Eat Well Live Well with Spinal Cord Injury :

1. Eat Well Live Well with Spinal Cord Injury: Addressing Secondary Health Complications through Nutrition Joanne Smith B.A., BRT Dip., CNP Kylie James, B.Sc., O.T., CNP

8. Common Question SCI patients asked… What are you taking?

9. Equally important question often not asked… What are you eating?

10. Bad Diet Disease

11. SCI FACTS: • Poor diets • Nutrient deficient

12. Common Nutrient Deficiencies Vitamin A B2 (riboflavin) B9 (folic acid) B12 Vitamin D Vitamin E Calcium Chromium Magnesium Zinc Fiber EFA’s

13. Constipation/ bowel obstruction Diarrhea UTI’s Obesity Pressure sores Osteoporosis Arthritis Type 2 diabetes Heart disease Pain Sleep disorders Digestive dysfunction Average - 7 Secondary Health Complications a Year:

14. Why Use Supplements? • Digestive dysfunction deceases nutrient absorption • Body has an increased demand for specific nutrients to address health conditions • Food alone may not be able to provide the nutrient levels required for therapeutic effect • Addresses clients compliance & preference • Certain medications deplete nutrients • Processed foods limited in nutrients

15. Nutritional Protocols

16. Weight Gain

17. SCI FACTS: • One of the most common secondary health complications • 65% of people with SCI are overweight - 1/3rd obese • Contributes to other health issues: • Type 2 diabetes • CVD/reduced life expectancy • Joint problems and pain • High blood pressure/stress on kidneys • Hormonal imbalances

18. Client Case: • 50 years old • C 5-6-7 incomplete quadriplegic • 3 yrs. post injury • Gained 40 lbs post injury • Developed pressure sore on coccyx

19. 1. Increase Protein • Necessary for hormone productioninvolved in weight loss • Does not raise insulin • Helps curb appetite Healthy Sources • Fish • Chicken/turkey • Nuts/seeds • Legumes/lentils

20. 2. Reduce Refined Carbohydrates • Helps balance blood sugar levels • Improves insulin sensitivity • SCI associated with glucose intolerance & insulin resistance Healthy low GI complex carbohydrates • Wild/brown rice • Vegetables • Quinoa • Legumes/lentils

21. 3. Eat Good Fats • Increases metabolic rate • Helps curb cravings • Helps suppress appetite Healthy sources • Oily fish • Nuts/seeds • Eggs • Olives/oil • Avocado

22. 4. Increase Fiber • Helps slow release of glucose/decreases risk of insulin resistance • Helps to feel full faster • Helps rid the body of toxins • Calorie-free Healthy sources • Fruits/vegetables • Oats • Legumes/lentils

23. 5. Boost Metabolism • Helps thermogenic foods that help stimulate metabolism Healthy sources • Hot peppers • Green tea • Apples/apple cider vinegar • Brussels sprouts/broccoli • Celery • Berries

24. 6. Chromium • Helps improve insulin sensitivity Healthy sources • Whole grains • Tomatoes • Onions • Broccoli Supplement dose • 200-400 mcg/day

25. Outcome

26. Lost 40 lbs in 20 weeks • In conjunction with working out 2 hours a day (arm bike & body weight support treadmill) 5x/week • Increased energy • Increased self-esteem

27. Pressure Sores

28. SCI FACTS: • 85-95% risk of developing • Risk increases with time since injury • Accounts for high number of re-hospitalizations • Can be life-threatening • Contributes to other health issues: • Infection/osteomyelitis • Fatigue

29. Client Case: • 47 years old • C4-5 incomplete quadriplegic • 25 yrs. post injury • Developed 1st sore • At 9 months- stage 4 sore on sacrum – required surgery for infection • Post-surgery healing - rate of 5% every two weeks

30. 1. Increase Calories • To meet increased energy and protein needsrequired for healing • 30-35 calories per kg of body weight Healthy sources • Nut butters • Dried fruits/juices • Avocados • Whole grains • Coconut milk

31. 2. Increase Protein • Essential for growth and repair of new tissues • 1.2-1.5 grams of protein per kg of body weight Healthy sources • Fish • Beef/poultry • Quinoa/beans/lentils • Nuts/seeds • Protein powders/smoothies

32. 3. Take Vitamins A,C, E & zinc • Supports collagen production & stimulates immune system Increase foods rich in these vitamins • Yellow & orange vegetables/sweet potato • Broccoli, red & green peppers • Sunflower seeds, olives/oil • Pumpkin seeds, yogurt Supplements • Vitamin A (5000 IU/d) • Vitamin C (3000 mg/d) • Vitamin E (400-800 IU/day) • Zinc (50-100 mg/day)

33. 4. Drink 8 cups Fluids/day • Helps skin wounds heal more quickly • Carries important repair substances • Eliminates wastes/toxins

34. 5. Eat Healthy Fats • Required for proper cell production • Helps maintain skin integrity and elasticity Healthy Sources • Fish/fish oils • Walnuts • Flax seeds

35. 6. Take Amino Acid Supplements • Supports skin wounds Supplements • Glutamine (5-40 grams/day) • Lysine (3000 mg/day) • Proline (2000 mg/day)

36. Outcome

37. Healing time increased from 5% to 10% every 2 weeks • Wound completely healed in 6 months

38. Nutrition is… • An integral part of rehabilitation process • Important for helping prevent and reduce secondary health complications • Key in optimizing long term health & well-being So what are you eating?

39. www.eatwelllivewellwithsci.com kylie@korunutrition.com 416.562.1344 fruitfulelements@gmail.com 416.992.2927