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  • PMO-057 Dietary intervention for individuals with spinal cord injuries—a 2 year report on the spinal clinic for obese out-patient project (scoop)

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Obesity
PMO-057 Dietary intervention for individuals with spinal cord injuries—a 2 year report on the spinal clinic for obese out-patient project (scoop)
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  1. S S H Wong1,2,
  2. A Graham3,
  3. A Jamous3,
  4. L Spillman1,
  5. G Grimble2,
  6. A Forbes2
  1. 1Department of Nutrition and Dietetics, National Spinal Injuries Centre, Aylesbury, UK
  2. 2Centre for Gastroenterology and Clinical Nutrition, University College London, London, UK
  3. 3National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK

Abstract

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.

https://doi.org/10.1136/gutjnl-2012-302514b.57

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