While government guidelines emphasize optimum levels of nutrients for the general population, specific nutrient guidelines for people with physical and cognitive disabilities are lacking. Although having a disability does not necessarily require a significant alteration from national dietary guidelines (e.g., low fat, low cholesterol diet, high fiber intake), certain modifications to the nutritional component of a health promotion curriculum may need to be tailored to people with various types of physical and cognitive disabilities. For example, a common secondary condition among people with cerebral palsy, Down syndrome, and spinal cord injury is premature onset of osteoporosis. While there is little research on specific guidelines for calcium intake among persons with these disabilities, it is plausible that a higher intake of calcium may be required at an earlier age to slow or reduce the progression of osteoporosis.

Individuals with stroke who are taking a blood thinner to prevent blood clots (i.e., Coumadin), may need to avoid a high intake of Vitamin K since this nutrient plays an essential role in blood clot formation. A comprehensive nutrition program for stroke survivors would include food choices that have a low concentration of Vitamin K while still maintaining adequate levels of other important nutrients.

Fluid intake in persons with various disabling conditions is another area that has not been clearly examined. Individuals who are incontinent may be reluctant to drink large amounts of fluids to avoid having to catheterize themselves more frequently during the day. This could result in dehydration and potentially cause other medical complications (e.g., syncope, urinary tract infections, impaired thermoregulation). Similarly, constipation is another common secondary condition among people with paralysis and increased fluid and fiber intake would help improve this condition.

Another secondary condition that must be considered for people with physical and cognitive disabilities is increased or decreased weight gain related to medication use. One of the major side effects of psychotropic medications is excess weight gain. It is important for health professionals to be aware of the impact that various medications can have on nutritional status and take appropriate action to avoid large increases in weight through alterations in caloric intake and increased physical activity.