The Post-Polio Institute Protein Power “Diet”


By Dr. Richard L. Bruno
Director, The Post-Polio Institute
Englewood Hospital and Medical Center

Note: Check with your doctor before changing or starting any diet.

“Breakfast? Sorry, don’t have the time. In the morning there’s too much to do, like showering and dressing and getting to work. I grab a cup of coffee (or two or three) and maybe a donut at work…”

“Lunch? Don’t think so. I’m still catching up from my late start in the morning. I grab a cup of coffee (or two or three) and maybe wolf down half a Big Mac…”

“Dinner? I’m either too tired or hungry as Patton’s Third Army. I either defrost a piece of pizza and drag myself into bed or eat everything that isn’t nailed down!

“So why am I totally exhausted but can’t stop gaining weight?”

Polio Survivors vs. Breakfast. Americans are not very good at taking care of themselves. American’s with disabilities are no better, and maybe a little worse, at self-care because it takes so much time to do things nondisabled folk do in a flash, like showering and dressing. There’s hardly any time or energy left for planning meals, shopping, cooking … or even eating.

One group of people with disabilities shows the consequences of poor eating habits: North America’s 1.8 million polio survivors. Nearly 76 percent of polio survivors experience Post-Polio Sequelae (PPS). PPS are requiring polio survivors to use new assistive devices or aids they discarded years ago, like braces, canes, crutches, wheelchairs and scooters, to slow down and to rest during the day. The problem is, most polio survivors are Type A, hard working, pressured, perfectionistic super-achievers, who have pushed themselves beyond their physical limits and allow no time for self-indulgent luxuries like food. Polio survivors don’t want to slow down or rest, not only because they’re afraid if they are less Type A people won’t like them, but also because they are afraid of gaining weight if they become more sedentary. But they shouldn’t be afraid. Food is good! Eating properly doesn’t lead to becoming fat, and it actually reduces PPS symptoms.

Dr. Susan Creange at The Post-Polio Institute discovered that polio survivors with blood sugar levels in the low normal range have as much difficulty paying attention and concentrating as would diabetics with blood sugars as low as if they had taken too much insulin. “Polio survivors’ ‘Type A diet’–three cups of coffee for breakfast, skipping lunch and eating pizza for dinner–is actually starving their nervous systems and causing PPS symptoms,” says Creange. The relationship between diet and PPS was seen in the 1998 National Post-Polio Survey: The less protein polio survivors had at breakfast the more severe were their daily weakness and fatigue.

Why do polio survivors function as if they have low blood sugar and report more symptoms when they don’t eat protein at breakfast? Because polio survivors are running their nervous systems on “half a tank of gas.” About 50 percent of all brain stem and motor neurons were killed decades ago by the poliovirus. What’s worse, the metabolic apparatus–the internal power plant–of the neurons that survived the original poliovirus infection was severely damaged. So polio survivors have been running their full-tilt, Type A lives on half the normal number of neurons, neurons that are less able to use their only source of fuel, blood sugar. Dr. Creange found that even normal levels of blood sugar were not enough to fuel the remaining poliovirus-damaged, metabolically impaired neurons. And that’s where protein at breakfast comes in.

Protein: The fuel that keeps on giving. Protein provides a long-lasting, “slow-release” supply of blood sugar throughout the day. Polio survivors who had protein for breakfast reported fewer PPS symptoms because their fuel tank stayed full longer. They didn’t need to “fill up” throughout the day with short-lasting sugar fixes, like soda or candy bars.

Mom was right about one thing: Breakfast is the most important meal of the day. Since a polio survivor can use more energy just getting showered and dressed than a nondisabled person does running a marathon, you need protein early and often. It’s a good idea to eat breakfast before showering to “break your fast” and fill your tank before your neurons need the fuel. When we ask our post-polio patients to eat protein every day at breakfast, and have small, non-carbohydrate snacks throughout the day, they report an almost immediate reduction in nearly all the symptoms of PPS, especially fatigue. But the “protein power” diet is neither a fad nor a miracle; it’s just common sense. No engine can be expected to run without fuel!

