Eating behavior, diet quality, mental health, and functional outcomes in individuals with spinal cord injury.

CONTEXT/

OBJECTIVE

We hypothesized that individuals with chronic spinal cord injury would exhibit altered eating behaviors and lower diet quality, which would be associated with higher levels of psychological distress and decreased functional independence.

DESIGN

Cross-sectional study.

SETTING

Tertiary Physical Medicine and Rehabilitation Hospital.

PARTICIPANTS

Fifty individuals with chronic SCI and 50 age- and sex-matched healthy controls were included.

INTERVENTIONS: Not applicable.

OUTCOME MEASURES: Eating behaviors were assessed using the Adult Eating Behavior Questionnaire (AEBQ), psychological distress using the Depression Anxiety Stress Scale-21 (DASS-21), diet quality using the Healthy Eating Index-2015 (HEI-2015), and functional independence using the Spinal Cord Independence Measure III (SCIM-III).

RESULTS

The groups were comparable in age, sex, marital status, and anthropometric measures (P > 0.05). Most patients had paraplegia (78.0%) and incomplete SCI (62.0%). Median time since injury was 11.5 months (IQR, 6.0-21.25), and mean total SCIM-III score was 59.0 ± 20.9. Emotional Overeating and Satiety Responsiveness scores were significantly higher in the SCI group than in the control group (P = 0.001 and P = 0.003, respectively). In unadjusted analyses, several AEBQ domains showed nominal associations with DASS-21 scores; however, none remained statistically significant after correction for multiple testing. In regression analyses, higher BMI and stress were associated with greater Emotional Overeating. For Satiety Responsiveness, anxiety and female sex remained significant predictors, whereas associations with BMI and stress were not consistent in sensitivity analyses.

CONCLUSION

Individuals with chronic SCI showed altered eating behaviors and lower diet quality compared with healthy controls. Associations between eating behavior and psychological distress should be interpreted cautiously and confirmed in larger studies.