Researchers surveyed dietitians at hospitals around the world that care for people with spinal cord injuries to understand how these facilities plan and serve meals. They found that while most hospitals cook fresh food and let patients choose from a café-style menu, there’s a big difference in how much nutrition they aim to provide. Most hospitals focus on calories and protein, but very few pay attention to limiting unhealthy fats—which is important because people with spinal cord injuries have a higher risk of heart disease. This study shows that hospitals need better guidelines to make sure all patients get the nutrition they need.

The Quick Take

  • What they studied: How hospitals that care for people with spinal cord injuries organize their food services and plan their menus
  • Who participated: 16 nutrition experts (dietitians) from 5 different countries who work in hospitals specializing in spinal cord injury care
  • Key finding: Most hospitals cook fresh food and use café-style dining, but they have very different nutrition goals—some aim for 1,500 calories daily while others aim for 2,700. Only 1 in 5 hospitals actively limit unhealthy fats in their menus.
  • What it means for you: If you or a loved one is in a spinal cord injury rehabilitation facility, the quality of nutrition planning may vary significantly depending on which hospital you’re in. This research suggests hospitals should adopt more consistent nutrition standards, especially for heart health.

The Research Details

Researchers created an online survey and asked nutrition experts who work in spinal cord injury hospitals to answer questions about how their facilities organize food service and plan menus. The survey asked about things like whether food is cooked fresh or pre-made, what style of dining the hospital uses (like a café where patients choose), and what nutrition targets the hospital sets for daily meals. Sixteen nutrition experts from hospitals in five countries completed the survey. The researchers analyzed the answers by counting how many hospitals did each thing and by reading through written comments to find common themes.

People with spinal cord injuries often spend weeks or months in the hospital and depend completely on hospital meals for nutrition. Unlike other patients who might go home and eat what they want, these patients have limited choices. Understanding how hospitals plan nutrition is important because good nutrition helps with healing, prevents complications, and supports overall health during recovery.

This is a small pilot study with only 16 participants, so the findings give us a starting point but shouldn’t be considered definitive. The researchers were careful to recruit people from different countries and different types of facilities, which is good. However, because the sample is small and the survey was voluntary, we can’t be completely sure these results represent all spinal cord injury hospitals worldwide. The study is honest about being a first step that should lead to larger research.

What the Results Show

Most hospitals (10 out of 16, or 63%) are rehabilitation centers rather than acute care hospitals. The majority of these rehabilitation centers (6 out of 10, or 60%) cook food fresh in-house and use a café-style dining model where patients can see and choose their food. This is generally considered better for patient satisfaction and nutrition compared to pre-made meals delivered to rooms. Three-quarters of hospitals (12 out of 16) set a daily calorie target for their menus, but these targets vary widely from 1,500 to 2,700 calories per day—a huge range that suggests hospitals are using different standards. Most hospitals (10 out of 16, or 63%) also set a daily protein target, typically between 80 and 110 grams, which is important for muscle maintenance and healing.

A concerning finding is that only 3 out of 16 hospitals (19%) reported having a specific daily target for limiting saturated fat. This is important because people with spinal cord injuries have higher rates of heart disease and stroke compared to the general population. The study also found that nutrition practices vary significantly from facility to facility, suggesting there’s no standard approach to feeding this population.

This is one of the first studies to look at how spinal cord injury hospitals actually organize their food services. Previous research has shown that nutrition is important for people with spinal cord injuries, but nobody had really examined what hospitals are actually doing. This study fills that gap and shows that there’s room for improvement, especially in standardizing nutrition goals across different hospitals.

The biggest limitation is the small sample size—only 16 dietitians from 5 countries. This means we’re getting a snapshot of just a few hospitals, not a complete picture worldwide. The survey was voluntary, so hospitals with better nutrition programs might have been more likely to participate. We don’t know if the hospitals that didn’t respond have better or worse practices. Additionally, the survey only asked dietitians, so we don’t have information about what patients actually think about the food or whether they’re getting enough nutrition.

The Bottom Line

Based on this research, hospitals caring for people with spinal cord injuries should: (1) establish consistent nutrition targets across all facilities, (2) pay more attention to limiting unhealthy fats to reduce heart disease risk, and (3) continue using fresh-cooked food and café-style dining when possible. Confidence level: Moderate—this is a small pilot study, so these are suggestions for improvement rather than proven requirements.

This research matters most to: hospital administrators and dietitians at spinal cord injury facilities, patients with spinal cord injuries and their families, and healthcare organizations that set standards for hospital nutrition. If you’re admitted to a spinal cord injury rehabilitation facility, you might ask about their nutrition targets and whether they limit unhealthy fats.

Better nutrition planning won’t show immediate results, but over weeks and months of hospitalization, improved nutrition can support better healing, stronger muscles, and lower risk of complications like infections or heart problems.

Want to Apply This Research?

  • If you’re in a spinal cord injury facility, track your daily calorie and protein intake using the app’s food log feature. Compare your actual intake to the facility’s stated nutrition targets to ensure you’re meeting goals.
  • Work with your hospital dietitian to understand your personalized nutrition needs. Use the app to photograph and log meals served, which helps identify patterns and ensures you’re getting adequate nutrition during your stay.
  • Set weekly check-ins with your dietitian to review nutrition data from the app. Monitor energy levels, wound healing, and muscle strength as indicators of whether nutrition goals are being met. Track any concerns about food quality or variety.

This research describes current practices at some spinal cord injury hospitals but should not be used to diagnose or treat any medical condition. If you have a spinal cord injury or are admitted to a rehabilitation facility, work with your healthcare team and registered dietitian to develop a nutrition plan tailored to your individual needs. This study is a small pilot survey and does not provide definitive medical recommendations. Always consult with qualified healthcare professionals before making changes to your nutrition or medical care.