title: Longitudinal association between lifestyle and coronary heart disease risk factors among individuals with spinal cord injury.
abstract: OBJECTIVE
  To investigate: (1) the course of coronary heart disease risk factors (lipid profiles and body mass index (BMI)) in the first five years after discharge from inpatient spinal cord injury (SCI) rehabilitation and (2) the association between lifestyle (physical activity, self-care related to fitness, smoking, alcohol, body mass and low-fat diet) and coronary heart disease risk factors during that period.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Individuals with SCI (N=130). Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG) and BMI were determined at discharge from inpatient rehabilitation and 1 and 5 years after discharge. Using multilevel regression models, the effects of lifestyle (drinking alcohol, smoking, active lifestyle and self-care) on the lipid profiles and BMI were determined.
  
  
  RESULTS
  After correction for lesion and personal characteristics, no changes in lipid profiles in the five years after discharge were seen, whereas the BMI increased significantly with 1.8 kg m(-2). A high percentage was at risk of cardiovascular disease due to high BMI (63-75%) or HDL (66-95%). The individuals who indicated to maintain their fitness level as good as possible and the individuals with a low BMI showed better lipid profiles. Individuals with a more active lifestyle showed higher HDL levels. Individuals who avoid smoking showed a 1.5 kg m(-2) higher BMI.
  
  
  CONCLUSIONS
  Lipid profiles seem to stabilize in the years after discharge from inpatient SCI rehabilitation, whereas the BMI increased. Lifestyle factors associated with a favorable lipid profile and BMI could be identified.
authors.affiliation: Amsterdam Rehabilitation Research Center, Reade, Amsterdam, The Netherlands. s.d.groot@reade.nl
authors.forename: S
authors.initials: S
authors.lastname: de Groot
authors.forename: M W
authors.initials: MW
authors.lastname: Post
authors.forename: G J
authors.initials: GJ
authors.lastname: Snoek
authors.forename: M
authors.initials: M
authors.lastname: Schuitemaker
authors.forename: L H
authors.initials: LH
authors.lastname: van der Woude
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000209:etiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012648:Self Care; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D014280:Triglycerides; D002784:Cholesterol