{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:12:43Z","timestamp":1792663963891,"version":"4.5.0"},"reference-count":116,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"Following a spinal cord injury (SCI), neurogenic obesity results from changes in body composition, physical impairment, and endometabolic physiology and when dietary intake exceeds energy expenditure. Given the postinjury reductions in lean body mass, sympathetic nervous system dysfunction, and anabolic deficiencies, energy balance is no longer in balance, and thereby an obesogenic environment is created that instigates cardiometabolic dysfunction. Accurate determination of metabolic rate can prevent excess caloric intake while promoting positive body habitus and mitigating obesity-related comorbidities. Metabolic rate as determined by indirect calorimetry (IC) has not been adopted in routine clinical care for persons with SCI despite several studies indicating its importance. This article reviews current literature on measured and predicted metabolic rate and energy expenditure after SCI and stresses the importance of IC as standard of care for persons with SCI.<\/jats:p>","DOI":"10.46292\/sci20-00030","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T13:50:45Z","timestamp":1616161845000},"page":"92-99","source":"Crossref","is-referenced-by-count":24,"title":["Energy Expenditure Following Spinal Cord Injury: A Delicate Balance"],"prefix":"10.46292","volume":"27","author":[{"given":"Gary J.","family":"Farkas","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Sneij","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Gater","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"},{"name":"Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"6","key":"i1082-0744-27-1-92-b1","series-title":"Am J Clin Nutr","first-page":"1223","article-title":"Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury compared with control subjects","volume":"68","year":"1998","unstructured":"Monroe\n MB,\n \n \n Tataranni\n PA,\n \n \n Pratley\n R,\n \n \n Manore\n MM,\n \n \n Skinner\n JS,\n \n \n Ravussin\n E.\n \n \n Lower daily energy expenditure as measured by a respiratory chamber in subjects with spinal cord injury 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R.\n\t\t\t\t\t2018;\n\t\t\t\t\t10(\n\t\t\t\t\t4):\n\t\t\t\t\t373\u2013\n\t\t\t\t\t381.\n\t\t\t\t\tdoi:10.1016\/j.pmrj.2017.08.40."},{"issue":"4","key":"i1082-0744-27-1-92-b55","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1038\/sc.2015.193","article-title":"Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review","volume":"54","year":"2016","unstructured":"Nevin\n AN,\n \n \n Steenson\n J,\n \n \n Vivanti\n A,\n \n \n Hickman\n IJ.\n \n \n Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2016;\n\t\t\t\t\t54(\n\t\t\t\t\t4):\n\t\t\t\t\t248\u2013\n\t\t\t\t\t53.\n\t\t\t\t\tdoi:10.1038\/sc.2015.193."},{"issue":"3","key":"i1082-0744-27-1-92-b56","series-title":"J Spinal Cord 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section.\n\t\t\t\t\tParaplegia.\n\t\t\t\t\t1995;\n\t\t\t\t\t33(\n\t\t\t\t\t11):\n\t\t\t\t\t674\u2013\n\t\t\t\t\t677.\n\t\t\t\t\tdoi:10.1038\/sc.1995.141"},{"issue":"3","key":"i1082-0744-27-1-92-b3","series-title":"Arch Phys Med Rehabil","first-page":"107","article-title":"Glucose intolerance in spinal cord injury","volume":"64","year":"1983","unstructured":"Duckworth\n WC,\n \n \n Jallepalli\n P,\n \n \n Solomon\n SS.