Does Proper Nutrition Help Provide Resilience Against Brain Damage Prior to the Injury?

Concussions and CTE What You Need to Know    6 Part Series    Part 6…Get Part 1 Here

When it comes to your brain health, a good blood supply, and cell regeneration is what keeps the game up! If your body has sufficient resources to address these two critical needs of your body, your brain can prevent injury altogether. To make sure that these are sufficiently available, a balanced diet is needed.

Supplementation of the diet with healthy products increases the resilience of your brain and insulates it against trauma. For a good blood supply, your red blood cells should be in good form too. They need iron for their normal production and hemoglobin levels should also be up to the mark. This ensures a rapid and complete delivery of oxygen, preventing the risk of hypoxia.

“Supplementation of the diet with healthy products increases the resilience of your brain and insulates it against trauma.”

A healthy diet also helps neurons in achieving a perfect chemical balance because most of these chemicals need amino acids for their formation. The brain completely depends on a healthy liver and gastrointestinal tract to use food well. The gut is expected to properly absorb nutrients and deliver them to the brain.

Proteins

Proteins are extensively important for brain health because they play major structural and functional role in your brain. Starting from proteins required for enzymes production to amino acids being the precursors of neurotransmitters, proteins provide it all!

Your brain cells also need protein constituents for preventing injury and recovering from the abuse. Their membranes need proteins along with fats for their formation to provide protection to the cells, so that they can tolerate the impact of concussion and even prevent it. Proteins are also crucial in the development of neurons; hence, the regeneration of cells is associated with them. The growth factors like brain-derived neurotrophic factors are mainly responsible for this task.

“…membranes need proteins along with fats for their formation to provide protection to the cells, so that they can tolerate the impact of concussion and even prevent it.”

Proteins break down into their building blocks called amino acids and these amino acids form many neurotransmitters. These neurotransmitters help in coordination, memory, control of moods and many other functions, which are essential for improving brain resilience to trauma.

Some common amino acids that help protection against TBI include:

• Alanine
• Glutamate
• Tryptophan
• Leucine
• Isoleucine
• Valine

Sources of proteins mainly include plants and animals. Animal sources generally have a better amino acid profile. These sources include:

• Meat
• Poultry
• Dairy products

Plant sources include:

• Spirulina
• Parsley
• Avocados
• Legumes
• Nuts
• Cruciferous Vegetables (cauliflower, broccoli etc.)

Healthy fats

The brain cells contain lots of fat as a part of their structure. So, to maintain normal function, intake of dietary fats is critical. The types of fats recommended for brain include omega-3 and 6. These are free radical killers and also lower the cholesterol levels. They protect your cardiovascular system and prevent stroke.

In the brain, especially when an injury has occurred and inflammation has made its way, these fatty acids counter the harmful impacts of free radicals and other inflammatory cytokines. That’s why they can speed up the recovery process. However, taken in an appropriate amount in a normal diet, they can also strengthen your brain cells and immune system which ultimately leads to limiting the after-effects of a concussion.

DHA, one of the Omega-3 fatty acids, being present in the gray matter of the brain abundantly, promotes communication by letting synapses stay healthy and functional. These communications can be inside the brain as well as outside it to the whole body. Transmission of impulse throughout the body is also controlled by myelin sheath and DHA plays a vital role in its formation. It helps the brain in monitoring mood and memory as well.

Fats are also useful for maintaining the structural integrity of cellular membranes. These include axonal as well as other parts of the neuronal cell membrane. Since axons form the connections and build synapses, a healthy amount of fat is required to keep the axons working and synapses functioning properly.

The main sources of these fats include fish like salmon, sardines, anchovies, herring, mackerel, and Atlantic sturgeon. The recommended intake of fish is thrice a week. They can also be obtained from plant sources and that include canola, flax seeds, and olives. Flax seeds can be grounded and added to food for easy intake.

