Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
Br J Nutr. 2024 Feb 14;131(3):489-499. doi: 10.1017/S0007114523002088. Epub 2023 Sep 20.
In chronic spinal cord injury (SCI), individuals experience dietary inadequacies complicated by an understudied research area. Our objectives were to assess (1) the agreement between methods of estimating energy requirement (EER) and estimated energy intake (EEI) and (2) whether dietary protein intake met SCI-specific protein guidelines. Persons with chronic SCI ( = 43) completed 3-day food records to assess EEI and dietary protein intake. EER was determined with the Long and Institute of Medicine (IOM) methods and the SCI-specific Farkas method. Protein requirements were calculated as 0·8-1·0 g/kg of body weight (BW)/d. Reporting accuracy and bias were calculated and correlated to body composition. Compared with IOM and Long methods ( < 0·05), the SCI-specific method did not overestimate the EEI ( = 0·200). Reporting accuracy and bias were best for SCI-specific (98·9 %, -1·12 %) compared with Long (94·8 %, -5·24 %) and IOM (64·1 %, -35·4 %) methods. BW ( = -0·403), BMI ( = -0·323) and total fat mass ( = -0·346) correlated with the IOM reporting bias (all, < 0·05). BW correlated with the SCI-specific and Long reporting bias ( = -0·313, = 0·041). Seven (16 %) participants met BW-specific protein guidelines. The regression of dietary protein intake on BW demonstrated no association between the variables ( = 0·067, = 0·730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0·833 g ( = 0·0001). The SCI-specific method for EER had the best agreement with the EEI. Protein intake decreased with increasing BW, contrary to protein requirements for chronic SCI.
在慢性脊髓损伤(SCI)中,个体经历饮食不足,这是一个研究不足的复杂问题。我们的目标是评估(1)估计能量需求(EER)和估计能量摄入(EEI)的方法之间的一致性,以及(2)饮食蛋白质摄入量是否符合 SCI 特异性蛋白质指南。慢性 SCI 患者(n=43)完成了 3 天的食物记录,以评估 EEI 和饮食蛋白质摄入量。EER 通过长法和医学研究所(IOM)方法以及 SCI 特异性 Farkas 方法确定。蛋白质需求计算为 0.8-1.0 g/kg 体重(BW)/d。计算了报告准确性和偏差,并与身体成分相关。与 IOM 和长法(<0.05)相比,SCI 特异性方法没有高估 EEI(=0.200)。与长法(94.8%,-5.24%)和 IOM(64.1%,-35.4%)方法相比,SCI 特异性方法的报告准确性和偏差最佳(98.9%,-1.12%)。BW(=-0.403)、BMI(=-0.323)和总脂肪量(=-0.346)与 IOM 报告偏差相关(均<0.05)。BW 与 SCI 特异性和长法报告偏差相关(=-0.313,=0.041)。7 名(16%)参与者符合 BW 特异性蛋白质指南。饮食蛋白质摄入量与 BW 的回归显示变量之间没有关联(=0.067,=0.730)。相比之下,BW 每增加 1kg,总蛋白和必需蛋白摄入量之间的差值减少 0.833g(=0.0001)。EER 的 SCI 特异性方法与 EEI 具有最佳一致性。蛋白质摄入量随 BW 的增加而减少,与慢性 SCI 的蛋白质需求相反。