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SCI Nutrition Decoded: Your Comprehensive Guide

An image of a person's spine with text that says SCI Nutrition Decoded: Your Comprehensive Guide

“SCI Nutrition Decoded: Your Comprehensive Guide” was written by Kaitlyn Wilson and edited/reviewed by Gabi Abreu, BSc and Jackie Silver, MHSc, RD.

Medical Disclaimer: The information in this article is meant for educational purposes only. It is not intended to be personalized medical or nutrition advice. For a plan tailored to your needs, please consult with a Registered Dietitian or qualified healthcare professional.
Disclosure: This post may contain affiliate links with which I may earn a small commission but at no additional cost to you. Affiliate links help bloggers like me to provide you with free content. All opinions expressed here are genuine. 

Last updated: March 25, 2024

SCI Nutrition: Importance of Nutrition for Paralysis

From a young age, lots of us hear about the importance of eating well for good health. Whether that be fostered through school, interactions with friends and family, or through the media. 

Nutrition information is everywhere we look! Unfortunately, not all information is created equal, and it is a heavy task to find reliable, evidence-based nutrition information. 

Additionally, the task to eat based on evidence becomes more difficult with the added layer of a health consideration, such as paralysis from spinal cord injury (SCI), spina bifida,  multiple sclerosis (MS) and more. 

For anyone with paralysis, nutrition can be even more important to:

  • Improve overall wellness
  • Prevent and manage common health issues
  • Help regulate bowel and bladder function
  • Support good bone and skin health
A graphic listing the importance of nutrition for paralysis

We’ve compiled this blog post with current and evidence-based nutrition information for people living with spinal cord injuries (SCI). While our focus is on spinal cord injuries, the subjects covered hold relevance for anyone experiencing paralysis, including those with spina bifida or multiple sclerosis.

Read on to learn about:

Five Common Health Issues for People with Paralysis

Damage to the spinal cord can also impact the functioning of other bodily systems, like your skin, urinary and digestive systems, and bone strength. These changes can result in additional health challenges, but the good news is that nutrition can play a significant role in preventing and improving many of these health issues! 

A graphic listing common health issues for people with paralysis

Listed below are five common health challenges encountered by individuals with paralysis, emphasizing the significant role that SCI nutrition can play in addressing them:

  1. Pressure Sores

Pressure sores / wounds occur when something presses on the skin for a while, leading to injury to both the skin and the tissues beneath it. These sores are more likely to develop on bony areas of the body, such as the coccyx. Anyone who uses a wheelchair is at risk of pressure wounds due to prolonged sitting. Other factors that promote pressure wounds include friction, moisture, poor nutrition, and immobility

  1. Cardiometabolic Risks

 People with SCI are more likely to have cardiometabolic risks.Cardiometabolic diseases refers to a group of health conditions that affect both the heart (cardio) and metabolism.These risks include high blood pressure, insulin resistance (a factor in pre-diabetes and diabetes), and an imbalance of lipids such as cholesterol. These are all risk factors for cardiovascular disease (CVD).

  1. Neurogenic Bladder

For people with SCI, communication between the brain and spinal cord nerves that control the bladder is disrupted. This means there is little to no sensation and muscle control of the bladder. As a result, the bladder might become overactive or underactive, leading to problems like urinary incontinence (having difficulty controlling the flow of urine). UTIs, which are infections in the urinary tract, are quite common among people with SCI

  1. Neurogenic Bowel

In a neurogenic bowel, there is a loss of motor and sensory control of the gastrointestinal tract, anus, and rectum. This means that the transit time of stool in the intestines is slow, and one may not be able to feel the need to make a bowel movement or lose the ability to use the muscles that control bowel movements. People with neurogenic bowel might experience fecal incontinence, diarrhea, or severe constipation

  1. Osteoporosis

Bone density decreases with SCI (due to reduced weight bearing), causing an increased risk of osteoporosis. This is when more bone is broken down than replaced. Bone loss causes weaker bones that fracture more easily.

A closeup of a bone - osteoporosis

Building Balanced Meals for SCI Nutrition

Consuming a well-rounded diet is crucial for SCI nutrition, as it ensures your body receives all the necessary nutrients for long-term health by preventing and improving the health issues discussed above.

