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 0.8-1.0 g/kg of body weight (BW)/day. Reporting accuracy and bias were calculated and correlated to body composition. Compared to IOM and Long methods (P<0.05), the SCI-specific method did not overestimate the EEI (P=0.200). Reporting accuracy and bias were best for SCI-specific (98.9%, -1.12%) compared to Long (94.8%, -5.24%) and IOM (64.1%, -35.4%) methods. BW (r=-0.403), body mass index (r=-0.323), and total fat mass (r =-0.346) correlated with the IOM reporting bias (all, P<0.05). BW correlated with the SCI-specific and Long reporting bias (r=-0.313, P=0.041). Seven (16%) participants met BW-specific protein guidelines. The regression of protein intake on BW demonstrated no association between the variables (β=0.067, P=0.730). In contrast, for every 1 kg increase in BW, the delta between total and required protein intake decreased by 0.833 g (P=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.