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Nutrition is important for everyone to maintain good health. After a spinal cord injury, nutrition can be even more important to improve overall wellness, achieve and maintain a healthy weight and help regulate bowel and bladder function. People with SCI are also at a high risk for cardiometabolic disease (including obesity, high blood pressure, high blood sugar, and high cholesterol). Eating a well balanced diet can help prevent the long term complications associated with SCI such as weight gain, constipation and skin breakdown.
Staying healthy is on everyone’s minds right now, and diet and nutrition play a huge part in helping strengthening our immune system which is so important during the COVID-19 pandemic. Check out our list of Nutrition resources for guidance and advice on how to best manage your nutrition and health.
How much should you weigh after a spinal cord injury?
Spinal cord injury results in changes in body composition and metabolic activity, for this reason, healthy weight guidelines for the general public have to be adjusted for people with SCI. Research suggest that individuals with paraplegia should weigh 5-10% less and those with tetraplegia, 10-15% less than those in the general guidelines. Persons with paraplegia need about 28 calories per kilogram (kg) of your ideal body weight. If you have tetraplegia, you need about 23 calories per kg of ideal body weight (the weight you should be). To determine your weight in kg, divide your weight in pounds by 2.2. For example, if you have tetraplegia and your ideal weight is 175 lbs., divide that number by 2.2, which equals 79 kg. Multiply 79 kg by 23 calories, and you get about 1,800 calories per day. These are only general guides, however, and do not account for differences in age, gender or activity levels. You will need to make adjustments based on your own experience with gaining or losing weight.
Formula for People with Paraplegia
1/2 Your Target Weight x 28 = Daily Calorie Intake to Reach Target Weight
Formula for People with Tetraplegia
1/2 Your Target Weight x 23 = Daily Calorie Intake to Reach Target Weight
General Guidelines
Plan Ahead: Allow plenty of time to plan and shop for your meals. Waiting until the last minute or when you’re really hungry often results in overeating or choosing faster, less healthful meals.
Don’t skip meals; this leads to snacking and overeating later.
Divide up your plate: half of it should be vegetables; a quarter of it should be meat or other protein; and about a quarter of it should be a starch or grain like rice or potato.
Eat a variety of protein, grains, fruits and vegetables; Choose low fat, high fiber foods.
Read nutrition labels closely. One of the most important things to learn from the nutrition label is how many servings are in a package, because the calories and other ingredients are given per serving. This is easy to miss.
Watch your beverage calories. It’s very easy to use up a large chunk of your daily calorie allotment in beverages. Water is the preferred beverage, but if you can’t live without soda pop, switch to the “diet” version.
Weigh yourself as often as possible. It’s hard to find a place to get yourself weighed routinely, but it’s important to know if you are gaining or losing weight.
Bladder And Bowel Health
Get enough fluids: People with SCI may also be at higher risk for urinary tract infections. Drink plenty of fluids, preferably water, to help flush your bladder and keep your urine light in color. This also helps prevent kidney and bladder stones. Drink a minimum of 1.5 L of liquid each day Fluid also keeps the stool soft, making it easier to pass.
Eat 15-30 grams of fiber every day: People with SCI may have neurogenic bowel, meaning muscles in the bowel may not work right. A healthy diet can be helpful in regulating your bowel program. Fiber helps move the stool through the bowel, however, for some, having more than 20g of fibre per day can increase the likelihood of constipation. For this, individuals should increase their fibre intake gradually and assess their reaction.
Nutrients to Support Immune Function
Eating nutrient-rich foods will help support your immune system and give your body extra protection, but no one food or supplement can prevent illness.
Vitamin C: Powerful antioxidant to help reduce oxidative damage to tissues ,including the lungs (Berries, Green/red peppers,Green leafy vegetables.
Vitamin A: Natural antiviral and helps enhance activity of white blood cells. (Carrots, Sweet potato, Squash, Kale, Liver, Butter)
Vitamin D: Protective against respiratory infections, studies shows that supplementing with vitamin D can reduce the rate of respiratory infections. (Sun, Eggs (yolks), Cod liver oil)
Probiotics: Help decrease intestinal inflammation & Facilitate nutrient absorption (Plain unsweetened yogurt, Sauerkraut, Kombucha)
Protein plays a role in the body’s immune system, especially for healing and recovery. Eat a variety of protein foods including seafood, lean meat, poultry, eggs, beans and peas, soy products and unsalted nuts and seeds.
Vitamin E works as an antioxidant and may support immune function. Include vitamin E in your diet with fortified cereals, sunflower seeds, almonds, vegetable oils (such as sunflower or safflower oil), hazelnuts and peanut butter.
Zinc helps the immune system work properly and may help wounds heal. Zinc can be found in lean meat, poultry, seafood, milk, whole grain products, beans, seeds and nuts.