\n \n \n Glucose intolerance in spinal cord injury.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t1983;\n\t\t\t\t\t64(\n\t\t\t\t\t3):\n\t\t\t\t\t107\u2013\n\t\t\t\t\t110."},{"issue":"6","key":"i1082-0744-27-1-92-b4","series-title":"Metabolism","first-page":"749","article-title":"Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging","volume":"43","year":"1994","unstructured":"Bauman\n WA,\n \n \n Spungen\n AM.\n \n \n Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging.\n\t\t\t\t\tMetabolism.\n\t\t\t\t\t1994;\n\t\t\t\t\t43(\n\t\t\t\t\t6):\n\t\t\t\t\t749\u2013\n\t\t\t\t\t56."},{"issue":"11","key":"i1082-0744-27-1-92-b5","series-title":"Spinal Cord","first-page":"765","article-title":"The effect of residual neurological deficit on oral glucose tolerance in persons with chronic spinal cord injury","volume":"37","year":"1999","unstructured":"Bauman\n WA,\n \n \n Adkins\n RH,\n \n \n Spungen\n AM,\n \n \n Waters\n RL.\n \n \n The effect of residual neurological deficit on oral glucose tolerance in persons with chronic spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t1999;\n\t\t\t\t\t37(\n\t\t\t\t\t11):\n\t\t\t\t\t765\u2013\n\t\t\t\t\t771."},{"issue":"4","key":"i1082-0744-27-1-92-b6","series-title":"J Spinal Cord Med","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1080\/10790268.2001.11753584","article-title":"Carbohydrate and lipid metabolism in chronic spinal cord 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Rehabil.\n\t\t\t\t\t2015;\n\t\t\t\t\t96(\n\t\t\t\t\t9):\n\t\t\t\t\t1646\u2013\n\t\t\t\t\t1653.\n\t\t\t\t\tdoi:10.1016\/j.apmr.2015.05.013."},{"issue":"6","key":"i1082-0744-27-1-92-b37","series-title":"J Spinal Cord Med","first-page":"699","article-title":"Longitudinal changes in body composition and metabolic profile between exercise clinical trials in men with chronic spinal cord injury","volume":"39","year":"2016","unstructured":"Gorgey\n AS,\n \n \n Martin\n H,\n \n \n Metz\n A,\n \n \n Khalil\n RE,\n \n \n Dolbow\n DR,\n \n \n Gater\n DR.\n \n \n Longitudinal changes in body composition and metabolic profile between exercise clinical trials in men with chronic spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t39(\n\t\t\t\t\t6):\n\t\t\t\t\t699\u2013\n\t\t\t\t\t712."},{"key":"i1082-0744-27-1-92-b38","series-title":"PM R.","article-title":"Gender dimorphism in central adiposity may explain metabolic dysfunction after spinal cord injury [published online 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metabolic status of paraplegics","volume":"22","year":"1985","unstructured":"Lee\n BY,\n \n \n Agarwal\n N,\n \n \n Corcoran\n L,\n \n \n Thoden\n WR,\n \n \n Del Guercio\n LR.\n \n \n Assessment of nutritional and metabolic status of paraplegics.\n\t\t\t\t\tJ Rehabil Res Dev.\n\t\t\t\t\t1985;\n\t\t\t\t\t22(\n\t\t\t\t\t3):\n\t\t\t\t\t11\u2013\n\t\t\t\t\t17."},{"issue":"9","key":"i1082-0744-27-1-92-b41","series-title":"Arch Phys Med Rehabil","first-page":"965","article-title":"The relationship between total body potassium and resting energy expenditure in individuals with paraplegia","volume":"74","year":"1993","unstructured":"Spungen\n AM,\n \n \n Bauman\n WA,\n \n \n Wang\n J,\n \n \n Pierson\n RN,\n J.\n \n \n The relationship between total body potassium and resting energy expenditure in individuals with paraplegia.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t1993;\n\t\t\t\t\t74(\n\t\t\t\t\t9):\n\t\t\t\t\t965\u2013\n\t\t\t\t\t968."