Sports Related Concussions (SRCs) are a type of traumatic brain injury that can disrupt brain function and lead to a cascade of inflammatory responses. While rest and medical management are crucial components of recovery, nutrition plays a role in supporting the brain's healing.
Whole foods can provide the necessary nutrients to reduce inflammation, support brain health, and promote overall recovery. Supplementation may also have a role in brain healing.
The Power of Whole Foods
Whole foods should be the cornerstone of a nutritional plan. This is particularly true for concussion recovery. Essential vitamins, minerals, and antioxidants are available in whole foods and work with your body's systems to promote healing. Remember, all living things are related to one another in a complex ecosystem. We come from the earth in the same way our food does. Getting nutrients in their natural form has many advantages including the right dose and the appropriate packing for delivery.
Sources: Local food market, farmer's markets, local farms. For our NYC friends, check out this website.
Pro Tip: Eating frequent (3 meals + 2 snacks per day) that are well balanced can help to balance energy availability during injury recovery. Energy demands can remain high even with diminished training loads with the stress on the body. Trauma to the body can cause a increase in the need for calories. Getting at least 1.5g/kg of protein per day from quality sources is important for recovery.
Your brain is 2% of your body weight but can use 20% of available energy at any moment. Do not restrict calories. Try to get 10 servings of whole foods (fresh fruits, vegetables, nuts, beans) daily. A lofty goal for most, but attainable with some planning. A serving size can be estimated to be the size of your fist. (check out the hand guide.)
Omega-3 Fatty Acids (Fish Oil)
When I was young people would say that "fish is brain food." Omega-3 fatty acids, particularly DHA (Docosahexaenoic Acid) and EPA (Eicosapentaenoic Acid), are powerful anti-inflammatory agents. They play a crucial role in maintaining the integrity of brain cell membranes and reducing neuro-inflammation after a concussion.
Sources: Fatty fish like fresh salmon, mackerel, tuna, trout, and sardines are excellent sources of DHA and EPA. For those who don’t consume fish regularly, a high-quality fish oil supplement with third party validation or medical-grade options can be beneficial. We can also consume Omega 3s through plant-based foods such as flax seeds, flax powder, flax oil, chia seeds, walnuts, algal oil, edamame, and seaweed–which is typically recommended for vegans/vegetarians. After all, fish consume their Omega 3s through plants and we can too! View the Omega 3 content in various foods through the NIH Website.
Pro tip: Try adding a handful of chia seeds, flax seeds or walnuts into your smoothie or oatmeal. (Smoothie recipes for the busy athlete)
Antioxidant-Rich Foods
Concussions lead to oxidative stressors in the brain, which is a part of inflammation and healing. We can encourage healthy healing with appropriate factors for metabolism. The right supplies make all the difference in the work your body needs to do. Consuming foods rich in antioxidants can help to neutralize stress on brain cells. We can find antioxidants in Vitamins such as A, C, E, and the trace element selenium.
Sources: Dark blue, purple, and red fruits (like blueberries, blackberries, and pomegranates), colorful peppers, leafy greens (such as spinach and kale), and selenium-rich brazil nuts–all which are rich in antioxidants that support brain health.
Fun fact: one brazil nut contains over 100% of an adult’s daily selenium needs!
Pro Tip: Include brazil nuts in your trail mix or smoothie.
Combining some palatable foods such as peanut butter or honey with small amounts of the above can help to tune your taste buds and "hide" less familiar foods, building your food repertoire for future meals. Taste buds change and "crave" familiar foods.
Magnesium
Magnesium is often prescribed for migraine headache sufferers and has neuro-protective potential, stabilizing neuronal membranes. It can also help reduce the frequency and severity of post-concussion headaches, a common symptom similar in presentation to migraine headaches, experienced during recovery.
Sources: Leafy green vegetables, nuts, seeds, lentils, chickpeas, and whole grains are natural sources of magnesium. Including these in your diet can help maintain adequate magnesium levels.
Pro Tip: Add some frozen spinach to your eggs, a pasta sauce, or sneak them into a smoothie. Or even make a hearty lentil soup packed with leafy greens vegetables.
Vitamin B2 (Riboflavin)
Vitamin B2 plays is important for energy production and reducing oxidative stress. After a concussion, the brain's demand for energy increases, making riboflavin a helpful nutrient during recovery.
Sources: Incorporating foods like almonds, whole grains (brown rice, wild rice, oatmeal, whole wheat bread), wheat germ, milk, yogurt, mushrooms, soybeans, and fortified nutritional yeast can help ensure adequate Vitamin B2.
Pro Tip: Find ways to swap out refined grains for whole grains (e.g. choose a whole wheat bagel, whole wheat toast or a bowl of oatmeal over plain white bread. Add milk to your oatmeal for added vitamin B2).
Supplementation
While whole foods should be prioritized, certain supplements can provide additional support during concussion recovery. These supplements target specific pathways that may not be fully addressed through diet alone.
Creatine
Creatine is well-known for its role in muscle energy metabolism, but emerging research suggests it also supports brain health during immense stress by enhancing ATP production, which is crucial for cellular energy. This can be particularly beneficial during the high energy demands of brain recovery. We can naturally find creatine in meat and fish, however our body can only produce 1g of creatine daily and store a limited amount in the muscle, and for vegans/vegetarians the availability and storage of creatine may be even lower compared to meat-eaters. Creatine monohydrate supplementation can increase our muscle creatine stores and may help to reduce post concussion symptoms.
Supplement Recommendation: Creatine monohydrate is the most studied form and can be easily incorporated into a recovery plan.
A loading dose = 5g of creatine 4x per day (20g total) for 5 days or 0.3g of creatine per kilogram of body weight split up into 3-4 doses daily for 5 days. After 5 days, a maintenance dose can be used for the remainder of the time.
Maintenance dosing = 3-5g of creatine daily.
A loading dose is not necessary. You can start on the maintenance dose, but creatine stores will take longer to reach capacity. The benefits will take longer to take effect. View more about Creatine on the AIS website.
CoQ10
Coenzyme Q10 (CoQ10) is an antioxidant that plays a key role in cellular energy production. Although not as commonly recommended, CoQ10 may offer neuro-protective benefits by supporting mitochondrial function and reducing oxidative stress in the brain.
Supplement Recommendation: CoQ10 can be considered, especially if dietary intake of this nutrient is low.
Feverfew and Butterbur
These herbs are traditionally used for migraine headache prevention, but they may also help alleviate post-concussion headaches. Their anti-inflammatory properties make them a consideration in concussion recovery.
Supplement Recommendation: Not routinely recommended as feverfew or butterbur may interact with other medications. Consult your doctor before initiating.
Conclusions
Like all injuries we encounter, we hold this philosophy - there is opportunity in adversity. Many athletes focus less than they should on nutrition. Whole foods have virtually everything your body needs when care is taken to get appropriate variety and quantities. A food-first philosophy ensures that the body receives nutrients in their most bioavailable form. Whole foods and targeted supplementation (in situations where whole food options are limited) offer a comprehensive approach to supporting brain recovery after a concussion. Anti-inflammatory foods, antioxidants, and key nutrients like omega-3s, magnesium, and creatine can enhance and expedite recovery after a concussion.
The implementation of proper nutritional strategies that meet individuals needs and support overall brain health can transcend recovery to better lifestyle choices overall.
