Eating right is hard for anyone, but it’s especially hard for those of us with paralysis and other physical disabilities. We have so many unique challenges — who has the time or energy to worry about nutrition?
But nutrition is actually one of the most important things to focus on. We need to fight disease and infections, recover from injury, and have the stamina to tackle our taxing daily routines and pursue our best lives. All of that depends in part on what we eat and drink.
Below, you’ll find a comprehensive guide to nutrition if you live with paralysis, based on interviews with multiple experts.
The Basics
To start us off, holistic nutritionist Vanessa Vitali at Boulder Functional Nutrition offers some foundational nutritional principles that everyone should follow.
Balanced Diet
If you only remember one thing from this article, remember this: Aim for a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. This will provide essential nutrients and support your overall health.
Protein
Protein plays a vital role in maintaining muscle mass, which is particularly important for those of us with paralysis. Protein is also essential for repairing muscles. Including lean protein sources like poultry, fish, tofu, and legumes can help protect – and even grow – the muscles you have.
Fiber
Many people with paralysis have gastrointestinal issues, including limited bowel function. Consuming enough fiber can help manage these issues and maintain bowel regularity.
Water
Staying hydrated is crucial to help prevent urinary tract infections and maintain your overall health.
Foods to Fill Your Plate
Flint Rehab, which specializes in neurorehabilitation, discusses several foods (you could even call them superfoods) that are important for optimal health. These foods are good for everyone, but they have particular benefits for people with paralysis.
Dark Leafy Greens
These vegetables, which include things like spinach, kale, and collard greens, have lots of essential nutrients. For example, they contain:
- Magnesium, which helps regulate nerve and muscle function. It also can help you relax and even sleep better.
- Folate, which helps promote healthy bones and nerves.
- Vitamins A, C, E, and K, which provide antioxidants to defend against free radicals that can damage tissues and cells in your body. Antioxidants also help your body get rid of toxins.
- Fiber, which, as I mentioned, is important for maintaining a regular bowel program.
- Antioxidants, which can help protect the nervous system from additional damage following a spinal cord injury.
Berries
Raspberries, strawberries, blueberries, and other varieties pack a big nutritional punch. Like leafy greens, they contain antioxidants. They also have a lot of water, which we all need plenty of. And berries contain what’s called resveratrol, a substance that has been found to prevent damage connected to oxidative stress and protect the spinal cord after injury.
Orange Vegetables
Pumpkins, carrots, sweet potatoes, and other orange vegetables contain loads of vitamin A, which can promote a healthy immune system. Vitamin A can also help keep your skin from breaking down and make you less prone to pressure injuries.
Oily Fish
Oily fish like salmon and mackerel has lots of omega 3 fatty acids, which studies have shown can both prevent and help treat nerve damage. Fish also has protein for building and maintaining muscle.
As a bonus, you get plenty of vitamin D from eating oily fish, which helps protect bones. People in wheelchairs who don’t bear weight on their legs are at risk of osteoporosis, so vitamin D is especially important for them.
Dairy
Along the same lines, dairy products have lots of calcium, which is another essential ingredient for strong bones. Insufficient calcium can also lead to muscle spasms and cramping – something that people with paralysis already have a heightened risk of.
Dairy also contains large amounts of vitamin B12, which helps produce a fatty substance called myelin that protects nerve cells.
Beans
Beans have protein, fiber, and folate, all of which Flint Rehab says can help promote recovery after a spinal cord injury. They’re also satiating, which will make it easier to control your calorie intake.
Citrus Fruits
Citrus fruits like oranges and grapefruit have lots of Vitamin C. This is important for tissue regeneration and healing following any injury.
Additional Things to Keep in Mind
Here are some other important considerations when developing a nutrition plan, according to Vitali and three other experts: Catherine Gervacio, a registered dietician and nutrition writer for Living Fit; Dr. Danielle Kelvas, medical advisor for RS KOSO, a dietary supplement company; and Tori Vasko, a registered dietician at Easy Chickpeasy.
Caloric Needs
Vitali notes that many people with paralysis burn fewer calories because they’re less physically active. Caloric needs also can vary depending on the level and severity of the injury.
Even if you’re active in adaptive sports and other activities like travel, you need to carefully balance the calories you burn with those you consume to avoid gaining weight (or losing it, if that’s not your goal).
