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Persons with SCI can develop a wide array of secondary complications post-injury. In particular, cardiometabolic disease (CMD) is a leading cause of death after the first year of injury. However, the risk of developing CMD among individuals with SCI is modifiable and may be mitigated by targeted nutrition intervention. Utilizing SCI- specific clinical practice and dietary guidelines, this study proposes to deliver individualized nutrition counseling to individuals with chronic SCI. A dietitian with SCI specialization will counsel participants using 1) bimonthly FaceTime calls and 2) between session support and monitoring through the Ate photo-journaling and messaging app.

This randomized, waitlist control study will enroll 96 participants. Three primary outcome assessment timepoints are: baseline, 3-months post-baseline, and 6-months post-baseline. The immediate treatment group will receive telenutrition (TN) counseling during the first 3 months followed by a 3-month follow-up period. The delayed treatment group will receive the intervention during months 4-6. Specific Aims: 1) Prospectively examine the effect of TN on diet quality, 2) Prospectively examine the effect of TN on physiological risk components of CMD, 3) Prospectively examine the effect of TN on bowel and bladder function and subsequent changes in quality of life and the incidence of autonomic dysreflexia.