Key Points

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  • Adequate dietary consumption is important in maintaining bone health.
  • Age and gender, but not level of injury, predict total caloric intake in individuals with SCI.
  • Individuals with SCI are at a significant risk for malnutrition.
  • VFSS, BSE and FEES are all appropriate screening tools for diagnosing dysphagia in individuals with SCI.
  • Several risk factors for dysphagia in individuals with SCI exist, the most common being presence of a tracheostomy, ventilator use, increasing age, and presence of a nasogastric tube.
  • Individuals with tetraplegia have higher rates of altered glucose metabolism.
  • Impaired gallbladder emptying is seen in diabetic and obese SCI individuals.
  • Strict guidelines for diet and exercise interventions are important for patients with SCI due to the inconsistent nature of their energy balance causing weight gain leading to obesity.
  • A combined diet and exercise program can help patients reduce weight following SCI without compromising total lean mass and overall health.
  • A diet intervention focusing on anti-inflammatory foods and supplements can reduce inflammation serum markers, but may not show improvement in motor nerve conduction.
  • Participation in a holistic wellness program is positively associated with improved eating and weight-related behaviours in persons with SCI.
  • A combined nutrition, exercise and behaviour modification program can help persons with SCI increase metabolically active lean tissue, work efficiency, resting oxygen uptake and strength.
  • Having a high social participation is positively associated with better self-rated health, and receiving sufficient social support is positively associated with a greater dietary satisfaction, in persons with SCI.
  • Having a positive perceived food environment is associated with higher physical and mental scores of health-related quality of life, and higher diet satisfaction in persons with SCI.
  • Dietary counseling alone does significantly improve results in lipid profile; consultation with a registered dietitian should be obtained as individualized diets may enhance compliance.
  • Blood concentrations of DHA and EPA increased as a result of supplementation; however, no significant changes in lipid profile were identified.
  • DHA and EPA supplementation increase upper body strength and endurance in persons with SCI.
  • Vitamin D deficiency is highly prevalent in individuals with chronic SCI.
  • Individuals with SCI should be screened for vitamin D deficiency according to guideline practices and, if when necessary, replacement therapy should be initiated.
  • Clinicians should conduct early screening for and treatment of vitamin B12 deficiency.
  • Creatine supplementation does not result in improvements in muscle strength,
    endurance or function in weak upper limb muscles.
  • Creatine supplementation enhances exercise capacity in persons with complete tetraplegia and may promote greater exercise training benefits.
  • Consumption of a standard liquid meal does not change blood pressure, heart rate or noradrenalin levels in individuals with tetraplegia and postural hypotension.
  • The consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI.
  • Nutrient-induced thermogenesis is not decreased in tetraplegic individuals with low sympathoadrenal activity; efferent sympathoadrenal stimulation from the brain is not necessary for nutrient-induced thermogenesis.
  • Impairment of sympathetic control of the kidney secondary to SCI resulting in tetraplegia does not impact renal sodium conservation in response to dietary salt restriction.