Nutrition and Spinal Cord Injury: The Basics

September is Spinal Cord Injury Awareness month! 

Recent statistics show that approximately 285,000 people are living with a spinal cord injury (SCI) in the United States. When the spinal cord is damaged, communication between brain and spinal cord is disrupted. Many people falsely assume that muscle function is the only thing affected. This is far from the truth. I’d like to give a brief overview of some of the functions affected by spinal cord injuries and how they relate to nutrition.

 

Ability to Self-feed

Feeding ourselves is something many people take for granted. It is a task you learn as a child and never think twice about after that. However, following a SCI that affects hand function, this becomes an important topic. Not being able to feed yourself can be a huge blow to your confidence. I’m not going to lie, it took me several months following my injury to be able to feed myself again. This can definitely affect what and how much someone can eat. To this day, there are still certain foods I struggle to eat. It is important to find what works for you. Working with an occupational therapist (OT) can be very helpful, as they are familiar with what adaptive eating utensils are available.

 

Bowel Function

Spinal cord injuries often result in an inability to control bowel function. This can slow the process of food passing through your intestines, ultimately leading to constipation. The reverse can also be true, with many individuals dealing with diarrhea and accidents. Adjusting fiber and fluid intake is important to maintain a bowel program. Finding the right combination of fiber and fluid is key to keep things running smoothly through your intestines.

 

Bladder Function

Like bowel function, bladder control is also affected. Depending on the level of spinal cord injury, the bladder may be flaccid or spastic. This means that an individual may be prone to leaking or holding urine. Many people living with spinal cord injuries use self-catheterization as part of their bladder management routine. By introducing something foreign to your body, it increases your risk of infection. Consuming enough fluid is important to help decrease that risk. Water is the best liquid to drink, as other fluids like carbonated and caffeinated beverages can irritate your bladder.

 

Pressure Sores

Overall mobility is affected following a spinal cord injury, and this often results in the need to use a wheelchair. Because wheelchair users have a higher risk of developing pressure sores, prevention is key when it comes to these types of skin injuries. In addition to performing pressure reliefs, what you eat also plays a role in both prevention and treatment. Making sure you get enough protein is necessary to both building and maintaining skin integrity. Other nutrients necessary for wound healing include vitamin C and zinc.

 

Weight management

Immediately following the spinal cord injury, it is common to lose weight. This is because muscle tissue follows “use it or lose it”. Since the brain can no longer control the muscles, they begin to atrophy or break down. For example, in the months following my injury I lost about 15 pounds. It may not sound like much, but at 5’3” and 110lbs it was a lot.

After this initial weight loss, it is common for people with spinal cord injuries to gain weight. This is partly because muscle burns more calories at rest than other types of tissues. Once that muscle tissue is lost, the number of calories burned at rest decreases. The other side to this is that eating habits often remain the same. Determining how many calories someone with a spinal cord injury needs is very tricky. Some adaptive athletes may even burn more calories than an able-bodied equivalent! Most apps and other estimates are developed for the able-bodied population, and do not take into account these differences. It is important to work with a Registered Dietitian if this is something you are interested in.

Benefits of maintaining a healthy body weight can include:

• Easier transfers
• Increased independence
• Decreased risk of pressure ulcers

And remember these benefits go both ways, whether you have excess weight or you weigh too little!

 

While this is just barely touches the surface of spinal cord injury nutrition, I hope you found it valuable. I’d love to hear your questions and comments below!

 

Note: If you or someone you know is having issues with any of the topics discussed here, it is always important to speak with a medical professional. If left untreated, issues with any of these topics can become life-threatening.