Vitamins

Vitamins are a diverse group of nutrients available abundantly in the human diet. They act as strengthening factors in brain health and help in running the metabolism smoothly. They are cofactors of enzymes and also prevent injury by building a strong immune system. Some important vitamin that specifically helps with brain injuries include:

• Vitamin B-complex

The B-complex vitamins work in the chorus to promote the health of the brain and immune system by protecting nerve tissue against oxidation, enhancing memory and insulating nerve cells. Your body requires B vitamins to produce many neurotransmitters.

Consuming sufficient amounts of the B-complex vitamins, including vitamins B-6 and B-12, also helps ensure proper nervous system function, metabolism and keeps your eyes, hair, liver and skin healthy. The daily value for vitamin B-6 is 2 milligrams approximately, and for vitamin B-12 is 6 micrograms. Many foods contain at least small amounts of one or both of these essential vitamins. Fish contains vitamin B12 and B6. Besides meat, there are many good vegetarian sources of B vitamins, including whole grain pasta, grains, rice, wheat germ and nuts.

• Vitamin C and E

The structure of brain largely contains fatty acids. That’s why; it is susceptible to oxidation damage caused by free radicals. To counter this damage, reactive oxygen species need to be countered and for this purpose, you need vitamins that are antioxidant in nature.

Antioxidants are nutrients that combat and neutralize free radicals. Vitamin C, E, and mineral called selenium play a major role in this fight. You can obtain these nutrients from a diet rich in antioxidants.

Carotenoids are found in dark green leafy vegetable, sweet potatoes, kale, and spinach. Vitamin C is found in vegetables like pepper and broccoli and citrus fruits like oranges. Vitamin E is also found in seeds, soybeans, nuts and vegetable oils.

Supplementation of antioxidants is recommended since they are the major force of the body, supposed to deflect free radicals and preventing diseases including heart disease, Parkinson’s, cancer, cataract and the aging process itself.

Managing proper nutrition

Breakfast is the most important meal of the day. Start out the day with a meal that is low in fat, high in proteins and low in carbs and sugar. This will help you achieve peak mental performance during the day. Specifically eat proteins first and then complex carbohydrates in your meal. The goal of a healthy breakfast is to let L-tyrosine and brain-healthy proteins and amino acids to reach your brain as early in the day as possible.

Add fruits and vegetables to your diet for supplementation of vitamins and minerals. Fruits are also are rich in iron. The better the iron levels, the better hemoglobin. Therefore, oxygen carrying capacity of the cells boosts up and faster regeneration of the injured tissues happens.

Your three meals should contain a balanced combination of proteins, fats, and carbs. Carbohydrates are taken in limited amount and proteins the most. Proteins also give a satiating effect and signal your brain for inducing a feeling of fullness. This helps you in controlling your weight gain while keeping a healthy brain. Now that’s a perfect package: a sound brain in a well-toned body!

A lifestyle that includes proper exercise, ample relaxation time, yoga or meditation and plenty of sleep, helps in boosting brain health. These factors aid in the regeneration of cells and invigorate your mental state. Physical activity also helps in preventing a concussion by practice. Your body becomes habitual of strenuousness gradually and less prone to injuries particularly concussion during sports.

What Nutrients/Type Of Diet Can Exacerbate Brain Injury Or Smother Brain Healing?

Eating the right diet is just one side of the picture. What’s equally important is to identify the foods that can harm your brain health and, more importantly, can hinder the process of recovery following brain injury.

Here are some foods that you should exclude from your diet.

• Refined Sugar

Sugar in any for is bad for the recovery process. There’s a misconception regarding sugary eatables that they provide an instant boost of energy which is often required after injury. However, the research proves it to be more damaging than helping. Sugar consumption increases glucose metabolism but it comes with a side effect- the risk of hyperglycemia.

Many patients have even reported headaches after consumption of high sugar content. Artificial sweeteners are even worse! They have high inflammatory potential and increase the levels of pro-inflammatory cytokines. These cytokines exacerbate the effect of injury and lead to poor healing.

Results of a population- based cross-sectional study have shown that the risk of dementia is significantly higher among individuals who derive the major proportion of their daily energy from sugar. In another study, researchers found that individual who ate a diet rich in refined sugar performed poor in tasks requiring greater use of intelligence.