Did you know Canada’s Food Guide was most recently updated in 2019? These new guidelines use a term called the “plate method,” which recommends filling half your plate with vegetables, one-quarter of your plate with starches, one-quarter with a protein source, and making water your drink of choice. 

Feel free to use our graphic below as a guideline or template when planning your meals to ensure they’re balanced. 

Please note that this is a guide, and not a hard rule. It is helpful to keep in mind when planning your meals or modifying your recipes to include more vegetables, as an example. You will also have to modify it for one-pot recipes. 

A graphic showing a plateful of balanced meals

Protein Needs for SCI Nutrition

The amount of protein your body needs to thrive will depend on your phase of SCI injury. The two phases of SCI are the acute phase and the rehabilitation phase. The acute phase is short-term and happens directly after injury until you are stabilized. The rehabilitation phase, otherwise known as the long-term phase, is the time after you are stabilized. It essentially encompasses the entirety of one’s life post-SCI.

Acute Phase. At this phase of SCI, your body is considered to be in “metabolic stress.” Metabolic stress is your body’s complicated and short-term response to traumatic injury. At this time, your body requires more protein and calories for the cells that play a role in immunity and wound repair. 

(Information from Nutrition Therapy and Pathophysiology 4th Ed. Textbook)

Your health care team should ensure your body is being nourished appropriately. During this phase, your body needs approximately 2 grams of protein for every 1 kg of body weight (this is more than double the amount of protein recommended for general healthy adults). 

(Information from Nutrition Therapy and Pathophysiology 4th Ed. Textbook)

Rehabilitation Phase. Nutrition supports restoration goals in the rehabilitation phase. Your body needs less protein in the rehabilitation phase of SCI compared to the acute phase. Without pressure ulcers or infection, your body needs about 0.8 to 1.0 grams of protein for every 1 kg of body weight.  

(Information from Nutrition Therapy and Pathophysiology 4th Ed. Textbook)

A graphic explaining protein needs for SCI

SCI Nutrition and Calorie Needs: Why We Don’t Recommend Calorie Counting

Calorie counting used to be one of the biggest trends in the health and fitness industry, however, nutrition research has shifted the views of many professionals to discontinue recommending counting every food item we eat.

Specifically for SCI nutrition, there is a common misconception that the risk of cardiovascular disease is increased solely due to an overconsumption of calories. 

The misconception arises from the belief that individuals with SCI may overconsume, given that their overall calorie requirements are lower compared to those who are able-bodied. This reduced calorie need is attributed to decreased mobility, muscle loss, and changes in nervous system function.

Additionally, resting energy expenditure, which is the rate your body uses calories without physical activity, is reported to be 10% lower for people with SCI compared to those who are able-bodied. 

A graphic explaining SCI nutrition: why we don't recommend counting calories

Regardless of slightly lower caloric needs, there are several problems with reducing calorie consumption solely due to cardiovascular risk. 

1) There is weak and conditional evidence for the long-term calorie guidelines set by some organizations (see below), according to the Academy of Nutrition and Dietetics

Some organizations suggest that individuals with paralysis affecting all legs and arms (quadriplegia) should consume about 22.7 calories per kilogram (kg) of body weight each day. For those with paralysis affecting only their legs (paraplegia), it is suggested to consume about 27.9 calories per kilogram (kg) of body weight each day.

2) Using calorie consumption as a sole risk factor for cardiovascular disease does not consider the complexity of SCI. Changes occur in the body after SCI that alter cardiometabolic risks. This means it’s not as simple as just “eating too much” and there are factors beyond your control.

For example, some research shows alterations of brain regions involved with signals from the GI tract (commonly known as the “gut-brain” axis) and metabolic regulation. Alterations in the gut-brain axis can affect appetite, digestion, and nutrient absorption which can lead to imbalances in energy metabolism, blood sugar levels, and body weight which in turn may increase cardiometabolic risk.

There are also changes to body composition due to immobility, such as impaired blood supply from vasculature (blood vessels)  to the muscles, which can increase cardiometabolic risk. 

3) Calories alone do not account for the nutrients you are getting, how full foods make you feel, and the overall quality of your diet. For example, the energy you get from 100 calories is the same whether you eat an apple or part of a chocolate bar, but the difference is the nutritional value and amount of food. 

