Vitamin D, diet, and lifestyle in a chronic SCI population

Spinal Cord, 2019 · DOI: 10.1038/s41393-018-0148-1 · Published: February 1, 2019

Spinal Cord Injury Nutrition & Dietetics

Simple Explanation

This study looked at factors that affect vitamin D levels in people with long-term spinal cord injuries (SCI). It examined diet, lifestyle, and clinical factors. The study found that vitamin D levels in people with SCI are not related to the level or severity of their injury. Instead, vitamin D levels were linked to taking vitamin D supplements and other lifestyle factors. Most participants didn't get enough vitamin D or calcium from their diet alone, highlighting the importance of supplements. Exercise, not smoking, and drinking wine were also linked to better vitamin D levels.

Study Duration

Between 5/31/2013 and 8/8/2016

Participants

174 participants with chronic spinal cord injury

Evidence Level

Cross-sectional study

Key Findings

1
Plasma 25(OH)D level in chronic SCI is not associated with clinical factors specific to SCI such as injury level and completeness, injury duration, and mobility mode
2
Total vitamin D intake was found to be the most closely associated with plasma 25(OH)D levels.
3
supplement intake was statistically significantly associated with increased 25(OH)D (p < 0.001), but dietary intake was not (p = 0.305)

Research Summary

This study investigated the factors associated with vitamin D levels in individuals with chronic spinal cord injury (SCI). It found that SCI-specific factors like injury level and duration were not determinants of vitamin D levels. Instead, personal, nutritional, and lifestyle factors, particularly total vitamin D intake (especially from supplements), were significant predictors of vitamin D levels. Most participants had inadequate vitamin D intake from diet alone. Other lifestyle factors such as exercise, wine consumption, and smoking status also influenced vitamin D levels. The study suggests the importance of vitamin D supplementation and lifestyle modifications for SCI patients.

Practical Implications

Vitamin D Supplementation

Clinicians should consider recommending vitamin D supplements for SCI patients to address inadequate dietary intake and improve vitamin D status.

Lifestyle Counseling

Healthcare providers should educate SCI patients on the impact of lifestyle choices like exercise, smoking, and alcohol consumption on their vitamin D levels.

Personalized Interventions

Interventions to improve vitamin D status should be personalized, considering factors like age, sex, race, and individual dietary habits.

Study Limitations

1
Questions in our health questionnaire could have better assessed direct sun exposure instead of time spent outside between sunrise and sunset.
2
completion of the FFQ on the same date as the study visit or a detailed personal interview may have more accurately represented dietary intake
3
subjects in the study had to be healthy enough to travel to the VA, which could have potentially limited our ability to study persons with greater levels of injury and completeness of SCI.

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