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Long Term Nutritional Considerations with Spinal Cord Injury

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Long Term Nutritional Considerations with Spinal Cord Injury Presented by: Sarah Feasel, MEd, RD, LD Clinical Nutrition Manager National Rehabilitation Hospital – PowerPoint PPT presentation

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Title: Long Term Nutritional Considerations with Spinal Cord Injury


1
Long Term Nutritional Considerations with Spinal
Cord Injury
  • Presented by
  • Sarah Feasel, MEd, RD, LD
  • Clinical Nutrition Manager
  • National Rehabilitation Hospital
  • Washington, DC

2
Objectives
  • Nutritional needs following SCI
  • Calories and Metabolism
  • Using food labels
  • Secondary conditions of SCI related to diet
  • Metabolic syndrome
  • Overweight and Obesity
  • Dietary Recommendations
  • Conclusions

3
Changing Nutritional Needs
  • Nutritional needs change a great deal after SCI
  • Calorie needs change the most
  • Calorie needs decrease because of decreased
    activity
  • Calorie needs also decrease because there is less
    lean body tissue or muscle which promotes a
    faster metabolism (how fast your body burns
    calories)

4
Putting it in Perspective
  • After injury we see weight loss in our patients.
    This is mainly due to loss of muscle or lean body
    tissue.
  • If you dont use it you lose it!

5
What are calories anyway?!?!
  • Quick Calorie Lesson
  • A calorie is a unit of measurement - but it
    doesn't measure weight
  • A calorie is a unit of energy. When you hear
    something contains 100 calories, it's a way of
    describing how much energy your body could get
    from eating or drinking it.

6
Much more about calories
  • Calories aren't bad for you. Your body needs
    calories for energy.
  • But eating TOO MANY calories - and not burning
    enough of them off through activity - can lead to
    weight gain
  • Most foods and drinks contain calories.
  • Some foods, such as an apple, contain few
    calories
  • Other foods, such as ice cream, contain more
    calories
  • Calories can come from 4 different areas in our
    foods
  • Carbohydrates have 4 calories per gram
  • Protein has 4 calories per gram
  • Fat has 9 calories per gram
  • Alcohol has 7 calories per gram

7
(No Transcript)
8
Balancing Act
  • To maintain a healthy weight range, it is
    important to balance calories from foods and
    beverages with the calories that we use
  • Think of the calories you consume and the
    calories you burn as your calorie budget for the
    day. You need to decide how you want to spend
    those calories
  • To lose weight Consume fewer calories than you
    burn each day.
  • To do this either cut back on your calories or
    exercise more!

9
Why do we care about diet with SCI?
  • The doctors, nurses, therapists, and dietitians
    who have treated you are concerned about your
    diet for several reasons.
  • Poor diet can lead to many problems that can make
    your job and the job of your care givers harder.

10
What are Secondary Conditions Related to SCI and
Nutrition?
  • Metabolic Syndrome
  • Bowel Problems
  • Kidney Stones
  • Pressure Ulcers
  • Urinary Tract Infections
  • Overweight and Obesity

11
Explaining Metabolic Syndrome
  • Metabolic Syndrome is not a single disease but a
    group of health problems that is believed to
    arise due to a combination of genetic factors and
    lifestyle factors including overeating and lack
    of physical activity.
  • If 3 of these categories are met you would could
    have metabolic syndrome
  • Symptoms of Metabolic Syndrome
  • Waist Circumference greater than 40 inches for
    men and 35 inches for women (in SCI population it
    is likely a different estimation)
  • Triglyceride level 150 mg/dL
  • HDL (good cholesterol) lt 40 mg/dL in men and lt50
    mg/dL in women
  • Blood pressure gt 130/85 mmHg
  • Blood sugar gt 110 mg/dL

12
Overweight and Obesity
  • For the general population overweight and obesity
    can be categorized by using a measurement called
    BMI (Body Mass Index)
  • This index uses your weight and height to then
    calculate a number which will categorize you into
    one of 5 categories
  • BMIlt18.5- Underweight
  • BMI 18.5-24.9- Normal Weight
  • BMI 25-29.9- Overweight
  • BMI 30-39.9- Obese
  • BMI gt40- Extreme Obese
  • In SCI patients we use BMI but the numbers do not
    truly mean the same thing as in the general
    population. SCI patients need to watch out for
    being OVERFAT!

13
Overweight and Obesity
Example Patient 1 Young male BMI 17.9,
Underweight Average fat in 3 areas assessed
28.2 fat This would make this patient obese
because the in this age group the amount of fat
that is considered acceptable is 18-25, making
this seemingly underweight patient obese.
14
Dietary Recommendations to Prevent Metabolic
Syndrome and Overweight/Obesity
  • Complications of Metabolic Syndrome can be
    prevented through diet.
  • Early Intervention is key!
  • 1.) Limit your Fat Intake
  • Try to increase your fruit and vegetable intake
  • Go vegetarian every now and again
  • Choose fat free or low fat dairy products
  • Choose lean meats and skinless poultry and fish

15
Dietary Recommendations to Prevent Metabolic
Syndrome and Overweight/Obesity
  • Complications of Metabolic Syndrome can be
    prevented through diet.
  • Early Intervention is key!
  • 2.) Reduce your use of Saturated Fat and Trans
    Fat
  • These are the fats that are solid at room
    temperature
  • Animal fats/Lard
  • Shortening
  • Tropical oils like palm and coconut oil

16
Dietary Recommendations to Prevent Metabolic
Syndrome and Overweight/Obesity
  • Complications of Metabolic Syndrome can be
    prevented through diet.
  • Early Intervention is key!
  • 3.) Eat less cholesterol
  • Cholesterol is in foods from animal origin
  • If you reduce the amount of animal fat in your
    diet, you will reduce your cholesterol intake

17
Dietary Recommendations to Prevent Metabolic
Syndrome and Overweight/Obesity
  • Complications of Metabolic Syndrome can be
    prevented through diet.
  • Early Intervention is key!
  • 4.) Limit the empty calories
  • Choose water or diet beverages over regular soda
    or juices
  • Try not to add extra sugar to anything
  • Think when eating convenience foods
  • Think about condiments

18
Dietary Recommendations to Prevent Metabolic
Syndrome and Overweight/Obesity
  • Complications of Metabolic Syndrome can be
    prevented through diet.
  • Early Intervention is key!
  • 5.) Remember the difference between sometimes and
    everyday foods
  • Sometimes foods are foods that we might call
    bad or unhealthy
  • Everyday foods are things like fruits,
    vegetables, lean meat, low-fat dairy, healthy
    oils, beans

19
Nutrition and SCI Conclusions
  • This is a tremendously large topic and I hope
    that I was able to give an overview of the topic
    with some helpful recommendations
  • Changing the way you eat is a complex task and
    not something that will magically happen
    overnight, it takes time
  • You may experience difficulties but take it one
    meal at a time?

20
  • References
  • 1.) The American Dietetic Association,
    www.eatright.org
  • 2.) Steps to Your Health, Morrison Management
    Specialists publication 2007
  • 3.) Photo used from www.umm.edu

21
  • THANK YOU?
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