Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

N - CARDIOMETABOLIC




A registered dietitian should assess individuals with SCI for age, ethnicity, gender, time since injury, level of injury, activity level, dietary habits, smoking behaviour, alcohol intake, and weight status as these factors are associated with abnormal blood lipids, particularly decreased HDL cholesterol. (Adapted from NUTR 2009, p.10; Level A)
Consider establishing caloric targets and consider indirect calorimetry, if available, to estimate energy expenditure and assess energy needs. If not available, clinicians should consult a dietician and use caloric diaries. (CAN-SCIP 2020; Level C)

Clinicians may consider instituting the following nutritional measures in the post-acute period:

  1. For all individuals with SCI, adopt a heart-healthy nutrition plan focusing on fruits, vegetables, whole grains, low-fat dairy, poultry, fish, legumes, non-tropical vegetable oils and nuts while limiting sweets and sugar-sweetened beverages, and red meats
  2. Adopt the Dietary Approach to Stopping Hypertension (DASH) nutritional plan or Mediterranean nutritional plan if hypertension or additional cardiometabolic risk factors are present. DASH Nutritional Plan: https://www.heartandstroke.ca/get-healthy/healthy-eating/dash-diet
(Adapted from NASH 2018, p.407; Level C)

A registered dietician treating individuals with SCI living in a community setting should have SCI-specific nutrition and energy needs expertise and knowledge to conduct a nutrition assessment as part of the annual medical exam to develop and implement an individualized therapeutic nutrition plan. The nutrition assessment should include but is not limited to:

  1. Food and nutrition-related history (specifically knowledge deficits, beliefs and attitudes, body image, mealtime behaviours, physical ability to self-feed, access to food- and nutrition-related supplies, meal preparation and food avoidances)
  2. Anthropometric measurements (specifically body composition and weight)
  3. Biochemical data, medical tests and procedures (specifically serum lipid and glucose levels)
  4. Social history (specifically isolation)
  5. Nutrition-focused physical findings (specifically bowel and bladder function).
(NUTR 2009, p.6; Level B)
An annual nutrition assessment by a registered dietitian should be conducted to identify nutrition-related concerns that may affect the health and quality of life of individuals living with SCI. (NUTR 2009, p.6; Level B)