Nutrition and Post-Polio Lauro S. Halstead, MD, National Rehabilitation Hospital, Washington, DC

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

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