There seem to be two main explanations to why sugar might impair recovery following an injury. First, eating a diet rich in refined sugar and fats can reduce the levels of brain-derived neurotrophic factor (BDNF). A decrease in the levels of BDNF can result in decreased neuronal plasticity and can, therefore, smother recovery.

The second explanation is insulin resistance following persistent hyperglycemia. Insulin causes dilation of blood vessels which then leads to increased supply of glucose to the target area. But insulin resistance makes blood vessels impervious to the effects of insulin. The same phenomenon occurs in the case of brain too when prolonged hyperglycemia leads to insulin resistance which then leads to diminished supply of blood to brain areas and resultant delay in recovery.

Are artificial sweeteners any better? The simple answer is, ‘They are not!”. Take aspartame for example. It is one of the most commonly used artificial sweeteners used. But the use of this artificial sweetener can lead to an increase in the inhibitory neurotransmitter like phenylalanine. Phenylalanine is a neurotoxin and can cause serious deficits in brain structure and function. In fact, the use of aspartame has been linked to tumor production as well.

• Fried food

Fried foods are huge enemies of your recovery process. They are dipped in oils and laden with harmful fats. With excessive heating, even unsaturated fats turn into saturated ones. Eating such food leads to increase in fats build up in your body. With metabolism of these fats, free radicals are produced abundantly, elevating oxidative burden. This is the least thing you need after concussion! Your body struggles with free radicals already, adding fried food is like salt to the injury. So, avoid French fries, fried chicken, onion rings and other eatables like these.

Several mechanisms have been proposed for explaining the cognitive declining following long-term intake of fatty food. The first mechanism is inflammation result for eating a high-fat food. Research shows the intake of fatty foods is linked with the increase in inflammatory cytokines which then damages the brain structure.

Another reason is an increase insulin resistance. Finally, one major cause for structural and functional brain damage is an abnormality in the microvasculature. High-fat food can lead to cholesterol and fat deposition in the blood vessels supplying the brain. Not only can these occluded blood vessels lead to stroke but they can also lead poor outcomes in terms of recovery following TBI.

• Alcohol

Alcohol has a dual effect related to inflammation. In moderation, it provides relief by reducing levels of C-proteins in your body which is basically a biomarker of inflammation. However, in excess, alcohol is a poison for the recovery process. If you consume too much alcohol, it will metabolize in the liver, generating lots of harmful by-products and will contribute to the oxidative burden. It also causes a decline in cognition and some researchers have shed light on the fact that during a concussion, the tolerance levels deteriorate.

There has been a lot scientific evidence showing that alcohol can actually lead to a decline in the number of brain neurons, especially in those areas of the brain that are generally related to cognition, decision, and performing skilled tasks. Another aspect for brain damage following alcohol intake is the nutritional deficiencies this habit can create. Thiamine deficiency, which can cause serious cognitive and functional brain impairments both in acute and long term settings, is a recognized side effect of alcohol intake.

In short, alcohol should be off limits. However, you can consume red wine because it has abundant antioxidants and helps with the inflammation.

• Processed meat

Bologna, sausage, and hot dogs- foods that fascinate everyone around you- are worst when it comes to the recovery process. They have advanced glycation end products which are powerful inflammatory agents. So, it’s recommended to avoid processed meat after concussion.

• Saturated and trans fats

Trans fats are designed by humans and your body isn’t adapted to digest them properly. As a result, they are metabolized partially and produce a lot of free radicals. They also increase the levels of inflammatory cytokines, exacerbating brain injury.

• Refined products

Refined products like flour also trigger inflammation. They have artificial sweeteners, additives, and preservatives that boost your energy levels but provide a rich source of pro-inflammatory molecules.

• Dairy products

Dairy products are pro-inflammatory in nature and it’s recommended to avoid them during the healing process. For some people, it’s hard to digest milk because of its casein content and it triggers the elevation of pro-inflammatory cytokines. Dairy products also have lots of saturated and trans fats which contribute to oxidative burden, exacerbating the brain injury.

