After someone sustains a concussion/TBI it is obviously important that they rest, cognitively, meaning they do not have a lot of external input and stay away from blue screens as often as possible. The following nutritional outline is meant to subsidize the healing of a brain trauma and NOT treat it. Concussions/TBI’s needs proper hydration, nutrition, rest (both physical and cognitive) and time to heal properly.
The goal of a nutrition plan is to:
- Decrease inflammation
- Create an environment ideal for soft tissue and brain tissue healing
- Mitigate further neurological damage and chemical changes
- Decrease the probability of future concussions/TBI injuries
- Decrease the amount of calories to allow the intestinal track time to recover as well
- Maintain hydration and electrolyte levels while healing
- SPEED RECOVERY so the athlete can get back on the playing field
- Minimize the deconditioning (getting out of shape)
The nutrition plan should be balanced and include the following:
Protein: Wild Fish, free range eggs, chicken and turkey and other game meats
Fats: Avocado, coconut oil/butter/milk, olive oil, nut butters (almond, cashew), free-range cheeses (high in Vitamin D and healthy fats), nuts & seeds
Carbs: Berries (blueberries among the best), green leafy veggies, cauliflower, carrots, mushrooms, tomatoes, onions. etc.
Water: Roughly ½ your body weight in ounces
- N-acetyl Cysteine
- Fish Oils
- Vitamin D – depending on where you live, being outside may provide enough for you already
- Minerals are generally covered entirely if you follow the plan below pretty closely.
What to AVOID after a concussion/TBI event:
This is of paramount importance as this can actually make or break the healing process and even worsen the person’s condition:
- Sugar & Sugary drinks – absolutely and without debate
- Gatorade/PowerAde, Vitamin Water and the like are included here
- Energy drinks of ANY KIND!
- Foods with added chemicals, preservatives and the like
- Processed foods of any kind: chips, cookies, breads, cereals, boxed foods
Shop on the outside portion of the grocery store and avoid anything in a package, box or has an ingredient list longer than your name and address. I say this in jest, but do be very cautious about processed foods and even foods you think are not, just check the label first.
Why is nutrition so important for the pre- & post concussed/TBI person?
Well, this is a great question and one worth the time to answer. You can search the internet for what a concussion or TBI is and how you get them and so on. Even the management of it can be easily found with little effort. However, the nutritional portion is a little more difficult. That is primarily due to the lack of actual data on the process and how nutrition affects the rest of the system. Here is a quick list of what a concussion/TBI does to the body parts:
- Brain: tissue bruising, loss of cognitive function, loss of memory (amnesia – short and long-term), unconsciousness, impaired cognitive function (inability to process information quickly or at all), skull damage and fracture, internal bleeding of the tissues surrounding the brain (hematoma’s), vision changes and impairment – and this is the short list!
- Gastrointestinal tract: New data is showing that the GI tract is greatly affected by concussions/TBI, dysregulation of food processing and immune system function due to this, even neural degeneration within the GI tract
- Orthopedic: neck pain and altered biomechanics of the cervical spine, thoracic spine and shoulders which can slow return to play
So this was a short list of the basic problems that come after a concussion/TBI event. Nutrition plays a huge role in assisting all of these in healing and returning to normal with as little damage or further damage as possible as well to decrease the possibility of future injury. Someone who has suffered a concussion/TBI is 1½ times more likely to have another one and people that have had 2, are 3 times more likely for a 3rd. So while treating one, you can help prevent another, partially anyway.
Everyone is affected differently based on the variables in the mechanism of their injury. Some heal in darker or light rooms while others need less cognitive (verbal or written input) through the eyes and ears. Since we are different and handle an injury differently, one area that can be controlled is the post concussion/TBI time frame. While more and more information about concussion management is being discovered every day, some areas of post-concussion treatment and care are being overlooked. A lot of this lay in the world of nutrition and hydration to assist in the decreasing of inflammation and assist in tissue repair. Regardless of an individual’s age, an injury to the brain, head and neck tissues can alter thought patterns, movement patterns and the way your nervous system functions. A concussion or TBI requires a more focused nutritional and hydration approach for healing as the brain tissue heals differently than muscles or ligaments and thus requires special attention.
Now to the nutritional information
Protein is always important for any athlete/person as it is the building blocks of muscles and required for recovery as well. The basic outline includes the normal intake of protein for the injured or non-injured athlete/person alike. For the concussion/TBI athlete, you can decrease some of the daily requirements (from .8-1.0 grams a day to roughly .6 grams per pound of body weight per day. Example: a 100 lb athlete/person would require 60 grams of protein a day) while they are healing to help with a lower calorie requirement during healing.
Healthy fats, are a cornerstone of the brain healing process. These were mentioned above, but the importance cannot be over stated, from avocados to fish oil supplements, they are all important in allowing the brain to heal and should constitute a good portion of the daily intake (roughly 25-30%; Example: a 100 lb athlete would need roughly 1,000 calories/day, if protein is 240 calories – 60 grams x 4 =240 calories – of this, then fat should be roughly 30 grams – 30% of 1000 calories – a day or roughly 1 ½ avocados a day) of food.
Carbohydrates are still necessary, however, you have to be careful of sugar intake. I bring in berries as the only fruit source due to their low sugar count. After that, I turn the attention to veggies as they are obviously good for you but also carry another not often thought of benefit. Veggies fill you up and keep you feeling ‘full’ during non-eating hours. For the injured athlete, who is not training, practicing or playing, their activity levels have dropped significantly and while they are healing they can become quite deconditioned and basically ‘out of shape’ for their sport. The best way to mitigate that is by keeping calories lower and focus on clean quality calories to keep the body functioning as smoothly as possible while it is in a healing mode. Because of this, if you follow the plan pretty closely, you can eat as many berries and veggies as you can possibly tolerate.
Water, or hydration, is also very important and can be accidentally forgotten about during this time due to the inactivity the person or athlete is going through. The typical protocol for water intake is roughly ½ your body weight in ounces – 100 lb person drinks 50 oz of water a day. This is a rough outline, but a great guideline. For electrolytes, your diet will cover those pretty well if you are eating as suggested above.
Hopefully after reading through this you can have a better understanding of how to handle the post-concussed/TBI injury and how nutrition can help the healing and preventative process. This is a general outline and plan to follow as all of us are impacted by these injuries differently, we should all seek the help of a professional for treatment and planning post injury. I have been trained to deal with patients recovering from post-concussion/TBI injury, therefore, feel free to call my office for a consult if you or someone you knows has had such injury.