Associations between eating windows and demographics in veterans with spinal cord injury: Results of a single-site study

Context Obesity after spinal cord injury (SCI) is a major healthcare concern due to its associated increased morbidity and mortality. Veterans with SCI constitute the largest single group of individuals with SCI nationwide, and have high prevalence of obesity (>75%) and cardiometabolic dysfunction (≥50%) – a fact that highlights the importance of studying Veterans specifically. Daily eating patterns, such as the time between the first and last eating activity (“eating window”), are understudied in this group. These patterns are critical to understanding determinants of obesity and potential targets for treatment, and informing future studies comparing SCI and non-SCI populations.Objective We sought to quantify eating windows of Veterans with SCI and obesity and study baseline demographic data associated with these eating windows, leveraging the unique VA SCI / Disorders Registry.Methods We recruited Veterans with chronic SCI (≥ 1 year post-injury), paraplegia (injury levels T1 – S5), and obesity (body mass index (BMI) > 22 kg/m2, an SCI-specific cutoff), from a single Veterans Affairs SCI Center. Veterans tracked start and stop times of eating and drinking (>0 kcals) over two consecutive weeks.Results Forty-five Veterans participated in the study. Participants were predominantly older (>60 years old), male, white, with a BMI of 31 kg/m2 (IQR 11). The median eating window was 10.8 h (IQR 3.5). Eating windows were shorter on weekends (p = 0.037), for rural residents (p < 0.001), those with caregivers (p < 0.001), and those not working (p < 0.001). In adjusted, multivariable analyses, eating windows were shorter only for those not working (p = 0.042).Conclusion In a sample of Veterans with SCI and obesity, the median eating window was 10.8 h. Lower employment levels may be associated with shorter eating windows – are a potential factor to be explored that may contribute to this overall eating pattern. SCI profoundly impacts metabolism, and a better understanding of how eating windows induce additional metabolic effects and potentially increases risk of obesity after SCI is needed.