What should you eat if you have a spinal cord injury? A comprehensive nutrition guide

Following a spinal cord injury (SCI), individuals often experience a reduction in their metabolic rate and daily energy expenditure, making weight management more challenging. A specialized diet is crucial for preventing complications, promoting healing, and addressing the specific nutritional needs of those asking what should you eat if you have a spinal cord injury?.

Quick Summary

This article outlines a healthy nutrition plan for spinal cord injury patients, focusing on reduced calorie needs and emphasizing key nutrients. It covers diet strategies for managing weight, promoting bowel and bladder health, healing pressure sores, and strengthening bones to support overall well-being.

Key Points

• Adjust Caloric Intake: Reduce daily calorie consumption to match lower energy needs after a spinal cord injury and prevent weight gain.

• Boost Fiber and Fluids: Increase fiber-rich foods and fluid intake to manage common bowel issues like constipation and support bladder health.

• Prioritize Protein: Ensure adequate protein intake, which is essential for tissue repair and preventing and healing pressure injuries.

• Fortify Bones: Consume enough calcium and Vitamin D from diet or supplements to counteract bone density loss associated with SCI.

• Embrace Anti-Inflammatory Foods: Incorporate foods high in omega-3s and antioxidants to help reduce inflammation and manage pain.

• Consult a Dietitian: Work with a professional to create a personalized nutrition plan that considers your specific injury level and health needs.

The Unique Nutritional Needs After Spinal Cord Injury

After a spinal cord injury (SCI), the body undergoes significant physiological changes that alter nutritional requirements. The loss of muscle mass below the level of injury and a decrease in physical activity lead to a lower metabolic rate, meaning fewer calories are needed to maintain a healthy weight. Good nutrition becomes a powerful tool for managing health, preventing secondary complications, and improving quality of life.

Prioritizing Weight Management

Weight control is a primary concern for individuals with SCI. An average of 10% less energy is expended daily compared to able-bodied individuals, but many people with SCI consume an excess of 300 to 500 kcal/day. This surplus can lead to obesity and an increased risk of cardiometabolic diseases like diabetes and heart disease. Conversely, being underweight increases the risk of pressure injuries due to less protective padding over bony areas. A balanced diet focusing on high-nutrient, low-calorie foods is essential for maintaining a healthy weight.

Supporting Bowel and Bladder Function

SCI can interrupt nerve signals to the bowel, slowing transit time and leading to issues like constipation. A diet high in fiber and fluids is critical for effective bowel management. Staying well-hydrated is also essential for bladder health, helping to prevent urinary tract infections (UTIs) and kidney stones.

High-fiber foods for bowel health:

• Whole grains: oats, quinoa, brown rice, whole-wheat bread
• Fruits: apples, berries, pears, citrus fruits
• Vegetables: leafy greens, broccoli, beans, peas
• Legumes: lentils, beans
• Nuts and seeds: walnuts, almonds, flaxseed

Healing and Preventing Pressure Injuries

Pressure injuries (also known as pressure ulcers or bedsores) are a common and serious complication of SCI. Proper nutrition is vital for both prevention and healing, as compromised nutritional status can delay recovery. Increased protein intake is needed for wound healing, along with specific vitamins and minerals.

Key nutrients for skin health:

• Protein: Lean meats, fish, eggs, beans, and low-fat dairy
• Vitamin C: Citrus fruits, berries, red peppers, broccoli
• Zinc: Lean meat, eggs, seafood, nuts, and legumes
• Vitamin A: Orange vegetables like sweet potatoes and carrots

Protecting Bone Health and Managing Inflammation

Bone density loss (osteoporosis) below the level of injury is a significant risk for people with SCI, increasing fracture risk. An anti-inflammatory diet can also help manage chronic pain.

Nutrients for bone health and inflammation reduction:

• Calcium: Low-fat dairy, fortified milk alternatives, leafy greens
• Vitamin D: Fortified foods, fatty fish, and moderate sunlight exposure
• Omega-3 fatty acids: Oily fish like salmon, mackerel, and walnuts

Comparison of Healthy vs. Less Healthy Food Choices for SCI

Aspect	Healthy Choices	Less Healthy Choices
Grains	Whole grains (oats, brown rice, quinoa)	Refined grains (white bread, pastries)
Protein	Lean meats, fish, eggs, tofu, legumes	High-fat processed meats (sausage, bacon, hot dogs)
Fats	Healthy unsaturated fats (avocado, olive oil, nuts, seeds)	Saturated and trans fats (fried foods, butter, processed snacks)
Fruits	Fresh or canned fruit in 100% juice	Canned fruit in syrup, sugary juices
Hydration	Water, unsweetened tea	Sugar-sweetened beverages (soda, sports drinks)
Sodium	Fresh foods, low-sodium versions of canned goods	Processed and fast foods, excessive salt

The Importance of Professional Guidance

Developing a personalized nutrition plan is highly recommended. A registered dietitian with experience in spinal cord injuries can assess your individual needs based on your injury level, metabolic rate, physical activity, and potential complications. They can provide tailored advice on portion control, macronutrient balance, and specific food choices. Your care team can also help you navigate potential issues like gastrointestinal side effects from medication.