A photo of various foods labeled with their respective calories

4) Counting calories typically doesn’t take a good toll on people mentally. Especially in younger females, monitoring calories has links with disordered eating behaviors, compulsive exercise, increased risk for developing an eating disorder, and detriments to general well being. It’s also inconvenient to count calories at every meal and snack, which may cause more stress throughout the day.

5) Calorie counting was popular when weight was commonly used as a sole indicator of health. Now, more professionals are recognizing Health at Every Size® principles.  Health and well-being involves attention to physical, economic, social, spiritual, emotional, and other needs. There are many indicators of health that are not about weight.

There is evidence that weight-centric practice is harmful. The fatphobic beliefs still held by many healthcare professionals lead to poorer quality of care and avoidance of healthcare. In addition, one study showed an increased risk of dying from cardiovascular disease in people with SCI who lost weight compared to people with SCI who maintained the same weight. 

SCI Nutrition: Pressure Wounds

Pressure wounds are painful, increase risk for  infections, and negatively impact daily quality of life. The good news is that SCI nutrition can support you in preventing and managing pressure wounds. 

Did you know that there are changes to the skin after SCI that increases the risk of pressure sores? 25-66% of people with spinal cord injuries will have a pressure wound at some point

The changes after SCI that increase the risk of pressure ulcers include changes to the skin’s collagen, blood supply from vasculature, and less adrenergic receptors (which are involved in wound repair). This means prevention of pressure wounds using nutrition is super important!

Someone dressing a pressure wound

We have another blog post that focuses on the management of pressure wounds called How to Promote Wound Healing through Nutrition. Check it out for information on the 4 stages of pressure wounds, risks for pressure wounds, protein & calorie requirements, fluid intake, and vitamins & minerals.

This blog post will briefly summarize SCI nutrition for the prevention and management of pressure wounds.

For the prevention of pressure wounds, emphasis is on meeting nutritional recommendations with a well-balanced diet. This is important, since poor nutrition can increase the risk of getting pressure wounds and complications associated with them. 

For the management of pressure wounds, emphasis is on providing your body with the nutrients it needs for optimal healing. We highly recommend reading How to Promote Wound Healing through Nutrition.

  • Extra Protein: your body needs more protein to heal a pressure wound, prevent and fight infection, and protect the immune system. You can even need more than double the amount of protein when you have a serious wound. 

Supplements for the prevention and management of pressure wounds are not generally recommended because of mixed evidence. However, they may be appropriate if you are deficient in certain vitamins or minerals. You should talk to a registered health professional about taking a multivitamin (or any other supplement), if you are not getting enough nutrition through food or are concerned about this.

A graphic explaining nutrition for preventing and managing pressure wounds

SCI Nutrition: High Blood Fats

One part of understanding your heart health is knowing about blood fats, which include cholesterol and triglycerides. Cholesterol and triglycerides play important roles in the body. However, when blood fats get too high there is an increased risk for heart diseases. 

The current research suggests there are elevated blood fats after spinal cord injury, which contributes to having a higher risk for heart disease. The good news is that there are several ways we can lower high blood fats for a healthy heart!

Let’s first start by talking a little more about cholesterol. You may have heard that high blood cholesterol is bad for your heart. This is true to an extent, but did you know there is something called “good” cholesterol?

Cholesterol travels through your blood on proteins called “lipoproteins.” There are two types of lipoproteins that we want to talk about for heart health: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

  • LDL (low-density lipoprotein) cholesterol is sometimes called “bad” cholesterol. This is the type of cholesterol that raises your risk for heart disease and stroke, by building up on the walls of your blood vessels.
  • HDL (high-density lipoprotein) cholesterol is sometimes called “good” cholesterol. This type of cholesterol can lower your risk for heart disease and stroke!
Someone holding up a blackboard with the different types of cholesterol written on it - SCI nutrition

So, the goal with wanting to improve your heart health is to lower your LDL cholesterol and to raise your HDL cholesterol. How can we do this?

Interestingly, the cholesterol you eat from your foods, called dietary cholesterol, does not raise the cholesterol in your blood. Research has debunked the myth that cholesterol in foods is bad. 

