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Patients with SCI generally need fewer calories due to reduced metabolic activity resulting from inactive musculature.

Nutrition Assessment
Establish Resting Energy Expenditure (REE) by indirect calorimetry in a laboratory setting generally after a 12-hour fast. (Laboratory testing is not available)

Determine the recommended daily calorie intake based on measured REE value patient's reported activity level established goal.

Goal = Gain Weight or Maintain Current Weight
  • Little to no exercise, daily calories needed = REE x 1.2
  • Light exercise (1–3 days per week), daily calories needed = REE x 1.375
  • Moderate exercise (3–5 days per week), daily calories needed = REE x 1.55
  • Heavy exercise (6–7 days per week), daily calories needed = REE x 1.725
  • Very heavy exercise (twice per day, extra heavy workouts), daily calories needed = REE x 1.9

Goal = Weight Loss
Reduce daily calorie intake (as calculated above) between 200 and 300 calories

Individuals with chronic SCI tend to have markedly higher than recommended levels dietary fat and carbohydrate (CHO) intake. Such a diet promotes poor metabolic health and excess adipose tissue accumulation.

Nutritional guidance should promote general health with emphasis on for SCI-specific health concerns

  • Immune System
  • Bowel Management
  • Skin
  • Musculoskeletal System

General Recommendation
Consult with a professional dietitian/nutritionist (preferably knowledgeable in SCI health-related issues) to achieve individualized health-related goals.

Roza AM, Shizgal HM. The Harris Benedict equation reevaluated: resting energy requirements and the body cell mass. Am J Clin Nutr. 1984 Jul;40(1):168-82.

Dionyssiotis Y. Malnutrition in spinal cord injury: more than nutritional deficiency. J Clin Med Res. 2012 Aug;4(4):227-36.

Groah SL, Nash MS, Ljungberg IH, et al. Nutrient intake and body habitus after spinal cord injury: an analysis by sex and level of injury. The journal of spinal cord medicine. 2009;32(1):25-33.

Jensen MP, Molton IR, Groah SL, et al. Secondary health conditions in individuals aging with SCI: terminology, concepts and analytic approaches. Spinal cord. May 2012;50(5):373-378.

Bauman WA, Spungen AM. Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. Metabolism: clinical and experimental. Jun 1994;43(6):749-756.



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The University of Alabama at Birmingham Spinal Cord Injury Model System provides this website as an auxiliary resource for the primary care of patients with spinal cord injury.The contents of this website were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SIMS0020). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.