The comparison of total energy and protein intake relative to estimated requirements in chronic spinal cord injury

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 (n=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<middle dot>8-1<middle dot>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 (P<0<middle dot>05), the SCI-specific method did not overestimate the EEI (P=0<middle dot>200). Reporting accuracy and bias were best for SCI-specific (98<middle dot>9%,-1<middle dot>12 %) compared with Long (94<middle dot>8%,-5<middle dot>24 %) and IOM (64<middle dot>1%,-35<middle dot>4 %) methods.BW (r=-0<middle dot>403), BMI (r=-0<middle dot>323) and total fat mass (r=-0<middle dot>346) correlated with the IOM reporting bias (all,P<0<middle dot>05). BW correlated with the SCI-specific and Long reporting bias (r=-0<middle dot>313,P=0<middle dot>041). Seven (16 %) participants met BW-specific protein guidelines. The regression of dietary protein intake on BW demonstrated no association between the variables (beta=0<middle dot>067,P=0<middle dot>730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0<middle dot>833 g (P=0<middle dot>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