Post-Polio Syndrome (PPS) presents unique challenges, and proper nutrition plays a vital role in managing its symptoms and enhancing overall well-being. This article explores essential dietary considerations for individuals with PPS, drawing upon expert recommendations and practical advice.
Understanding Post-Polio Syndrome and Its Impact
Post-Polio Syndrome (PPS) is a condition affecting polio survivors years after recovering from the initial poliomyelitis virus attack. It is characterized by a further weakening of muscles previously affected by the polio infection. Common symptoms include slowly progressive muscle weakness, fatigue (both general and muscular), and a decrease in muscle size (muscular atrophy). Joint pain and skeletal deformities like scoliosis are also frequently observed. PPS is not life-threatening but can significantly impair an individual's ability to function independently.
The Cornerstone of a PPS Diet: Balanced Nutrition
Maintaining good nutrition is an ongoing and changeable process. Bones are constantly remodeled, tissues replaced, and immune systems challenged. Good nutrition is important for everyone; for polio survivors, it's essential. One cause of fatigue associated with the late effects of polio may be poor nutrition. For example, iron and some vitamins inside red blood cells are needed to carry oxygen to the body’s cells. The foundation of any healthy diet, especially for those with PPS, lies in balance and variety.
The Essential Food Groups
Foods are listed in three categories which are all essential for our bodies: carbohydrates, fats and proteins. Carbohydrates may be complex carbohydrates, such as whole grains, vegetables and fiber-rich fruits which are the healthiest for our bodies. Carbohydrates may also be simple, such as sugar, white flour and white rice, which are not as nutritious. All fats aren’t equal, either. Polyunsaturated and monounsaturated fatty acids, such as those found in fish, nuts, avocados and olive or canola oil offer the most helpful types for our body. Nutritionists often encourage including some protein at each meal, beginning with breakfast. Our first daily meal could include protein from an egg, nuts sprinkled on cereal, some type of nut butter on toast, lean meat and/or a milk product which contains some protein. The main types include dairy, fruits, vegetables, fats, meats, fish, poultry, nuts, dry beans and grains of all kinds. We need to eat foods from all types. Also, it’s important to eat foods containing enough fiber to maintain a healthy digestive process.
Emphasizing Protein Intake
Protein provides a long lasting, "slow release" supply of blood sugar throughout the day. Polio survivors who had protein for breakfast reported a reduction in 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. Protein plays a crucial role in muscle maintenance and energy production. For individuals with PPS, adequate protein intake is particularly important due to muscle weakness and fatigue. Nutritionists often encourage including some protein at each meal, beginning with breakfast.
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Why Protein Matters: Proteins are in all human cells. Proteins are made from amino acids, and new proteins are being made (synthesized) and broken down (degraded) each day. This protein turnover applies to muscle cells, as well, which are constantly synthesizing new protein every day. All of this means that for the muscles to have a fighting chance to maintain or increase their strength, there has to be a generous amount of protein in the diet.
Protein at Breakfast: 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 their daily weakness and fatigue. 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 checkup.
Good Sources of Protein: Lean meats, fish, poultry, eggs, dairy products, nuts, seeds, and legumes are excellent sources of protein.
Prioritizing Complex Carbohydrates and Fiber
Carbohydrates may be complex carbohydrates, such as whole grains, vegetables and fiber-rich fruits which are the healthiest for our bodies. Carbohydrates may also be simple, such as sugar, white flour and white rice, which are not as nutritious. Complex carbohydrates provide sustained energy release, preventing blood sugar spikes and crashes. Fiber is essential for digestive health and can help manage weight.
Choosing Wisely: Opt for whole grains like brown rice, quinoa, and oats over refined grains like white bread and pasta. Include plenty of fiber-rich fruits and vegetables in your diet.
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Serving Suggestions: One serving of grains is 1 ounce, or about one cup of whole grain cereal, one slice of bread, ½ cup cooked pasta, rice or cooked cereal. We are encouraged to eat at least five to nine servings of fruits and vegetables per day, with the total amount depending upon age, size and activity level. A serving is about ½ cup of cooked or 1 cup of uncooked fruits or vegetables.
Healthy Fats: Fuel and Function
All fats aren’t equal, either. Polyunsaturated and monounsaturated fatty acids, such as those found in fish, nuts, avocados and olive or canola oil offer the most helpful types for our body. Healthy fats are crucial for brain function, hormone production, and nutrient absorption.
Good Fat Sources: Include sources like fatty fish (salmon, tuna), avocados, nuts, seeds, and olive oil in your diet.
Limit Unhealthy Fats: Minimize saturated and trans fats found in processed foods, fried foods, and fatty meats.
The Importance of Vitamins and Minerals
Various beneficial compounds, known as antioxidants, are found naturally in food or man-made supplements and may help to protect against cell damage from harmful molecules called free radicals. There are many other important nutrients that can best be found only in food. Dairy products contain much needed calcium, protein, vitamins, carbohydrates and other minerals. Three cups per day of low-fat milk, or its equivalent, will provide most people with adequate dairy needs. One ounce or about 1¼ to 1½-inch cube of cheese is equivalent to one cup of milk. Yogurt also offers many probiotics that help the digestive system. Vitamins and minerals are essential for various bodily functions, including energy production, immune function, and nerve health. It may be advisable to take a quality vitamin and mineral supplement that supplies at least the recommended dietary allowance needed.
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- Key Nutrients: Focus on vitamins D and B12, calcium, magnesium, and potassium.
- Food First: Prioritize obtaining nutrients from whole foods, but consider supplementation if necessary, under the guidance of a healthcare professional.
