The Low-Carb Diet That Prevented Polio

SummaryIn the summer of 1948, the polio epidemic was raging across the United States, and it was hitting the city of Asheville, North Carolina, particularly hard. Parents had been ordered to keep their children quarantined in their homes, and residents were even advised to leave the state if possible. Among the town’s citizens was Dr. Benjamin Sandler, one of the few medical doctors of the time who recognized the profound connection between malnutrition and disease. Dr. Sandler’s research had convinced him that a diet high in refined sugar and starch was setting the stage for the polio infections (as well as many other illnesses). With his belief far too “radical” for public-health officials to even consider, Dr. Sandler took his case to the local newspapers and radio stations, who were convinced enough to report his theory and his proposed polio-prevention diet to the public. The story quickly went national, and rates of the disease proceeded to drop as people across the country started following the diet. (See chapter 7 of Diet Prevents Polio for a detailed discussion of the results.) Sadly and predictably, the medical field refused to acknowledge the efficacy of Dr. Sandler’s diet, leaving the sampling of newspaper clips here to document the “diet that prevented polio.” Reprinted by the Lee Foundation for Nutritional Research. Multiple original sources. 

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The Low-Carb Diet That Prevented Polio: Newspaper Accounts of the Asheville Polio Experiment

[Note: For clarity the newspaper reports below have been rearranged relative to their order in the original document.]
“Diet Is Major Factor in Polio Prevention, Dr. Sandler Believes”

From the Asheville Citizen, North Carolina, August 5, 1948

A theory concerning a major cause of human infection with polio has been advanced by Dr. Benjamin P. Sandler of Asheville, NC.

Dr. Sandler, a recognized authority in nutrition research, was the first doctor to transmit polio to the rabbit, believed [before then] to be immune—a test he completed in 1938. His theory is twofold:

1) He believes he has found a major cause of polio in humans.
2) He believes that preventive measures are simple, easy, and quickly applicable.

Dr. Sandler believes the major cause [of polio] is low blood sugar in the human body, caused—paradoxically as it may sound—by eating too much sweets and starchy food. The preventive measures? Cut out foods containing sugars and starches.

In [just] twenty-four hours, according to Dr. Sandler, the body can build up sufficient resistance to the polio virus to prevent disease. The [preventive] diet would have to be continued, of course.

“The crisis is here, and hours have become precious,” he said. “I have been impelled to bring this directly to the newspapers because of my profound conviction that, through community cooperation and general acceptance of a diet low in sugars and starches, this epidemic can be got under control in about two weeks time.

“I am willing to state without reserve that such a diet, strictly observed, can build up in twenty-four hours time a resistance in the human body sufficiently strong to combat the disease successfully. The answer lies simply in maintaining a normal blood sugar.”

Here is Dr. Sandler’s program:

  1. Eliminate from the diet sugar and foods containing sugar, such as soft drinks, fruit juices (except tomato juice), ice cream, cakes, pastries, pies, candies, and canned and preserved fruits. (Saccharin may be substituted for sugar.)
  2. Cut down the consumption of starchy foods, such as bread, rolls, pancakes, potatoes, rice, corn, cereals, and grits.
  3. Substitute for such starch foods and starchy vegetables the following: tomatoes, string beans, cucumbers, greens, lettuce, turnips, carrots, red beets, cabbage, onions, and soybeans.
  4. Do not eat fresh fruits or melons more than once a day, and [even] then only in small quantities.
  5. Eat more-protective, protein foods, such as eggs, pork and beef products, fish (fresh or canned), poultry, milk, cream [sic], and cheese.

Eat three substantial meals a day, advises Dr. Sandler. And avoid exertion and fatigue because they are known to be associated with low blood sugar content. Avoid swimming in cold water. Rest as much as possible.

Dr. Sandler suggests that the recommended diet be followed until the polio danger season officially is declared over by local health authorities.

“One of the puzzling characteristics of polio,” Dr. Sandler said yesterday, “has been its prevalence in warm weather. Many people cut down on protective protein foods—such as meat, fish, and poultry—because of a mistaken idea that a ‘light’ diet is better for them in warm weather. And they increase consumption of cooling foods and beverages—most of them heavily sweetened. It is this increase in consumption of sugar that produces a lowering of blood sugar and thereby a lowering of the body’s resistance to the polio virus and other diseases.”

Here is the basis for the Sandler theories:

A normal blood sugar content of 100 mg in each 100 cc of blood is necessary to maintain resistance to bodily infection. Any appreciable lowering of this blood sugar content (say, to from 75 to 55 mg) can lower the barriers and permit bodily invasion by the virus of polio.

Dr. Sandler offers as the scientific basis for these statements research done with rabbits and monkeys. He began this research at Willard Parker Hospital in New York during the metropolitan area’s record polio outbreak of 1931.

