Excessive weight gain is common in people with paraplegia. Researchers determine how dietary intake and energy expended varies from day to day in this patient population.

Paraplegia is the loss of sensation and muscle function in the lower part of the body, usually due to a spinal chord injury (SCI). Paraplegics are at a higher risk of developing chronic diseases, such as diabetes and hypertension. This is because they are less active and are more likely to be overweight, compared to people without paraplegia. The amount of energy expended is usually lower in this group due to an increase in inactivity (including an increase in the amount of time spent sitting or lying down).

The article, published in the International Journal of Behavioral Nutrition and Physical Activity, comprised of 33 participants with chronic paraplegia. Eligible participants were between the ages of 18 and 65 and had either been diagnosed with a spinal chord injury for a minimum of one year or had neurologically incomplete injuries (but used a wheelchair for 75% of their day). The participants were required to have minimal weight changes) in the preceding three months, with no plans to change their diet and physical activity regimen. Each person wore a multi-sensor activity monitor (Actiheart) and completed a weighed food diary for seven consecutive days. A weighed food diary involves weighing and recording the masses of the foods being consumed. If the Actiheart monitor was worn for at least 80% of the time in a 24-hour period, the day was considered valid. Outcomes measured during the study include weight, resting metabolic rate, energy expenditure, and energy intake.

The results of the study showed that dietary intake and physical activity in this group, vary from day to day. It showed that men were more active than women.Participants with spinal chord injury lower on the spinal chord were more active than people with injury higher on the spinal chord. The number of valid days, based on the Actiheart data, ranged from four to seven days. The study found that varying number of days are required to measure various levels of physical activity, with four days noted as an appropriate amount of time to measure sedentary activity. The article notes that this is the first study to demonstrate energy balance variability in this patient population.

Written by Anuolu Bank-Oni, Pharm.D, CDE

Reference: Nightingale et al. “Energy balance components in persons with paraplegia: daily variation and appropriate measurement duration”. International Journal of Behavioral Nutrition and Physical Activity (2017) 14:132. DOI 10.1186/s12966-017-0590-z

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