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Macronutrients intake in overweight adults with chronic spinal cord injury – result from Spinal Clinic for Obese Outpatient Project (SCOOP)

Published online by Cambridge University Press:  19 November 2010

S. S. Wong
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK Centre of Gastroenterology and Clinical Nutrition, University College London Hospital, Aylesbury, UK
A. Graham
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK
T. Ng
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK
A. Forbes
Affiliation:
Centre of Gastroenterology and Clinical Nutrition, University College London Hospital, Aylesbury, UK
G. Grimble
Affiliation:
Centre of Gastroenterology and Clinical Nutrition, University College London Hospital, Aylesbury, UK
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Abstract

Type
Abstract
Copyright
Copyright © The Authors 2010

Approximately 40 000 British currently live with spinal cord injury (SCI)(1) and up to 60% of them are estimated to be overweight or obese(Reference Gupta, White and Sandford2). This study aims to describe the macronutrients intake in a sample of adults with SCI before they attend a weight management clinic. Twenty-two adults, aged 19–75 years completed a 7-d food diary and their weights and body compositions were measured. Nutrient intake was compared to the British Reference Nutrient Intake (RNI) set by the Department of Health(3) and the National Diet Nutrition Survey (NDNS) data(Reference Henderson, Gregory and Swan4). These data are summarised in Table 1, of 22 patients included (47.1±13.4 years; BMI: 35.5 kg/m2). The total energy intake was lower than the general able-bodied population (male: 7.15 MJ (1721 kcal)/d v. 9.72 MJ (2312 kcal)/d; Female: 5.17 MJ (1242 kcal)/d v. 6.87 MJ (1632 kcal)/d). Overall, men consumed more energy per kg body weight than women [66.5256 kJ/d/kg (15.9 kcal/d/kg) v. 56.9024 kJ/d/kg (13.6 kcal/d/kg)] and consumed more alcohol than the national average (11.9 g v. 6.5 g/d). Men consumed proportionately more fat than women [22.1752 kJ/kg/d (5.3 kcal/kg/d, 33.1% of total energy v. 17.9912 kJ/kg/d (4.3 kcal/kg/d), 31.7% of total energy) but women consumed more carbohydrate [30.1248 kJ/kg/d (7.2 kcal/kg/d), 52.6% v. 28.0328 kJ/kg/d (6.7 kcal/kg/d), 42.3%] and protein [10.46 kJ/kg/d (2.5 kcal/kg/d), 18% v. 10.878 kJ/kg/d (2.6 kcal/kg/d), 16%]. Both males and females were found to consume more sugar and protein than the recommendation and women were found to consume more carbohydrate than the RNI. There is a fall in the intake dietary fibre when compared to the NDNS and RNI. Energy intakes appeared to be 9% less than that which would be calculated using Schofield's approach(Reference Schofield5) (6.73 MJ/d v. 7.42 MJ/d, P<0.05). The present study shows there is evidence of nutrient imbalance, relative to the RNI and national data for both men and women with SCI. Current guidance (RNI) on nutritional requirement may be overestimated in the SCI population and their diets are too high in sugar and excessive alcohol consumption, but low in fruits and vegetables and this may contribute towards obesity and poor vitamin and minerals status. In order to determine the optimal nutritional requirements in this specific ‘at risk’ group of patients, further research on measuring energy expenditure and nutrient intake, with a larger sample size is warranted.

SCI: spinal cord injury group; NDNS: National Dietary and Nutrition Survey(Reference Henderson, Gregory and Swan4); RNI: reference nutrient intake(3).

References

1.Spinal Injury Association (2009) http://www.spinal.co.uk/page/Some-basic-facts-about-SCI (accessed 8 February 2010).Google Scholar
2.Gupta, N, White, K & Sandford, P (2006) Spinal Cord 44, 9294.CrossRefGoogle ScholarPubMed
3.Department of Health (1991) Dietary Reference Values of Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects No. 41. London: H.M. Stationery Office.Google Scholar
4.Henderson, L, Gregory, J & Swan, G (2003a) The National Diet and Nutrition Survey: Adults Aged 19 to 64 years. Vol. 2. Energy, Protein, Carbohydrates, Fat and Alcohol Intake. London: The Stationery Office.Google Scholar
5.Schofield, WN (1985) Predicting basal metabolic rate, new standards and review of previous work. Hum Nutr Clin Nutr 44, 119.Google Scholar