Nov 2, 2019

Nutrition and Post-Polio

Post-Polio Health (ISSN 1066-5331)

Vol. 14, No. 1, Winter 1998

Nutrition and Post-Polio

Lauro S. Halstead, MD, National Rehabilitation Hospital, Washington, DC

This is the story of my personal journey to learn more about nutrition. The path I followed and what I discovered along the way are specific to my body, my nutritional needs and my disability. Some of the principles I learned may apply to others, but the particulars relate only to me. I would no more recommend you follow my specific diet than I would urge you to take someone else's medication. If you want to change your eating habits, please do it under the guidance of a licensed nutritionist. That's what I did.

As it turned out, the nutritionist I worked with had a special interest in chronic disease, although she was unfamiliar with post-polio syndrome. Before going to her, I held what I considered was a traditional but "enlightened" view of nutrition. In other words, I was eating the kind of diet typically recommended in the medical literature and by the experts for a 61-year-old male with my medical history. What I quickly discovered is that "enlightened" is not always smart.

When I was in residency training many years ago, I attended a lecture by an eminent nutritionist who said males should restrict their intake of "visible" eggs to one or two a month; so I reduced mine to maybe half a dozen a year. A short time later, I heard another well-known nutritionist say he was starting his newborn son on 2% milk; I switched that night from whole milk (3%) to low fat (2%), and over the years limited my intake to what I used with cereal.
Then there was the issue of girth control. In the interest of watching my weight, I tried to avoid snacks and sweets, except on special occasions. Fortunately, I don't have a very sweet tooth, so this adjustment was not all that difficult.
And so it went. Over the years, I cut out greasy foods, then lightly fried foods, and finally even lean, red meat. By the time I saw the nutritionist for my first appointment in February 1996, my diet consisted, more or less, of the following:
  • For breakfast, one to two large glasses of orange juice, a bowl of raisin bran with milk and one banana;
  • For lunch, a large tossed salad with low calorie dressing, a half-pint of lowfat yogurt and fresh fruit; and
  • For supper, typically fish or chicken (with occasional red meat), vegetables, potato or pasta, and a salad.
  • I also drank a soft drink midmorning and mid-afternoon most days and had a nightcap at bedtime, most evenings.
Sounds pretty healthy, right? That's what I thought. too, especially when I considered that my cholesterol was normal, my weight was essentially the same as when I graduated from college, and people in the cafeteria line never tired of saying, "Wow, that's a healthy lunch!"
Well, my nutritionist did not agree. When I returned after the first week with a diary of everything I had eaten and the amounts, her comment was, "This is incredible," and she didn't mean it as a compliment.
As it turned out, she thought almost everything I was doing was wrong. The bananas and orange juice were 'empty' calories, the soft drinks were a sugar fix, and my lunch was skimpy at best. In short, I was on a starvation diet, in her opinion, which she calculated at 1300-1500 calories per day.
Well, if that were true, I asked, why wasn't I losing weight? Her explanation was that the body makes certain metabolic adjustments to accommodate different caloric intakes.
But it wasn't the caloric intake that bothered her so much. My biggest sin was the small amount of protein I was eating (about 5-6 ounces per day). "No wonder you're tired and weak. Anybody would be on that diet," she said. I, of course, thought instantly to myself, "Is this the cause of post-polio syndrome? Are we all just eating the wrong diet?"
The short answer is "no." But it is clear that a sensible diet can make you feel much better, as I was to find out fairly soon.
The main goals of my new nutritional plan were to increase the amount of protein, increase the number of calories, avoid the empty calories of orange juice and soft drinks, and finally, cut back on that