},{"key":"i1082-0744-27-1-92-b42","series-title":"J Spinal Cord Med.","first-page":"35","article-title":"Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury","year":"2012","unstructured":"Tanhoffer\n RA,\n \n \n Tanhoffer\n AIP,\n \n \n Raymond\n J,\n \n \n Hills\n AP,\n \n \n Davis\n GM.\n \n \n Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.2012:\n\t\t\t\t\t35\u2013\n\t\t\t\t\t45."},{"issue":"6","key":"i1082-0744-27-1-92-b43","series-title":"Arch Phys Med Rehabil","first-page":"758","article-title":"The relationship between basal metabolic rate and femur bone mineral density in men with traumatic spinal cord injury","volume":"88","year":"2007","unstructured":"Yilmaz\n B,\n \n \n Yasar\n E,\n \n \n Goktepe\n AS,\n \n \n .\n\t\t\t\t\tThe relationship between basal metabolic rate and femur bone mineral density in men with traumatic spinal cord injury.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2007;\n\t\t\t\t\t88(\n\t\t\t\t\t6):\n\t\t\t\t\t758\u2013\n\t\t\t\t\t761."},{"issue":"1","key":"i1082-0744-27-1-92-b44","series-title":"Int J Behav Nutr Phys Act","first-page":"132","article-title":"Energy balance components in persons with paraplegia: Daily variation and appropriate measurement duration","volume":"14","year":"2017","unstructured":"Nightingale\n TE,\n \n \n Williams\n S,\n \n \n Thompson\n D,\n \n \n Bilzon\n JLJ.\n \n \n Energy balance components in persons with paraplegia: Daily variation and appropriate measurement duration.\n\t\t\t\t\tInt J Behav Nutr Phys Act.\n\t\t\t\t\t2017;\n\t\t\t\t\t14(\n\t\t\t\t\t1):\n\t\t\t\t\t132."},{"issue":"6","key":"i1082-0744-27-1-92-b45","series-title":"Med Sci Sports Exerc","first-page":"1305","article-title":"Predicting basal metabolic rate in men with motor complete spinal cord injury","volume":"50","year":"2018","unstructured":"Nightingale\n TE,\n \n \n Gorgey\n AS.\n \n \n Predicting basal metabolic rate in men with motor complete spinal cord injury.\n\t\t\t\t\tMed Sci Sports Exerc.\n\t\t\t\t\t2018;\n\t\t\t\t\t50(\n\t\t\t\t\t6):\n\t\t\t\t\t1305\u2013\n\t\t\t\t\t1312."},{"issue":"6","key":"i1082-0744-27-1-92-b46","series-title":"J Spinal Cord Med","first-page":"569","article-title":"Comparison of nutritional intake between individuals with acute and chronic spinal cord injury","volume":"34","year":"2011","unstructured":"Perret\n C,\n \n \n Stoffel-Kurt\n N.\n \n \n Comparison of nutritional intake between individuals with acute and chronic spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2011;\n\t\t\t\t\t34(\n\t\t\t\t\t6):\n\t\t\t\t\t569\u2013\n\t\t\t\t\t575."},{"issue":"7","key":"i1082-0744-27-1-92-b47","series-title":"Paraplegia","first-page":"448","article-title":"Body composition and resting energy expenditure in long-term spinal cord injury","volume":"28","year":"1990","unstructured":"Sedlock\n DA,\n \n \n Laventure\n SJ.\n \n \n Body composition and resting energy expenditure in long-term spinal cord injury.\n\t\t\t\t\tParaplegia.\n\t\t\t\t\t1990;\n\t\t\t\t\t28(\n\t\t\t\t\t7):\n\t\t\t\t\t448\u2013\n\t\t\t\t\t454."},{"key":"i1082-0744-27-1-92-b48","series-title":"J Spinal Cord Med.","first-page":"1","article-title":"Resting energy expenditure in male athletes with a spinal cord injury","year":"2017","unstructured":"Pelly\n FE,\n \n \n Broad\n EM,\n \n \n Stuart\n N,\n \n \n Holmes\n MA.