Practical Dietary Strategies for PPS Management
Beyond the basics, several practical strategies can help individuals with PPS optimize their diet for symptom management.
Eating Regularly and Avoiding Skipping Meals
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. Research at the Post-Polio Institute found that polio survivors with blood sugar levels in the low normal range have as much difficulty paying attention and paying attention as would diabetics with blood sugars as low as if they had taken too much insulin. Regular meals and snacks help maintain stable blood sugar levels, preventing energy crashes and fatigue.
- Consistent Schedule: Aim for three balanced meals and 1-2 healthy snacks throughout the day.
- Never Skip Breakfast: It's a good idea to eat breakfast before showering and fill your tank before your neurons need the fuel.
Mindful Eating and Portion Control
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. Mindful eating involves paying attention to hunger and fullness cues, savoring each bite, and avoiding distractions while eating. Portion control helps manage weight and prevent overeating.
Listen to Your Body: Eat when you're hungry and stop when you're satisfied.
Use Smaller Plates: This can help control portion sizes.
Staying Hydrated
Water is essential for energy production, nutrient transport, and waste removal.
- Drink Plenty of Water: Aim for at least 8 glasses of water per day.
- Other Hydrating Beverages: Include herbal teas, infused water, and diluted juices.
Addressing Swallowing Difficulties
A speech therapist can show you ways to compensate for swallowing difficulties. Voice strengthening exercises also might be helpful. If muscles involved in breathing and swallowing are affected, you may experience difficulty with these functions. Some individuals with PPS may experience swallowing difficulties.
- Modify Food Textures: Pureed foods, thickened liquids, and soft foods may be easier to swallow.
- Sit Upright: Maintain an upright position while eating and for some time afterward.
The Role of Supplements
It may be advisable to take a quality vitamin and mineral supplement that supplies at least the recommended dietary allowance needed. While a balanced diet should be the primary focus, certain supplements may be beneficial for individuals with PPS.
- Vitamin D: Supports bone health and immune function.
- Vitamin B12: Essential for nerve health and energy production.
- Coenzyme Q10 (CoQ10): An antioxidant that may improve energy levels.
Important Note: Consult with a healthcare professional before starting any new supplements.
Foods to Embrace: A Rainbow on Your Plate
Add a little more color to your diet by including fruits and vegetables offered in the basic rainbow colors of red, orange, yellow/light green, green and blue/purple. Each fruit and vegetable contains a slightly different array of vitamins, minerals, phytochemicals and important fiber that helps protect cells from damage. Emphasize whole, unprocessed foods that provide a wide range of nutrients.
- Fruits and Vegetables: Aim for a variety of colorful fruits and vegetables daily.
- Lean Proteins: Choose lean meats, poultry, fish, beans, and lentils.
- Whole Grains: Opt for whole grains like brown rice, quinoa, and oats.
- Healthy Fats: Include avocados, nuts, seeds, and olive oil.
Foods to Limit or Avoid
Limit activities that cause pain or fatigue. Moderation is key. Overdoing it on a good day can lead to several subsequent bad days. Certain foods and beverages can exacerbate PPS symptoms.
- Processed Foods: These are often high in unhealthy fats, sugar, and sodium.
- Sugary Drinks: Soda, juice, and sweetened beverages can lead to blood sugar crashes.
- Excessive Caffeine: While caffeine may provide a temporary energy boost, it can disrupt sleep and worsen fatigue.
- Alcohol: Can interfere with sleep and medication.
Lifestyle Considerations
Beyond diet, several lifestyle factors can influence the management of PPS symptoms.
Regular, Judicious Exercise
A number of controlled studies have demonstrated that nonfatiguing exercises may improve muscle strength and reduce tiredness. Doctors recommend that polio survivors follow standard healthy lifestyle practices: consuming a well-balanced diet, exercising judiciously (preferably under the supervision of an experienced health professional), and visiting a doctor regularly. There has been much debate about whether to encourage or discourage exercise for polio survivors or individuals who already have PPS. A commonsense approach, in which people use individual tolerance as their limit, is currently recommended. Exercising to maintain fitness is important, but avoid overusing your muscles and joints and exercising to the point of pain or fatigue.
Prioritizing Sleep
You might need to change your sleeping patterns, such as avoiding sleeping on your back, or use a device that helps open your airway when you sleep. If you have restless legs syndrome, treatment for that disorder may help improve sleep quality and reduce fatigue. Adequate sleep is crucial for energy restoration and muscle recovery.
- Establish a Regular Sleep Schedule: Go to bed and wake up at the same time each day.
- Create a Relaxing Bedtime Routine: Avoid screen time before bed and create a calming environment.
Stress Management
Stress can exacerbate PPS symptoms.
- Practice Relaxation Techniques: Deep breathing, meditation, and yoga can help reduce stress.
- Seek Support: Connect with friends, family, or a support group.
Consulting Professionals
If you want to change your eating habits, please do it under the guidance of a licensed nutritionist. The information provided in this article is for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with healthcare professionals for personalized guidance.
Doctors
Doctors recommend that polio survivors follow standard healthy lifestyle practices: consuming a well-balanced diet, exercising judiciously (preferably under the supervision of an experienced health professional), and visiting a doctor regularly.
Registered Dietitians
Can provide individualized dietary recommendations based on your specific needs and medical history.
Physical Therapists
Your doctor or therapist may prescribe exercises for you that strengthen your muscles without fatiguing them. These usually include less strenuous activities, such as swimming or water aerobics, that you perform every other day at a relaxed pace.
Occupational Therapists
Can help you adapt your environment and daily activities to conserve energy.
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