Authorities had noted that rabbits normally are resistant to polio virus. Dr. Sandler, observing that studies had shown in rabbits that the blood sugar never dropped below 100 mg, began pondering the far-differing case of the rhesus monkey, a notoriously easy prey to poliomyelitis. In monkeys, blood sugar content frequently was observed to fall to abnormally low levels, around 50 mg. Furthermore, observations on humans who had recovered from polio revealed low blood sugar—hypoglycemia is the technical term—to be frequently present.

From these [test subjects]—rabbits, monkeys, and humans—Dr. Sandler first deduced that low blood sugar could be an important factor in susceptibility to the polio virus. The job was to check this deduction, through experiments in which the blood sugar content of rabbits would be lowered and their susceptibility to polio again tested.

In the laboratories of the Morrisania Hospital in New York, ten years ago, Dr. Sandler began a series of experiments in which insulin was injected in rabbits to lower their blood sugar for periods of four to six hours. Once the blood sugar content had been thus dropped, the doctor attempted again to transmit the polio virus to the normally highly resistant animals.

The rabbits fell easy victims. The animals showed evidence of polio infection within eight to ten hours after intracerebral inoculation with the virus, indicating rapid spread of the disease during the period of hypoglycemia. (Dr. Sandler reported on these studies in the American Journal of Pathology in January 1941.) Some rabbits died within fourteen hours after infection. Characteristic nerve cell destruction, with paralysis, was in evidence.

Chronic hypoglycemia (low blood sugar) is a common disorder in childhood and adolescence, Dr. Sandler points out, and is readily influenced by diet as well as exertion. This, he believes, serves to explain the high incidence of polio in younger age groups as well as the frequently reported occurrence of the disease following strenuous physical exertion.

Dr. Sandler received his degree in medicine at New York University in 1931. He interned at Morrisania City Hospital in New York City and later was on the staff there as well as at Polyclinic and Montefiore Hospitals in New York City. From July 1941 to February 1947, he was in the U.S. Naval Medical Corps, attaining the rank of commander.

He has done considerable research on polio and the relationship between diet and disease. He has published six papers on the latter subject as well as papers on other medical subjects. His research includes a period assisting the research staff at Willard Parker Hospital in New York City during the epidemic there in 1931 and independent research later, when he “gave” polio to a rhesus monkey, transmitted it to a rabbit, and then [transmitted it] to another monkey.

Summarizing the evidence for [his] contention that low blood sugar is a factor of susceptibility to polio and that a diet aimed to prevent low blood sugar can prevent polio, [he] submits the following:

1. Low blood sugar is not present in the rabbit, a nonsusceptible animal.

2. Low blood sugar is present in monkeys, a susceptible animal.

3. Inducing low blood sugar in rabbits with insulin renders the animals susceptible [to polio infection].

4. Physical exertion and swimming in cold water predispose to polio because they may be associated with low blood sugar.

5. The diet campaign aimed to prevent low blood sugar and thereby prevent polio had a significant effect on the number of cases during the 1948 epidemic, both locally, in the city of Asheville, the state of North Carolina, and in the nearby Southeastern states, as shown by the earlier peak dates in those states. The diet campaign also had a significant effect on the number of cases throughout the country, as shown by the change in the trend of the 1948 epidemic when compared with the trend [of the] 1946 [epidemic].

6. The unique change in [the 1948 curve] in the graph comparing 1946 with 1948 is exceptional in that the change occurred immediately after the release of the diet instructions and because such a change had never before occurred in the history of polio in this country.

7. Although the 1949 polio epidemic for the country as a whole was more severe than the 1948 epidemic, the city of Asheville and the state of North Carolina experienced the greatest reduction in the number of cases in 1949—in spite of the fact that North Carolina had the second highest case rate in the country in 1948. [Specifically] the state of North Carolina had a case rate of 66.3 in 1948 and a case rate of only 6.3 in 1949. South Dakota had a case rate 153.9 in 1948, the highest in the nation, but showed a reduction in 1949 to only 63.0.

8. Polio epidemics have occurred throughout the world in past years only in those countries with high per capita sugar consumption. Epidemics are unknown in countries with low sugar consumption. The greater the sugar consumption, the more severe the epidemic.

“Diet Will Immunize Persons from Polio, Physician Asserts”

From The Daily Courier, Connellsville, Pennsylvania, August 5, 1948

Asheville, NC, Aug. 5—A former Navy doctor today proclaimed “without reserve” the discovery that a controlled diet will immunize a person within twenty-four hours from infection by the dread infantile paralysis virus.

