8 replies to this topic

[Apparelyzed]

Paraplegic And Quadriplegic Weight Loss Tips

One pound of fat contains approximately 3,500 calories, so to lose one pound a week, a person should consume approximately 3,500 fewer calories per week. This can be done by reducing the daily intake by 500 calories per day (500 x 7 days will provide a deficit of 3,500 calories per week). To lose 2 pounds per week, a deficit of 1,000 calories per day is required.

If this seems impossible, remember that physical activity also contributes significantly to weight loss. The deficit of 500 to 1,000 calories can come from a combination of increased physical activity and reduced intake on a daily basis. Of course, this will vary depending on the level of spinal cord injury.

What is a desirable weight?

Presentation given on June 13, 2006, by Vickeri Barton, RD, CD Dietitian, Harborview Medical Center.

Right after injury, people lose a significant amount of weight. "It's not uncommon for a young man to lose 40 lbs. while in the hospital," Barton reported. "And a lot of that is the initial loss of muscle mass due to inactivity. But before going home, weight starts to go up again."

While there are no weight guidelines specifically for people with SCI, weight charts for the general public, such as those from life insurance companies (see Desirable Weight Charts pdf, 57kb), can be adjusted for use with the SCI population. To compensate for a reduction in muscle mass, the general rule is to subtract 5-10% for paraplegia and 10-15% for tetraplegia (quadriplegia). For example, if the desirable weight for a medium-build, 5-foot 11-inch man is around 160 lbs., the recommendation of a similar-size man with paraplegia would be 5%-10% less, or 144 lbs. to 152 lbs. For a man with tetraplegia, desirable weight would be even lower-136 lbs. to 144 lbs.

Weight is only one factor, however. More important is the amount of fat a person is carrying around. This is often determined using the body mass index (BMI), calculated by dividing your weight by your height (see BMI chart pdf, 75kb). But Barton doesn't use this on SCI patients, "because of the research evidence that BMI often underestimates body fat in SCI." A recent study compared 19 males with SCI to 19 non-injured males matched for age, height and weight. (1) While the groups had similar BMIs, subjects with SCI averaged 8.9 kg less lean (muscle) mass, 7.1 kg more fat mass, 9.4% more body fat, and 3.7 kg more fat in the trunk than the non-injured controls. Fat mass refers to an actual measurement of the quantity of fat described by weight of the mass, whereas percent body fat refers to that amount of fat mass in comparison with the percent lean muscle mass and percent water the human body contains.

Estimating Calorie Needs

"People with SCI often ask me how many calories they need," Barton said. A formula to calculate calorie needs in SCI was developed in a 1985 study (2) that is still quoted widely today:

Persons with paraplegia: 27.9 calories times body weight in kg. (1 kg. = 2.2 lbs)
Persons with tetraplegia (quadriplegia): 22.7 calories times body weight in kg.

If you are already overweight, the calculation should be based on your desirable weight, not your current weight. For example, a person with tetraplegia (quadriplegia) whose desirable weight is 165 pounds, or 75 kg, needs 1703 (75 x 22.7) calories per day. A 165-pound person with paraplegia would need 2093 calories per day. Unfortunately, "this formula doesn't take into account your gender, age or activity level," Barton said. "You probably need 200-300 fewer calories per day if you're 50 rather than 20 years old. And you use more calories with activity." Even the amount of air in wheelchair tires can affect energy expenditure (less air makes it harder to push) and calorie needs.

Tips for preventing weight gain:

Avoid foods that are high in fat and sugar.
Reduce how much alcohol you drink.
Avoid stress, frustration, and boredom.
If you are depressed, seek medical treatment.

Avoid a sedentary lifestyle by increasing your activity level:

Perform aerobic exercise for at least 30 minutes a day, 3 times a week .
Increase physical activity by walking rather than driving.
Climb stairs rather than using an elevator or escalator.
Always talk to your health care provider before starting an exercise program.

FAD DIETS

A fad diet is one that makes unrealistic promises. Most fad diets are very low in carbohydrates and in calories, causing fluid loss from the body, which indicates a loss of weight on the scale. Once the body gets rehydrated with water, the weight will come right back.

Evaluation of a fad diet:

Is the diet medically and nutritionally safe? Get an opinion from a physician and a registered dietitian.

Red flags for fad diets include: overemphasis on a specific food group or groups, limited food choices, and a "calories do not count" approach.

These are ways to decide whether to use a diet or not. If there is no nutritionally or medically reliable information provided, and if there are no statistics to back the claims, then it is not a good diet to consider. Remember, if it sounds too good to be true, then it probably is.

