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TBI & Concussions

Updated: Mar 30

By: William Sanders RD, LD, ACSM-CPT

Concussions and traumatic brain injuries (TBI) are similar to other injuries, in that proper recovery requires adequate rest and nutrition. Although concussions vary drastically from one individual to another in terms of severity and debilitation, there are some nutrition- and activity-related measures that can be utilized to prevent the severity of these injuries and accelerate recovery. Currently, there is no protocol for recovery from mild to moderate traumatic brain injury (TBI). This article discusses a few areas research has shown may be effective for preventing and accelerating recovery; however, doctors must always be consulted treatment advice.

After a concussion, protein and calorie needs are drastically increased. Meeting these increased needs shortly after injury can accelerate recovery (Frakes, 2020). In clinical settings, in those who are severely incapacitated by TBI, early initiation of feeding results in better outcomes (improved recovery) than those receiving delayed initiation of nourishment (Balakrishnan, et al. 2018). Adequate protein and energy intake allows the body to repair damaged tissues.


Mood and emotional disorders (specifically depression) following a concussion or TBI are common (Wise, et el. 2012). After achieving an adequate rest period and following health professional approval, engaging in physical activity (at least 90 min per week of aerobic exercise training) can result in improvements in mood, cognitive function, and quality of life (Chin, et al. 2015 & Wise, et al. 2012).


Aside from food and exercise, research interest has accumulated around a few supplements:


Creatine

Due to its energy density and neuroprotective effects, creatine has been examined as a preventative agent against TBI and concussions by successfully reducing the overall severity of concussions in animals; however, human studies of this nature would be deemed unethical (Kreider, et al. 2017). So further studies are warranted to advise the use of creatine to prevent neurological damage, but this practice may increase in popularity. Foods that are rich sources of creatine are primarily animal based protein foods.


Omega 3 Fatty Acids

These fatty acids have been a topic of investigation as a means to enhance recovery from TBI; however, as promising as the results appear, all results are derived from animal and in vitro populations. Nearly all studies, allude to the need for more human studies; however, the means to perform a controlled clinical trial of this nature is unethical (Kumar, et al. 2014). Omega 3s are found in fatty fish, seafood and plant foods, but also commonly as a supplement.

Vitamins and Minerals

A small study suggests that supplemental vitamin D can reduce the severity of concussions in patients that possess below adequate levels of vitamin D (Sharma, et al. 2020). In fact, there are many other studies examining the effect of specific nutrients (such as vitamins and minerals) on TBI recovery that report similar findings (improved outcomes for those receiving supplementation that are already deficient in the nutrient).


Overall, TBIs and concussion are something to avoid. A balanced diet and regular exercise can help accelerate recovery and may prevent the severity of injury from TBI. There are many studies that have investigated TBI, but many are animal studies and there is limited evidence to safely suggest any supplement(s) for prevention or recovery in humans. If you would like to learn more about how to prevent injuries and achieve your peak performance see my articles on Athletic Recovery and Injury Prevention!
















References

Balakrishnan, B., Flynn-O’Brien, K. T., Simpson, P. M., Dasgupta, M., & Hanson, S. J. (2018). Enteral nutrition initiation in children admitted to pediatric intensive care units after Traumatic Brain Injury. Neurocritical Care, 30(1), 193–200. https://doi.org/10.1007/s12028-018-0597-6

Chin, L. M., Keyser, R. E., Dsurney, J., & Chan, L. (2015). Improved cognitive performance following aerobic exercise training in people with traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 96(4), 754–759. https://doi.org/10.1016/j.apmr.2014.11.009

Frakes, M. (2020). The Impact of Dietary Intake on Concussion Recovery in Division I NCAA Athletes. ProQuest Dissertations . Retrieved February 18, 2022, from https://www.proquest.com/openview/e9775ce195663e12a8b028f84c4a39ce/1?pq-origsite=gscholar&cbl=44156.

Kreider, R. B., Kalman, D. S., Antonio, J., Ziegenfuss, T. N., Wildman, R., Collins, R., Candow, D. G., Kleiner, S. M., Almada, A. L., & Lopez, H. L. (2017). International Society of Sports Nutrition Position Stand: Safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1). https://doi.org/10.1186/s12970-017-0173-z

Kumar, P. R., Essa, M. M., Al-Adawi, S., Dradekh, G., Memon, M. A., Akbar, M., & Manivasagam, T. (2014). Omega-3 fatty acids could alleviate the risks of traumatic brain injury – a mini review. Journal of Traditional and Complementary Medicine, 4(2), 89–92. https://doi.org/10.4103/2225-4110.130374

Sharma, S., Kumar, A., Choudhary, A., Sharma, S., Khurana, L., Sharma, N., Kumar, V., & Bisht, A. (2020). Neuroprotective role of oral vitamin D supplementation on consciousness and inflammatory biomarkers in determining severity outcome in acute traumatic brain injury patients: A double-blind randomized clinical trial. Clinical Drug Investigation, 40(4), 327–334. https://doi.org/10.1007/s40261-020-00896-5

Wise, E. K., Hoffman, J. M., Powell, J. M., Bombardier, C. H., & Bell, K. R. (2012). Benefits of exercise maintenance after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 93(8), 1319–1323. https://doi.org/10.1016/j.apmr.2012.05.009

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