What everyone ought to know about Nutrition and Spinal Cord Injury

Spinal Cord Injuries and Nutrition

How to live and eat well with a spinal cord injury?

For someone who has suffered a spinal cord injury the body undergoes a tremendous amount of physical and mental trauma. Not only does it suffer these effects it also goes through significant changes to the underlying cell structure leading to changes in the regulation of hormones, and the way the body utilizes food intake.

This article presents key topics that are represented in the novel Eat well, Live Well with Spinal Cord Injury.

Eat well, live well with Spinal Cord Injury is a highly educational book by two nutritionist Kylie James and Joanne E Smith who have both have suffered spinal cord injuries themselves. It presents a unique insight to some of the challenges people with spinal cord injury face after their injury and how to lead a healthy lifestyle following an injury.

I feel that I get sicker easier than other? How come?

Following a spinal cord injury, the body undergoes changes which can ultimately leave the person more susceptible to infections. Factors contributing to this include:

- Immune system suppression

- Paralyzed/weakened abdominal, intercostal and diaphragm muscles; which are essential in being able to clear airways.

- Decreased activation of lymphatic system as a result of decreased mobility. Lymphatic fluid is reliant on muscular contractions to move.

- Increase exposure to potential pathogens from touching wheelchair rims.

- Higher dependence on others for personal care, exposure from other people’s illnesses.

- High levels of stress, which can decrease immune function and increase constant cortisol release.

- Increased risk of secondary health complications such as pressure sores, low bone mineral density, arthritis, type 2 diabetes.

Why have I gained weight since my injury?

Weight gain is one of the most common secondary health complications for those with a spinal cord injury. 65% of people with SCI are overweight a third of the population are obese. Some of the factors that contribute to weight gain after a SCI include:

- Changes in body composition; higher proportion of fat mass and muscle wastage.

- Lower resting metabolic rate

- Some medications can contribute to weight gain

- Reduced physical activity

- Poor diets

- Mismatched caloric intake to expenditure

- Higher risk of nutrient deficiencies such as chromium which is important for blood sugar balance can often be depleted can lead to weight gain.

- Changes in economic status

- Hormonal changes, drop in testosterone, increase in estrogen à contributes to weight gain.

- Chronic low grade inflammation has been associated with depression, pain, weight gain, compromised immunity.

- Glucose intolerance and poor carbohydrate metabolism which can lead to insulin resistance and type 2 diabetes.

What are some of the risks associated with increases in weight gain?

- Increases in weight can decrease immune function.

- Increase stress on nerves and joints

- Decreased circulation

- Increased inflammation and pain

- Fatigue

- Compromised bowel and bladder routine

- Poor sleep

- Depression

- Increased risk of pressure sores due to skin folds

- High blood pressure

- Insulin resistance and type 2 diabetes

- Fatty liver

- Hormone imbalances

- Difficulty breathing

- Increased risk of blood clotting

- Reduced life expectancy.

How much food should I be eating?

­­­­­­­­­­­­Caloric intake in determined by our energy expenditure. Generally, those who have suffered a spinal cord injury have a lower energy expenditure due to increased time being spent sedentary and reduced demand from their muscles. In order to maintain a healthy weight our caloric intake needs to match up with that of our energy expenditure. Kylie James and Joanne E Smith demonstrated some simple calculations which have been modified for that of a person with a spinal cord injury.

I’ve gained some weight what do I do?

Best thing to do is consult an expert nutritionist or dietician who can come up with a meal plan that is sustainable and something that you are able to stick to.

Some hints to get you started on the right track:

- Reduced caloric intake

- Consume the appropriate portion sizes

- Balance sugar levels

- Restrict fruit intake to 0-1 fruits per day

- Restrict grain intake to 0-1 servings per day

- Set realistic weight loss goals around 0.5-1lbs per week.

How do I get healthy calories in my diet that can help decrease inflammation?

Almost everyone struggles to get the right type of calories into our bodies and to give our bodies the best chances of fighting infection if we were to get sick. Some foods to help with systemic inflammation include:

I’ve heard my metabolism has slowed down since my injury; how do I increase this?

Metabolism is a process by which your body converts what you eat and drink into energy (mayo clinic). Thermogenic foods have been shown to help stimulate metabolism these can include but not limited to whole foods (not processed foods), hot peppers, cayenne pepper, salsa, green tea, apple/apple cider vinegar, brussels sprouts/broccoli, celery.

There are some supplements which can assist with improving inflammation within the body. Please consult your doctor prior to taking any as there can be interactions between supplements and medications you might be taking.

- Chromium helps to improve insulin sensitivity.

- Omega 3 is a natural anti-inflammatory agent

Now I’ve read this, what do I do now?

Please seek medical advice before undergoing any diet/ lifestyle changes. Never change medications without seek medical advice prior. Speaking to your local nutritionist or dietician can also help set you up with a dietary plan. Remember diet is one important factor in improving your overall health and exercise and diet go hand in hand. Speak to your local Accredited Exercise Physiologist on how you can get moving.

The NDIS can also assist you in seeking professional advice from a dietician or Accredited Exercise Physiologist. Speak to your plan manager on how to get access to this type of funding.