Hostname: page-component-68c7f8b79f-r8tb2 Total loading time: 0 Render date: 2026-01-01T06:33:05.783Z Has data issue: false hasContentIssue false
Accepted manuscript

Positive and Negative Energy Surpluses in Persons with Chronic Spinal Cord Injury

Published online by Cambridge University Press:  26 December 2025

Ashraf S. Gorgey*
Affiliation:
Spinal Cord Injury and Disorder Service, Department of Veterans Affairs, Central Virginia VA Healthcare System, Richmond, Virginia Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia
Refka E. Khalil
Affiliation:
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia
*
Corresponding author: Ashraf S. Gorgey, MPT, PhD, FACSM, FACRM, Department of Veterans Affairs, Central Virginia VA Medical Center, Spinal Cord Injury Service & Disorders, 1201 Broad Rock Boulevard, Richmond, VA 23249; phone: 804-675-5000 x3386; email: ashraf.gorgey@va.gov
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Total energy expenditure (TEE) is estimated as the product of basal metabolic rate (BMR) and an SCI-specific factor. The agreement between TEE and total energy intake (TEI) was just established. The findings suggested the existence of positive and negative energy balance distributions. Forty-two males with chronic SCI underwent BMR followed by detailed metabolic profile after overnight fast. TEI and macronutrients of 3-day dietary logs were analyzed using the Nutrition Data System for Research software. Energy surplus was calculated as TEE minus TEI. Body composition assessment was conducted using dual energy x-ray absorptiometry. 57% of SCI participants were classified as negative energy surplus with an average TEI of 1284±422 compared to 2197±553 kcal/day in the positive energy group (P = 0.0002). Negative energy group had a higher BMR (9%; P =0.02), greater body weight (P =0.03), greater total body lean mass (P= 0.03) and consume greater percentage of protein compared to the positive energy group. Percentage macronutrients of protein explained 27% of the variance of energy surplus in a multivariate regression model (r2 =0.27; P = 0.008). TEI adjusted to fat-free mass explained 87% of the variance in energy surplus and 34.7 kcal/kg/day was recommended to balance TEI with TEE. Persons with SCI are either classified into negative or positive energy surplus groups. Larger body weight and greater protein intakes are among the major characteristics of the negative energy group. Clinicians may need to consider the spectrum of energy balance before starting dietary regimen after SCI.

Information

Type
Research Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society