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This comprehensive guide explores the vital role of nutrition in managing individuals with spinal cord injuries (SCI), addressing key concerns such as weight management, gastrointestinal health, and the prevention of complications. It emphasizes a multidisciplinary approach involving diet, functional ability, and psychosocial factors to enhance the quality of life. Strategies for improving fluid intake, ensuring skin integrity, and preventing metabolic disorders are discussed, alongside the importance of maintaining a balanced diet rich in essential nutrients for optimal recovery and independence.
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Angela DiTucci, R.D. SCI Nutrition
Gastrointestinal Genitourinary Respiratory Neuromuscular NUTRITION Skeletal Cardiovascular Integumentary Metabolic
Physical Ability • Functional Ability / Capacity • Mastication Ability • Swallowing Issues
Medications • High dose steroids • Anabolic therapy • Bowel • Bladder • Gastrointestinal • Pain • Cardiovascular
Use of Herb / Botanicals • Saint John’s Wort -”Makes you feel good.” -”It’s natural.” • Echinacea -”Boosts the immune system.” -”Protects against the common cold and flu.” • Garlic -”Lowers cholesterol.”
Psycho / Social Issues • Depression • Self image • Food = source of gratification • Feeding = important issue in independence and socialization • Ability to purchase food and prepare meals • Living arrangements / meal arrangements • Availability of community resources • Alcohol intake
Weight Change • Acute Phase = Weight loss -Increases risk of pressure ulcer development. -Increases susceptibility to fatigue -Decreased resistance to infection • Long-term Phase = Weight gain -Difficulty with lifts, transfers, ADL’s -Increases risk for Diabetes, CHD, HTN -Increases risk of pressure ulcer
Bowel Management • Fiber • Gas • Diarrhea • Fluid
Fluids • Digestion and absorption of food • Elimination of body waste • Regulation of body temperature • Distribution of nutrients to body cells • Prevention or urinary tract infections 2000 cc – 3000 cc fluid daily
Suggestions for Teaching to Increase Fluid Intake • Keep a water bottle. • If with impaired hand function, work with OT-adaptive straws / cups. • Drink 1-2 glasses of water every time the leg bag is emptied. • Drink before meals rather than afterwards when full. • Do most of the drinking before early evening measurements. • Caffeine, alcohol, juices
Skin Integrity • Risk Factors -Hypoalbuminemia -Weight -Anemia • Diet -High quality diets -Protein -Calories -Fluids -Zinc -Vitamin C -Vitamin A -Iron, Folate, B12
Impaired Glucose Tolerance • Risk Factors • Altered body metabolism • Decrease in muscle mass and increase in fat • Inactivity • Aging process
Lipid Abnormalities • Increased prevalence of Heart Disease • Lipid abnormalities • Glucose intolerance • Increased weight • Limited Activity • Risk Factors for Lipid Abnormalities • Impaired carbohydrate metabolism • Reduced activity • Increased adiposity • Changes in metabolism • HDL
Osteoporosis • Risk Factors • Diabetes • Steroid Use • Smoking • Vitamin D Deficiency • Excessive Alcohol and/or caffeine use • Additional Risk Factors 2° SCI • Inactivity • Changes in Autonomic and nervous systems
Osteoporosis • Intervention • Physical activity- weight bearing or resistance • Calcium • Vitamin D • Smoking cessation (smoking speeds up bone loss) • Limit ETOH/Caffeine (also speeds up bone loss)
Role of nutrition for the SCI person across the continuum of care.Team approach to the nutritional care of the SCI person.