SUMMARY

For weight loss to be successful, here is a summary of basic guidelines:

Aerobic physical activity will assist in increasing muscle tissue which will burn more calories. You should plan on 20-minute sessions at least 3 times per week.

Gradual changes in eating habits will help encourage a permanent lifestyle change.

A slow weight loss of 1 or 2 pounds a week, until the desirable body weight is reached, is best.

References

1. Healthy body mass index values often underestimate body fat in men with spinal cord injury. Jones LM, Legge M, Goulding A. Arch Phys Med Rehab 2003;84(7): 1068-71

2. Energy expenditure after spinal cord injury: an evaluation of stable rehabilitating patients. Cox SA, Weiss SM, Posuniak EA, Worthington P, Prioleau M, Heffley G. J Trauma 1985;May 25(5):419-23.

Source - adapted from: www.nlm.nih.gov/medlineplus/ency/article/001940.htm
www.sci.washington.edu/info/forums/reports/nutrition.asp

Attached Files

•  MetroLifeWeightTables.pdf   55.55K   102 downloads
•  BMITable.pdf   73.38K   117 downloads

[greybeard]

Oh no you don't! You are not going to put me off the nice thick pork chop I can smell cooking downstairs.

ps. If anyone's interested I may be tempted (for money) to forward my own diet sheet. It tastes wonderful, has plenty of nourishing Chianti and Rioja, and not a calorie to count anywhere. You could, of course, end up needing a wider wheelchair and start to look a little like the Michelin Man, but that's a small price to pay for contentment.

Edited by greybeard, 05 June 2011 - 05:29 PM.

[LeahC]

I have never dieted, I just don't over eat or eat many 'bad' foods. So many people wonder why they gain weight again after following their faddy, restricted diet. It's simple, swap fizzy drinks for water, juice or squash, swap that Big Mac for a carvery and that fry up can be grilled!

[ClaraTaylor]

And run up the stairs!

[The Black Sheep]

I started Weight Watchers a couple years ago when my sister managed to drag me onto a scale and I realized I weighed the same that my mom did when she was pregnant. This was about 9 years ago and I didn't realize just how much I was consuming.

Best friends:
Crystal Light
Diet Soda
Green Peppers
Brown Rice
Wheat Bread or anything whole wheat, rather than bleached flower
V8!
Egg whites
Onions
Drinking water while eating

I used to drink regular soda all the time and I think that was actually my biggest problem. One can of coke is 140 calories and it's completely NOT filling. Crystal light or diet soda is almost as tasty and you don't get the sugar shock either. Increasing fluids is huge. Soluble fiber is filling, takes longer to digest and cleans out.

Lost 30 lbs in 4 months.

[brockit79]

thanks for this!

I have been on a journey with weight loss being a yo-yo dieter over the years.

I feel glad that I had got to the point to realise that fAd diets are nonsense and make you focus on what you cant have.

From being disciplined before my accident and learning about food and how to cook healthy tasty food I now find that (and tbf it took a while) I prefer the healthier options i.e my heALTHY Not deceiving packaging that has healthy in the title. It means that I can have a treat now and then should I wish to; a little bit of what you fancy does you good.

I like that you have given rough amounts of calories that should see me through the day although it is important to consider other factors such as gender, injury level and typical activity levels.

[goose]

I just want to walk up some stairs. I'd be happy taking a couple of steps. That sure would help getting into and out of bed alot easier...cars too.

As far as diets, I've never been on one my entire life. I've never been a big eater either. I eat slow which can annoy people but it also means you get full quicker and eat less. The annoyed ones are usually the ones who could stand to drop a pound or two.

I stay completely away from fake sugar. Limit my soda intake. Drink lots of water and eat whatever I want in moderation. I never tell myself I can't have something. That only makes you want it more.
As far as a weight problem, it's never been an issue. And no, I'm not overweight.

Now, after saying all this, I'm about to eat some banana pudding!

Edited by goose, 22 October 2011 - 05:43 AM.

[Aparr]

I would love to travel stairs too! I've never been on a diet either, per say. I'm a diabetic so I have to count my carbs. so does that count as a diet?

[Clive]

I attended weigh less for six months and found that I lost 3 cm from my neck (I have no way of weighing myself) since then I've stopped weigh less but I've kept up with the diet during the time of work which is basically breakfast and lunch. During evenings I eat what my wife eats (I don't really have a choice) and on weekends I eat anything that comes along. I drink more water and less caffeinated drinks and take the dog out once a day. This regime is kept me reasonably in check.