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National Hospital for
Neurology and Neurosurgery
Healthy eating after a spinal
cord injury
Department of Nutrition and Dietetics
If you would like this document in another language or
format, or require the services of an interpreter, contact us
on 0203 448 3215. We will do our best to meet your needs.
Contents
Why is healthy eating important?
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Managing constipation
4
Pressure ulcers
5
Eating a balanced diet and the ‘eatwell’ plate
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Where can I get more information?
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How to contact us
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Where to find us
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This booklet has been written by the Department of Nutrition
and Dietetics at UCLH. The aim of the booklet is to provide
you with information about healthy eating after spinal cord
injury. It can also help you to maintain a healthy weight or
lose weight.
This booklet is intended for patients, their family or carers
under the care of the team at UCLH requiring general
dietary advice. It is not intended for patients with unwanted
weight loss. If you are experiencing undesirable weight loss
please ask the team to refer you to the dietitian for a full
assessment.
Why is healthy eating important?
Healthy eating is important for everyone. Following a spinal
cord injury you may be more likely to experience the
following:
 An initial weight loss. This can be due to the body’s
response to trauma or a reduced appetite due to
treatment and surgery.
 Bowel problems such as constipation. This can be caused
by not being as mobile as previously or food moving more
slowly through your gut.
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 Increased risk of pressure ulcers due to immobility, poor
circulation and lack of sensation;
 Long term weight gain. This is mostly caused by
decreased activity and reduced muscle which may mean
you need to eat less than you did previously to maintain
your weight.
Managing Constipation
To help with opening your bowels regularly it is important to
have adequate fibre and fluid in your diet. You should aim
for eight glasses of fluid per day; this can include tea, water,
squash and juice. Any increase in fibre in the diet should be
done gradually to prevent side effects such as bloating or
loose bowels. Good sources of fibre include:
 Wholegrain foods such as breakfast cereals and
wholemeal or granary breads;
 Fruits and vegetables;
 Beans, lentils and pulses.
Please note that if you have an individual bowel
management programme you may be given individualised
advice on fibre and fluid intakes.
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Pressure ulcers
Pressure ulcers are areas of soft tissue damage. These are
usually caused when parts of the body are in contact with
surfaces such as a bed or wheelchair for a long time. They
commonly occur in areas such as the ankles and the
sacrum (bottom).
Maintaining a healthy weight is one way to help reduce the
risk of pressure ulcers. Extra weight can cause more
pressure on the skin and increase the risk of skin
breakdown.
Protein is needed to help with wound healing. If you have a
mild pressure ulcer, take extra care to make sure you are
getting the recommended amounts of dairy and protein
foods that are detailed in this booklet. If you have more
severe pressure ulcers you should be referred to the
dietitian for dietary assessment as you may need to
increase the amount you are eating and drinking to help the
healing process.
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Eating a balanced diet
The best way to help prevent excess weight gain and
maintain a healthy weight is by eating a balanced diet. The
Food Standards Agency (FSA) has created the ‘eatwell’
plate (see page 7). This shows the five food groups in the
diet with the size of the portion on the plate representing the
proportion that food group should make up in our diets. The
model is not supposed to represent individual meals, rather
a reflection of your intake over a day or week.
As well as having a balanced diet it is also important to think
about the total amount of energy/calories that you eat and
drink. If you take in more energy than your body is using
then your weight will increase and you may become
overweight.
Each food group from the ‘eatwell’ plate is discussed in
more detail in the following pages. We have also included
some weight loss tips if you are trying to lose weight.
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Bread, rice, potatoes, pasta and other starchy foods
(carbohydrates)
This food group also includes breakfast cereals, noodles,
cous cous, chapatti and oats and is important for providing
energy, fibre and vitamins.
You should include at least one starchy food with each
meal. Wholegrain varieties are good choices as they are
usually digested more slowly and contain more fibre than
white and refined foods. Good choices include:
 Wholegrain breakfast cereals and oats, for example
porridge, muesli, shredded wheat;
 Granary, seeded or wholemeal breads, chapatti and pitta;
 Whole-wheat pasta.
