An examination of dietary intakes and nutritional status of chronic healthy spinal cord injured individuals

Abstract

To examine the nutritional composition of the dietary intake of chronic healthy spinal cord injured (SCI) individuals, 33 subjects affiliated with 3 SCI rehabilita tion centers logged their food consumption for 7 days. Prior to record keeping, subjects were trained by a registered dietitian on the accurate recording of their standard food choices and portion size, and were provided with scales to weigh food accurately. Dietary macro and micronutrients were analyzed with a computer software package, with nutritional analysis compared to the re commended daily allowances (RDA) of the Food and Nutrition Board of the National Academy of Sciences. Analysis showed caloric intake to be 75% of that recommended for able bodied persons, with a high reliance on fat for calories. Fat intake accounted for 37.9% of calories, well above the recommended level of 30% , but typical of the American diet. The ratio of polyunsaturated to saturated fat was approximately one half the recommended level, with carbo hydrate calories averaging 16.5% below optimal RDA. Protein consumption was within normal range, but average dietary fiber was only 25% of recommended levels. Micronutrient analysis showed deficiencies in both water and fat-soluble vitamins, with suboptimal intake of multiple minerals. Given the apparent reliance on a high-fat and low-carbohydrate diet, this research shows that nutritional intervention and education of SCI persons are needed, and that a registered dietitian should be included in the SCI health care team.

Assessment of the effect of increased dietary fibre intake on bowel function in patients with spinal cord injury

“…Mendaro et al reported that subjects consumed 16.4 g 'dietetic fibres' 2 and Levine et al reported that women consumed 14.3 g fibre/d and men 12.2 g/d. 8 The current study group also had a higher intake of dietary fibre than the Australian average of 17 g/d. This relatively high baseline dietary fibre intake is probably because a high fibre diet is recommended in the patient education manual and the nursing staff, when educating patients regarding bowel management, discuss and constantly reinforce this.…”

“…Food fre quency questionnaires, which were utilised in Levine's study may tend to overestimate consump tion, thus the difference may in fact be greater. 8 Other studies of nutrient intake in SCI have focused on the acute phase or compared the intakes of paraplegic subjects with tetraplegic subjects, but numbers of subjects in the current study were too small for this comparison.…”

“…Mendaro et ai, recorded that subjects studied continued their diet containing 2270 kcal and 16.4 g 'dietary fibres'. z There has been no other attempt to quantify fibre intakes in SCI patients apart from a study by Levine et al where it was demonstrated that men consumed 12.2 g fibre daily and women 14.3 g. 8 It is well documented that fibre in the form of wheat bran increases stool weight and decreases colonic transit time in healthy individuals, or individuals with diverticulae and constipation. In spinal units SCI individuals are usually recommended to increase their fibre intake, but it is not known what effect this will have on bowel function in this special group of patients.…”

Evidence-based and heuristic approaches for customization of care in cardiometabolic syndrome after spinal cord injury

“…31,[33][34][35] Previous studies also report a broader range of caloric restriction for men (∼300-900 kcal) for men than women (∼300 kcal). [36][37][38][39] Whether these deficits are sufficient to offset gender-dependent reductions of caloric expenditure is unknown due to a lack of information on total caloric expenditure changes following SCI. Nonetheless, data comparing resting energy expenditure and average daily caloric ingestion indicate a surplus intake of ∼300-500 kcal per day.…”

Potential role of oxidative stress on the prescription of rehabilitation interventions in spinal cord injury

“…Studies analyzing nutritional intake after SCI indicate that people with SCI tend to have less than the recommended intake of antioxidant vitamins (especially vitamins C, E and A). [71][72][73][74][75] Although most studies of nutritional status in SCI are framed with respect to risk of obesity and cardiovascular disease, 71,73 dietary antioxidant capacity should also be considered in rehabilitation and exercise management following SCI. …”