Leisure-time physical activity and diet quality are not associated in people with chronic spinal cord injury.

STUDY DESIGN: Cross-sectional. OBJECTIVE: To determine the association between leisure-time physical activity (LTPA) and adherence to Eating Well with Canada's Food Guide (CFG) in community-dwelling adults with chronic Spinal Cord Injury (SCI). SETTING: Ontario, Canada. METHODS: Participants were recruited as part of the Study of Health and Activity in People with SCI (SHAPE-SCI). Dietary data were collected using 24-h recalls and analysed for adherence to CFG recommendations by age group and gender. LTPA was assessed using the Physical Activity Recall Assessment for Persons with SCI. Statistical analysis comprised correlations, multiple regression and χ(2). RESULTS: We studied 75 adults (n=61 M; 42.4±11.8 years; 25.5±5.2 kg m(-2)) with chronic (≥1-year post-injury) SCI. Of these, 37% of participants were inactive, 29% were low-active and 33% were high-active. Fewer than 5% of participants were 100% adherent with CFG; 85% were adherent to ≤50%. Activity level and overall adherence to CFG were not correlated (r=-0.052, P=0.666). Although there were no associations between LTPA and vegetables and fruit, grain products, milk and alternatives, or other foods (all P>0.05), high activity was associated with consuming less than the minimum number of recommended servings of meat and alternatives (φ=-0.258, P=0.026). CONCLUSION: Clinicians need to be aware of the poor diet quality, and low levels of physical activity, of people with chronic SCI. They should not assume that those who are more active consume better quality diets than those who are low active or inactive. SPONSORSHIP: Canadian Institutes of Health Research.

Lowering body mass index cutoffs better identifies obese persons with spinal cord injury.

STUDY DESIGN: Cross-sectional, non-experimental design. OBJECTIVES: (1) Determine the sensitivity and specificity of the general population body mass index (BMI) cutoff for obesity (30 kg m(-2)) in a representative sample of persons with spinal cord injury (SCI); (2) develop a more sensitive BMI cutoff for obesity based on percentage of fat mass (%FM) and C-reactive protein (CRP). SETTING: Ontario, Canada. METHODS: A total of 77 community-dwelling adults with chronic SCI underwent anthropometric measures (%FM by bioelectrical impedance analysis, length, weight, BMI (kg m(-2))) and provided blood samples to determine CRP. Sensitivity and specificity analyses, piecewise regression, non-linear regression, and receiver-operator characteristic curves were used to determine new BMI cutoffs. RESULTS: A BMI cutoff of 30 kg m(-2) failed to identify 73.9% of obese participants vs 26.1% at a lowered cutoff of 25 kg m(-2). BMI cutoffs based on risk levels of the %FM and CRP considered together ranged from 22.1 kg m(-2)-26.5 kg m(-2). CONCLUSIONS: People with chronic SCI and BMI values >22 kg m(-2) should be considered as being at high risk for obesity and obesity-related chronic diseases. SPONSORSHIP: Canadian Institutes of Health Research.

Construct validation and test-retest reliability of the seniors in the community: risk evaluation for eating and nutrition questionnaire.

BACKGROUND: We performed two studies. Study 1 was a construct validation of Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN), a 15-item questionnaire for assessing nutritional risk. In Study 2, we examined the test-retest reliability of SCREEN. METHODS: Study 1 was a cross-sectional study, and Study 2 was a cohort study. For Study 1, ten diverse community sites were used to recruit participants. A total of 128 older adults attended a clinic to provide medical and nutritional history and anthropometric measurements. A dietitian interviewed each participant. Dietitians used clinical judgment to rate the probability of nutritional risk from 1 (low risk) to 10 (high risk). Spearman's rho correlation and receiver operating characteristic curves were completed. An abbreviated SCREEN was developed through multiple linear regression analysis. In Study 2, SCREEN was randomly distributed to members of a seniors' recreation center where a self-selected sample (n = 124) completed two mailed SCREENs, 4 weeks apart. The test-retest reliability was estimated through paired correlations of total scores and individual items. RESULTS: In Study 1, total and abbreviated SCREEN scores were significantly associated with the dietitian nutritional risk rating (rho = -.47 and rho = -.60, respectively). Study 2 revealed that the test-retest reliability of SCREEN was adequate. CONCLUSIONS: SCREEN appears to be a valid and reliable tool for identifying community-dwelling older adults at risk for impaired nutritional states.