{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:56:21Z","timestamp":1781326581293,"version":"3.54.1"},"reference-count":50,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100032605","name":"Swiss Paraplegic Foundation","doi-asserted-by":"crossref","award":["Foko_2021_01"],"award-info":[{"award-number":["Foko_2021_01"]}],"id":[{"id":"10.13039\/100032605","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objective: Rapid, validated dietary screening tools are lacking for individuals with spinal cord injury (SCI), where routine clinical check-ups do not allow sufficient time for extensive dietary assessments typically required to evaluate adherence to dietary recommendations. We developed a 15-item dietary screener (SCI NutriTool) and evaluated its accuracy in classifying non-adherence to a healthy food pyramid compared with a validated food frequency questionnaire (FFQ). Methods: The SCI NutriTool was developed through literature review and expert consensus. In a validation study, 51 adults with SCI (mean age 57.0 years; 76.5% men; 68.8% traumatic injury) completed the SCI NutriTool twice and a validated 97-item FFQ, which served as the reference method. Results: The SCI NutriTool demonstrated substantial variability in performance across food groups, reflecting its domain-specific screening properties. Sensitivity was high for fruits and vegetables (91.7%), protein-rich foods (90.5%), and sweetened\/alcoholic beverages and snacks (82.4%), with relatively high positive predictive values (PPV: 73.7\u201390.5%), supporting the tool\u2019s ability to identify individuals who are likely non-adherent and may benefit from further nutritional assessment or counselling. In contrast, for starchy foods and nuts, oils, and fatty spreads\/sauces, sensitivity was low (20.0% and 50.0%), while specificity was modest. This indicates that the tool performs better in correctly identifying adherent individuals in these domains, which is reflected in higher negative predictive values (NPV: up to 94.1%). However, the low sensitivity suggests that individuals with non-adherence may be missed, limiting the tool\u2019s usefulness as an early screening trigger for these food groups. Conclusions: The SCI NutriTool\u2019s performance varies across food groups, demonstrating a stronger ability to identify non-adherence in protein-rich foods, fruit and vegetables, sweetened and alcoholic beverages, and snacks, but limited discriminatory capacity for others. In particular, it is not suitable for screening non-adherence to starchy foods and fats. Accordingly, it is best used as a triage tool to guide further dietary assessment and targeted nutritional interventions rather than as a standalone diagnostic instrument.<\/jats:p>","DOI":"10.3390\/nu18111737","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:06:56Z","timestamp":1780049216000},"page":"1737","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["SCI NutriTool: Development and Validation of a Questionnaire to Assess Non-Adherence to the Healthy Food Pyramid in Individuals with Spinal Cord Injury in Switzerland"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0108-2576","authenticated-orcid":false,"given":"Marija","family":"Glisic","sequence":"first","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Institute of Social and Preventive Medicine (ISPM), University of Bern, 3012 Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge","family":"Eriks-Hoogland","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Faculty of Health Sciences and Medicine, University of Lucerne, 6005 Lucerne, Switzerland"},{"name":"Swiss Paraplegic Centre, 6207 Nottwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-4789","authenticated-orcid":false,"given":"Angeline","family":"Chatelan","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1227 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khadija","family":"Maham","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Mattmann","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Centre, 6207 Nottwil, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4548-8500","authenticated-orcid":false,"given":"Pedro","family":"Marques-Vidal","sequence":"additional","affiliation":[{"name":"Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, 1011 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1086-8914","authenticated-orcid":false,"given":"Sara","family":"Rubinelli","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Medicine, University of Lucerne, 6005 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3953-589X","authenticated-orcid":false,"given":"Claudio","family":"Perret","sequence":"additional","affiliation":[{"name":"Swiss Paraplegic Research, 6207 Nottwil, Switzerland"},{"name":"Faculty of Health Sciences and Medicine, University of Lucerne, 6005 Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1038\/sc.2010.53","article-title":"Challenges, concerns and common problems: Physiological consequences of spinal cord injury and microgravity","volume":"49","author":"Scott","year":"2011","journal-title":"Spinal Cord"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/s41392-023-01477-6","article-title":"Spinal cord injury: Molecular mechanisms and therapeutic interventions","volume":"8","author":"Hu","year":"2023","journal-title":"Signal Transduct. 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