The Role of Nutrition
The key to preventing a pressure sore is maintaining healthy skin (Klebine et al., 2000). Nutrition plays a vital role in ensuring that healthy skin is maintained. Cruse et al. (2000) concluded in their study on the relationship between nutrition status and the healing of pressure sores that most people with SCI have an impaired nutrition status, which contributes to delayed wound healing.
Keeping a diet that includes foods high in complex carbohydrates, such as breads, pasta, cereals, or starchy vegetables, helps to maintain a healthy body weight by providing a feeling of fullness for a longer period of time than with simple carbohydrates (The Institute for Rehabilitation and Research [TIRR], 2002). Maintaining a healthy body weight is essential for performing weight shifts and utilizing the correct technique during transfers. It is also important to include foods high in fiber as they help to maintain an effective bowel program for people with SCI. Moisture from bowel and bladder accidents weakens skin and causes it to break down more quickly (Klebine et al., 2000).
A diet that includes an adequate amount of fruits and vegetables is also an important aspect of proper nutrition in preventing pressure sores. Diets rich in vitamins A and C help keep skin healthy and also help the body resist urinary tract infections, another common secondary condition for people with SCI (TIRR, 2002). Fruits and vegetables are also good sources of fiber, which aids in the digestive process and bowel program. In addition, most fruits and vegetables contain potassium, a necessary nutrient for regulating blood pressure, heart and kidney function, maintaining fluid balance in the body, and aiding nerve function and muscle contraction (TIRR, 2002).
Dairy products, which provide calcium and vitamin D, also play an essential role in the diets of people with SCI. People with SCI are at increased risk for developing osteoporosis because the bones located in the parts of the body that are paralyzed continue to lose bone mass due to a lack of weight-bearing. In addition, calcium is important for maintaining a healthy circulatory system (Klebine et al., 2000). A healthy circulatory system helps prevent pressure sores by providing adequate blood flow to all parts of the body. It is essential for people with SCI to maintain adequate amounts of calcium as well as vitamin D, which helps the body absorb calcium.
Foods containing protein are also essential in preventing pressure sores in people with SCI. Protein allows for the growth and repair of the cells in the body, and also helps the body resist disease by aiding in the formation of antibodies (TIRR, 2002). However, foods high in protein can add substantial amounts of fat, cholesterol, and calories to the diet, which can increase the chance of heart disease and make it difficult to maintain a healthy body weight. For these reasons, attention must be paid to portion size and fat content of foods that contain protein, such as meat, poultry, fish, and eggs. While protein must be included in the diet of people with SCI in moderation, it is an essential component in maintaining healthy skin and preventing pressure sores.
Fats, oils, and sweets, while also a necessary part of the diet of people with SCI, should be eaten only in small amounts. Fat adds taste to foods, provides energy, and helps cells and nerves function. It also allows absorption of vitamins A, D, E, and K (TIRR, 2002). While fat is an important component in maintaining healthy skin and bones by aiding the absorption of vitamins E and D, it should be consumed in only small amounts to maintain a healthy body weight. Maintaining a healthy body weight also means not being underweight. In their study of 560 people with SCI, Krause et al. found that being underweight was consistently associated with a higher risk of pressure sores (2001).