaspoon of salt per litre of water and soak produce for 5-10 minutes.
   • Rinse well to remove salt and any loosened contaminants.
3. Scrubbing & Peeling
   • Firm-skinned produce (apples, peppers, pears) should be scrubbed with a brush under running water
   • Peeling can reduce pesticide exposure, though some nutrients are lost in the process.
4. Running Water Method
   • For leafy greens (spinach, kale, celery), rinse thoroughly under cool running water, rubbing gently to remove dirt and residue.
   • Shake off excess water or use a salad spinner to dry.
5. Commercial Produce Washes
   • Some store-bought vegetable washes may help break down pesticide residues, though vinegar or baking soda soaks are just as effective.

Nutrition Tips for Young Onset Parkinson’s

Beyond pesticide considerations, diet plays a crucial role in managing Parkinson’s symptoms. Here are some key dietary strategies:

Prioritise Antioxidant-Rich Foods
Oxidative stress is believed to contribute to dopaminergic neuron damage in Parkinson’s. Foods rich in antioxidants help combat this:

• Berries (blueberries, raspberries, blackberries)
• Leafy greens (spinach, kale, Swiss chard/silverbeet)
• Nuts and seeds (walnuts, flaxseeds, chia seeds)

Maintain Gut Health
Emerging research suggests a gut-brain connection in Parkinson’s. Supporting gut health may improve digestion and medication absorption:

• Fermented foods (yoghurt, kimchi, sauerkraut)
• High-fibre foods (whole grains, legumes, vegetables)
• Adequate hydration** to prevent constipation

Balance Protein Intake
Levodopa absorption can be affected by protein intake, so timing meals strategically is important:

• Consume protein later in the day to optimise medication effectiveness.
• Choose lean protein sources like fish, poultry, and plant-based options.

Reduce Processed Foods
Highly processed foods can contribute to inflammation and oxidative stress, potentially worsening symptoms:

• Limit refined sugars and trans fats found in processed snacks.
• Opt for whole, minimally processed foods whenever possible.
• Avoid canned fruits and vegetables, diet and non-diet soda, fried foods, beef, ice cream, yoghurt, and cheese.

Consider Omega-3 Fatty Acids
Omega-3s support brain health and may reduce inflammation:

• Fatty fish (salmon, sardines, mackerel)
• Flaxseeds and walnuts
• Algal oil supplements for plant-based alternatives.

Understanding the Dirty Dozen and Clean Fifteen can help people with young onset Parkinson’s make informed choices about pesticide exposure while maintaining a nutrient-rich diet. By prioritising antioxidants, gut health, balanced protein intake, and whole foods, people can support their overall wellbeing and symptom management.

For further guidance, consulting a dietitian specialising in Parkinson’s can help tailor dietary strategies to individual needs. See Dietitians Australia.

 

References

Bloem, Bastiaan R et al. (2023) The inadequacy of current pesticide regulations for protecting brain health: the case of glyphosate and Parkinson’s disease. The Lancet Planetary Health, Volume 7, Issue 12, e948 – e949Environmental Working Group. (2023).

EWG’s 2023 Shopper’s Guide to Pesticides in Produce. Retrieved from https://www.ewg.org

Marras, C., Canning, C. G., & Goldman, S. M. (2018). Pesticides and Parkinson’s disease: A review of epidemiological studies. Movement Disorders, 33 (10), 1505-1513. [https://doi.org/10.1002/mds.27427](https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mds.27427)

Mischley, L. https://educationismedicine.com/pro-pd

Mishcley, L. https://www.parkinson-school.com/p/parkinson-school-2023-food-pro-diet-10yearsummary

Tansey, M. G., Goldberg, M. S., & Neuroinflammation Research Group. (2019). The role of diet and inflammation in Parkinson’s disease progression. Journal of Neuroinflammation, 16 (1), 94. [https://doi.org/10.1186/s12974-019-1476-7](https://jneuroinflammation.biomedcentral.com/articles/10.1186/s12974-019-1476-7)