Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review.

Stojic, S; Eriks-Hoogland, I; Gamba, M; Valido, E; Minder, Beatrice; Chatelan, A; Karagounis, L.G.; Ballesteros, M; Diaz, C; Brach, M; Stoyanov, J; Diviani, N; Rubinelli, S; Perret, C; Glisic, M (2023). Mapping of Dietary Interventions Beneficial in the Prevention of Secondary Health Conditions in Spinal Cord Injured Population: A Systematic Review. Journal of nutrition, health & aging, 27(7), pp. 524-541. Springer 10.1007/s12603-023-1937-6

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Individuals with spinal cord injury are at risk of secondary health conditions (SHC) that develop as a consequence of autonomic dysfunction, prolonged oxidative stress and inflammation, and physical inactivity coupled with inadequate energy and nutritional intake. SHC can be debilitating and even life-threatening, and its prevention remains one of the major challenges in the continuum of medical care of aging SCI population. An unhealthy diet is a major driver of inflammation, oxidative stress, and unfavourable metabolic status and may be a practical preventive target to tackle increased SHC risk post-injury.


To provide a catalogue of dietary interventions beneficial in prevention of SHC among individuals with SCI by conducting a systematic review of the literature on dietary interventions and dietary supplementation in promoting health and well-being after the injury. In addition, we aimed to provide a summary of observational studies exploring the association between habitual diet (macro- and micronutrients intake and dietary patterns) and health patterns following the injury.


This review was registered at PROSPERO (University of York) with registration number CRD42022373773. Four medical databases (, MEDLINE [Ovid], Cochrane CENTRAL, and Web of Science Core Collection) and Google Scholar were searched from inception until 11th July 2022. Studies were included if they were clinical trials or observational studies conducted in adult individuals with SCI and provided information of interest. Based on strength of the study design and risk of bias assessment (using the NIH tool), we classified studies from Level 1 (most reliable studies) to Level 4 (least reliable studies).


Of 12,313 unique citations, 47 articles (based on 43 original studies) comprising 32 interventional (22 RCTs, 3 NRCT, and 7 pre-post studies) and 11 observational studies (2 cohort studies, 2 case-control, 1 post-intervention follow-up study, and 6 cross-sectional studies) were included in the present systematic review. Twenty studies (46.5%) were classified as Level 1 or 2, indicating high/moderate methodological quality. Based on those studies, dietary strategies including high protein diet, intermittent fasting, balanced diet in combination with physical conditioning and electrical stimulation, and dietary supplementation including alpha-lipoic acid, creatine, vitamin D, and cranberry-derived supplements and probiotics were mapped as the most promising in prevention of SHC among individuals with SCI.


To develop timely and effective preventive strategies targeting major SHC (e.g., cardiometabolic diseases, urinary tract infections) in SCI, further research is warranted to confirm the effectiveness of dietary strategies/interventions identified through the current systematic review of the literature.

Item Type:

Journal Article (Review Article)


13 Central Units > Administrative Director's Office > University Library of Bern
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Gamba Rincón, Magda Rocío, Minder, Beatrice, Karagounis, Leonidas, Diaz Rios, Catalina, Glisic, Marija


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services
000 Computer science, knowledge & systems > 020 Library & information sciences






[223] Swiss Paraplegic Foundation = Schweizer Paraplegiker-Stiftung




Beatrice Minder Wyssmann

Date Deposited:

31 Aug 2023 08:27

Last Modified:

31 Aug 2023 11:58

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Spinal cord injury cardiovascular diseases functioning gastrointestinal health neurological recovery nutrition




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