It is important for everyone to maintain a healthy, balanced diet. After a serious injury, however, that importance takes on a greater sense of urgency—especially if that specific injury drastically limits your mobility like with spinal cord injuries. When one experiences a spinal cord injury, their susceptibility to other internal damage increases. The Academy of Nutrition and Dietetics recommends that a registered dietitian make a nutrition assessment of a spinal cord injury victim within the first 48 hours after suffering the injury. This assessment would provide important information not only about nutrient needs, but also about conditions that may predispose the victim to “nutrient-related complications.” Post-injury recommendations reportedly not only help address the victim’s specific injury but also help the victim respond to therapies and therefore improve their recovery.
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Why is Nutrition Important to Consider After Suffering a Spinal Cord Injury?
Vickeri Barton, RD, CD, Registered Dietitian and Associate Director of Nutrition Services at Harborview Medical Center in Seattle, Washington presented a lecture at the University of Washington that outlines the importance of heightening your awareness when it comes to nutrition after spinal cord injuries. According to her report, she outlined five risks of additional medical complications that can arise in spinal cord injury victims. These include:
- diabetes
- higher cholesterol
- obesity
- pressure sores
- osteoporosis (It is recommended that you get a DEXA Scan to assess your bone density and risk for bone density loss)
Nutrition is not only important to consider for physical health reasons, but also your emotional health. Because of decreased mobility caused by the spinal cord injury, one is at greater risk for weight gain. While this presents numerous physical health challenges (some of which have already been listed) weight gain potentially leads to less or more labored mobility and loss of independence. It may require increased costs caused by hiring assistants or buying a larger wheelchair. All of these stresses could have a combined effect on one’s emotional health and well-being, more specifically contributing to low self-esteem and depression. Spinal cord injuries often leave their victims’ bodies permanently changed.
Supporting Statistics and Studies
- 24.6% of patients with spinal cord injuries require dietary modifications right after their injury
- 8.2% of patients are discharged with feeding tubes after acute care
- Immediate nutrition intervention after Spinal Cord injuries are reported to help:
- Reduce fat intake
- Improved bowel function and quality of life
- Enhance victim’s response to further dietary treatment
- Reduces hospitalizations after injury and decreases length of hospital stay
Calorie and Protein Needs
Spinal cord injury victims suffer from reduced metabolic activity and endure changes to body composition. This means that generally they need less calories than they consumed before their injury. Using the University of Washington’s Metropolitan Life Desirable Weight Table to calculate estimates of healthy body weights, those who suffer from paraplegia should weigh between 5%-10% less than the guidelines and those with tetraplegia should weigh between 10%-15% less. In the nutritional assessment following the injury, an ideal weight should be calculated in order to determine the proper nutrition plan. General guidelines suggest the following in relation to the person’s ideal body weight in kilograms (kg):
- Paraplegic injuries require about 28 calories per kg
- Tetraplegic injuries require about 23 calories per kg
These guidelines do not factor in age, sex, mobility level or severity of injury, so specific adjustments will need to be made that will consider these factors. As for protein intake, spinal cord injury victims typically require the same amount as they did prior to the injury. An increase in protein would be necessary if the injured person developed a pressure sore or other wound that would require additional protein in order to heal.
General Health and Diet Recommendations
While many of the following recommendations can be applied to all of us, they are particularly helpful for those who have suffered spinal cord injuries.
1.) Plan Ahead
Allow yourself time to plan and shop for your meals. This is particularly important to take into account for the time it will take to both shop for the food and prepare it. When you fail to plan ahead, you often resort to eating foods that are easy to get a hold of but that may not necessarily be the healthiest. This can contribute to overeating and weight gain. Planning helps instill a sense of control over your life and self-satisfaction.
2.) Establish a routine (and stick to it!)
Your body is a naturally ordered system and therefore responds best to natural routine maintenance. Remember not to skip meals, as that will lead to overeating later, and will negatively affect your metabolism. Establish a routine that YOU want. Following your own schedule will be easier than following one someone has established for you.
3.) Eat Low Fat, High Fiber Foods
Divide up your plate, make sure that you have the proper balance of vegetables, proteins, grains, and fruits. Limit your fat and dairy intake.
4.) Exercise Regularly
Regular, appropriate physical activity is essential for those who have suffered from a spinal cord injury. Research suggests that exercise improves blood lipid parameters and weight maintenance.
Whether you are competing in paralympic sports or wheelchair activities, or simply getting out of the house, exercise will help strengthen you physically and emotionally. There is no substitute for regular exercise.
5.) Drink Enough Fluids
Especially drink enough water, as most other drinks have a high sugar intake. Drinking enough water will keep you hydrated and will help you maintain healthy bowels.
Note on Sources: These guidelines are general, and are to be used as a supplement and not in place of a doctor’s guidance. These suggestions have been provided by Vickeri Barton of the University of Washington and other professionals who have helped thousands of individuals who have suffered from spinal cord injuries.