Nutrition and Spinal Cord Injury

High angle view of disabled woman in wheelchair holding cup of tea in her hand and reaching her hand for the buns on the table

Nutrition is important for everyone to maintain good health. After a spinal cord injury (SCI), 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. Maintaining a healthy weight also allows easier transfers, protects shoulders from wear and tear, and allows greater flexibility and mobility.

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 fiber per day can increase the likelihood of constipation. For this, individuals should increase their fiber 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.

Nutritional Needs Table

This nutritional needs table e guides you in promoting overall health and improving everyday problem issues with your bowel, bladder, skin, bone, and muscle.

Li, J, Yarar-Fisher, C, Pasipanodya, E, Gorgey, A, Wood, S, & Klebine, P. (2023). Nutrition and spinal cord injury [Fact sheet]. Model Systems Knowledge Translation Center (MSKTC). 

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

Nutrition & 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 guide  List of Adaptive and Inclusive Workouts for adaptive fitness resources available local, national and online that you can access to help you stay active and healthy!

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

Videos

Books/Podcasts

  • 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.
  • Nutrition after Spinal Cord Injury- Low-Carb High-protein Diet for Improving Health: The UAB Spinal Cord Injury Model Systems now offers this guidebook on understanding nutrition, metabolic health, balancing daily calories, making healthier food choices, along with sample menu items healthy shopping list.
  • 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.
  • The Paralysis Nutrition Podcast: Registered Dietitian who’s married to a quadriplegic and specializes in nutrition for spinal cord injury and paralysis. I’m on a mission to help people living with paralysis lose weight and regulate their bowels so they can live happier, healthier lives.

Articles

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.
  • Paralysis Nutrition: A key part of living a full and healthy life is maintaining proper nutrition to decrease the risk for infections, pressure sores and fatigue. Take a look at Christopher & Dana Reeve Foundation tips and understand the basics of eating right.
  • Living with SCI Nutrition: Spinal Cord Injury BC guide to nutrition, includes tips on making the right food and beverage choices can help you stay healthy and prevent complications.
  • The Miami Project Diet and Nutrition: Offer many tips that can be useful in developing a more healthy diet.
  • 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.

For MORE nutrition resources visit our additional resources page HERE

If you would like your resource link featured on our website please fill out this FORM

Disclaimer: 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