{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:28:57Z","timestamp":1790393337333,"version":"4.1.0"},"reference-count":194,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:p>Following spinal cord injury (SCI), individuals are at high risk for obesity and several chronic cardiometabolic disorders due to a deterioration in body composition, hypometabolic rate, and endometabolic dysregulation. Countermeasures to the consequences of an SCI include adopting a healthy diet that provides adequate nutrition to maintain good body habitus and cardiometabolic health. A proper diet for individuals with SCI should distribute carbohydrates, protein, and fat to optimize a lower energy intake requirement and should stress foods with low caloric yet high nutrient density. The purpose of this article is to present available evidence on how nutritional status after SCI should advance future research to further develop SCI-specific guidelines for total energy intake, as it relates to percent carbohydrates, protein, fat, and all vitamins and minerals, that take into consideration the adaptations after SCI.<\/jats:p>","DOI":"10.46292\/sci20-00031","type":"journal-article","created":{"date-parts":[[2021,3,19]],"date-time":"2021-03-19T13:48:41Z","timestamp":1616161721000},"page":"100-108","source":"Crossref","is-referenced-by-count":33,"title":["Dietetics After Spinal Cord Injury: Current Evidence and Future Perspectives"],"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":"The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"4","key":"i1082-0744-27-1-100-b1","series-title":"J Spinal Cord Med","first-page":"378","article-title":"Neurogenic obesity and systemic inflammation following spinal cord injury: a review","volume":"41","year":"2018","unstructured":"Farkas\n              GJ,\n            \n      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  Caudill\n              C,\n            \n            \n              Sistrun\n              S,\n            \n          \n          .\n\t\t\t\t\tFrequency of dietary recalls, nutritional assessment, and body composition assessment in men with chronic spinal cord injury.\n\t\t\t\t\tArch Phys Med 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":"i1082-0744-27-1-100-b55","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         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evoked resistance exercise after spinal cord injury on cardio-metabolic risk factors: an open-label randomized clinical trial.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2019;\n\t\t\t\t\t36(\n\t\t\t\t\t18):\n\t\t\t\t\t2631\u2013\n\t\t\t\t\t2645.\n\t\t\t\t\tdoi:10.1089\/neu.2018.6136."},{"issue":"4","key":"i1082-0744-27-1-100-b57","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1038\/sc.2008.134","article-title":"Evidence of dietary inadequacy in adults with chronic spinal cord injury","volume":"47","year":"2009","unstructured":"Walters\n              JL,\n            \n            \n              Buchholz\n              AC,\n            \n            \n              Martin Ginis\n              KA.\n            \n          \n          Evidence of dietary inadequacy in adults with chronic spinal cord injury.\n\t\t\t\t\tSpinal 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Rehabil.\n\t\t\t\t\t2005;\n\t\t\t\t\t86(\n\t\t\t\t\t4):\n\t\t\t\t\t664\u2013\n\t\t\t\t\t71.\n\t\t\t\t\tdoi:10.1016\/j.apmr.2004.10.023"},{"issue":"6","key":"i1082-0744-27-1-100-b71","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":"8","key":"i1082-0744-27-1-100-b72","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1038\/sj.sc.3101179","article-title":"Energy expenditure and nutritional adequacy of rehabilitation paraplegics with 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Nutr.\n\t\t\t\t\t1991;\n\t\t\t\t\t15(\n\t\t\t\t\t3):\n\t\t\t\t\t319\u2013\n\t\t\t\t\t322.\n\t\t\t\t\tdoi:10.1177\/0148607191015003319."},{"issue":"9","key":"i1082-0744-27-1-100-b79","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1038\/sj.sc.3100439","article-title":"The metabolic response to spinal cord injury","volume":"35","year":"1997","unstructured":"Rodriguez\n              DJ,\n            \n            \n              Benzel\n              EC,\n            \n            \n              Clevenger\n              FW.\n            \n          \n          The metabolic response to spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t1997;\n\t\t\t\t\t35(\n\t\t\t\t\t9):\n\t\t\t\t\t599\u2013\n\t\t\t\t\t604.\n\t\t\t\t\tdoi:10.1038\/sj.sc.3100439."},{"key":"i1082-0744-27-1-100-b80","series-title":"Nutrition Support Core Curriculum, American Society of Parenteral and Enteral Nutrition","first-page":"199","article-title":"Nutrition support in 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          Ribas-Cardus\n              F,\n            \n            \n              Rintala\n              DH,\n            \n            \n              Rodriguez\n              GP.