A primary care provider's guide to diet and nutrition after spinal cord injury

David R. Gater, Craig Bauman, Rachel Cowan

Research output: Contribution to journalArticlepeer-review

Abstract

Physiological changes that occur after spinal cord injury (SCI) are profound and affect almost every organ system in the human body. Energy balance is significantly altered due to motor paralysis, spasticity or flaccidity, neurogenic sarcopenia, neurogenic osteopenia, sympathetic nervous system disruption, and blunted anabolism. Energy expenditure is markedly reduced, whereas hypothalamic control of appetite and satiety is diminished, resulting in discordant energy intake. Ultimately, neurogenic obesity ensues as the result of a positive energy balance. Even though nutritional guidelines for persons with SCI have been available since 2009, the necessity for body composition assessment and total daily energy expenditure was insufficiently addressed such that most individuals with SCI continued in positive energy balance despite "adherence"to the guidelines. Macronutrients must be carefully assessed to optimize caloric intake, while micronutrient consumption may need to be supplemented in order to meet recommended daily allowances. Such a diet would emphasize foods with low caloric yet high nutrient density. This article reviews current literature regarding nutritional requirements for SCI and provides a straightforward plan for implementing more rigorous dietary interventions meant to address the obesity crisis in this especially vulnerable population.

Original languageEnglish (US)
Pages (from-to)197-202
Number of pages6
JournalTopics in Spinal Cord Injury Rehabilitation
Volume26
Issue number3
DOIs
StatePublished - Jun 2020
Externally publishedYes

Keywords

  • Body composition
  • Diet
  • Energy expenditure
  • Energy intake
  • Metabolism
  • Obesity
  • Paraplegia
  • Spinal cord injury
  • Tetraplegia

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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