Research Update: Weight Management and Wellness of Individuals with SCI

Individuals with spinal cord injury (SCI) are at an increased risk for obesity and related hypertension, dyslipidemia, diabetes mellitus, cardiovascular disease, obstructive pulmonary disease, and certain cancers. However, very little research has been done to develop any weight management program that is safe, effective and specifically for individuals with SCI. It is believed that such a program would need to use a combination of dietary management and exercise to be effective in helping to prevent obesity and other health problems.

Objectives

EatRight is weight management program designed at the University of Alabama at Birmingham (UAB) for the general population. It is a 12-week program that includes diet instruction, behavior modification support, and exercise.

This research project aims to create a similar program specifically designed for individuals with SCI. This SCI EatRight program will seek to teach individuals with SCI to effectively manage their body weight and improve their nutritional status and overall health.

The specific aims of this SCI EatRight program are:

• to understand the food preferences, eating habits, and nutritional and health status among persons with SCI, particularly those who are overweight;
• to identify the associated factors for overweight. These factors include demographic and injury-related variables, life-style characteristics, weight history, and psychosocial factors;
• to modify the existing EatRight weight loss program for the special nutrition needs and metabolic characteristics of individuals with SCI;
• to preliminarily execute the revised SCI EatRight weight management program in a small sample of community-residing persons with SCI;
• to assess the feasibility of the revised SCI EatRight program regarding the class setting and format, class schedule, transportation, compliance, and cost;
• to make further revisions if indicated by the pilot test;
• to examine the effectiveness and safety of the finalized SCI EatRight program regarding the improvement in dietary habits, physical activity, weight control, body composition, nutritional status, general health, and psychological well-being; and
• to identify the contributing factors for the success in weight management among individuals with SCI who participate in the SCI EatRight program.

The SCI EatRight program is to be created in 3 phases:

1 - EatRight emphasizes a low fat diet. This program will need to be modified for individuals with SCI. The SCI EatRight program will emphasize adequate intakes of protein, fiber, and fluid for improving or maintaining skin integrity, bowel function, and urological status. The other components of the original EatRight program such as behavior modification, stress management, and exercise session will also need to be modified for individuals with SCI.

2 - The SCI EatRight program will first be pilot tested on a small number of people. The results will be used to improve the effectiveness of the program. The participants will have to be 1) injured for more than 1 year, 2) between 20 and 65 years old, 3) generally healthy without significant medical problems, 4) without a special need for dietary attention and preparation (i.e., without  ventilator-dependence, dysphagia, or enteral feeding), 5) ready for diet change and weight control, and 7) able to provide written consent.

3 - A total of 20 individuals with SCI will participate in SCI EatRight, a program based on the EatRight weight management program. The study will test the safety and effectiveness of SCI EatRight.

Conclusion

Diet and exercise are believed to be a safe and cost-effective way to prevent and treat obesity and improve overall health. For individuals with SCI who are at risk for obesity, a weight management program that combines dietary instruction, tips for increased physical activity, and a home-based exercise program can be of great benefit in preventing secondary complications and improving wellness.

The 12-week series of nutrition classes, exercise sessions, and sample menus are free to participants. All participants must be able to attend classed once every week. Transportation service is available upon request. To get a free evaluation to see if you qualify to participate in the SCI EatRight program, contact Dr. Yu-ying Chen at yychen@uab.edu or 205-934-3329.