Nutrition in athletes with motor disabilities (L’alimentazione nell’atleta disabile motorio)

A correct diet is essential for athletes with disabilities and an aid for sport and exercise, which have long been recognised as important component in the therapy and rehabilitation of people with disabilities. Dietary recommendations for athletes with disabilities should not differ from those for able-bodied athletes and should be related to the level of physical activity and body composition of the athletes. Assessment of body composition of athletes with disabilities is essential, specially in individuals with a great loss of metabolically active tissue and an asymmetric distribution of fat between the upper and lower part of the spinal lesion. Several methodologies for assessing body composition are available. DEXA (Dual energy X-ray absorptiometry) is widely used with athletes with disabilities too, even if other methodologies such as skinfold calipers, anthropometric measures and bioelectrical impedance analysis (BIA) are more commonly used in sport science because they are non-invasive, cheaper, more accessible and can be consequently easy tracked over time. In athletes with spinal cord injury has been observed a lower total and resting energy expenditure, up to 30%, than in healthy control. Nowadays no prediction equations to estimate resting metabolic rate in athletes with disabilities are available, therefore energy expenditure is commonly assessed using indirect calorimetry. In athletes with disabilities the total energy expenditure should account in most part for the energy expended in physical activity, often greater than that of resting metabolic rate. In order to avoid malnutrition, dietary issues for athletes with disabilities should be fine tuned to the nature of their disability and any impact the disability may have on their metabolism. Special nutrition recommendations are needed since individuals with disabilities are at major risk of medical complication such as: epithelial wound and pressure ulcers, urolithiasis and urinary tract infection, osteoporosis and chronic constipation.