Author(s): CRAVEN, S., RISVANG, L., BAUMGART, J., VERLAAN, S., JONVIK, K., Institution: UNIVERSITY OF BRITISH COLUMBIA OKANAGAN, Country: CANADA, Abstract-ID: 1632

INTRODUCTION:
Wheelchair users are at increased risk of low bone mineral density (BMD) due to chronically reduced mechanical loading on the skeletal system. Further, previous studies have found wheelchair athletes at risk for nutrient deficiencies related to bone health, such as clinically low S-vitamin D levels. This study aimed to describe dietary intake in sports and non-sports active wheelchair users and investigate the effects of 24-weeks nutrition optimization targeting bone health.
METHODS:
Adult wheelchair users with BMD Z-score ≤ 0.0 at lumbar spine or hip were randomized to resistance exercise or no exercise, with both groups receiving nutrition optimization in the form of counselling and supplementation of protein, vitamin D, and calcium. Measurements occurred at baseline, mid-, and post-intervention. BMD and body composition were measured with dual-energy X-ray absorptiometry. Fasted venous blood samples were collected to assess nutrient biomarkers. Dietary intake was recorded by three 24-hour dietary recalls collected within 2-weeks of each time point and assessed via the Norwegian Food Database.
Differences between sports active (≥ 1-year organized sports; ≥3 training hours per week) and non-sports active participants were assessed by Fisher’s exact tests. Baseline nutrient intake and biomarker status were determined categorically according to Nordic Nutrition Recommendations 2012 and sport-specific recommendations. A linear mixed-effects model was used to investigate the effects of the nutrition optimization protocol on intake of energy (EI), protein, and calcium, and S-vitamin D.
RESULTS:
Baseline included 45 participants (BMI 24±5kg/m2; 40% female; 49% sports active). Estimated EI was 204 kcal/day lower than calculated energy need, with no difference in prevalence of low EI between sports (50%) and non-sports (44%) active. Majority (73%) of sports active participants met recommended protein intake for athletes of >1.2 g/kg/day, but only 14% met carbohydrate intake for athletes of >5 g/kg/day. Recommended vitamin D intake was met by 71% of participants; however, 93% had S-vitamin D levels <80 nmol/L. From baseline to mid-intervention there was significant increase in S-vitamin D, and intake of protein and calcium. S-vitamin D and calcium intake remained significantly increased to post-intervention. Across all timepoints non-sports active had significantly lower EI (-467±132 kcal/day) and calcium intake (-306±116 mg/day).
CONCLUSION:
We found notable nutritional challenges in wheelchair users, including low EI and S-vitamin D, despite meeting vitamin D intake recommendations. Protein but not carbohydrate recommendations were met by sports active participants. 24-week nutrition optimization targeting bone health led to increased S-vitamin D levels and protein and calcium intake, emphasizing the value of targeted dietary support for sports and non-sports active wheelchair users.