The Post-Polio Institute Protein Power "Diet"

The Post-Polio Institute Protein Power "Diet"
by Dr. Richard L. Bruno

"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 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 non-disabled 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 are 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, 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; 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 less 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 many polio survivors use more energy just getting showered and dressed than does a non-disabled person who runs 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 loose it" lifestyles without using new assistive devices or resting, lost equal amounts of leg muscle strength, about 2% 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% 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 everyday.  We suggest 16 grams of protein at breakfast; that's about 1/4 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.  In general one ounce of meat or fish contains about 7 grams of protein:  Remember, you want foods that have many more grams of protein than they do fat. 

 The Protein Power "Diet"
Cottage Cheese (Lite) (1 cup) = 28.0g Protein and 2.3g Fat
  Salmon   (3 ounces) = 17.0g Protein and 5.4g Fat
  Yogurt    (8 ounces) = 12.0g Protein and 4.0g Fat
  Tofu       (6 ounces) = 10.0g Protein and 5.9g Fat
  Milk (8 ounces = 1 cup)          
   Skim Plus Milk = 11.0g Protein and 0g Fat
   2% Milk = 8.0g Protein and 3.0g Fat
   Soy Milk = 7.0g Protein and 5.0g Fat
  2 Egg Whites = 6.8g Protein and 0g Fat
  Bagel (Lenders) = 6.0g Protein and 1.4g Fat
  Egg Beaters (1/4 cup) = 5.0g Protein and 0g Fat

Snack Bars:
    Fudge Brownie = 26g Protein and 2.5g Fat
     Source One = 15.0g Protein and 3.0g Fat
   GeniSoy Bar = 14.0g Protein and 3.5g Fat
   Balance Bar = 14.0g Protein and 6.0g Fat
   Cliff (Luna) Bar = 10.0g Protein and 5.0g Fat

Protein Drinks:
  Boost High Protein = 15.0g Protein and 6.0g Fat
  Met-Rx in 2% Milk = 46.0g Protein and 5.5g Fat  
  Designer Protein Powder in 2% Milk = 25.5g Protein and 3.0g Fat
  Carnation Instant Breakfast in 2% Milk = 12.0g Protein and 3.0g Fat

Higher Fat:
  Swiss Cheese (1 ounces) = 8.1g Protein and 7.8g Fat
  Lite 'n' Lively Cheese (1 ounces) = 6.4g Protein and 4.3g Fat
  Hard Boiled Egg = 6.1g Protein and 5.6g Fat
  Cream Cheese (Lite) (1 ounces) = 2.9g Protein and 4.7g Fat
  Peanut Butter (1 TBS) = 3.5g Protein and 4.0g Fat
Lower Protein:
  Quaker Life = 5.2g Protein and 1.8g Fat
  English Muffin = 4.5g Protein and 1.1g Fat
  Oatmeal (1 package) = 4.4g Protein and 1.7g Fat
  Cheerios (1 1/2 cups = 1 oz) = 4.3g Protein and 1.8g Fat
  Shredded Wheat  (1 ounces) = 3.1g Protein and 0.6g Fat
  Total  (1 cup) = 2.8g Protein and 0.6g Fat

Not Good:
  Egg McMuffin = 17.0g Protein and 32.0g Fat
  Bacon (3 strips) = 5.8g Protein and 9.4g Fat
Coffee = 0.1g Protein and 0.0g Fat
  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)

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