Weight loss tip:
Although we should have some carbohydrate at each meal
it is important to watch portion size.
Try not to fill more than a quarter to a third of your plate with
carbohydrate. Try not to have more than one type with each
meal, for example avoid garlic bread and pasta together.
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Fruits and vegetables
This food group provides essential vitamins and minerals as
well as fibre. You can use fresh, frozen, tinned or dried
aiming for a minimum of five portions each day.
A portion is 80 grams which looks like:
 One apple, banana, pear or other similar sized fruit;
 One tablespoon dried fruit;
 Three tablespoons cooked vegetables or small bowl of
salad.
Weight loss tip:
Vegetables are generally low in calories so filling up with
them can help with weight loss. Try to fill at least a third to a
half of your plate with vegetables.
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Milk and dairy foods
This food group provides calcium, protein and other
vitamins. Two to three servings a day are needed for
adequate calcium intake.
A serving is:
 200mls milk;
 150grams or one small pot of yoghurt;
 30grams cheese – about the same size as a small
matchbox or three tablespoons of cottage cheese;
Weight loss tip:
Dairy foods can be high in fat and saturated fats which can
affect weight and cholesterol levels. To reduce fat intake:
 Choose skimmed semi skimmed or one percent milk;
 Choose low fat or light yoghurts;
 Choose reduced fat cheese or cottage cheese;
 Reduce intake of cheddar and high fat cheeses, try
grating or choosing a stronger cheese to help use less.
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Meat, fish, eggs, beans and other non dairy protein
sources
These foods are a good source of a variety of vitamins and
minerals as well as providing protein used for repair and
growth in the body. We should aim for two servings a day.
A serving is:
 Palm sized portion of meat or chicken;
 Three tablespoons cooked chickpeas, beans or other
pulses;
 140grams fish – about the size of a computer mouse;
 Two eggs;
 One tablespoon of unsalted nuts.
Weight loss tip:
Some protein foods can be high in fats. To minimise this try
the following:
 Choose lean cuts of meat and mince (less than 10
percent fat);
 Remove chicken skin and visible fat on meat and bacon;
 Try to grill meat and fish instead of frying;
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 Limit intake of pies, sausages, salami and other fatty
meats;
 Poach or boil eggs rather than frying.
Foods and drinks high in fat and sugar
This food group includes cakes, biscuits, butter, cream, oil,
sweets and sugary drinks. We should try to eat only small
amounts of these foods as they provide little nutrients other
than sugar and fat and too much can cause weight gain.
Weight loss tip:
To reduce intake try the following:
 Have fun sized chocolate bar or two squares dark
chocolate instead of normal sized bar;
 Choose diet or sugar free drinks;
 Spread butter thinly on toast and measure oil with a
teaspoon when cooking;
 Avoid deep fried foods;
 Try alternative snacks such as low fat yoghurt, fruit or a
small portion of unsalted nuts (30grams).
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More weight loss tips:
 Do not skip meals as this makes you more likely to snack
or have bigger portions later;
 Use a smaller plate for meals to help with portion control;
 Eat slowly so your brain has chance to register you are
full to prevent overeating at meals;
 When buying ready made meals compare the food labels
to help you pick those containing less calories and fat.
 Avoid high sugar drinks such as Coca-Cola, lucozade,
fanta or large amounts of fruit juice. Choose water or
sugar free alternatives instead.
Where can I get more information?
For recipe ideas, meal plans and guidance on reading food
labels visit:
www.nhs.uk/livewell
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How to contact us
The Department of Nutrition and Dietetics
The National Hospital for Neurology and Neurosurgery
Box 91
London
WC1N 3BG
Direct Line: 020 3448 3215
Switchboard: 0845 155 5000 / 020 3456 7890
Fax: 020 7380 9811
Website: www.uclh.nhs.uk/nhnn
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Space for notes and questions
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Where to find us
Publication date: 2013
Date last reviewed: April 2016
Date next review due: April 2018
Leaflet code: UCLH/SH/NHNN/
© University College London Hospitals NHS Foundation Trust 2013
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