Pyramid dietary management for patients with spinal cord injury

Authors: Yang Xiaoxin, Qi Yan; Chief Judge: Zhai Hua

Unit: Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)

This popular science work is one of the popular science materials in the series "Don't be afraid of spinal cord injuries, there are ways to prevent and rehabilitate them"

Spinal cord injury (SCI) often leads to neurogenic bowel, which manifests as constipation or fecal incontinence. Because patients with spinal cord injury usually live a sedentary life, we have established a pyramid diet model to provide patients with a healthy and scientific diet plan, and guide patients with spinal cord injury to improve muscle strength, endurance, cardiopulmonary and renal metabolic functions through scientific nutritional intake and reasonable rehabilitation treatment.

Diet pyramid for people with spinal cord injury

Notes in the figure: BM: w-3 PUFA: polyunsaturated fatty acids; CHO: carbohydrates; FODMAP: fermentable oligosaccharides, disaccharides, monosaccharides and polyols

1. Every spinal cord injury patient is required to have three meals a day, and can eat snacks between meals.

1. Daily carbohydrates are 5g/kg, so about 300g is needed;

2. If you take 1.5g/kg of protein per day, you need about 90g;

3. The total amount of fat consumed per day is about 50g;

4. The total amount of multivitamin intake is about 120 mg;

5. The total daily intake of dietary fiber is about 15 g.

6. The daily water intake (including beverages, porridge, etc.) is calculated based on 200 ml of water per hour, at least 40 ml/kg per day. Intermittent catheterization can flexibly adjust the water intake according to urine volume.

1. Quadriplegia: 22.7 kcal/(kg·d), requiring 1,300 kcal per day;

2. Paraplegia: 27.9 kcal/(kg·d), requiring 1600 kcal per day;

3. For patients with spinal cord injury and pressure sores, the intake is 30-40 kcal/(kg·d); 2100 kcal is required per day.

1. Stage II pressure ulcer: 1.2-1.5 g/(kg·d), 90 g per day;

2. Stage III and IV pressure ulcers: 1.5-2.0 g/(kg·d), 120 g per day.

2. Personalized Dietary Guidance

1. You can supplement appropriate amounts of vitamins, minerals, W-3PUFA and probiotics according to your different needs.

2. To prevent urinary tract infection, it is recommended to eat fruits and vegetables such as bananas, blueberries, strawberries, kiwis, cucumbers, eggplants, lettuce, spinach, leeks, pumpkins, and tomatoes.

3. Pay attention to eating less: saturated fatty acids, salt, sugar, caffeine, pepper, alcohol, carbonated drinks, and strong tea.

(Some pictures in this article are from the Internet)

References:

1. Farkas GJ, Pitot MA, Berg AS, Gater DR. Correction: Nutritional status in chronic spinal cord injury: a systematic review and meta-analysis. Spinal Cord. 2019;57(3):256. doi:10.1038/s41393-019-0252-x

2. Silveira SL, Winter LL, Clark R, Ledoux T, Robinson-Whelen S. Baseline Dietary Intake of Individuals with Spinal Cord Injury Who Are Overweight or Obese. J Acad Nutr Diet. 2019;119(2):301-309. doi:10.1016/j.jand.2018.08.153

3. Ciccotti M, Raguzzini A, Sciarra T, et al. Nutraceutical-based Integrative Medicine: Adopting a Mediterranean Diet Pyramid for Attaining Healthy Aging in Veterans with Disabilities. Curr Pharm Des. 2018;24(35):4186-4196. doi:10.2174/1381612824666181003113444

4. Sciarra T, Ciccotti M, Aiello P, et al. Polypharmacy and Nutraceuticals in Veterans: Pros and Cons. Front Pharmacol. 2019;10:994. Published 2019 Sep 10. doi:10.3389/fphar.2019.00994