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Micronutrient intake in overweight adults with spinal cord injury: analysis before and after dietetic intervention

Published online by Cambridge University Press:  26 April 2012

S. S. Wong*
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury Centre for Gastroenterology and Clinical Nutrition, University College London Hospitals, London
L. Spillman
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury
A. Graham
Affiliation:
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury
G. Grimble
Affiliation:
Centre for Gastroenterology and Clinical Nutrition, University College London Hospitals, London
A. Forbes
Affiliation:
Centre for Gastroenterology and Clinical Nutrition, University College London Hospitals, London
*
Correspondence: Samford Wong, email address: Samford.Wong@buckshealthcare.nhs.uk
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Abstract

Type
Abstract
Copyright
Copyright © The Authors 2012

There is currently limited evidence reporting the nutritional status of patients with spinal cord injury (SCI)(Reference Tomey1, Reference Walters2). This study aims (i) to describe micronutrient intake with reference to the UK Lower Reference Nutrient Intake (LRNI)(3)and the national survey dataReference Henderson, Gregory, Irving and Swan4 and (ii) to compare the micronutrient intake of overweight SCI adults, before and after dietetic intervention. Thirty-two SCI patients’ (52.4±11.5 years; BMI: 32.9±4.7 kg/m2; 41% female) 7-day food diaries were analysed at baseline and follow-up. The average weight loss was 3.7% after dietetic intervention. A significant reduction was found for zinc (p=0.005) and folate (p=0.05) intake in women and riboflavin (p=0.05) in men after intervention. Male and female participants failed to meet the LRNI for selenium before intervention, and females failed to meet the LRNI for potassium and selenium after intervention. In addition, our data show disparity when compared to findings of the national survey. Individuals are likely to have reduced physical activity and become institutionalised after SCI. Currently there is no generally recommended vitamin D intake for individuals less than 65 years old. Of participants aged 65 or above, 80% and 100% did not meet the LRNI for Vitamin D at initial assessment and follow-up respectively. The low vitamin D intake may be associated with an increased risk of complication such as osteoporosis. This study reveals possible micronutrient deficiencies in relation to the UK standards despite participants’ diets containing excess energy, suggesting that their diets contain nutritionally poor quality food. With the exception of Zn, folate and riboflavin, there was no significant difference in micronutrient intake following dietetic intervention, suggesting that the quality of the diet was, in general, improved without severely compromising the micronutrient profile. When working with overweight SCI patients, clinicians must be aware of pre-existing dietary inadequacies of micronutrients and facilitate improvements in the quality of the diet as well as reducing energy intake. Further research on nutrient intake in this group of vulnerable patients is warranted.

SCI: Spinal Cord Injury; NDNS: National Dietary and Nutrition Survey; RNI: Reference Nutrient Intake; LRNI: Lower Reference Nutrient Intake; d: day; *P<0.05; †P<0.01; aaged 19–20; baged 50+.

References

1.Tomey, et al. (2005) Arch Phys Med Rehabil 86, 664671.CrossRefGoogle Scholar
2.Walters, JL et al. (2009) Spinal Cord 47, 318322.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, Irving, K & Swan, G (2003) The National Diet and Nutritional Survey: Adults aged 19–64 years. Volume 3: Vitamins and Mineral Intake and Urinary Analysis. London: HMSO.Google Scholar