| Summary: | Nutritional practices and body composition of para-athletes can impact their health and athletic performance. There is a paucity of research on the nutritional practices, including dietary and supplement intake, body composition and bone health of spinal cord-injured (SCI) endurance hand cyclists. This study assessed the body composition and dietary and supplement intake of 12 national-level SCI endurance hand cyclists (age: 44.0 ± 9.3 years). Bone mineral density (BMD) was assessed in a sub-sample of participants (<i>n</i> = 4) using dual-energy x-ray absorptiometry (DXA). Estimated body fat percentage was healthy (18.4 ± 5.1%) and lumbar spine BMD for the sub-sample was adequate, however hip BMD was low (<i>Z</i>-score and/or <i>T</i>-scores < −2). Carbohydrate intake for male and female participants was below the recommended intake (3.8 (2.9–4.1) and 2.4 (2.0–2.7) g/kg BW, respectively). Overall protein intake was adequate, whilst fat intake was high for both males and females (39.7 (37.7–41.6) and 42.1 (39.0–45.3)% of total energy, respectively). The reported intakes for a few key micronutrients were also below the recommended dietary allowance (RDA) and/or adequate intake (AI) for males (vitamin D, calcium). The prevalence of supplement use before, during, and after training was 40%, 100%, and 60%, respectively. In conclusion, the hand cyclists could benefit from nutritional guidance to match their daily carbohydrate intake with exercise requirements and optimise their fat intake. Optimal vitamin D and calcium intake is also important especially in the light of poor bone health below the lesion level.
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