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A scoping review characterizing nutrition outcomes in adults with spinal cord injuries and disorders
Priya Iyer1,2, On Kiu Choi1,2, Chenxi Yan1,2
1Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Objectives:
This scoping review aimed to characterize the range of nutrition outcomes and identify the measurement tools and approaches used in spinal cord injuries and disorders (SCI/D) research.
Background:
Individuals with SCI/D experience significant nutrition-related health challenges, yet the diversity and inconsistency in reported nutrition outcomes across research limit evidence synthesis and practical application.
Method:
A search strategy employing JBI methodology focused on studies in the English language meeting predefined criteria was applied across six databases: MEDLINE, CINAHL, Cochrane Central, Scopus, EMBASE, and PsycINFO. The synthesis of common nutrition outcomes and measurement approaches included frequency counts and percentages. Outcomes were categorized using the Nutrition Care Process and Dietetic Outcomes Toolkit frameworks. Findings were reported following the PRISMA-Extension for Scoping Reviews guidelines.
Results:
Of 195 included studies, most were from the United States (52%; n = 102), with the highest research outputs seen from 2010 to 2020. The most reported outcomes were related to clinical and health status (n = 181; 93%), particularly body composition and biochemical markers such as weight, body mass index, and lipid profiles. Dietary assessment outcomes appeared in 35% (n = 68) of studies, with macronutrient and energy intake most frequently assessed. However, only 10% (n = 20) of studies reported outcomes related to nutrition knowledge or behaviors, and just 11% (n = 22) addressed psychosocial factors. Measurement tools varied widely across studies. Objective measures were commonly used for body composition, while dietary intake assessments often relied on self-report methods prone to bias. Few studies used validated instruments or gold-standard tools such as DXA or diet quality indices.
Conclusion:
There is substantial variability in nutrition outcomes and measurement tools across SCI/D research, with critical gaps in nutrition outcomes in behavioral and psychosocial domains. Establishing a core nutrition dataset with validated, standardized measures is essential to advance research quality, comparability, and clinical translation in this population.
