The comparison of total energy and protein intake relative to estimated requirements in chronic spinal cord injury

Br J Nutr, 2024 · DOI: 10.1017/S0007114523002088 · Published: February 14, 2024

Spinal Cord Injury Nutrition & Dietetics Rehabilitation

Simple Explanation

Spinal cord injury (SCI) leads to lasting neurological problems and early aging, which can shorten lifespan. After an SCI, people often lose body weight, mainly from losing body protein and gaining fat. This change in body composition can weaken muscles and bones. Also, people with SCI often burn fewer calories because they are less active and have a slower metabolism. It's important for people with SCI to get the right amount of energy and protein to keep their muscles strong and avoid gaining too much fat. This study found that a special method for estimating energy needs in people with SCI was more accurate than other methods. The study also found that many people with SCI don't get enough protein, especially those who weigh more.

Study Duration

Not specified

Participants

43 persons with chronic SCI

Evidence Level

Not specified

Key Findings

1
The SCI-specific method for EER had the best agreement with the EEI and did not significantly overestimate it.
2
Only 16 % of the participants with chronic SCI met dietary protein guidelines by BW, and dietary protein intake decreased with increasing BW.
3
At the BW threshold of 72·4 kg, protein intake moved from within required ranges and overconsumption to underconsumption, with the degree of underconsumption increasing with BW.

Research Summary

This study compared different methods of estimating energy needs and protein intake in people with chronic spinal cord injury (SCI). The study found that a SCI-specific method for estimating energy needs was more accurate than other common methods. The study also found that many people with SCI don't get enough protein, especially those who weigh more, highlighting the need for improved nutritional guidelines for this population.

Practical Implications

Improved Energy Estimation

The SCI-specific method should be considered for more accurate energy requirement estimations in clinical settings for individuals with chronic SCI.

Dietary Protein Intake

Increased awareness and monitoring of protein intake are crucial, particularly for SCI individuals with higher body weight, to prevent underconsumption and potential loss of FFM.

Personalized Nutrition Guidelines

Establish new energy and dietary protein intake clinical guidelines as a prevention technique against neurogenic obesity for persons with chronic SCI.

Study Limitations

1
Participants self-reported dietary intake, potentially modifying eating behavior or consuming perceived healthy foods.
2
Dietary records were collected for 3 non-consecutive days, rather than daily, to mitigate potential misreporting.
3
Total energy expenditure and protein requirements were not measured using the reference standards of doubly labeled water and nitrogen balance, respectively.

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