Conclusion And Summary Of Recommendations

Talking about a healthy diet to boost resilience and rehabilitation following TBI, there are some basics you need to cover:

• Eat a balanced diet including grains, nuts, vegetables, and fruits.
• Eat beans, poultry, lean meat, fish and low-fat dairy products like yogurt and cheese.
• Keep yourself sufficiently hydrated.
• Avoid salt, alcohol, sugar, and fatty eatables.
• Eat unsaturated fats moderately, but limit the consumption of Trans and saturated fats.

The nutrition based healing following traumatic brain injury is a complicated subject. However, the nutrition following a traumatic insult is just as important as any other medication. It is, therefore, important that you avoid making all the decisions on your own. You should always maintain a liaison with your healthcare provider and make decisions based on their recommendations.

While the preliminary research on the role of nutrition in improving TBI outcomes sounds promising, but the international bodies are still silent on making recommendations on what exactly should be the constituents of diet following a traumatic brain event.

One factor that determines the nutritional intervention required is the severity of trauma and the extent of brain injury. In the case of severe brain trauma, the needed nutritional interventions can only be provided in an in-hospital setting because that involves the administration of intravenous nutrition.

Nutrition in the first 2 weeks

Here is what your nutritional plan should look like in the first two weeks following a traumatic brain insult:

• You should consume 50% more energy than your average daily energy intake.
• The daily protein intake should increase to 1.0-1.5 g/kg/day.
• The average blood glucose levels should stay in a range of 140 and 160 mg/dl.
• Although there are no current guidelines, but high dose of following supplemental nutrients have shown benefit in clinical research. Therefore, the dose of these nutrients should be tittered by a qualified healthcare professional only:
  • Antioxidants (including vitamin A, E, D, and polyphenols)
  • Choline
  • Creatine
  • BCAAs
  • Minerals (zinc, magnesium)
  • Omega fatty acids

Nutrition for improving rehabilitation and resilience

Following acute insult, you may consider making following changes:

• The energy requirements should be 10-20% higher than the usual daily energy intake.
• Protein intake should be between 0.9-1 g/kg/day.
• You may consider including following supplements to your diet:
  • A quality multivitamin supplement giving you: vitamin C (500-200 mg/day), vitamin D (2000 IU to 4000 IU/day), calcium (600 to 900 mg/day), magnesium (400 to 600 mg/day), folate (800 mcg), vitamin B6 (50 mg), and vitamin B12 (1,000 mg/day).
  • A quality fish oil supplement giving you EPA/DHA in a ratio of 2:1.
  • Melatonin (1-5 mg/day)
  • Phosphatidyl choline
  • 1-2 servings of a BCCA based protein supplement
  • You may also consider taking reservetraol, curcumin, liquid vitamin D, and green tea extract supplement as well.

This is what your everyday diet should look like

• Vegetables and fruits:

It’s a no-brainer that vegetables and fruits help in a speedy recovery. They are packed with vitamins and minerals that help in boosting the healing process. Many of these nutrients act as antioxidants and fight free radicals. A concussion causes major inflammation issues and vegetables and fruits can counter those for you. Vitamin C and E are particularly important in limiting inflammation and they are abundantly found in green vegetables and citrus fruits. Tomatoes, spinach, kale and other green vegetables are recommended in large amount. Green leafy vegetables also have magnesium in a large amount and magnesium is crucial for concussion recovery. It also aids in transmission of nerve impulse throughout your body and maintains coordination even during injury.

Fruits like oranges and avocados have a high amount of antioxidants. Apples are also friendly fruits because they have high iron levels. Iron levels are important during the recovery phase of concussion because a hypoxic tissue never recovers fast. High levels of iron keep your blood production healthy and ensure efficient delivery of oxygen to the healing tissue. It also makes sure that circulation of blood is unhindered so that nutrients reach to the inflamed or injured area rapidly. Fruits like strawberries, cherries, and blueberries also limit inflammation and prove healthy in dealing with a concussion.

You can also consume fruits juices for better results because they have all the required nutrients, plus they keep you hydrated. Water is an important constituent to maintain blood flow and juices replace it. In fact, they perk up its function by providing extra electrolytes.

