7 Nutritional Concerns after SCI

Concern: Weight gain

• Reduced mobility
• Diet high in fats, low in fibre
• Reduced energy requirements 

• Cardiovascular problems
• Diabetes
• Increased blood pressure
• Further immobility
• Skin breakdown

• Eat a low-fat diet
• Eat a reduced-calorie diet
• Have smaller servings
• Eat healthy snacks, such as fruits and vegetables
• Exercise as tolerated

Concern: Weight loss

• Fatigue, depression
• Poor appetite
• Reduced activity level
• Lack of exercise
• Loss of muscle mass
• Increased energy needs after your injury

• Skin breakdown
• Inability of the sores to heal
• Compromised immune system
• Fatigue, and as a result, further immobility

• Ensure you diet is high in proteins and calories
• Ensure your calorie intake is higher than your energy output during activities
• Increase your activity level as tolerated
• Get fresh air
• Consider taking a nutritional supplement, such as Ensure

Concern: Bowel dysfunction

• Compromised nervous system function
• Immobility
• Diet that is poor in fibre
• Inadequate fluid intake
• Medication side effects

• Involuntary bowel movement
• Constipation
• Abdominal distention (swelling) and discomfort

• Bowel training
• Drink adequate fluids each day (2 to 3 litres a day)¹
• Eat a high-fibre diet (15 to 30 grams a day)¹

Concern: Bladder dysfunction

• Compromised nervous system function
• Voiding routine (urination) has changed
• Recurring urinary infections

• Chronic infections
• Kidney stones

• Drink adequate fluids each day (2 to 3 litres a day)²
• Make sure you have adequate urine output

Concern: Osteoporosis

• Reduced mobility
• Reduced calcium intake
• Reduced vitamin D intake (vitamin D helps calcium to be absorbed in the body)

• Bone density loss (thin/weak bones)
• Reduced strength
• Bone fractures
• Further immobility

• Take a calcium supplement (1000³ to 1200⁴ mg a day)
• Increase vitamin D through sun exposure at least 15 minutes a day or by taking a vitamin D supplement (400³ to 800⁴ IU a day)
• Do weight-bearing and resistance exercises

Concern: Pressure sores

• Poor positioning
• Immobility
• Weight gain or loss
• A diet low in proteins
• Compromised or weakened immune system
• Compromised or reduced blood flow

• Chronic sores that are not healing
• Infection
• Pain
• Increased hospital stay and bed rest

What you can do:

• Repositioning at lease every 2 hours
• Maintain a healthy weight

• Adequate intake of protein, calories, and vitamins A and C, minerals zinc and iron

Concern: Pre-existing medical conditions – Diabetes and cardiovascular disease

• Altered metabolism can lead to insulin resistance and glucose intolerance
• Immobility
• Diet rich in fats and sugars
• Lack of exercise
• Hypertension (high blood pressure)
• Increased waist size

• Weight gain
• Worsening of the existing health problems
• Blockage of the blood vessels
• Stroke

• Eat at a regular time
• Do not skip meals
• Eat a diet low in fat and sugar
• Exercise
• Maintain a healthy blood pressure
• Eat an adequate amount of fibre

Footnotes:

1. American Dietetic Association, Clinical Practice Guidelines for Spinal Cord Injury, Neurogenic Bowel, ADA Evidence Analysis Library, 2010 (www.adaevidencelibrary.com)

2. 2. American Dietetic Association, Clinical Practice Guidelines for Spinal Cord Injury, Neurogenic Bowel, ADA Evidence Analysis Library, 2010 (www.adaevidencelibrary.com)

3. Dietary Reference Intakes: Recommendations for Individuals, Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, 2001

    

4. Canadian Consensus Conference on Osteoporosis, 2006 Update, JOGC No 172, S95-S112, February, 2006