Other nutrients, including vitamin B6, B12, copper, folate, selenium and iron also may support immune response and play a role in a healthful eating style.
Food Safety Concerns Regarding COVID-19
While practicing home food safety and good personal hygiene are always important, handwashing is especially critical in reducing the spread of COVID-19 and should be done often. Before preparing or eating food, it’s important to wash your hands with clean water and soap for a minimum of 20 seconds. According to the U.S. Food and Drug Administration, the Centers for Disease Control and Prevention there is currently no evidence to suggest that COVID-19 can be transmitted through food or food packaging. For more information on food safety visit: Proper hygiene and food safety practices.
Cooking Adapted Tools, Tips:
Cutting board with knife: A cutting board that comes with an attached knife.
Handi reacher: Helps grab lighter items from higher shelves and from the floor.
Lap tray and kitchen trolley: A lap tray helps transport hot items and protect your legs while sitting in your chair. A kitchen trolley can also be used to carry things and move things from one room to another.
U-cuffs and wide handles: Cuffs and wide handles improve your grip for utensils and other kitchen tools.
Use the front stove burners. Reaching over a hot stove could cause burns.
Avoid spills by only filling pots and pans half way.
Place items you use often on lower shelves to prevent reaching and bending over.
Use non-slip surface under items and/or to open jars and containers
Check out our complete resources list of Adapted Devices HERE
Exercise
Exercise regularly, it helps to increase the metabolic rate, burn calories and provides mood-boosting endorphins, so it is good for your health and wellness. Visit our List of Adaptive and Inclusive Home Workouts for adaptive fitness resources available online that you can access to help you stay active and healthy at home!
Virtual Seminar: Nutrition for SCI and Paralysis
Mount Sinai SCI was pleased to host “Nutrition for SCI and Paralysis” with special guest Fatimah Fakhoury, MS RD CDN, as part of a virtual presentation to address nutrition, managing weight and healthier choices for people with Spinal Cord Injuries and paralysis.
Learn more about Fatimah paralysis nutrition program that gives people living with paralysis a wealth of information on proper nutrition after SCI. Topics include optimal nutrition for paralysis, portion control & making better food choices, meal planning & prepping, improving bowel issues, maintaining strong skin, supplements, and more. For more information and to apply for the 1:1 or group program, visit www.paralysisnutrition.com. You can see the full seminar on our YouTube Channel : HERE
Steps toward healthier eating
Having the right nutrition information is the first step toward healthy eating, but changing your eating habits can be difficult. Convenience, access, cost, preparation and taste preferences are all factors in how and what we eat. Healthier eating may take some adjustment, but it can be done, and it doesn’t have to cost more. Try to make changes gradually.
Infographics
Dietary Guidelines for Individuals with Spinal Cord Injuries
Nutrition for Adults with Spinal Cord Injury
Nutrition & Spinal Cord Injury General Eating Guidelines
Nutrition and Spinal Cord Injury
Healthy eating: A guide for you after spinal cord injury
Spinal Cord Essentials- Cooking and Preparing Meals
Nutrition Guide for Neurogenic Bowel and Bladder
Gut-Healthy Snack Guide for Paralysis
Gastroesophageal Reflux and SCI
Eat Right: Food, Nutrition and Health Tips from the Academy of Nutrition and Dietetics
Shop Smart— Get the Facts on the New Food Labels
Home Food Safety Shopping Guide
Videos
SCI Nutrition 101 – Health & Wellness During Covid-19: The North American Spinal Cord Injury Consortium (NASCIC) Nutrition Series
Eat Well, Live Well with Spinal Cord Injury: NorCal SCI hosted the authors of “Eat Well, Live Well with Spinal Cord Injury”, Certified Nutrition Practitioners Joanne Smith and Kylie James, as part of a virtual presentation to address a variety of topics that affect the SCI community through nutrition.
Everyday Nutrition for Persons with SCI: Northwest Regional Spinal Cord Injury System present the latest American Dietetic Association nutrition recommendations for persons with SCI.
Helpful Tools for Cooking When You Have a Spinal Cord Injury: Created by Craig Hospital and the Christopher & Dana Reeve Foundation, this video highlights functional tools or adaptive equipment available for people with hand weakness who would like to gain more independence in their daily activities.
Nutrition Tips Series: Christopher & Dana Reeve Foundation Nutrition Tips Video Series
Books/Recipes/Apps
Eat Well, Live Well with Spinal Cord Injury: A practical nutritional guide written specifically for people with spinal cord injuries, as well as their families, friends, caregivers, health care and medical professionals.