\n \n \n Resting energy expenditure in male athletes with a spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.2017:\n\t\t\t\t\t1\u2013\n\t\t\t\t\t8."},{"issue":"1","key":"i1082-0744-27-1-92-b49","series-title":"Spinal Cord","first-page":"3","article-title":"Nutritional status in chronic spinal cord injury: A systematic review and meta-analysis","volume":"57","year":"2019","unstructured":"Farkas\n GJ,\n \n \n Pitot\n MA,\n \n \n Berg\n AS,\n \n \n Gater\n DR.\n \n \n Nutritional status in chronic spinal cord injury: A systematic review and meta-analysis.\n\t\t\t\t\tSpinal 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Cord Med.","first-page":"32","article-title":"Age-related prevalence of low testosterone in men with spinal cord injury","year":"2014","unstructured":"Bauman\n WA,\n \n \n La Fountaine\n MF,\n \n \n Spungen\n AM.\n \n \n Age-related prevalence of low testosterone in men with spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.2014:\n\t\t\t\t\t32\u2013\n\t\t\t\t\t39."},{"issue":"4","key":"i1082-0744-27-1-92-b54","series-title":"PM R","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/j.pmrj.2017.08.40","article-title":"Relationship between gonadal function and cardiometabolic risk in young men with chronic spinal cord injury","volume":"10","year":"2018","unstructured":"Sullivan\n SD,\n \n \n Nash\n MS,\n \n \n Tefara\n E,\n \n \n Tinsley\n E,\n \n \n Groah\n S.\n \n \n Relationship between gonadal function and cardiometabolic risk in young men with chronic spinal cord injury.\n\t\t\t\t\tPM 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Med","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1080\/10790268.2019.1608062","article-title":"Measured and predicted resting energy expenditure in wheelchair rugby athletes","volume":"43","year":"2020","unstructured":"Broad\n EM,\n \n \n Newsome\n LJ,\n \n \n Drew\n DA,\n \n \n Barfield\n J.\n \n \n Measured and predicted resting energy expenditure in wheelchair rugby athletes.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2020;\n\t\t\t\t\t43(\n\t\t\t\t\t3):\n\t\t\t\t\t388\u2013\n\t\t\t\t\t397.\n\t\t\t\t\tdoi:10.1080\/10790268.2019.1608062."},{"issue":"11","key":"i1082-0744-27-1-92-b57","series-title":"Ann Intern Med","doi-asserted-by":"publisher","first-page":"789\u2013+","DOI":"10.7326\/0003-4819-159-11-201312030-00016","article-title":"The myth of healthy obesity [editorial material]","volume":"159","year":"2013","unstructured":"Hill\n JO,\n \n \n Wyatt\n HR.\n \n \n The myth of healthy obesity [editorial material].\n\t\t\t\t\tAnn Intern Med.\n\t\t\t\t\t2013;\n\t\t\t\t\t159(\n\t\t\t\t\t11):\n\t\t\t\t\t789\u2013+.\n\t\t\t\t\tdoi:10.7326\/0003-4819-159-11-201312030-00016"},{"issue":"3","key":"i1082-0744-27-1-92-b58","series-title":"Res Q Exerc Sport","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1080\/02701367.2013.816224","article-title":"The energy balance study: the design and baseline results for a longitudinal study of energy balance","volume":"84","year":"2013","unstructured":"Hand\n GA,\n \n \n Shook\n RP,\n \n \n Paluch\n AE,\n \n \n .\n\t\t\t\t\tThe energy balance study: the design and baseline results for a longitudinal study of energy balance.\n\t\t\t\t\tRes Q Exerc Sport.\n\t\t\t\t\t2013;\n\t\t\t\t\t84(\n\t\t\t\t\t3):\n\t\t\t\t\t275\u2013\n\t\t\t\t\t286.\n\t\t\t\t\tdoi:10.1080\/02701367.2013.816224."}],"container-title":["Topics in Spinal Cord Injury 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