• Nuts

Nuts are packed with abundant proteins and omega-3 fatty acids. Proteins act as a rich source of amino acids that are critical for the formation of neurotransmitters. During a concussion, the chemical balance of brain gets imbalanced which affects the nerve transmission greatly. It also makes you prone to mood swings and severe depression. To prevent these effects of concussion, you need to use nuts as snacks. Eat lots of almonds as they are rich in amino acids. Proteins also renovate a lot of tissue damage done by a concussion. Cellular membranes also need proteins for their regeneration and maintenance of structural integrity.

Almonds and walnuts are also responsible for limiting inflammation. They have omega-3 fatty acids which are considered healthy fats. These fatty acids are excellent antioxidants and reduce oxidative burden during a concussion. Their daily consumption reduces the amount of pro-inflammatory mediators in your body and your brain heals quickly. These nuts prove a healthy snack and need to be in your top recommended list for healing concussion!

• Eggs and dairy products

Eggs are major sources of proteins and provide relief in concussion episodes. They have essential amino acids that are naturally not produced in your body but required for speedy recovery. They are also rich in branch chain amino acids. Branched chain amino acids are crucial for cell regeneration and recovering tissue damage.

• Healthy oils

Saturated fats are known to suppress neuronal activity and are associated with poor injury outcomes. However, there are some healthy oils that are laden with antioxidants. They can not only fill your fats needs but also speed up the recovery of a brain injury. Such oils limit inflammation and ensure healthy caloric intake which is crucial for the recovery process. These oils include coconut oil, flaxseed oils, and olive oils. You can toss your vegetables in them or put them in your salad for extra flavoring because you don’t have to worry about health hazards now!

• Curcumin

Curcumin extract is often used in Indian food for flavor. However, one thing that’s often overlooked about curcumin is its anti-inflammatory powers. It’s a spice that limits inflammation in your body. it also has abundant antioxidant molecules that counter the free radical burden and improves recovery. Curcumin is sparingly soluble on water so one concern about its intake is to ensure the maximum absorption. Since it doesn’t dissolve well in water, its absorption is also not very effective in the gut. However, now there are some fat-soluble formations available which ensure curcumin absorption not only through your digestive tract but also through blood brain barrier.

• Green tea

Green tea is an excellent remedy for a concussion because it has miraculous flavonoids. These flavonoids not only give it flavor and taste but also act as strong antioxidants. A mild quantity of caffeine is also present in green tea and that helps big time! Research shows that caffeine helps in neuron regeneration and membrane stability. Another compound resveratrol, found abundantly in red wine, is present in green tea. Resveratrol is a powerful antioxidant and eases free radical damage. So, two to three cups of green tea a day greatly reduce the recovery time.

• Fish and sea foods

Fish and sea foods have plenty of proteins and amino acids required for tissue repair. However, the most amazing quality of these foods that helps with concussion recovery is fish oil. Fish oil is not produced in your body naturally and your dietary intake should have enough amount of it. Particularly when your brain has undergone concussion and your body has uncontrolled production of free radicals, fish oil becomes a basic need. Fishes like mackerel, salmon, and trout are recommended. However, avoid fried fish because it promotes inflammation.

• Lean meat

For any wound healing, lean meat is recommended because it provides lots of proteins. It also has a significant amount of iron that perks up your hemoglobin levels and increases production of red blood cells. Lean meat also has creatine and there’s limited evidence that creatine helps with inflammation.

• Melatonin-rich foods

Research has shown encouraging results in the case of melatonin being effective for brain injury. Melatonin is a hormone produced in your body naturally and helps in inducing sleep. It regulates chemical balance in your brain and helps in nerve transmission. Melatonin-rich foods include flaxseed, sunflower seeds, and cherries.

There you have it! The nutrition based healing is a scientifically approach that can fast-track your recovery following a traumatic brain event. Following the recommendations given in this book, you can make sure you recover from your injury in a speedy and healthy way. Following these guidelines, you will also make sure that you develop enough resilience for any misfortunate brain injury that you might experience in the future.

Stay healthy, stay safe!

I hope you enjoyed this 6-part series on concussions and CTE. All the studies and references used can be found below… for those of you that like to dig a little deeper.

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