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The comparison of total energy and protein intake relative to estimated requirements in chronic spinal cord injury

Published online by Cambridge University Press:  20 September 2023

Gary J. Farkas Open the ORCID record for Gary J. Farkas [Opens in a new window] ,
Arthur S. Berg ,
Alicia Sneij ,
David R. Dolbow ,
Ashraf S. Gorgey Open the ORCID record for Ashraf S. Gorgey [Opens in a new window]  and
David R. Gater Jr
Gary J. Farkas*
Affiliation:
Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
Arthur S. Berg
Affiliation:
Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
Alicia Sneij
Affiliation:
Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA
David R. Dolbow
Affiliation:
Department of Physical Therapy, William Carey University, Hattiesburg, MS, USA College of Osteopathic Medicine, William Carey University, Hattiesburg, MS, USA
Ashraf S. Gorgey
Affiliation:
Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA
David R. Gater Jr
Affiliation:
Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
*
*Corresponding author: Gary J. Farkas, Ph.D., email gjf50@med.miami.edu
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Abstract

In chronic spinal cord injury (SCI), individuals experience dietary inadequacies complicated by an understudied research area. Our objectives were to assess (1) the agreement between methods of estimating energy requirement (EER) and estimated energy intake (EEI) and (2) whether dietary protein intake met SCI-specific protein guidelines. Persons with chronic SCI (n = 43) completed 3-day food records to assess EEI and dietary protein intake. EER was determined with the Long and Institute of Medicine (IOM) methods and the SCI-specific Farkas method. Protein requirements were calculated as 0·8–1·0 g/kg of body weight (BW)/d. Reporting accuracy and bias were calculated and correlated to body composition. Compared with IOM and Long methods (P < 0·05), the SCI-specific method did not overestimate the EEI (P = 0·200). Reporting accuracy and bias were best for SCI-specific (98·9 %, −1·12 %) compared with Long (94·8 %, −5·24 %) and IOM (64·1 %, −35·4 %) methods. BW (r = –0·403), BMI (r = –0·323) and total fat mass (r = –0·346) correlated with the IOM reporting bias (all, P < 0·05). BW correlated with the SCI-specific and Long reporting bias (r = –0·313, P = 0·041). Seven (16 %) participants met BW-specific protein guidelines. The regression of dietary protein intake on BW demonstrated no association between the variables (β = 0·067, P = 0·730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0·833 g (P = 0·0001). The SCI-specific method for EER had the best agreement with the EEI. Protein intake decreased with increasing BW, contrary to protein requirements for chronic SCI.

Keywords

Spinal cord injuryTotal energy intakeDietary proteinEstimated energy requirementsObesity
Type
Research Article
Information
British Journal of Nutrition , Volume 131 , Issue 3 , 14 February 2024 , pp. 489 - 499
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

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Footnotes

†

Passed away in August 2022.

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