Energy expenditure and nutrient intake after spinal cord injury: a comprehensive review and practical recommendations.
Energy expenditure and nutrient intake after spinal cord injury: a comprehensive review and practical recommendations.
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DOI：
10.1017/s0007114521003822
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发表时间：
2022-09-14
影响因子：
3.6
通讯作者：
Gater, David R. Jr Jr
中科院分区：
文献类型：
--
作者：
Farkas, Gary J.;Sneij, Alicia;McMillan, David W.;Tiozzo, Eduard;Nash, Mark S.;Gater, David R. Jr Jr
关键词：
许多脊髓损伤（SCI）患者有一种或多种可预防的慢性疾病，与能量摄入过多和不良饮食习惯有关。尽管世界各地都有权威的饮食建议，但相对于需要适当的营养摄入仍然是一个问题。这些建议是针对非残疾人群制定的，并没有考虑到脊髓损伤后身体成分、低代谢率、激素失调和营养状况的损伤引起的变化。由于不存在以证据为基础的SCI饮食参考摄入量，因此确保适当摄入大量营养素和微量营养素以满足其能量需求成为一项挑战。在这篇压缩综述中，我们简要地评估了与脊髓损伤相关的能量平衡和食欲控制方面。我们报告了脊髓损伤后能量消耗、营养摄入及其关系的证据。我们将这些数据与美国心脏协会、澳大利亚膳食指南、美国人膳食指南、医学研究所膳食参考摄入量、英国公共卫生政府膳食建议、世卫组织健康饮食和美国瘫痪退伍军人临床实践指南等几项既定营养指南进行比较。我们还提供了实用的评估和营养建议，以促进脊髓损伤后的健康饮食模式。由于缺乏强有力的脊髓损伤研究，目前在PVA指南之外的饮食建议有限，无法满足脊髓损伤后独特的营养需求。未来的多中心临床试验需要建立全面的、以证据为基础的饮食参考值，这些参考值依赖于准确的、个体的能量需求评估。
Many persons with spinal cord injury (SCI) have one or more preventable chronic diseases related to excessive energetic intake and poor eating patterns. Appropriate nutrient consumption relative to need becomes a concern despite authoritative dietary recommendations from around the world. These recommendations were developed for the non-disabled population and do not account for the injury-induced changes in body composition, hypometabolic rate, hormonal dysregulation and nutrition status after SCI. Because evidence-based dietary reference intake values for SCI do not exist, ensuring appropriate consumption of macronutrient and micronutrients for their energy requirements becomes a challenge. In this compressive review, we briefly evaluate aspects of energy balance and appetite control relative to SCI. We report on the evidence regarding energy expenditure, nutrient intake and their relationship after SCI. We compare these data with several established nutritional guidelines from American Heart Association, Australian Dietary Guidelines, Dietary Guidelines for Americans, Institute of Medicine Dietary Reference Intake, Public Health England Government Dietary Recommendations, WHO Healthy Diet and the Paralyzed Veterans of America (PVA) Clinical Practice Guidelines. We also provide practical assessment and nutritional recommendations to facilitate a healthy dietary pattern after SCI. Because of a lack of strong SCI research, there are currently limited dietary recommendations outside of the PVA guidelines that capture the unique nutrient needs after SCI. Future multicentre clinical trials are needed to develop comprehensive, evidence-based dietary reference values specific for persons with SCI across the care continuum that rely on accurate, individual assessment of energy need.