\n            \n          \n          Dietary and serum lipids in individuals with spinal cord injury living in the community.\n\t\t\t\t\tJ Rehabil Res Dev.\n\t\t\t\t\t2001;\n\t\t\t\t\t38(\n\t\t\t\t\t2):\n\t\t\t\t\t225\u2013\n\t\t\t\t\t233."},{"issue":"2","key":"i1082-0744-27-1-100-b83","series-title":"J Spinal Cord Med","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1080\/10790268.2017.1319996","article-title":"Changes in alcohol use after the onset of spinal cord injury","volume":"41","year":"2018","unstructured":"Davis\n              JF,\n            \n            \n              Cao\n              Y,\n            \n            \n              Krause\n              JS.\n            \n          \n          Changes in alcohol use after the onset of spinal cord injury.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2018;\n\t\t\t\t\t41(\n\t\t\t\t\t2):\n\t\t\t\t\t230\u2013\n\t\t\t\t\t237.\n\t\t\t\t\tdoi:10.1080\/10790268.2017.1319996."},{"issue":"2","key":"i1082-0744-27-1-100-b84","series-title":"J Spinal Cord Med","first-page":"111","article-title":"Alcohol use associated with cervical spinal cord injury","volume":"27","year":"2004","unstructured":"Garrison\n              A,\n            \n            \n              Clifford\n              K,\n            \n            \n              Gleason\n              SF,\n            \n            \n              Tun\n              CG,\n            \n            \n              Brown\n              R,\n            \n            \n              Garshick\n              E.\n            \n          \n          Alcohol use associated with cervical spinal cord injury.\n\t\t\t\t\tJ Spinal Cord 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Rehabil.\n\t\t\t\t\t2004;\n\t\t\t\t\t85(\n\t\t\t\t\t11):\n\t\t\t\t\t1837\u2013\n\t\t\t\t\t47."},{"issue":"5","key":"i1082-0744-27-1-100-b86","series-title":"Spinal Cord","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1038\/sc.2010.160","article-title":"Psychological factors affecting alcohol use after spinal cord injury","volume":"49","year":"2011","unstructured":"Saunders\n              L,\n            \n            \n              Krause\n              J.\n            \n          \n          Psychological factors affecting alcohol use after spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2011;\n\t\t\t\t\t49(\n\t\t\t\t\t5):\n\t\t\t\t\t637\u2013\n\t\t\t\t\t642.\n\t\t\t\t\tdoi:10.1038\/sc.2010.160."},{"issue":"12","key":"i1082-0744-27-1-100-b87","series-title":"PLoS Pathog","doi-asserted-by":"publisher","DOI":"10.1371\/journal.ppat.1002223","article-title":"Nutritional immunology: a multi-dimensional approach","volume":"7","year":"2011","unstructured":"Ponton\n        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    JWO,\n            \n          \n          .\n\t\t\t\t\tThe ratio of macronutrients, not caloric intake, dictates cardiometabolic health, aging, and longevity in ad libitum-fed mice.\n\t\t\t\t\tCell Metab.\n\t\t\t\t\t2014;\n\t\t\t\t\t19(\n\t\t\t\t\t3):\n\t\t\t\t\t418\u2013\n\t\t\t\t\t430.\n\t\t\t\t\tdoi:10.1016\/j.cmet.2014.02.009."},{"issue":"10","key":"i1082-0744-27-1-100-b89","series-title":"PLoS One","doi-asserted-by":"publisher","first-page":"e25929","DOI":"10.1371\/journal.pone.0025929","article-title":"Testing protein leverage in lean humans: a randomised controlled experimental study","volume":"6","year":"2011","unstructured":"Gosby\n              AK,\n            \n            \n              Arthur\n              DC,\n            \n            \n              Namson\n              SL,\n            \n          \n          .\n\t\t\t\t\tTesting protein leverage in lean humans: a randomised controlled experimental study.\n\t\t\t\t\tPLoS One.\n\t\t\t\t\t2011;\n\t\t\t\t\t6(\n\t\t\t\t\t10):\n\t\t\t\t\te25929.\n\t\t\t\t\tdoi:10.1371\/journal.pone.0025929"},{"issue":"1","key":"i1082-0744-27-1-100-b90","series-title":"Obesity","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1002\/oby.20007","article-title":"Effects of Dietary protein to carbohydrate balance on energy intake, fat storage, and heat production in mice","volume":"21","year":"2013","unstructured":"Huang\n              X,\n            \n            \n              Hancock\n              DP,\n            \n            \n              Gosby\n              AK,\n            \n          \n          .\n\t\t\t\t\tEffects of Dietary protein to carbohydrate balance on energy intake, fat storage, and heat production in mice.\n\t\t\t\t\tObesity.\n\t\t\t\t\t2013;\n\t\t\t\t\t21(\n\t\t\t\t\t1):\n\t\t\t\t\t85\u2013\n\t\t\t\t\t92.\n\t\t\t\t\tdoi:10.1002\/oby.20007."