In terms of food choices, eating a lot of foods that are high in saturated fats raises LDL cholesterol levels. This means replacing saturated and trans fats with heart-healthy fats can lower your LDL cholesterol

Heart-healthy fats include monounsaturated fat and polyunsaturated fat. Omega-3 fats are especially healthy because it makes blood less likely to clot, slows the growth of plaque that can block blood vessels, and protects against irregular heart beats.

Foods that are a good source of Omega-3 fats for SCI nutrition include:

  • Salmon, sardines, mackerel, herring
  • Canola oil and soybean oil, or margarines made with these oils
  • Flaxseeds, walnuts
  • Soybeans, tofu
  • Omega Plus liquid eggs
Foods high in Omega-3, good for SCI nutrition

The following examples are foods that are sources of saturated and trans fats:

  • High fat processed meats such as sausage, bologna, salami and hot dogs
  • Fatty meats such as prime rib and regular ground beef
  • Full fat dairy products such as whole milk, high fat cheese, cream,
  • butter and lard
  • Coconut, palm and palm kernel oil
  • Lard

At Jackie Silver Nutrition, we are believers that all foods fit into a healthy and balanced lifestyle. This means we do not support the idea of categorizing foods into black-and-white categories such as “bad” or “good.” 

The research is supportive that food plays a larger role than physical health. A variety of types of food is important for our emotional, spiritual, and cultural well-being. Also, making large changes to your life all at once is less likely to be sustainable in the long term, so it is recommended to build on small changes

The reason why we add this disclaimer to to emphasize that you do not have to cut out foods that are high in saturated and trans fats completely. For a sustainable heart-healthy lifestyle, we recommend working with your registered dietitian to build on goals that are tailored to your needs. 

Our focus is on nutrition in this blog post, but we want to briefly mention that there are also other changes you can make to your life to help with blood fats for heart health. This includes managing stress, exercising, and getting enough sleep.

A graphic explaining SCI and blood fats: heart healthy lifestyle

SCI Nutrition: Neurogenic Bladder

It is frustrating having frequent UTIs or having a bladder accident when out in public. You are not alone if you experience loss of bladder control, difficulty emptying the bladder, UTIs, frequent urination, or the need to urinate urgently. 

This blog post will briefly review the nutrition tips for neurogenic bladder, but we recommend reading the full blog post about neurogenic bladder: The Best Nutrition Guide for Neurogenic Bowel and Bladder

  • Fluids. Drink enough water and/or other fluids (about 2-3 litres per day) to stay hydrated. Staying hydrated maintains blood pressure, prevents kidney and bladder stones, maintain kidney function, flush out the bladder, and prevent UTIs. 
  • Cranberry juice or tablets. There is conflicting research whether or not cranberry juice can help reduce the number of UTIs. However, they are likely not harmful. I like Utiva cranberry supplements, because they are made without PACs which can exacerbate kidney stones.
  • D-mannose supplements. D-mannose is a type of sugar. More studies are needed to determine how useful D-mannose is for UTIs, but one study demonstrated that it is safe and had promising results. Please ask your doctor or dietitian before starting a new supplement.
  • Foods to avoid. There is no conclusive evidence that avoiding certain foods will help reduce UTI symptoms. It could be a good idea to avoid potentially bladder-irritating foods and beverages such as coffee, tea, soda, alcohol, artificially sweetened beverages, and spicy peppers. 
A graphic explaining nutrition for preventing and managing neurogenic bladder

SCI Nutrition: Neurogenic Bowel

Do you have frequent constipation, diarrhea, bowel accidents and loss of bowel control, abdominal pain, bloating, and/or a poor appetite? These are all some of the signs of neurogenic bowel.

This post will briefly summarize the nutrition tips for neurogenic bowel here, but we recommend reading our comprehensive blog post about neurogenic bowel: The Best Nutrition Guide for Neurogenic Bowel and Bladder

Fiber: Fiber has lots of health benefits. It improves constipation, reduces diarrhea, supports bowel regularity, reduces hemorrhoids, diverticular disease, and colorectal cancer, promotes healthy gut bacteria, helps lower blood cholesterol, and stabilizes blood sugar levels. 

Soluble fiber dissolves in water, and helps with constipation and diarrhea. Sources of soluble fiber include oatmeal, barley, legumes, chia seeds, apples, pears, oranges, bananas, and more. Insoluble fiber does not dissolve in water, and helps with constipation. Sources of insoluble fiber include whole grains, ground flax seeds, nuts, cauliflower, leafy greens, and more. 

