Obesity intervention in persons with spinal cord injury

Abstract

This is the first demonstration that a carefully planned program with time-calorie displacement diet is effective for overweight/obese individuals with SCI to lose weight without compromising total lean mass and overall health. It provides foundation for a future large clinical trial for weight loss of persons with SCI or other spinal cord dysfunction.

Effect of Exercise on Disorders of Carbohydrate and Lipid Metabolism in Adults With Traumatic Spinal Cord Injury: Systematic Review of the Evidence

“…Only 3 subjects were assigned to each group, and no control group was included for comparison. There were 12 studies that reported carbohydrate-related outcomes (9,10,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35) (Table 1) and 15 that reported lipid-related outcomes (9,10,26,27,30,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) (Table 2). Only 1 study included cardiovascular morbidity as an endpoint (Table 2), and this was assessed using a survey instrument with variable levels of sensitivity and specificity when tested in able-bodied populations (45).…”

“…There was no difference in HDL-C levels between athletes with SCI and sedentary, ablebodied subjects (35). Surprisingly, 1 FES study reported a statistically significant reduction in HDL-C after a 10-week leg cycling program (30), as did the weight management study (44). Another FES study identified no changes in HDL-C among participants with either high or normal baseline levels of TC (40).…”

“…However, 2 additional survey studies showed no difference in TC levels between SCI patients who were physically active and those who were sedentary (42) or between SCI athletes and sedentary, able-bodied subjects (35). The study examining the weight management training program found no significant change in TC after training (44).…”

“…We identified 16 studies involving 369 individuals that reported lipid- (9,10,26,27,30,(35)(36)(37)(38)(39)(40)(41)(42)(43)(44) or cardiovascular-(45) related outcomes ( Table 2). The overall quality of SCI-specific evidence supporting exercise as a therapy for lipid metabolism disorders was low (46,47).…”

“…One survey examined the association between physical activity and cardiovascular morbidity, with both variables measured using a self-report survey instrument (45). One study, categorized as ''other,'' examined the effects of a weight management training program, including an exerciserelated curriculum, on lipid outcomes (44).…”