Nutrition
What should you eat to stay healthy? Hardly a day goes by without someone trying to answer that question. Newspapers, magazines, books, radio, and television give us a lot of advice about what we should or should not eat. Much of this advice is confusing because we don’t know enough about nutrition to identify the “ideal” diet for each person. People differ, and their food needs vary depending on their age, gender, body size, physical activity, and other conditions—such as a spinal cord injury [SCI].
Additional material about Canada's Food Guide to Healthy Eating (supplement material)
To maintain the nutrients you need, try to eat at least the minimum number of servings from each food group in Canada’s Food Guide to Healthy Living. If you do not eat the suggested servings, you may want to speak with a Registered Dietitian for advice. You may also require vitamin/mineral supplements.
If you have swallowing problems, the consistency of your food and fluids may be changed or restricted.
Body weight
The following Acceptable Weight Ranges chart is from Yes You Can! (see reference above). The acceptable weight ranges in this table vary slightly from other weight standards for people with spinal cord injuries (SCI). Use the table as a guideline but be aware that these values may be higher than other SCI weight charts.
Don’t just go by numbers—go by how you feel. You know you’re in trouble when you have difficulty breathing, find transfers more difficult, or no longer fit into your chair. If that happens, make changes in the type and amount of food you eat so you can lose weight. Better yet, eat healthy choices and smaller portion sizes most of the time, and avoid gaining too much weight in the first place.
Acceptable Weight Ranges
|
Height
(feet/inches)
|
Weight
(pounds)
|
|
MEN
|
|
|
5’1”
5’2”
5’3”
5’4”
5’5”
5’6”
5’7”
5’8”
5’9”
5’10”
5’11”
6’0”
6’1”
6’2”
6’3”
|
123-129
125-131
127-133
129-135
131-137
133-140
135-145
137-146
139-149
141-152
144-155
147-159
150-163
153-167
157-171
|
|
WOMEN
4’9”
4’10”
4’11”
5’0”
5’1”
5’2”
5’3”
5’4”
5’5”
5’6”
5’7”
5’8”
5’9”
5’10”
5’11”
|
97-106
98-108
99-110
101-113
103-116
106-119
109-122
112-125
115-128
118-131
121-134
124-137
127-140
130-143
133-146
|
Activity and body weight
Most people with a spinal cord injury will not have the same activity level as before their injury. When you are less active, you use less energy. This means that fewer calories are used, so you need fewer calories to maintain your weight. Be as active as you can in daily activities and exercise to increase your metabolism and burn off more calories.
Your new normal weight will be about 5% to 10% less than before the SCI, maybe even a greater percent loss if your weight was high.
Most people need to eat less food than prior to injury to stay at a healthy weight. It is usual to lose a fair amount of weight in the first few months after your injury. However, most people will gain back the weight and find it hard not to gain too much weight.
Over the years, weight control can be difficult. If you have gained weight or have trouble losing weight, think about reasons for it and seek help to change things.
Other suggestions
- Keep a food and activity journal to help you record progress and stay focused on your goals.
- Find an activity buddy, partner with a friend or family member for exercise. Sharing a common goal will help keep you on track.
- You can add protein and calories to your diet the heart healthy way. For example, add extra lean protein, add skim milk powder or egg whites to your casseroles, etc.
Weight gain
If you are underweight and need to gain weight, refer to weight gain in
Yes, You Can! (Chapter 8 / Nutrition).
Make sure most of the food you eat provides nutrition (e.g. protein, vitamins, minerals, fibre, healthy fats) as well as energy (calories). Think about the reasons that you may not be eating enough. Seek help to overcome those problems.
You may also want to try commercial supplements that are high in protein and calories, in the form of drinks, puddings or cereals. Ask your dietitian for more information.
Fibre content of foods
The target amount for fibre intake is 20 to 30 grams/day. Choose at least one “medium” or “high” fibre food at meals and snacks. The following fibre values are for one serving. The serving sizes are commonly used portions. Most serving sizes are given under “Type of Food,” but a few are given beside the individual foods (for example, crackers and cookies). Fibre content remains the same after cooking.
Eat foods with high fibre content
Increase the fibre in your diet
- Choose whole grain breads, cereals and crackers, whole wheat pasta and brown rice.
- Eat a high fibre cereal every day, either on its own or mixed with another cereal.
- Add brain or wheat germ to hamburger patties, coating mixes, casseroles, cookies, cereals or eat a high fibre cereal every day, either on its own or mixed with another cereal.
