SCI Nutrition

Angela DiTucci, R.D.

Gastrointestinal

Genitourinary Respiratory

Neuromuscular

NUTRITION

Skeletal

Cardiovascular Integumentary

Metabolic

Physical Ability

Functional Ability / Capacity

Mastication Ability

Swallowing Issues

Medications

High dose steroids Anabolic therapy Bowel Bladder Gastrointestinal Pain Cardiovascular

Use of Herb / Botanicals

Saint John’s Wort-”Makes you feel good.”-”It’s natural.”

Echinacea-”Boosts the immune system.”

-”Protects against the common cold and flu.” Garlic

-”Lowers cholesterol.”

Psycho / Social Issues

Depression Self image Food = source of gratification Feeding = important issue in independence

and socialization Ability to purchase food and prepare meals Living arrangements / meal arrangements Availability of community resources Alcohol intake

Weight Change

Acute Phase = Weight loss-Increases risk of pressure ulcer development.-Increases susceptibility to fatigue-Decreased resistance to infection

Long-term Phase = Weight gain-Difficulty with lifts, transfers, ADL’s-Increases risk for Diabetes, CHD, HTN-Increases risk of pressure ulcer

Bowel Management

Fiber

Gas

Diarrhea

Fluid

Fluids

Digestion and absorption of food Elimination of body waste Regulation of body temperature Distribution of nutrients to body cells Prevention or urinary tract infections

2000 cc – 3000 cc fluid daily

Suggestions for Teaching to Increase Fluid Intake Keep a water bottle. If with impaired hand function, work with OT-

adaptive straws / cups. Drink 1-2 glasses of water every time the leg bag

is emptied. Drink before meals rather than afterwards when

full. Do most of the drinking before early evening

measurements. Caffeine, alcohol, juices

Skin Integrity Risk Factors

-Hypoalbuminemia-Weight-Anemia

Diet-High quality diets -Protein-Calories -Fluids-Zinc -Vitamin C-Vitamin A -Iron, Folate, B12

Impaired Glucose Tolerance

Risk Factors• Altered body metabolism• Decrease in muscle mass and

increase in fat• Inactivity• Aging process

Lipid Abnormalities

Increased prevalence of Heart Disease• Lipid abnormalities• Glucose intolerance• Increased weight• Limited Activity

Risk Factors for Lipid Abnormalities• Impaired carbohydrate metabolism• Reduced activity • Increased adiposity • Changes in metabolism

HDL

Osteoporosis Risk Factors

• Diabetes• Steroid Use• Smoking• Vitamin D Deficiency• Excessive Alcohol and/or caffeine use

Additional Risk Factors 2° SCI• Inactivity• Changes in Autonomic and nervous systems

Osteoporosis

Intervention• Physical activity- weight bearing or resistance• Calcium• Vitamin D• Smoking cessation (smoking speeds up bone

loss)• Limit ETOH/Caffeine (also speeds up bone

loss)

Role of nutrition for the SCI person across the continuum of care.

Team approach to the nutritional care of the SCI person.