Association between diet quality, lipid profile and body weight in participants with spinal injury

Patients will be provided with dietary education and offered menu selection of food choices from a “cardio-diet”. Data will be collected at baseline, every 4 weeks during hospital stay and 6-8 weeks post discharge. Cardio-metabolic profile data collection include: Anthropometry – Height, body weight, waist circumference Biochemistry – Lipid profile (Total cholesterol, HDL, LDL, TG) fasting BGL, HbA1c, CRP, homocysteine, insulin resistance (HOMA-IR) Clinical – Body composition using bio-impedance spectroscopy (SFB7) and blood pressure Diet –A validated Food Frequency questionnaire (DHQ III) will be used to quantify pre-morbid/pre-hospital intake data. Dietary intake during admission will be measured using a 3-day food record, representing 2 weekdays and one weekend day. Diet quality will be assessed at each point using Mediterranean diet assessment tool (MEDAS). All recruited patients will be offered the “cardio-diet” menu in line with the Mediterranean diet, low saturated fat with high fruits and vegetables, low salt intake including wholegrains and legumes. Additionally, meals will be tailored using small, regular and large serves based on the energy requirements calculated using spinal cord injury specific guidelines. . Dietary intake will be measured using a 3-day food record, representing 2 weekdays and one weekend day. The form will be completed by either the patient/family and/or the nursing staff.Diet quality as well as compliance will be assessed at baseline and each check point during the intervention period using the validated 14-item Mediterranean Diet Assessment Tool (MEDAS) Education – 1 x 30 minute group session (week 2) and 2 x 15 minute duration one-on-one tailored nutrition education sessions of 15 minutes duration each at week 4 and week 8 with written handouts will be provided during the 12-week intervention period. Nutrition education will incorporate modules in line with social cognitive theory and protection motivation theory with behaviour change techniques including motivational interviewing, goal-setting and positive reinforcement/feedback in addition to self-monitoring of behaviour. Nutrition education handouts will bee purpose-designed, specifically for this study and education sessions are conducted by the accredited practicing dietitian at all times. All baseline markers will be tested at periodic intervals of 0, 4, 8, & 12 weeks except for body composition and biochemistry, which will be reviewed at baseline, 12 weeks and post discharge only. If patients are discharged home prior, follow-up will be completed in the community for that period. Community follow-up at ~6-8 weeks post discharge (as 18 weeks’ review or more depending on the time of discharge) will follow all discharges. The findings will be reported according to the STROBE statement.