- Replace half the flour in baking with whole wheat or oat flour.
- Choose at least 5 to 10 servings of vegetables and fruit each day. A serving is ½ cup (125 ml) or one whole vegetable or fruit. Eat the skins or peels where appropriate.
- Add raisins, strawberries or bananas to your cereal.
- Add fruit to muffins and cookies when baking.
- Use prunes or prune juice in small amounts. Prunes and prune juice contain a natural laxative. Don’t use them too often or in large amounts as they may cause a lazy bowel.
- Eat more legumes, such as cooked dried peas, beans and lentils.
- Use extra vegetables in casseroles, on pizza or in salads. Add carrots, green peppers, broccoli, spinach, corn or peas to your recipes.
- Add kidney beans, chickpeas, and lentils to soups, casseroles, salads and spaghetti sauce.
- Enjoy stir-fried vegetables more often.
- Add 1 to 2 tbsp (15 to 30 ml) of ground flaxseed to cereal, applesauce, pudding or in juice.
Choose high fibre foods daily
Your diet can harden or soften your stool. Try to have high fibre food. Some foods containing more than 6 grams of fibre per ½ cup (125 ml) serving:
- 100% Bran® and Fibre One®
- All Bran Buds with psyllium®
- All Bran®
- Beans and lentils
- Beans
Some foods containing more than 4 grams of fibre per ½ cup (125 ml) serving:
- bran flakes
- corn bran cereal
- baked potato with skin
- split peas
- dates
- figs
- raisins
Some foods containing more than 2 grams of fibre per ½ cup (125 ml) serving:
- brown rice
- Red River® cereal
- Shredded Wheat®
- whole wheat bread
- apples
- bananas
- carrots
- corn
- green peas
- oranges
- peaches
- pears
- spinach
- strawberries
- sweet potato
Nutrition resources
There are many resources for nutrition information. Make sure the ones you use are credible and from a reliable source. Some good ones to check are:
Dietitians of Canada
This award winning site features credible nutrition information through many interactive components that help adults assess their food choices and activity patterns.
Canadian Health Network
Canada’s national network of health information providers, this Health Canada funded website provides easy access to reliable health information from over 500 organizations across the country.
Swallowing disorders
The muscles used for swallowing are located in the neck. When sensation, strength and/or coordination of these muscles are affected after a spinal cord injury, swallowing problems may occur. This is called dysphagia and can affect your ability to swallow safely.
As a result, there will be a higher risk of food or liquids going down your windpipe and possibly in your lungs (this is called aspiration). Untreated problems may lead to dehydration, malnutrition, a chest infection or aspiration pneumonia.
Solid foods could become lodged in your windpipe, preventing you from breathing. A speech-language pathologist (SLP) can assess swallowing problems and can make recommendations to avoid these complications.
Symptoms
Symptoms of a swallowing disorder include:
- unexplained weight loss and/or changes in appetite/eating behaviour
- choking, coughing and/or throat clearing which may occur during or after swallowing food or liquid
- food or liquid coming our of your nose
- wet or gurgly sounding voice during or after eating or drinking
- extra effort and/or time needed to chew or swallow
- trouble squeezing food or liquid down the throat
- pocketing of food in the mouth after swallowing
- extra swallows needed to swallow one mouthful of food or liquid
- sudden increase in temperature and/or congestion within 30 to 60 minutes of eating or drinking
- difficulty starting a swallow
- development of aspiration pneumonia
Assessment
If a swallowing problem is suspected, a referral will be sent to the SLP who will then determine whether or not further assessment of the swallow is needed. This may include watching you eat different types of food and liquids. The SLP would watch and listen to see how well your swallow.
You may also need to have a test called a modified barium swallow. During this test, your mouth and throat will be examined to see whether or not the structures and muscles are moving normally.
Food and liquid can be observed as it moves through the mouth and throat. Specific treatments may be tried to see if they improve your swallow.
Treatment
No two people are alike in their swallowing problem, so you will have an individual treatment plan developed for you after your assessment.
Treatment may include:
- changing the consistency of your foods or liquids
- doing exercises to improve your swallow
- and certain strategies or techniques to make your swallow safer.
The change in your ability to swallow may be permanent or may improve with time. The speech-language pathologist works closely with the dietitian and the rest of the rehab team to ensure that you are able to enjoy your meals safely.
 |
Source: Spinal Cord Injury, Alberta Education Initiative: Glenrose Rehabilitation Hospital & Foothills Medical Centre
|