Introduction Obesity is common after spinal cord injuries (SCI)1 and it is associated with chronic nutrition related complications. We previously reported that a simple dietetic-intervention can help SCI patients to lose weight without compromising lean body mass.2
Methods The present study aimed to assess the effectiveness of a dietitian led weight management clinic. Thirty-one individuals (52.4±11.5 years; body mass index (BMI): 32.9 kg/m2; 41% female) with SCI were referred for consultation to include nutritional advice and cognitive behaviour therapy in three consultations over 4 months. Outcomes measures included body composition from anthropometric measurements of BMI, mid upper-arm circumference (MUAC), triceps skinfold thickness (TSF) and mid-arm muscle circumference (MAMC), sitting blood pressure and dietary assessment of nutrient intake by 7-d food diary.
Results Of the thirty-one individuals, 15 (48.4%) reported one or more co-morbidities. Mean weight loss was 4.5 kg (SD 6.2) at week 16. Analysis of the pre- to post-intervention difference (using paired t-test) showed a significant reduction in weight (104.2 vs 100.4 kg, p=0.001), BMI (34 vs 33.1 kg/m2, p=0.004), total energy intake (6.84 vs 5.62 MJ/d, p=0.029), total fat (p=0.005), saturated fat (p=0.001) and alcohol (p=0.003). No significant changes were found in MUAC, TSF, MAMC and sitting blood pressure post intervention. We noted a significant reduction in MAMC at 1-year follow-up (30.2 vs 27.1 cm, p<0.001). The 7-d food diary showed an average energy intake of 7.65 MJ/d, which is 15% below the estimated requirement.
Conclusion The findings of this study suggest that current guidance overestimates nutritional requirements in the SCI population, and that simple dietetic-intervention could help overweight SCI patients to achieve weight loss, but that it may not be sufficient to stimulate/maintain muscle mass long term. Further research is warranted to test whether combining lifestyle and intensive physical therapy could reduce long-term muscle wasting.
Competing interests None declared.
References 1. Gupta N, et al. Spinal Cord 2006;44:92–4.
2. Wong S, et al. Food Nutr Sci 2011;2:901–7.
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