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Nutritional Needs of a Person with Spinal Cord Injury - Part 1
By: Pouran D. Faghri, MD  Associate Professor, University of CT
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Proper diet and good nutrition is important for every body, however it is even more important of a person with spinal cord injury (SCI). Good nutrition provides you with the energy needed to perform everyday tasks, strengthen your body’s immune system, and helps all the body systems to work properly. Due to the spinal injury there are several changes in the body system and how it works, but many of these changes can be managed with proper nutrition following the injury. Getting the right amount of protein, carbohydrates, fiber, minerals and vitamins will help your body stay strong, fight infection and promote the healing process. Below are some health concerns following spinal cord injury that can be managed by proper nutrition:

Heart and blood pressure problems

Due to the improvements in medical technology and health care, people with spinal cord injury are now living longer. At the same time, due to their injury most of them do not follow an active lifestyle or proper diet and therefore cardiovascular problems including heart attacks and high blood pressure are major concerns following the injury. High levels of blood cholesterol can damage the arteries and the heart and a diet high in salt can also cause high blood pressure and heart problems.

Recommendations : Watch the amount of cholesterol that you consume. Have your cholesterol checked at least yearly; avoid foods that contain high amounts of cholesterol and reduce the amount of salt in your diet.

Bowel Management

Depending on the level of spinal cord injury, some people may experience a neurological bowel; meaning that the communication between the brain and the intestine is disrupted and therefore downward muscular movements of the bowel are completely absent or reduced, leading to severe constipation and an inability to empty the bowel.

Recommendations : Follow a healthy diet that is high in fiber and drink lots of fluids. It is recommended that a diet should contain at least 25-35 grams of fiber and eight to ten glasses of liquid every day.

Pressure Sores

Pressure sores are always a major concern following spinal cord injury. The skin breaks down due to the pressure that is imposed on it for such a long period of time and the skin is more likely to break down if a person does not follow a healthy diet.

Recommendations: A diet high in proteins, vitamins and minerals could help pressure sores to heal quickly.

Kidney or bladder stones

People with SCI are at a higher risk for developing kidney stones due to the release of calcium from the bones, calcium indigestion and improper diet.

Recommendations : Avoid dairy products such as mild, cheese, yogurt and ice cream. Make water the beverage of your choice and drink plenty of it.

Urinary tract infection (UTI)

Depending on the level of injury some people with SCI may loose their bladder function. They may use either a permanent catheter or an indwelling catheter for urination, exposing the person with SCI to major urinary track infections.

Recommendations: A diet high in fluid is recommended. Managing a bladder problem is individualized; you need to understand how much you need to drink to manage your problem. Avoid drinking carbonated beverages, orange juice and other citrus juices as these drinks change the bladder PH to alkaline, in turn causing an unpleasant odor and providing a breeding ground for bacteria.

Weight management

Both weight loss and weight gain can be consequences of SCI. Immediately following SCI, most individuals lose some weight for several different reasons. The injury puts a lot of stress on the body increasing the metabolic rate, meaning that the body burns energy at a much faster rate than before. In addition paralyzed muscles also atrophy and add more weight loss. This condition usually lasts for a few months and then the metabolic rate begins to slow down and the person will begin to gain weight back.

Understanding calories and how they work is very important for a person with SCI. A calorie is the amount of energy in food and is usually measured in grams. Fifty to sixty percent of your daily caloric intake should come from carbohydrates, 20 percent from proteins and 30 percent from fat. With this understanding you can calculate your daily allowance of each of these nutrients.

Recommendations: Because the nutritional needs are different in a person with SCI, you may find that your “ideal body image” may need to change as well. To manage a healthy weight you need to watch what you are eating, avoid fatty foods and food high in sugar. Make exercise a habit of yours; exercise will not only help you manage your body weight, but can also build up muscles and prevent muscle loss (especially FES induced exercises). Exercise also increases cardiovascular fitness and therefore, you are less fatigued and can participate in daily activities for longer periods of time.

Look for part two of this article, What Each Nutrient Can Do For You & Where They Can Be Found in our next newsletter.



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