The interaction of macronutrients and body composition among individuals with chronic spinal cord injury

Abstract

Changes in body composition and dietary intake occur following spinal cord injury (SCI). The Geometric Framework for Nutrition (GFN) is a tool that allows the examination of the complex relationships between multiple nutrition factors and health parameters within a single model. This study aimed to utilize the GFN to examine the associations between self-reported macronutrient intakes and body composition in persons with chronic SCI. Forty-eight individuals with chronic SCI were recruited. Participants completed and returned 3- or 5-day self-reported dietary recall sheets. Dietary intake of macronutrients (fats, proteins, and carbohydrates) were analysed. Anthropometric measures (circumferences), dual-energy x-ray absorptiometry (DXA), and magnetic resonance imaging (MRI) were used to assess whlole-body composition. Associations between all circumference measures and carbohydrates were observed. Among MRI measures, only significant associations between subcutaneous adipose tissue and protein x carbohydrate as well as carbohydrates alone were identified. Carbohydrates were negatively associated with several measures of fat mass as measured by DXA. Overall, carbohydrates appear to play an important role in body composition among individuals with SCI. Higher carbohydrate intake was associated with lower fat mass. Additional research is needed to determine how carbohydrate intake influences body composition and cardiometabolic health after SCI.

Keywords: Body composition; Carbohydrates; Geometric framework for nutrition; Macronutrients; Nutrition; Spinal cord injury.

Fig. 1.

Supine anthropometric measures. Two-dimensional representations of each geometric framework for nutrition (GFN) response surface within macronutrient intake state spaces are provided. The median value of the third factor (identified with parentheses on each x-axis) limits each response surface. Red regions represent increased anthropometric circumferences, and blue regions represent reduced anthropometric circumferences. (a) and (b) represent supine abdominal circumference (cm); (c) and (d) represent supine waist circumference (cm); (e) and (f) represent supine hip circumference (cm). In all examples, lower carbohydrate intake is associated with increased circumferences. Nutrient intake is quantified in grams. Kcal quantities can be calculated using conversion factors: 9 kcal/g (fat) and 4 kcal/g (protein and carbohydrates).

Fig. 2.

Seated anthropometric measures. Two-dimensional representations of each geometric framework for nutrition (GFN) response surface within macronutrient intake state spaces are provided. The median value of the third factor (identified with parentheses on each x-axis) limits each response surface. Red regions represent increased anthropometric circumferences, and blue regions represent reduced anthropometric circumferences. (a) and (b) represent seated waist circumference (cm); (c) and (d) represent seated abdominal circumference (cm). In all examples, lower carbohydrate intake is associated with increased circumferences.

Fig. 3.

MRI measures of fat mass. Two-dimensional representations of each geometric framework for nutrition (GFN) response surface within macronutrient intake state spaces are provided. The median value of the third factor (identified with parentheses on each x-axis) limits each response surface. Red regions represent increased fat mass, and blue regions represent reduced fat mass. (a), (b) and (c) represent subcutaneous adipose tissue area (cm²); (d), (e) and (f) represent visceral adipose tissue area (cm²). In all examples, lower carbohydrate intake is associated with increased fat mass.

Fig. 4.

Dual-energy X-ray absorptiometry (DXA) measures of fat mass. Two-dimensional representations of each geometric framework for nutrition (GFN) response surface within macronutrient intake state spaces are provided. The median value of the third factor (identified with parentheses on each x-axis) limits each response surface. Red regions represent increased fat mass, and blue regions represent reduced fat mass. (a) and (b) represent lower extremity fat mass (kg); (c) and (d) represent trunk fat mass (kg); (e) and (f) represent total fat mass (kg). In all examples, lower carbohydrate intake is associated with increased fat mass.