Dietary manipulation and testosterone replacement therapy may explain changes in body composition after spinal cord injury: A retrospective case report

Table 1 Case individual (n = 1) and cohort (n = 8) physical characteristics, cohort values are presented as mean ± SD

Characteristics	Case Participant	Cohort	Total
	(n = 1)	(n = 8)	(n = 9)
Age (yr)	31	36 ± 9	36 ± 8
Sex	Male (n = 1)	Male (n = 8)	Male (n = 9)
Ethnicity	Caucasian (n = 1)	African American	African American
		(n = 3)	(n = 3)
		Caucasian (n = 5)	Caucasian (n = 6)
Weight (kg)	77	77 ± 11	77 ± 10
Height (m)	1.8	1.8 ± 5	1.8 ± 5
BMI (kg/m2)	24.8	24 ± 4	24 ± 4
Level of injury	T5-T6	C6-T11	C6-T11
Time since injury (yr)	7	7 ± 7	7 ± 7
AIS classification	A	A (n = 5)	A (n = 6)
		B (n = 3)	B (n = 3)
Level of Paralysis	Paraplegia	Paraplegia (n = 3)	Paraplegia (n = 4)
		Tetraplegia (n = 5)	Tetraplegia (n = 5)

AIS: American Spinal Injury Association Impairment Scale; BMI: Body mass index.

Table 2 Data for case participant and cohort dietary consumption during, pre-trial over 4 wk (only for the case report), phases I (weeks 1-8) and II (weeks 9-16) of the intervention. Percentage difference between phases I and II, as well as between the case report and the cohort

Energy (kcal)
	Case	Cohort	%difference
Pre-trial	1935
Phase I	1801.8	1528.9 ± 538	18%
Phase II	1357.2	1543.2 ± 544	- 12%
%difference	- 25%	1%
Calories from protein (%)
	Case	Cohort	%difference
Pre-trial	19.0
Phase I	20.6	20.80 ± 5.9	- 0.22%
Phase II	28.2	20.25 ± 5.9	7.98%
%difference	7.66	- 0.54
Calories from carbohydrate (%)
	Case	Cohort	%difference
Pre-trial	39.0
Phase I	41.1	41.4 ± 7.6	- 0.30%
Phase II	39.9	41.6 ± 10	- 1.70%
%difference	- 1.17	0.23
Calories from fat (%)
	Case	Cohort	%difference
Pre-trial	40.8
Phase I	36.8	36.0 ± 6.7	0.75%
Phase II	30.3	36.7 ± 5.7	- 6.45%
%difference	- 6.50	0.71
Soluble dietary fiber (g)
	Case	Cohort	%difference
Pre-trial	6.56
Phase I	6.55	4.19 ± 1.6	56%
Phase II	6.67	3.89 ± 2.1	71.5%
%difference	2%	- 7%

Differences for percentage protein, percentage carbohydrate, and percentage fat were calculated as the absolute difference between phase I and phase II or differences between the case report and the studied cohort.

Table 3 Body composition data of the case participant following 16 wk of dietary manipulation and testosterone replacement therapy

Body Composition	Pre-trial	BL	P1	% Change
DXA-Fat (kg)	30.6	30.20	21.41	-29
DXA-Lean (kg)	44.4	43.27	46.39	7.2
DXA-Body Weight (kg)	77.9	76.70	70.30	-8.3
MRI-SAT (cm2)	-	92.25	64.12	-31
MRI-W.M. (cm2)	-	69.73	72.13	3.5
MRI-ABS.M (cm2)	-	61.62	67.17	9.0
MRI-ABS.IMF (cm2)	-	8.10	4.96	-39
MRI-%IMF (%)	-	11.80	7.05	-4.81
MRI-VAT (cm2)	-	46	40.5	-12%
MRI-trunk SAT (cm2)	-	182	142	-22%

DXA: Dual energy x-ray absorptiometry; MRI: Magnetic resonance imaging; MRI-W.M.: Whole thigh muscle CSA; MRI-ABS.M: Absolute thigh muscle CSA; MRI-ABS.IMF: Absolute intramuscular fat CSA; VAT: Visceral adipose tissue; SAT: Subcutaneous adipose tissue; BL: Baseline; PI: Post-intervention. The pre-trial phase was conducted 4 wk prior to baseline measurements. Body composition was only measured by DXA in the pre-trial phase. % change was calculated as [(P1 - BL) / BL] × 100%.

¹: Change in % IMF is presented as the difference between P1-BL.