Our patients worry that using a wheelchair, resting more and having breakfast will cause them to get fat and have more PPS symptoms. A four-year follow-up study found that U.S. and Swedish polio survivors, living their typical Type A “use it or lose it” lifestyles without using new assistive devices or resting, lost equal amounts of leg muscle strength, about 2 percent per year. However, when subjects from the two countries were looked at separately, the Swedes gained only 6 ounces per year, while the Americans gained over 2 pounds; that’s 220 percent more weight! Although weight gain alone is not responsible for the progression of muscle weakness in polio survivors, it is Americans’ high fat, Big Mac diet that causes them to get fat. You can fuel your neurons, feel stronger and less fatigued without gaining weight, if you choose low fat, low cholesterol sources of protein. In fact many of our patients, even as they slow down, sit down more, and use a scooter, lose weight (about a pound per week) if they eat more protein, reduce portion size and limit carbohydrates.

We aren’t recommending one of those “all protein, no carbohydrate” diets. We aren’t recommending a “diet” at all, but a method for eating healthy every day. We suggest 16 grams of protein at breakfast; that’s about a quarter of the daily protein requirement (70 grams) for a 150 pound person. (Always check with your doctor, especially if you have kidney problems, before changing your diet and ask to have your cholesterol measured at your yearly check up.)

Look at the list protein-rich foods and select different breakfasts so you can have a variety throughout the week. Remember, you want foods that have more grams of protein than they do fat:

The Protein Power “Diet”
Protein Fat
(grams) (grams)
Great:
Cottage Cheese (Lite) (1 cup) 28.0 2.3
Salmon (3 ounces) 17.0 5.4
Yogurt (8 ounces) 12.0 4.0
Tofu (6 ounces) 10.0 5.9
2 Egg Whites 6.8 0
Bagel (Lenders) 6.0 1.4
Egg Beaters (1/4 cup) 5.0 0
Milk (8 ounces = 1 cup):
Skim Plus Milk 11.0 0
2% Milk 8.0 3.0
Soy Milk 7.0 5.0
Snack Bars:
MET-Rx
Fudge Brownie 26.0 2.5
Source One 15.0 3.0
GeniSoy Bar 14.0 3.5
Balance Bar 14.0 6.0
Cliff (Luna) Bar 10.0 5.0
Protein Drinks:
Met-Rx in 2% Milk 46.0 5.5
Designer Protein Powder in 2% Milk 25.5 3.0
Carnation Instant Breakfast in 2% Milk 12.0 3.0
Higher Fat:
Swiss Cheese (1 ounce) 8.1 7.8
Lite ‘n’ Lively Cheese (1 ounce) 6.4 4.3
Hard Boiled Egg 6.1 5.6
Cream Cheese (Lite) (1 ounce) 2.9 4.7
Peanut Butter (1 TBS) 3.5 4.0
Lower Protein:
Quaker Life 5.2 1.8
English Muffin 4.5 1.1
Oatmeal (1 package) 4.4 1.7
Cheerios (1 1/2 cups = 1 ounce) 4.3 1.8
Shredded Wheat (1 ounce) 3.1 0.6
Total (1 cup) 2.8 0.6
Not Good:
Egg McMuffin 17.0 32.0!
Bacon (3 strips) 5.8 9.4
Coffee 0.1! 0.0

POLIO SURVIVOR’S POWER BREAKFASTS:

12-minute breakfast: 2 hard boiled eggs (12 g) and an English Muffin (4.5 g)

8-minute breakfast: 3 scrambled egg whites (10 g) and a bagel (6 g)

6-minute breakfast: Toasted bagel (6 g), lite cream cheese (3 g) and 1 glass 2% milk (8 g)

4-minute breakfast: Yogurt (12 g) and 1 ounces of low-fat cheese (6 g)

2-minute breakfast: 1/2 cup low-fat cottage cheese (14 g)


Support New Mobility

Wait! Before you wander off to other parts of the internet, please consider supporting New Mobility. For more than three decades, New Mobility has published groundbreaking content for active wheelchair users. We share practical advice from wheelchair users across the country, review life-changing technology and demand equity in healthcare, travel and all facets of life. But none of this is cheap, easy or profitable. Your support helps us give wheelchair users the resources to build a fulfilling life.

donate today

2 Comments
Oldest
Newest Most Voted
Inline Feedbacks
View all comments
Corkey
Corkey
1 year ago

Please name the proteins for organic diets; we eat no meat; chia takes the place of eggs.

Kathleen Lloyd
Kathleen Lloyd
1 year ago

If we want to supplement with protein powders which of the three different proteins powders is better for PPS?