A variety of high fiber foods, good for SCI nutrition

It is recommended that women aim for about 25 grams and men aim for 38 grams of fiber per day, but please do not worry about the numbers. You should be able to hit the target as long as you include foods rich in fiber during meals and snacks.

I recommend beginning with about 15 grams of fiber and then slowly building up. This helps make sure your GI tract can tolerate the amount of fiber. Please note that for SCI nutrition, we do not want to overload our bodies with fiber as that can have negative consequences for neurogenic bowel. We want to hit the sweet spot for fiber consumption that will help our bowels.

Fluids. Staying hydrated helps with constipation. The general recommendation is 2-3 liters of fluids per day. 

Something I commonly hear from my clients is restricting fluid to avoid having to empty their catheters frequently. I encourage you to do your best to drink enough fluids for your bowel and bladder health, even if it means having to go to the washroom more often. No one enjoys having a UTI!

Probiotics. Probiotics are supplements or foods that benefit your gut health. They contain live micro-organisms or “good” bacteria in sufficient numbers that positively alter the amount of good bacteria living in your intestines. 

The amount of research studies on the benefits of probiotics for neurogenic bowel and bladder is lacking, unfortunately. It’s also a complicated subject as there are many different types, or strains, of probiotics that have various functions (ie. there are some probiotics for those with IBS, some for antibiotic-associated diarrhea, general health, and much more). 

Probiotic supplements, good for sci nutrition

SCI Nutrition: A Weight-Inclusive Approach

In our practice at Jackie Silver Nutrition, we follow a weight-inclusive approach, which means that we shift our focus away from numbers or the scale as indicators of health status and focus on the many other health indicators that are not about weight. Research shows that using just BMI or body weight is not a good marker of overall health status.

Body weight and BMI alone does not consider how much fat vs. muscle someone has, the distribution of fat (fat around organs, also called visceral fat, has the most risk), and metabolic health

Although the literature does point out weight management as a strategy for SCI management because of an increased risk of cardiovascular disease, it’s not the sole indicator of your health. There are many other indicators of health such as labs (improved cholesterol or blood sugar levels), enhanced blood pressure values, improved body image, improved energy levels, decreased anxiety and stress, improved digestive health, reaching fitness milestones, sleep, and the list goes on!

We focus on building sustainable habits that last rather than the number on the scale or calorie counting. When you make these healthy lifestyle changes, it is possible that the weight will go down if that’s what your body needs and wants. If not, that’s okay — continue to focus on the positive results in other important areas of your life!

Weight inclusive figures

SCI Nutrition: Bone Health

Bone is a living tissue that is constantly being broken down and rebuilt. Research has shown more bone loss in people with SCIs, and this is connected to a greater risk for osteoporosis and fractures. If you have osteoporosis, more bone is being broken down than what is being replaced. 

Keeping as much bone strength as possible after SCI decreases the risk of fractures. Fortunately, nutrition is one factor that can aid in preserving bone strength. The most notable nutrients that support good bone health are calcium and vitamin D

Calcium is the most abundant mineral in our bodies, and it plays a role in hardening and strengthening bones. It is also important for our muscles, heart, and nerves to work properly. 

Our bodies cannot make calcium. So if we do not get enough calcium in our diets, our bodies will take what they need from our bones. Over time, this makes us more prone to osteoporosis.  

Some rich sources of calcium include:

  • Milk and dairy products
  • Tofu that is set with calcium
  • Fish, such as salmon and tuna
  • Foods that are fortified with calcium (where the manufacturer adds calcium to the doos)
Foods that are high in calcium, good for SCI nutrition

Vitamin D helps your body absorb the calcium and phosphorus you need from foods. It also has other roles in the body to keep your muscles and immune system functioning well. Vitamin D deficiency is common for people with SCI.

Vitamin D is not found a lot in foods. Some examples of sources include: 

  • Cod liver oil
  • Fatty fish
  • Fortified cereals such as milk and cereals

Most of the vitamin D we need comes from being in the sun, because our skin can make it. However, depending on which region you live in, it may be recommended to take a vitamin D supplement to ensure your body gets enough. It is recommended to speak with your health care provider to see if a vitamin D supplement is the right fit for your needs. 