Dr. Benjamin P. Sandler said that he and other doctors had learned through experiments started ten years ago that elimination of sugars and starches from the diet will ward off polio. Sandler, now a physician at the Oteen Veterans Hospital here, released the information about his reported discovery during the height of a record-breaking polio epidemic that to date has struck 1,172 persons in North Carolina.

“I am talking about this discovery now,” Sandler said, “because I think the polio crisis requires immediate release of all our research findings.”

Sandler said it had been learned after exhaustive experiments that infantile paralysis victims frequently have a low blood sugar content, caused by eating sugars and starches. “Cut out those foods, and in one day’s time the body builds up sufficient resistance to ward off the polio virus,” he said. “I am willing to state this without reserve.”

Sandler’s “polio immunization” diet means avoiding all sweet foods. Soft drinks, fruits, ice cream, candy, and other such delicacies are forbidden, as are starches, such as bread or rolls, pancakes, and potatoes. Sandler recommends three square meals a day, however, with emphasis placed on “protein protective” foods such as meats, fish, poultry, milk, and milk products. He agrees with most other polio researchers that plenty of rest is also required.

Sandler explained the oddity of a low sugar count being caused by eating too much sugar. Eating sugar does raise the blood sugar briefly, he said, but in the long run it lowers the count greatly.

Sandler said that a “hot weather” diet has plenty to do with the prevalence of polio during the summer months. “Many people cut down on protective protein foods during the heat because of a mistaken idea that a ‘light diet’ is better for them in warm weather,” he said. “They increase consumption of cooling food and beverages, many of them heavily sweet. That way, they lower their blood sugar content.”

“Polio Diet Is Suggested: Low Sugar and Starch Use Seen [as] Aid in Controlling Disease”

From The New York Times, August 6, 1948

Asheville, NC, Aug. 5 (AP)—Dr. Benjamin Sandler of Asheville believes that a major cause of susceptibility to polio is low blood sugar in the body. He says that a diet low in sugars and starches will control the disease.

A member of the staff at Oteen Veterans Hospital, he has based his findings on experiments with rabbits and monkeys. He is a specialist in nutrition research.

“Community cooperation and the general acceptance” of his proposed diet would control North Carolina’s worst polio outbreak in about two weeks, he said today.

Through today, the State Board of Health reports 1,199 cases and 65 deaths this year. Spokesmen for the board were not immediately available for comment on Dr. Sandler’s proposal.

Dr. Sandler recommends that during the polio season the [eating] of sugar, soft drinks, juices, and pastries be eliminated. He also advises cutting down on breads, rice, corn cereals, and grits. He favors consumption of more pork, beef, fish, and dairy products.

“Doctor Balks Polio with Blood Diet”

From the Waterloo Daily Courier, Waterloo, Iowa, August 5, 1948

Asheville, NC (AP)—A former Navy doctor today proclaimed “without reserve” the discovery that a controlled diet will immunize a person within twenty-four hours from infection by the dread infantile paralysis virus.

Dr. Benjamin P. Sandler said that he and other doctors had learned through experiments started ten years ago that elimination of sugars and starches from the diet will ward off polio. Sandler, now a physician at the Oteen Veterans hospital here, released the information about his reported discovery during the height of a record-breaking polio epidemic that to date has struck 1,172 persons in North Carolina.

“I am talking about this discovery now,” Sandler said, “because I think the polio crisis requires immediate release of all our research findings.”

Sandler said it had been learned after exhaustive experiments that infantile paralysis victims frequently have a low blood sugar content, caused by eating sugars and starches. “Cut out those foods, and in one day’s time the body builds up sufficient resistance to ward off the polio virus,” he said. “I am willing to state this without reserve.”

Sandler’s “polio immunization” diet means avoiding all sweet foods. Soft drinks, fruits, ice cream, candy, and other such delicacies are forbidden, as are starches, such as bread or rolls, pancakes, and potatoes. Sandler recommends three square meals a day, however, with emphasis placed on “protein protective” foods such as meats, fish, poultry, milk, and milk products. He agrees with most other polio researchers that plenty of rest is also required.

Sandler explained the oddity of a low sugar count being caused by eating too much sugar. Eating sugar does raise the blood sugar briefly, he said, but in the long run it lowers the count greatly. Sandler said that a “hot weather” diet has plenty to do with the prevalence of polio during the summer months.

[Additional content—letter by Dr. Sandler to the medical journal Chest:]
Thoreau, Pulmonary Tuberculosis, and Dietary Deficiency

From Chest, Vol. 63, No. 5, May 1973

To the Editor:

I wonder if Henry David Thoreau was responsible for his [own] death from pulmonary tuberculosis in his prime, at the age of forty-five?

