Basic Review of Digestion

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2 Basic Review of Digestion In the mouth, food is broken down, mixed with saliva, and formed into a bolus. Wave like muscle movements, called peristalsis, push the food throughout the rest of the digestive tract. The food bolus formed in the mouth is pushed down the esophagus and enters the stomach. The stomach churns the food with acid creating a semi liquid substance which is pushed into the small intestine.

3 Basic Review of Digestion Most nutrients are absorbed in the small intestine. Food particles that are not absorbed, such as fiber, pass into the large intestine (also called the colon). The large intestine is the site of water absorption.

4 SCI and Weight Maintaining a healthy weight is extremely important after spinal cord injury (SCI). Being overweight or underweight after SCI can increase the risk of many complications including skin breakdown and osteoporosis. An individual may lose weight immediately after SCI, but weight gain is typical after completing a rehabilitation program. Excess weight increases the risk for diabetes and heart disease.

5 SCI and Weight Too much weight also makes transfers difficult and may require more expensive specialized equipment such as larger wheelchairs and beds. Individuals with SCI gain weight due to decreased activity level and change in body composition. Loss of muscle mass decreases the body s metabolism so that fewer calories are needed each day.

6 Nutrition Tips for Weight Management Eat regular meals. Do not skip meals! Be aware of portion sizes. When filling your plate, half should be vegetable and/or salad, a quarter meat or protein, and a quarter starch. Eat low fat, high fiber foods. Watch beverage calories. Do not drink calories! Use low fat cooking methods: bake, broil, grill, poach, barbecue.

7 Nutrition Tips for Weight Management Avoid fried foods. Read food labels. Eat lean meat and trim fat before cooking. Choose fish more often.

8 SCI and Osteoporosis Osteoporosis is a disease in which bones become fragile and can break easily. Individuals with SCI are at an increased risk for osteoporosis because bones in the parts of the body that are paralyzed continue to lose bone mass. Eat or drink three servings of high calcium food daily. High calcium foods include: dairy products, soy products, green leafy vegetables, canned sardines and salmon, and orange juice with added

9 SCI and Osteoporosis Avoid caffeine because it inhibits the absorption of calcium. Get and adequate amount of Vitamin D because it is necessary for the absorption of calcium. Vitamin D is made in the skin from sunlight. Very few food items provide Vitamin D. Individuals who get little sun exposure should take a Vitamin D supplement. Weight bearing exercise also helps to build and maintain bone density.

10 SCI and Skin Care Individuals with SCI are at risk for developing skin breakdown, also known as pressure ulcers. Too much body weight creates added pressure which can cause the skin to breakdown, forming wounds. Too little body weight creates more bony areas. Pressure over bony surfaces without any padding from muscle or fat can cause the skin to breakdown, forming wounds. Eating a well balanced diet that includes plenty of protein, fruits, and vegetables will help keep the skin healthy. Adequate fluid intake is also necessary for keeping the skin healthy.

11 SCI and Skin Care If you are having a skin problem, such as a pressure sore or a healing surgical incision, you should increase your intake of protein, zinc, and vitamins A & C. Protein is found in meat, fowl, fish, eggs, milk and milk products, nuts, and beans. Protein is needed for collagen synthesis, a major protein in skin. Zinc is found in meat, fish, turkey, whole grain products, sunflower seeds, and dried beans.

12 SCI and Skin Care Vitamin A is found in dark green and dark yellow vegetables and fruits, egg yolks, liver, and dairy products. Vitamin C is found in citrus fruits, tomatoes, peppers, raw cabbage, greens, strawberries, pineapple, and potatoes. Vitamin C is needed for the synthesis of collagen.

13 SCI and Bowel Management The time required for food to move through the gut is slower after a spinal cord injury. If the bowel is not emptied on a regular basis, hard stools and impaction may occur. Drinking water and eating fiber foods such as fruits, vegetables, whole grains, and legumes may help soften the stools, making it easier for them to pass through the intestines. Fiber also makes stool bulkier, which stimulates movement of the bowel.

14 SCI and Bowel Management If high fiber foods are eaten only on occasion, loose stools and incontinence may occur. Therefore, fibrous foods should be gradually increased in the diet until the stools are soft and formed. Adequate fluid in the diet is also essential to help prevent impaction. Increase water intake along with increasing fiber intake to avoid cramping and abdominal pain.

15 Tips to Increase Fiber Intake Eat more vegetables, fruits, and grains. Select whole fruits instead of juice. Eat the skin of fresh fruit. Look for bread with 2 grams of fiber per slice. Eat dried beans, split peas, lentils, or other legumes at least 3 times a week.

16 Tips to Increase Fiber Intake Eat high fiber cereal at least 2 times a week. Add wheat bran, wheat germ, or milled flax seed to recipes. Eat fruit and vegetables with edible seeds. Eat high fiber snacks such as fig bars, bran muffins, and popcorn. Eat more grains: barley, couscous, bulgar, and brown rice.