Evidence of dietary inadequacy in adults with chronic spinal cord injury

Study design: Cross-sectional, observational study. Objective: Estimate prevalence of inadequate dietary intakes in community-dwelling men and women with chronic spinal cord injury (SCI). Setting: Ontario, Canada. Methods: In-home interviewer administered multiple-pass 24-h recalls were collected at baseline (n = 77) and at 6 months (n = 68). Dietary intake (adjusted to remove intra-individual variation) was compared with the dietary reference intakes (DRIs), specifically the estimated average requirement, adequate intake (AI) and acceptable macronutrient distribution ranges (AMDR). Results: Macronutrient intakes, as percentages of daily energy, for men (16% protein, 52% carbohydrate, 30% fat) and women (17% protein, 53% carbohydrate, 28% fat) were within the AMDR. Despite this, inadequate intakes for men (n = 63) and women (n = 14) were determined for vitamin A (92 and 57%), magnesium (89 and 71%), folate (75 and 79%), zinc (71 and 29%), vitamin C (52 and 14%), thiamine (22 and 14%), vitamin B12 (6 and 29%), riboflavin (5% men) and vitamin B6 (24% men). Mean usual intakes of fiber, vitamin D, calcium and potassium fell below the AI for men and women. In all, 53% of participants consumed a micronutrient supplement in the previous 24 h at baseline and at 6 months-specifically, calcium (29, 19%), multivitamin (26, 25%), vitamin D (22, 12%) and vitamin C (9, 6%). Conclusion: Our results show numerous nutrient inadequacies, relative to the DRIs, for men and women with SCI. This study has important implications for clinical dietetic practice in the SCI population. Sponsorship: Canadian Institutes of Health Research.