He lived the simple life, did not drink or smoke, and spent much time in outdoor activities. As far as we know, he had no contact with a tuberculous individual. During the two years of Spartan life at Walden Pond—from July 4, 1845, to September 6, 1847—he tried to be self-sufficient in all aspects of living and wanted to prove that one could maintain health on a cheap, plain diet. His expense for food for eight months was $8.74, for such staples as rice, molasses, rye meal, Indian meal, salt pork, flour, sugar, lard, apples, dried apple, sweet potatoes, one pumpkin, one watermelon, and salt.

In addition to these foods, he ate potatoes, green corn, and peas, which he raised. He wrote, “I sometimes caught a mess of fish for my dinner and once went so far as to slaughter a woodchuck that had ravaged my bean field…It was fit that I should live on rice, mainly, who love so well the philosophy of India…The reader will perceive that I am treating the subject rather from an economic than a dietetic point of view.”

Thus, Thoreau lived on a quantitatively adequate diet from the caloric standpoint, but on a qualitatively poor diet because of the very small amount of protein-rich foods. For two years, he ate enough to appease hunger and rarely catered to appetite. “Yet men have come to such a pass that they frequently starve not for want of necessaries but for want of luxuries,” he wrote. The essential and more expensive protein-rich foods, such as, meat, poultry, fish, pork, eggs, cheese, milk, and butter, presumably were the luxuries referred to.

My purpose in this communication is to suggest that Thoreau’s diet during the two years at Walden consisted mainly of foods with high carbohydrate content, chiefly starch, and was woefully lacking in high-quality protein. Based on the clinical research in the treatment of tuberculosis with a low-carbohydrate, high-protein diet,1,2 I have concluded that the most important factor in susceptibility to tuberculosis is poor nutrition, specifically a diet deficient in high-quality protein. Individuals who eat to excess to the point of obesity may develop tuberculosis because of deficient protein intake. Among my patients there were several who were obese and who had far advanced cavitary disease.

Faber,3 in an analysis of factors responsible for the increase in tuberculous mortality in Denmark, Sweden, and England during World War I, concluded that the reduced consumption of meat and fish was the most important nutritional factor. He found that “the total calories consumed was not diminished because there was sufficient bread and flour.”

Thus, it is possible that Thoreau developed a tuberculous lesion of minimal extent during the two years on his Walden diet. The lesion probably became inactive after he left Walden and returned to Concord to live with his family, where his diet improved. The lesion could have remained inactive or quiescent until he caught a severe cold in December 1860. The cold persisted and developed into chronic bronchitis with cough, which lasted all through 1861. His condition gradually worsened, and he died of “consumption” on May 6, 1862.

Benjamin P. Sandler, MD
Asheville, North Carolina

References

1. Sandler, BP, and Berke R. “Treatment of Tuberculosis with a Low Carbohydrate Diet.” Am. Rev. Tuberc., 46:238–261, 1942.
2. Sandler, BP. “Treatment of Tuberculosis with a Low Carbohydrate, High Protein Diet.” Dis. Chest, 17:398–422, 1950.
3. Farber, K. “Tuberculosis and Nutrition.” Acta. Tuberc. Scandinav., 12:287, 1938.

[Other references:]

The Works of Thoreau, selected and edited by Henry S. Canby. Houghton Mufflin Company, Boston, 1937.

Derleth, A. Concord Rebel. Chilton Company, Book Division, Philadelphia and New York, 1962.

[Additional content—obituary of Dr. Sandler:]
Dr. Benjamin P. Sandler, Nutritionist, 77, Is Dead

From The New York Times, May 23, 1979

Dr. Benjamin P. Sandler, who specialized in preventive nutrition, died Friday in Asheville, NC, after a long illness. He was seventy-seven years old and a resident of Asheville.

Dr. Sandler gained attention in the 1940s when he began to publish his controversial theories linking refined sugars and starches to the development of diseases, specifically tuberculosis, polio, and heart disease. He believed that a diet low in sugars and starches and high in proteins would decrease the body’s susceptibility to disease. Dr. Sandler wrote two books developeing his theories, Diet Prevents Polio and How to Prevent Heart Attacks. He also wrote numerous articles on nutrition, some of which appeared in the diet and health magazine Prevention.

Dr. Sandler’s articles recommending a low-carbohydrate diet to treat tuberculosis were published in 1942, while he was serving in the Navy Medical Corps. He left the Navy with the rank of commander in 1947 and served as a captain in the Navy Reserve until 1963.

In 1948 he joined the staff of the Oteen Veterans Hospital in Oteen, NC, near Asheville, and he remained on the hospital staff until he retired in 1972.

He is survived by his sister, Ethel Sandler. 

All content reprinted by the Lee Foundation for Nutritional Research. Date of publication unknown.

Patrick Earvolino, CN

Patrick Earvolino is a Certified Nutritionist and Special Projects Editor for Selene River Press, Inc.

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