There is a paucity of intervention studies investigating nutritional status and associated risk for persons with SCI. Many descriptive and observational publications address the risk for obesity, dyslipidemia and cardiovascular disease, impaired glycemic control and diabetes mellitus. Blood lipid profiles and indicators of impaired glucose tolerance and hyperinsulinemia of persons with SCI have been compared with those of able-bodied controls. Despite the high risk for CVD morbidity and mortality in individuals with SCI as evidenced by blood values, metabolic and lifestyle factors, few studies have addressed the benefits of risk reduction interventions aimed at modifiable factors and have been limited to exercise. Other studies have investigated vitamin and mineral status of persons with SCI and compared values to those of able-bodied controls or to general population norms and have found lower levels of a variety of nutrients in the SCI population. Few publications have suggested screening and supplementation strategies to address these trends.

• There is level 2 evidence that glucose uptake is higher in SCI individuals compared to able bodied individuals.
• There is level 4 evidence that SCI individuals with complete tetraplegia have higher rates of altered glucose metabolism than other SCI individuals.
• There is level 2 evidence that diabetic and obese SCI individuals show gallbladder emptying compared to healthy SCI individuals.
• There is level 4 evidence from one pre-post trial (Chen et al., 2006) that an intervention program combining diet and exercise is effective for reducing weight among overweight persons with SCI.
• There is level 1b evidence based on one RCT (Zemper et al., 2003) that improved health related behaviours are adopted following a holistic wellness program for individuals with SCI.
• There is level 4 evidence from one pre-post study (Liusuwah et al., 2007) that an education program combining nutrition, exercise and behaviour modification is effective in increasing whole body lean tissue, maximum power output, work efficiency, resting oxygen uptake and shoulder strength in persons with SCI.  
• There is level 2 evidence from one prospective controlled trial (Szlachic et al., 2001) that standard dietary counseling (daily total fat <30% of kcal, saturated fat <10% of kcal, cholesterol <300 mg, carbohydrate 60% of kcal) can reduce total and LDL cholesterol among individuals with SCI and total cholesterol >5.2mmol/L.
• There is level 4 evidence from one pre-post study (Javierre et al., 2005) that daily supplementation with DHA (1.5 g) and EPA (0.75 g) increases plasma DHA and EPA levels but does not alter total cholesterol, HDL, LDL, VLDL, triglycerides, or glucose.
• There is level 4 evidence from one pre-post study (Javierre et al., 2006) that omega-3 fatty acid supplementation increases upper body strength and endurance in persons with SCI.
• There is level 4 evidence from two pre-post studies (Bauman et al., 2005) that vitamin D3 supplementation raises serum 25(OH)D levels.  However, the dose and duration required to ensure vitamin D3 sufficiency remains unclear.
• There is level 1a evidence based on one RCT (Kendall et al., 2005) that creatine supplementation did not result in improvements in wrist extensor strength or muscle function.
• There is level 1a evidence based on one RCT cross-over trial (Jacobs et al., 2002) that creatine supplementation enhances exercise capacity in persons with complete tetraplegia and may promote greater exercise training benefits.
• There is level 3 evidence from one case control study (Baliga et al., 1997) that consumption of a standard liquid meal does not change blood pressure, heart rate or noradrenalin levels in tetraplegics with postural hypotension. 
• There is level 2 evidence based on one RCT cross-over trial (Nash et al., 2007) that the consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI. 
• There is level 3 evidence based on one case control study (Asknes et al., 1993) that meal-induced thermogenesis is not decreased in tetraplegic individuals with low sympathoadrenal activity and that efferent sympathoadrenal stimulation from the brain is not necessary for nutrient-induced thermogenesis.
• There is level 3 evidence based on one case control study (Sutters et al., 1992) that sympathetic control of the kidney is not required for renal sodium conservation in response to dietary salt restriction.    
• More research is needed to evaluate the role of nutrition in the management of post-acute SCI to provide the evidence base required for optimal clinical decisions.