Conclusion: Eating for Overall Well-being

Following a spinal cord injury, nutrition transitions from a simple health aspect to a cornerstone of comprehensive care. A well-planned diet that addresses reduced energy needs while providing crucial nutrients is essential for weight management, maintaining healthy bowel and bladder function, supporting tissue healing, and strengthening bones. By prioritizing whole foods, lean proteins, and plenty of fiber and water, individuals can mitigate common complications and significantly improve their long-term health and quality of life. For additional resources and support, consider visiting the Model Systems Knowledge Translation Center.

References

• University Hospitals Birmingham NHS Foundation Trust. (2025). Nutrition following a Spinal Cord Injury (SCI). Retrieved from https://www.uhb.nhs.uk/media/zlbox2q0/pi-nut-die-nutrition-following-spinal-injury.pdf
• Veterans Health Library. (2024). Nutrition and Spinal Cord Injury (SCI). Retrieved from https://www.veteranshealthlibrary.va.gov/LivingWith/SpinalCordInjury/StayingHealthy/3,41167
• Model Systems Knowledge Translation Center (MSKTC). (2024). Nutrition and Spinal Cord Injury. Retrieved from https://msktc.org/sci/factsheets/nutrition-and-spinal-cord-injury
• Nature. (2025). Treatment of obesity in spinal cord injury with tirzepatide. Retrieved from https://www.nature.com/articles/s41394-025-00699-w
• Lybrate. (2023). Food Categories Which Should Be Avoided By Patients Suffering From a Spinal Cord Injury. Retrieved from https://www.lybrate.com/topic/food-categories-which-should-be-avoided-by-patients-suffering-from-a-spinal-cord-injury/4b7416e25975f97688bb41938aec95f2
• Craig Hospital. (2023). Bowel Problems with Spinal Cord Injury. Retrieved from https://craighospital.org/resources/bowel-problems-with-spinal-cord-injury
• University of Utah Health. (n.d.). Spinal Cord Injuries and the Bladder. Retrieved from https://healthcare.utah.edu/urology/conditions/spinal-cord-injury
• Agency for Clinical Innovation. (2014). Nutrition fact sheet - healthy eating for adults with spinal cord injury. Retrieved from https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/388236/ACI-SSCIS-12.-Eat-health-nutrition.pdf

Frequently Asked Questions

How do my calorie needs change after a spinal cord injury?

After a spinal cord injury, your body's muscle mass and metabolic rate decrease, so you require fewer calories than before. A dietitian can help determine the appropriate caloric intake for your specific situation to manage weight and prevent related health issues.

What foods are best for managing bowel regularity?

To promote regular bowel movements and prevent constipation, focus on high-fiber foods such as whole grains, legumes, fruits, and vegetables. Additionally, maintaining proper hydration by drinking plenty of water is essential.

Can diet help prevent or heal pressure sores?

Yes, proper nutrition plays a critical role in skin health. Adequate protein intake is vital for wound healing, while vitamins C and A, and minerals like zinc, support skin integrity and fight infection, helping to prevent and treat pressure injuries.

What nutrients are important for bone health after an SCI?

Calcium and Vitamin D are crucial for maintaining bone density, which is often compromised after an SCI. Include low-fat dairy, fortified milks, leafy greens, and fatty fish in your diet to get these essential nutrients.

Which foods should I limit or avoid with a spinal cord injury?

It is best to limit foods high in saturated and trans fats, added sugars, and sodium, such as fast food, processed snacks, sugary drinks, and high-fat meats. These can contribute to weight gain and increase the risk of heart disease.

How can diet help with inflammation and pain?

An anti-inflammatory diet rich in omega-3 fatty acids, found in oily fish and walnuts, can help reduce inflammation throughout the body. Antioxidants from berries and colorful vegetables also provide protective benefits.

Why is proper hydration so important for bladder health?

Staying well-hydrated is key to preventing urinary tract infections and kidney stones, common complications with a neurogenic bladder. Drinking plenty of water helps flush out bacteria and prevents concentrated urine.