Calcium and vitamin D are not the only two nutrients that are important in maintaining bone health. 

The Framingham Osteoporosis Study researched the nutrients and foods that alter bone health by gathering data on more than 5000 men and women. Notably, other considerations include eating fruits and vegetables, seafood, and dairy products for beneficial effects on bone health. 

Foods that are high in vitamin D, good for SCI nutrition

Summary

In conclusion, try following some of these gentle nutrition tips to support good health after SCI:

  1. Prioritize balanced meals using the plate method to ensure your body receives all essential nutrients.
  2. Adjust your protein intake according to your phase of injury: aim for 2.0 grams of protein per kilogram of body weight during the acute phase and 0.8-1.0 grams per kilogram during the rehabilitation phase.
  3. Focus on consuming sufficient calories without the need for calorie counting, as this helps support overall well-being.
  4. Increase your fiber intake to support neurogenic bowel health (increased fiber also helps with managing cholesterol and blood sugar levels). 
  5. For individuals with pressure wounds, ensure an adequate intake of protein, calories, fluids, and essential vitamins and minerals to aid in wound healing.
  6. Combat high cholesterol by incorporating more healthy fats, such as Omega-3 and other unsaturated fats, and whole grains into your diet while reducing intake of saturated and trans fats.
  7. Maintain hydration to promote good health and prevent/control UTIs. Consult your healthcare provider about supplements like probiotics, cranberry, or D-mannose, and be mindful of food and beverage choices during UTI episodes.
  8. Choose foods high in calcium and vitamin D to maintain bone strength. Consult your health care provider about vitamin D supplements.  

Remember that these SCI nutrition tips are general recommendations. Always consult with a registered dietitian before making any significant dietary changes, especially if you have specific medical conditions or dietary needs.

A closeup of a spine

Check out these other helpful resources:

References

Bigford, G. Nash, M.S. (2017). Nutritional Health Considerations for Persons with Spinal Cord Injury. Topics in spinal cord injury rehabilitation. 23(3), 188-206. https://pubmed.ncbi.nlm.nih.gov/29339895/ 

Cardozo, L. Systematic review of overactive bladder therapy in females. Canadian Urological Association journal = Journal de l’Association des urologues du Canada. 5(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3193389/ 

Consortium for Spinal Cord Medicine: Clinical Practice Guidelines. (2001). Pressure ulcer prevention and treatment following spinal cord injury: a clinical practice guideline for health-care professionals. The journal of spinal cord medicine. https://pubmed.ncbi.nlm.nih.gov/11958176/ 

Consortium for Spinal Cord Medicine: Clinical Practice Guidelines. (2001). Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers. The journal of spinal cord medicine. https://pubmed.ncbi.nlm.nih.gov/17274492/ 

Eli, I., Lerner D.P., Ghogawala, Z. (2021). Acute Traumatic Spinal Cord Injury. Neurologic clinics. 39(2). 471-488.  https://pubmed.ncbi.nlm.nih.gov/33896529/ 

Farkas, G.J., Burton, A.M., McMillan, D.W., Sneij, A., Gater, D.R. (2022). The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury. Journal of Personalized Nutrition. 12(7). https://pubmed.ncbi.nlm.nih.gov/35887592/ 

Geoffroy, C., Warren, A. (2022). Pathophysiology of Spinal Cord Injury (SCI). MDPI – Multidisciplinary Digital Publishing Institute. https://directory.doabooks.org/handle/20.500.12854/95781 

Hamilton Health Sciences. (2015). Healthy eating: A guide for you after spinal cord injury. Spinal Cord Injury Rehabilitation Program. https://www.hamiltonhealthsciences.ca/wp-content/uploads/2019/08/SCI-HealthyEatingPORTRAIT.pdf 

Harvard T.H. Chan: School of Public Health. (October 27, 2022). BMI a poor metric for measuring people’s health. Say experts. News. https://www.hsph.harvard.edu/news/hsph-in-the-news/bmi-a-poor-metric-for-measuring-peoples-health-say-experts/ 