Dietary Supplements
Some people may need specific supplements like vitamin D or calcium based on their injury level, lifestyle, and dietary restrictions. Talk to your doctor before taking any supplements to make sure they’re safe for you.
Sugars and Processed Foods
Eating less sugary and highly processed foods can help manage weight and prevent potential complications like diabetes. “Processed foods can be high in sodium, unhealthy fats, and lacking in important nutrients,” Gervacio says. “Added sugars can lead to blood sugar spikes and contribute to overall poor health.”
Sodium
Cutting your sodium intake can reduce blood pressure and thus the risk of heart disease, which many people with paralysis are more susceptible to.
Alcohol and Caffeine
Some medications can interact with alcohol or caffeine. Talk to your doctor if this might be a concern.
Constipation and Gut Health
Constipation is an issue for many who live with paralysis. According to Gervacio, it may be due to limited physical activity, reduced hydration, or low fiber intake.
Vasko agrees. “Those with SCIs are at an increased risk of [constipation],” she says. Thus, “It’s especially important to choose high-fiber foods that will help to keep your gut happily moving along. A practical way to do this is to make sure you are including 1-3 servings of whole grains, fruits, veggies, or beans in each of your meals.”
Kelvas points out that foods like bread, rice, green bananas, and potatoes can make constipation worse. “Drink plenty of water, because dehydration is the number-one cause of constipation,” he says. “Maybe even consider a stool softening tea if you don’t have daily bowel movements.”
If you struggle with bloating, gas, acid reflux, and/or abdominal pain, consider food sensitivity testing. “Sometimes certain foods cause people’s inner gut lining to become inflamed,” Kelvas says. “This weakens their immune system. People with paralysis or spinal cord injuries are at a higher risk of getting sick, especially lung infections, so keeping their immune system in top shape is really important.”
Bone Health
This was mentioned above, but it bears repeating: Maintaining healthy bones is especially important when you live with paralysis, because parts of your body aren’t able to bear any weight, which can lead to bone loss.
“I’d recommend making sure you are getting good sources of calcium and vitamin D to keep your bones healthy,” Vasko says. “Calcium foods include milk and yogurt, tofu, dark green veggies like kale and broccoli, nuts, and seeds. Vitamin D can be a little trickier, especially if you don’t live in a sunny location or spend much time outdoors.” That said, it’s easy to find quality vitamin D supplements at your local pharmacy or grocery store.
Weight Management
In addition to fueling our bodies properly, good nutrition is vital for maintaining a healthy weight. Again, this is something everyone should do, but it’s critical for people with physical disabilities.
“Maintaining a consistent healthy weight is important for many reasons, including the ability to do activities such as transfers,” Beck says.
She also points out that if you’re under- or overweight, this will affect how you fit into your wheelchair and can increase the risk of developing a pressure injury. Plus, obesity is a risk for diabetes, hypertension, hyperlipidemia, and related conditions.
To help control your weight, Beck recommends a Mediterranean-type diet that’s heavy on fruits, vegetables, herbs, nuts, seeds, olive oil, beans, and whole grains.
“I also suggest to my patients to avoid the ‘Wicked Whites’: sugar, white pasta, white bread and white rice,” Beck says. These can cause excessive weight gain and promote inflammation, both of which are enemies of good health.
Individualized Plans
Despite these general principles that apply to everyone, different people have different specific nutritional needs. That’s why it’s best to work with a healthcare professional or registered dietitian to create a personalized meal plan.
Vitali sums things up nicely.
“Nutrition considerations for individuals with spinal cord injuries or paralysis should focus on maintaining muscle mass, preventing complications like pressure sores and urinary tract issues, and promoting overall well being,” she says. “A balanced diet, adequate hydration, and personalized dietary plans in consultation with healthcare professionals are essential for optimizing health and managing potential challenges.”
Where to Go From Here
Of course, we all know that eating better is easier said than done. No one’s diet is perfect, including mine, although I’ve made a lot of progress over the years.
And that’s what you want to shoot for: progress, not perfection.
If your current diet is less than great and you don’t know how to start improving it, begin with this simple step: Pick two or three items listed above to eat more or less of, like more leafy greens and less sugar.
Don’t worry about the rest of the advice – at least not yet. Once those two or three changes have become a habit, pick two or three more.
If you stick with your plan, in a relatively short time, you will have transformed your diet. You’ll feel better and have more energy, and you may even start to lose weight.
In other words, you’ll be that much closer to thriving. And that’s what we’re all shooting for.