Associations of the trunk skeletal musculature and dietary intake to biomarkers of cardiometabolic health after spinal cord injury

Summary Purpose Skeletal muscle atrophy and poor dietary habits may contribute to increased adiposity and impaired metabolic health after spinal cord injury (SCI). The relative association of trunk muscle cross‐sectional areas (CSA) versus dietary habits to central adiposity and impaired metabolic health after SCI remains unclear. Methods Twenty‐two men with motor complete SCI completed five‐day dietary recalls for 4 weeks. Trunk muscle CSAs as well as visceral and subcutaneous adipose tissue (VAT and SAT, respectively) were quantified using magnetic resonance imaging. Basal metabolic rate (BMR), glucose effectiveness, insulin sensitivity and lipid profile were measured after overnight fast. Results Antero‐lateral trunk muscle (r = −0·79, P < 0·001) and posterior trunk muscle (r = −0·56, P = 0·008) CSAs normalized to total trunk CSA were negatively related to VAT. Antero‐lateral trunk muscle ratio (TMR) was positively related to BMR (r = 0·54, P = 0·01), and posterior TMR was positively related to peak oxygen uptake (VO2 peak; r = 0·71, P = 0·003). After accounting for total TMR as a co‐variate, total fat (r = 0·47, P = 0·04) and protein (r = 0·61, P = 0·004) intakes were positively related to fasting insulin levels. Conclusion Trunk muscle CSAs normalized to total trunk CSA were negatively associated with central adiposity. Both trunk muscles and dietary macro‐nutrients are related to markers of metabolic health. The study highlights the significance of developing an exercise intervention with a healthy dietary regimen to attenuate the development of central adiposity associated metabolic disorders after SCI.