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What’s In Your Diet?


Maintain a healthy weight by eating appropriately portioned foods and exercising. Istock photo Udra-Arekuliasz
Reprinted from PN/Paraplegia News August 2016

The unique needs of individuals with spinal-cord injuries (SCI) leave questions about diet.

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Every five years the U.S. Department of Agriculture and the U.S. Department of Health and Human Services gather the nation’s nutrition and health experts to revise the Dietary Guidelines for Americans. 

The 2015-2020 guidelines were released earlier this year and are designed to provide steps to live a longer and healthier life. 

The unique needs of individuals with spinal-cord injuries (SCI) leave us questioning how they can apply the guidelines to their lives. 

Individuals with SCI cope with more frequent infections, decreased calorie needs from reduced physical activity and altered nutrition needs because of conditions such as wounds, osteoporosis and altered bowel and bladder function. 

The following tips lay out ways to embrace and implement the dietary guidelines while living healthy with SCI.  

Vitamins & Minerals

Nutrient-dense foods include those with the vitamins, minerals and nutrients that allow our bodies to perform at their best. 

Research indicates that individuals with SCI are more likely to rely on convenient, low-nutrient foods and to have poorer dietary habits and more common nutrient deficiencies than those without SCI. 


Eat less sugar. Istock photo by Rouzes-Choness

According to a 2009 study published in the Journal of Spinal Cord Medicine, poorer diet of those with SCI may be attributed, in part, to the physical challenges of shopping and meal preparation, including greater mobility limitations, the need for assistance and greater impact of barriers such as transportation.

Taking a vitamin or mineral supplement doesn’t make up for a poor diet, and a healthy diet can assist in managing and preventing complications from SCI. 

The foundation of your foods should include a variety of vegetables, whole grains, fruits, low-fat dairy products, lean proteins and healthy fats. 

More Fiber-Rich Foods

Fiber is a substance found in vegetables, fruits, beans, legumes and whole grains that adds bulk to your diet, makes you feel full faster, which can assist in maintaining a healthy body weight, and can keep bowels regular without having to take multiple medications. 

This is especially important for those with SCI, as neurogenic bowel is a common ailment.

Fiber-rich foods can speed up bowel programs and create a more desirable consistency of the stool and potentially reduce accidents. A diet high in fiber can also reduce risk of heart disease, diabetes, diverticulosis and hemorrhoids. 

There are two sources of fiber, soluble and insoluble. Soluble fiber attracts water and slows digestion. Foods that are high in soluble fiber include oats, nuts, seeds, peas, lentils, beans and skins of fruits and vegetables. 

Insoluble fiber speeds up the movement of stool through the digestive tract and adds bulk to the stool. Sources of insoluble fiber are wheat bran, seeds, whole grains, leafy green vegetables, cabbage and Brussels sprouts. 

When eating a high-fiber diet, it’s extra important to drink six to eight glasses of water per day to prevent bloating and gas. 

Replace refined grains such as white bread, pasta and rice with fiber-rich grains to increase the health of your meals. 

Limit Added Sugars 

The dietary guidelines recommend consuming less than 10% of your daily calories from added sugars. 

Foods that contribute added sugars include sodas, juices, alcohol, candy, desserts, flavored yogurts, refined grains and sugary cereals. 

For individuals with SCI, blood-sugar regulation is important because of the high risk of insulin resistance and diabetes. 

Limiting these foods will also help you to maintain a healthier body weight and maintain better heart health. Replace your desserts with fruit, juices with water, and sugary cereals with oatmeal or ancient grains. 

Choose Healthy Fats

Fat is an essential part of your diet, as it assists in maintaining healthy skin, hormone levels, lubricating joints and many other necessary functions. 

Multiple clinical trials have shown eating a diet rich in omega-3 fatty acids can reduce heart disease risk, inflammation and support brain function. 

The anti-inflammatory properties of omega-3s are especially beneficial for those with SCI, since chronic muscle and joint pain are frequently present. In addition, these fats have natural skin protectants that can help guard against pressure sores. 

The dietary guidelines recommend replacing saturated and trans fats with these sources of healthy fats: walnuts, almonds, flax seed, olive oil and fatty fish (salmon, mackerel, halibut and tuna).  

Saturated fats are commonly found in poultry skin, marbled meat, cheese and high-fat dairy products. 

To limit saturated fat, replace bacon and sausage at breakfast with sautéed vegetables with your eggs, and choose lean and skinless cuts of chicken, turkey, beef and pork. For dairy products choose low-fat cottage cheese, milk and yogurt. Replace meat with fish twice per week, or have a meatless day once a week.

Eat For Bone Health

A loss of bone strength and density is a common result of SCI, where most individuals lose 30-50% of their bone mass post-injury. 

A diet rich in calcium, magnesium and vitamin D can assist in maintaining strong bones. 

Foods rich in calcium include milk, yogurt, leafy green vegetables and soybeans. 

Magnesium assists with calcium absorption and is a common deficiency in most diets. Foods that 
are good sources of magnesium 
are leafy green vegetables (spinach, kale and collard greens), nuts and seeds, fish, avocados, bananas 
and yogurt. 

The best source of vitamin D is from the sun. Aim for 15 to 20 minutes of sunlight exposure between 10 a.m. and 3 p.m. daily. Incorporating dietary sources of vitamin D such as fatty fish, milk and fortified foods can boost your intake. Many individuals will require a vitamin D supplement to achieve adequacy. 

Maintain A Healthy Weight

Multiple studies have shown the majority of Americans today are overweight or obese, which is associated with an increased risk of chronic diseases such as diabetes, heart disease and cancer. 

The SCI population has similar rates of overweight and obese people  as the non-SCI population. Being overweight in combination with SCI also increases risk of poor sleep, fatty liver disease, pressure sores, stress on muscles and joints and poor circulation. 

Maintenance of a healthy body weight can be achieved through a healthy diet of appropriately portioned foods and a physically active lifestyle. 

The dietary guidelines will continue to evolve. They provide an outline of methods backed up by science that, if implemented, are proven to assist you in being the best version of yourself. 

Dan Greenwood, MS, RD, is registered dietician at the Minneapolis Department of Veterans Affairs Spinal Cord Injury and Disease Center.   

 

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What’s In Your Diet?

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