The interaction of macronutrients and body composition among individuals with chronic spinal cord injury

Changes in body composition and dietary intake occur following spinal cord injury (SCI). The Geometric Framework for Nutrition (GFN) is a tool that allows the examination of the complex relationships between multiple nutrition factors and health parameters within a single model. This study aimed to utilize the GFN to examine the associations between self-reported macronutrient intakes and body composition in persons with chronic SCI. Forty-eight individuals with chronic SCI were recruited. Participants completed and returned 3- or 5-day self-reported dietary recall sheets. Dietary intake of macronutrients (fats, proteins, and carbohydrates) were analysed. Anthropometric measures (circumferences), dual-energy x-ray absorptiometry (DXA), and magnetic resonance imaging (MRI) were used to assess whlole-body composition. Associations between all circumference measures and carbohydrates were observed. Among MRI measures, only significant associations between subcutaneous adipose tissue and protein x carbohydrate as well as carbohydrates alone were identified. Carbohydrates were negatively associated with several measures of fat mass as measured by DXA. Overall, carbohydrates appear to play an important role in body composition among individuals with SCI. Higher carbohydrate intake was associated with lower fat mass. Additional research is needed to determine how carbohydrate intake influences body composition and cardiometabolic health after SCI.

Calorie and macronutrients intake in people with spinal cord injuries: an analysis by sex and injury-related variables

OBJECTIVE

Current studies suggest that two of every three persons with spinal cord injury are at risk for the metabolic consequences of obesity. The objective of this study was to assess the dietary intakes in people with spinal cord injury based on sex- and injury-related variables.

METHODS

In total 162 people with spinal cord injury participated in this cross-sectional study. Their dietary intakes were assessed by a semiquantitative food-frequency questionnaire.

RESULTS

The percentages of total energy intake derived from macronutrients were 53% carbohydrate, 10% protein, and 37% fat for men and 52% carbohydrate, 11% protein, and 39% fat for women. There was excessive consumption of simple carbohydrates (102.17 ± 40.83). The participants with longer times since injury had lower cholesterol intakes (P = 0.02). The individuals with an incomplete injury consumed significantly more monounsaturated fatty acids (n = 114, 27.2 ± 12.01 g) than those with a complete injury (n = 48, 23.6 ± 8.08 g, P = 0.03). There was a significant positive correlation of age and time since injury with fiber intake (P < 0.05).

CONCLUSION

The balance of macronutrients shifted toward intakes of fat and simple carbohydrates at the expense of complex carbohydrates, fiber, and protein in these participants. Mean amounts of polyunsaturated and monounsaturated fatty acids in these participants were above the recommended intakes. Older participants and those with a longer time since injury tended to have lower calorie, fat, carbohydrate, saturated fat, and cholesterol intakes and higher fiber intakes.