Kirshblum, S.C., Priebe, M.M., Ho, C.H., Scelza, W.M., Chiodo, A.E., Wuermser, L. (2007). Spinal Cord Injury Medicine. 3. Rehabilitation Phase After Acute Spinal Cord Injury. Archives of physical medicine and rehabilitation. 88(3) https://pubmed.ncbi.nlm.nih.gov/17321851/ 

Kruger, E.A., Pires, M., Ngann, Y., Sterling, M., Rubayi, S. (2013). Comprehensive management of pressure ulcers in spinal cord injury: current concepts and future trends.  The journal of spinal cord medicine. 36(6), 572-585 https://pubmed.ncbi.nlm.nih.gov/24090179/ 

Park SY, Wilkens LR, Maskarinec G, Haiman CA, Kolonel LN, Marchand LL. (2018). Weight change in older adults and mortality: the Multiethnic Cohort Study. International Association for the Study of Obesity, 42(2). 205-212. https://pubmed.ncbi.nlm.nih.gov/28885999/ 

Phe, V., Pakzas, M., Haslam, C., Gonzales, G., Curtis, C., Porter, B., Chataway, J., Panicker, J.N. (2017). Open label feasibility study evaluating D-mannose combined with home-based monitoring of suspected urinary tract infections in patients with multiple sclerosis. Neurourology and urodynamics. 36(7), 1770-1775 https://pubmed.ncbi.nlm.nih.gov/27813195/ 

Plateau, C.R., Bone, S., Lanning, E., Meyer, C. (2018). Monitoring eating and activity: Links with disordered eating, compulsive exercise, and general wellbeing among young adults. International Journal of Eating Disorders. 51(11). 1270-1276 https://pubmed.ncbi.nlm.nih.gov/30508261/ 

Mayo Clinic. Neurogenic bladder and bowel management. https://www.mayoclinic.org/tests-procedures/neurogenic-bladder-bowel-management/about/pac-20394763 

Munoz, N., Posthauer, M.E., Cereda, E., Schols, J.M., Haesler, E. (2020). The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations. Advances in Skin & Wound Care. 33(3). 123-136. https://pubmed.ncbi.nlm.nih.gov/32058438/ 

Nelms, M.N., Sucher, K., Roberts, K., Doetsch, H.E., Rusnak, S., Sergakis, G., Hansen-Petrik, M., Heuberger R.A. (2020). Ch. 22. Diseases and Disorders of the Neurological System. In Nutrition Therapy and Pathophysiology 4th Ed. (p.630-632) Cengage. ISBN: 978-0-357-04171-0 

Nelms, M.N., Sucher, K., Roberts, K., Doetsch, H.E., Rusnak, S., Sergakis, G., Hansen-Petrik, M., Heuberger R.A. (2020). Ch 22. Metabolic Stress and the Critically Ill. In Nutrition Therapy and Pathophysiology 4th Ed. (p. 674-p.686). Cengage. ISBN: 978-0-357-04171-0

Westerterp, K.R. (2022). Control of Energy Expenditure in Humans. Endotext. https://www.ncbi.nlm.nih.gov/books/NBK278963/ 

About Kaitlyn

Kaitlyn is a recent graduate of an Honors Specialization in Nutrition & Dietetics (BScFN) and Kinesiology (BA) at Brescia University College, affiliated with Western University. In the fall she will be continuing her education to obtain a Master’s in Nutritional Sciences (MScFN) at Western University. Kaitlyn has a strong dedication to staying up-to-date with evidence-based nutrition practices. She loves cooking, reading, crocheting, and going for walks outdoors!

A headshot of Gabi Abreu

About Gabi

Gabi Abreu, BSc, is a Nutrition & Dietetics graduate from Toronto Metropolitan University and the Blog & Social Media Manager at Jackie Silver Nutrition. She is also the founder of the Working Woman’s Health Collection. WWHC was created with the purpose of inspiring women to achieve a healthy relationship with food, while taking into consideration the busy lifestyles that we live today. Beyond her professional pursuits, she loves experimenting with new recipes, trying new workout classes, and indulging her love for adventure through travel!

About Jackie

Jackie is a Registered Dietitian whose mission is to empower and support the neurodivergent and physically disabled communities through nutrition. Jackie runs a virtual private practice and blog which has simple recipes and health information tailored to these communities. She loves cooking, exercising, traveling, journaling, and spending time with family and friends.

Check out her full bio here →

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