Post Polio Litaff, Association A.C _APPLAC Mexico

History of polio

The history of Polio

Image copyrightBBC
Image captionPoliomyelitis has existed as long as human society, but became a major public health issue in late Victorian times with major epidemics in Europe and the United States. The disease, which causes spinal and respiratory paralysis, can kill and remains incurable but vaccines have assisted in its almost total eradication today.
Ancient Egyptian Polio suffererImage copyrightGETTY IMAGES
Image captionThis Egyptian stele (an upright stone carving) dating from 1403-1365 BC shows a priest with a walking stick and foot, deformities characteristic of polio. The disease was given its first clinical description in 1789 by the British physician Michael Underwood, and recognised as a condition by Jakob Heine in 1840. The first modern epidemics were fuelled by the growth of cities after the industrial revolution.
Child polio sufferers, New York 1916Image copyrightOTHER
Image captionIn 1916, New York experienced the first large epidemic, with more than 9,000 cases and 2,343 deaths. The 1916 toll nationwide was 27,000 cases and 6,000 deaths. Children were particularly affected; the image shows child patients suffering from eye paralysis. Major outbreaks became more frequent during the century: in 1952, the US saw a record 57,628 cases.
Iron Lung, 1938Image copyrightGETTY IMAGES
Image captionIn 1928, Philip Drinker and Louie Shaw developed the "iron lung" to save the lives of those left paralysed by polio and unable to breathe. Most patients would spend around two weeks in the device, but those left permanently paralysed faced a lifetime of confinement. By 1939, around 1,000 were in use in the US. Today, the iron lung is all but gone, made redundant by vaccinations and modern mechanical ventilators.
Salk and SabinImage copyrightGETTY IMAGES
Image captionA major breakthrough came in 1952 when Dr Jonas Salk (L) began to develop the first effective vaccine against polio. Mass public vaccination programmes followed and had an immediate effect; in the US alone cases fell from 35,000 in 1953 to 5,300 in 1957. In 1961, Albert Sabin (R) pioneered the more easily administered oral polio vaccine (OPV).
Schoolchildren in Holland receive the oral polio vaccine.Image copyrightGETTY IMAGES
Image captionDespite the availability of vaccines polio remained a threat, with 707 acute cases and 79 deaths in the UK as late as 1961. In 1962, Britain switched to Sabin's OPV vaccine, in line with most countries in the developed world. There have been no domestically acquired cases of the disease in the UK since 1982.
Map: Polio in 1988
Image captionBy 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.
Map: Polio in 2002Image copyrightBBC
Image captionThe WHO Americas region was certified polio free in 1994, with the last wild case recorded in the Western Pacific region (which includes China) in 1997. A further landmark came in 2002, when the WHO certified the European region polio-free.
Map: Polio in 2012
Image captionIn 2012, Polio remained officially endemic in four countries - Afghanistan, Nigeria, Pakistan and India, which was on the verge of being removed from the list having not had a case since January 2011. Despite so much progress, polio remained a risk with virus from Pakistan re-infecting China in 2011, which had been polio free for more than a decade.
Map: Polio in 2013
Image captionChina returned to its polio-free status, with no recorded incidents after 2011
Map: Polio in 2015
Image captionIn 2015, polio remains endemic in only two countries - Pakistan and Afghanistan. No new cases have been reported in Africa for the past year.

Post Polio Litaff, Association A.C _APPLAC Mexico

Taiwan parents warned against kids visiting Philippines over polio fears

The Philippines has reported three polio cases since September and parents should err on side of caution if they plan to visit with children

TAIPEI (Taiwan News) – Parents in Taiwan are advised to err on the side of caution if they are planning to visit the Philippines with their kids, since the country has recorded three polio cases since Sept. 19.
The confirmed cases involved children aged 3 to 5, from the provinces of, respectively, Lanao del Sur, Laguna, and Maguindanao, said Taiwan’s Centers for Disease Control (CDC). The Southeast Asian country has a relatively low immunization coverage rate of 66 percent against the highly-contagious poliovirus.
The Philippine government has since October embarked on a vaccination program that focuses on kids below the age of 5. Follow-up inoculation work will resume in late November and January, according to CDC.
Local residents or individuals who have stayed in the Philippines for more than four weeks are advised to receive polio vaccinations before leaving the country. The vaccines should be administered four weeks to 12 months prior to departure, in accordance with World Health Organization (WHO) guidelines.
Inter-departmental campaigns have been conducted to urge Filipino visitors and migrant workers in Taiwan to get polio shots. Taiwan residents are also encouraged to ensure they are protected against the disease before traveling to the Philippines.

Post Polio Litaff, Association A.C _APPLAC Mexico

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