Dietary Intake And Metabolic Markers In Athletes With Spinal Cord Injury Compared With Sedentary Non-disabled

Abstract

Although well studied in many populations, data on dietary habits of people with spinal cord injury (SCI), especially athletes, and the relation to metabolic markers compared to the able-bodied (AB) population is lacking. PURPOSE: To assess nutrient intake and associations between metabolic markers in SCI athletes compared with sedentary AB controls. METHODS: Paraplegic athletes (n = 14, 7 women; duration of injury 16.5±5.7 yrs, injury level T5-L5) were compared with 16 sedentary, age- and BMI-matched AB (8 women) controls. Fasting lipids, insulin (INS) and glucose (GLU) were assessed via 2-h oral glucose challenge with area under the curve (AUC) and HOMA calculated. Dietary intake was obtained from 3-day food diaries. Body composition was assessed with DXA. RESULTS: Metabolic markers and nutrient intakes did not differ between SCI and AB. Trunk fat mass was lower in SCI than in AB (5.7±1.6kg, 7.7±2.0kg; p<0.01). In SCI, dietary fat intake (% of energy) was related (all p<0.05) to INS-AUC (r=0.58), total cholesterol (r=0.59), LDL (r=0.96) and HDL (r=0.56). Fiber intake was related to fasting INS (r=-0.75) and HOMA (r=-0.72). After controlling for trunk fat, % dietary fat remained related to LDL (r=0.56) and fiber remained related to fasting INS (r=-0.86) and HOMA (r=-0.83). In AB, daily energy intake was related to fasting GLU (r=0.50). Protein intake (% of energy) was related to GLU-AUC (r=0.63), INS-AUC (r=0.62), and HDL (r=-0.49). Carbohydrate intake (grams) was related to fasting GLU (r=0.56), and GLU-AUC (r=0.46). Fiber was related to HOMA (r=0.49); and saturated fat to HOMA (r=0.51). After controlling for trunk fat in AB, energy intake remained associated with fasting GLU (r=0.48), % protein intake with GLU- and INS-AUC (r=0.59, 0.56), and carbohydrate intake (grams) with fasting GLU (r=0.58). CONCLUSIONS: Despite greatly differing physical activity levels, dietary intake was similar in SCI athletes and sedentary AB controls; however, associations between nutrients and metabolic markers differed between SCI and AB such that dietary fat intake appears to negatively and fiber favorably impact SCI compared to AB. Conversely, protein and carbohydrate intake had greater implications for AB metabolic profiles. Trunk fat mass appeared to explain most correlations between markers and nutrients in SCI, but not in AB.