The Paralysis Nutrition Cookbook: Registered dietitian and proud #quadwife Fatimah Fakhoury shows that healthy eating doesn’t have to mean giving up on favorite foods! In her new cooking book you will find 101 recipes to help you lose weight and improve bowel health for individuals with spinal cord injuries.
MyPlate Kitchen: Provides recipes and resources to support building healthy and budget-friendly meals. MyPlate Kitchen includes recipes from the USDA Food and Nutrition Service (FNS) programs including the Center for Nutrition Policy and Promotion (CNPP) and the Supplemental Nutrition Assistance Program (SNAP).
Nutrition.gov: Healthy recipes collection from the department of agriculture.
Fooducate: Track what you eat and your activities to see your progress and achieve your goals and scan nutrition labels for a quick assessment of how healthy something really is. (free on iOS and Android)
Plentiful: A free app, developed by City Harvest, you can find food pantries near you and reserve a time to pick up food without waiting in any lines.
Resources
EatRight® Weight Management Program: This weight management program, produced by the University of Alabama at Birmingham Department of Physical Medicine and Rehabilitation, is designed for individuals with spinal cord injury, and disease. EatRight is a 12 week program. There is workbook and video that guides you through the weekly lessons.
Eat Well, Live Well, with Spinal Cord Injury: Funded by the Paralyzed Veterans of America, Eat Well, Live Well with Spinal Cord Injury is a comprehensive, practical nutritional guide written specifically for individuals with spinal cord injuries, as well as their families, friends, caregivers, health and medical professionals.
SCI Nutrition, Dietary and Weight Management: United Spinal Association Nutrition Help Desk resources for persons with SCI
Adaptive Cooking Tools: Accessible Chef was able to test out adaptive cooking tools. Resources are divided into tools that make the physical aspects of cooking easier, tools that are safer for those with disabilities to operate, and tools that assist with the cognitive skills necessary for cooking.
Paralysis Nutrition: Registered dietitian Fatimah Fakhoury nutrition program empowers and educates people with paralysis to make healthier food choices, so they can regain control of their weight and improve bowel issues.
Accessible Wellness: Jackie is a Registered Dietitian who does virtual 1:1 nutrition counselling and empowers and motivates adults and children with disabilities to live healthy and active lifestyles and improve quality of life through nutrition.
NYC Free Meals: Three free meals will now be available daily for ALL New Yorkers in more than 400 Meal Hubs across the 5 boroughs. To find a location near you or text “NYC FOOD” to 877-877
COVID-19 Nutrition and Shopping Guide: New Mobility guide to nutrition and shopping during the Covid-19 crisis.
Making Health and Nutrition a Priority During the Coronavirus (COVID-19) Pandemic: American Society for Nutrition guide
MyPlate: Nutrition guide and app published by the USDA Center for Nutrition Policy and Promotion. Use the Start Simple with MyPlate mobile app to pick daily food goals, see real-time progress, and earn fun badges along the way.
Fast Food Nutrition Calculator: Fast food nutrition calculator can help you figure out the nutrition facts for an entire meal in major fast food chains and restaurants.
Stores offering Custom Hours to High Risk Population: As a result of COVID-19 response, some stores have created dedicated hours for seniors, people with disabilities and other vulnerable populations. Visit link for a frequently updated list.
The Basics of the Nutrition Facts Label: A quick guide to reading the Nutrition Facts label from EatRight.org
COVID-19 Nutrition Resource Center: The Academy of Nutrition and Dietetics COVID-19 Nutrition Resource Center
Infographics for food delivery and other resources: Putrino Lab created COVID19 inclusive instructions for ordering food to neurorehabilitation activities that can be done from home.
Getting Groceries During Quarantine: There may be times when you need to limit your trips to the grocery store. Here are some tips to help you make healthful decisions and reduce your trips to the store.
Restaurants and Fast Food Nutrition Facts: Make healthier food choices by arming yourself with the proper food nutrition information.
Invisible Hands Deliver: A free delivering service for those who do not feel safe leaving their homes during the COVID-19. They currently are making deliveries to Queens, Brooklyn, Jersey City & Riverdale.
Fresh Food Box: GrowNYC’s Fresh Food Box Program is a food access initiative that enables under-served communities to purchase fresh, healthy, and primarily regionally grown produce well below traditional retail prices.
Greenmarket Farmers Markets: Grow NYC Food Access Initiatives get fruits and vegetables where they are most needed in NYC. Visit their website to find your local farmers market.
For more nutrition resources visit our additional resources page HERE
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Disclamer: The information provided in this presentation is not meant to offer medical diagnosis or advice, or substitute for medical or other professional health care treatment. Linking to publications, materials or websites of other organizations or entities does not constitute endorsement by Mount Sinai of such publications, materials or websites. Mount Sinai provides these references and links because they may be of value to persons interested in SCI