},{"issue":"8","key":"i1082-0744-27-1-100-b91","series-title":"Am J Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1097\/01.phm.0000171172.96290.67","article-title":"Perceived barriers to exercise in people with spinal cord injury","volume":"84","year":"2005","unstructured":"Scelza\n              WM,\n            \n            \n              Kalpakjian\n              CZ,\n            \n            \n              Zemper\n              ED,\n            \n            \n              Tate\n              DG.\n            \n          \n          Perceived barriers to exercise in people with spinal cord injury.\n\t\t\t\t\tAm J Phys Med Rehabil.\n\t\t\t\t\t2005;\n\t\t\t\t\t84(\n\t\t\t\t\t8):\n\t\t\t\t\t576\u2013\n\t\t\t\t\t583.\n\t\t\t\t\tdoi:10.1097\/01.phm.0000171172.96290.67."},{"issue":"1","key":"i1082-0744-27-1-100-b92","series-title":"J Rehabil Res Dev","first-page":"1","article-title":"The relationship between energy expenditure and lean tissue in monozygotic twins discordant for spinal cord injury","volume":"41","year":"2004","unstructured":"Bauman\n              WA,\n            \n            \n              Spungen\n              AM,\n            \n            \n              Wang\n              J,\n            \n            \n              Pierson\n              RN.\n            \n          \n          The relationship between energy expenditure and lean tissue in monozygotic twins discordant for spinal cord injury.\n\t\t\t\t\tJ Rehabil Res Dev.\n\t\t\t\t\t2004;\n\t\t\t\t\t41(\n\t\t\t\t\t1):\n\t\t\t\t\t1\u2013\n\t\t\t\t\t8."},{"issue":"2","key":"i1082-0744-27-1-100-b93","series-title":"Am J Clin Nutr","first-page":"371","article-title":"Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition","volume":"77","year":"2003","unstructured":"Buchholz\n              AC,\n            \n            \n              McGillivray\n              CF,\n            \n            \n              Pencharz\n              PB.\n            \n          \n          Differences in resting metabolic rate between paraplegic and able-bodied subjects are explained by differences in body composition.\n\t\t\t\t\tAm J Clin Nutr.\n\t\t\t\t\t2003;\n\t\t\t\t\t77(\n\t\t\t\t\t2):\n\t\t\t\t\t371\u2013\n\t\t\t\t\t378."},{"issue":"4","key":"i1082-0744-27-1-100-b94","series-title":"Obesity Res","first-page":"563","article-title":"Physical activity levels are low in free-living adults with chronic paraplegia","volume":"11","year":"2003","unstructured":"Buchholz\n              AC,\n            \n            \n              McGillivray\n              CF,\n            \n            \n              Pencharz\n              PB.\n            \n          \n          Physical activity levels are low in free-living adults with chronic paraplegia.\n\t\t\t\t\tObesity Res.\n\t\t\t\t\t2003;\n\t\t\t\t\t11(\n\t\t\t\t\t4):\n\t\t\t\t\t563\u2013\n\t\t\t\t\t570."},{"issue":"277","key":"i1082-0744-27-1-100-b95","series-title":"Front Physiol. 2012","first-page":"1","article-title":"Upper gastrointestinal dysmotility after spinal cord injury: Is diminished vagal sensory processing one culprit?","volume":"3","year":"2012","unstructured":"Holmes\n              GM.\n            \n          \n          Upper gastrointestinal dysmotility after spinal cord injury: Is diminished vagal sensory processing one culprit?\n          \n            Front Physiol. 2012\n          2012;\n\t\t\t\t\t3(\n\t\t\t\t\t277):\n\t\t\t\t\t1\u2013\n\t\t\t\t\t12."},{"issue":"8","key":"i1082-0744-27-1-100-b96","series-title":"Am J Gastroenterol","first-page":"1295","article-title":"Delayed colonic transit in spinal cord-injured patients measured by in-111 amberlite scintigraphy","volume":"90","year":"1995","unstructured":"Keshavarzian\n              A,\n            \n            \n              Barnes\n              WE,\n            \n            \n              Bruninga\n              K,\n            \n            \n              Nemchausky\n              B,\n            \n            \n              Mermall\n              H,\n            \n            \n              Bushnell\n              D.\n            \n          \n          Delayed colonic transit in spinal cord-injured patients measured by in-111 amberlite scintigraphy.\n\t\t\t\t\tAm J Gastroenterol.\n\t\t\t\t\t1995;\n\t\t\t\t\t90(\n\t\t\t\t\t8):\n\t\t\t\t\t1295\u2013\n\t\t\t\t\t1300."},{"key":"i1082-0744-27-1-100-b97","series-title":"Brain","first-page":"695","article-title":"Sympathetic activity in man after spinal-cord injury \u2013 outflow to muscle below the lesion","volume":"109","year":"1986","unstructured":"Stjernberg\n              L,\n            \n            \n              Blumberg\n              H,\n            \n            \n              Wallin\n              BG.\n            \n          \n          Sympathetic activity in man after spinal-cord injury \u2013 outflow to muscle below the 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