If you have kids – and especially if you have kids who participate in sports – you have probably heard a lot about concussions. Concussions are a common injury in youth. Ten years ago they were estimated to affect upwards of 3.6 million people in the United States annually. With better understanding and diagnosis this number has likely grown.
Recently, new research and new practices have brought to light a range of concussion-related issues that were previously poorly understood or not recognized. Memory impairments, headache, irritability, sleep disturbances and sensitivity to light and sound are common symptoms. On top of this, the social isolation that can come while recovering from a head injury can lead to changes in mood.
For athletes, the goal is to ensure full recovery before returning to play. As a result, return to play guidelines for concussions have been developed. These instructions include a range of environmental strategies to support concussion recovery, but did you know that nutrition also plays a role in recovery? Concussion nutrition is an exciting emerging tool for treatment.
Here is a countdown of the top 6 nutritional strategies under investigation for their role in concussion management:
Turmeric is a vibrant yellow-orange spice commonly used in Indian and South Asian cuisine. Turmeric contains curcumin, which is a phytochemical. In animal models, curcumin improves neural plasticity and signalling, reduces neural inflammation and improves balance. Such improvements translate into better concussion recovery.
This is all good stuff, but curcumin needs to be studied in people (not only animals) to see if the benefits are similar. Even so, this spice is safe to add to your diet post-concussion. There is no guarantee that it will be beneficial but it is tasty and otherwise harmless.
Creatine is a supplement that you may associate with gym rats trying to bulk up. You may have written it off as a pseudo-supplement when in reality it has been well researched in athletes. Many athletes take creatine in supplement form, but it is also a natural component in meat and fish.
Believe it or not, creatine has potential to help heal from a concussion. When taken at the onset of head injury creatine can reduce the effects of a concussion. In children with severe brain injury, creatine supplementation can improve physical, cognitive, and behavioural function. The next step? Research in children with minor head injuries like concussions.
Normally, sports supplements, including creatine, are not recommended in children and adolescents. While it is a supplement that shows promise, at the moment there are insufficient guidelines to support its general use. Interested in trialling creatine for management of severe concussion symptoms? Then do so under the direction of a sports doctor and concussion specialist.
#4 Antioxidant Vitamins
Antioxidants are substances that help combat the damage created by oxidation of molecules in the body. Oxidation is a chemical process that leads to the production of materials like free radicals that can damage cells. Dietitians recommend getting antioxidants from food sources like brightly-coloured vegetables. If you are using supplements, stick to the guidelines. Doses of antioxidants that are too high can make them work in the opposite way that they usually do and result in more cell damage.
Even so, vitamins C, D, E are antioxidants that may improve concussion symptoms and hasten recovery.
Here is a chart that shows sources of these vitamins:
|Vitamin C||Fruits and Vegetables such as tropical fruit, citrus fruit, berries and bell peppers.|
|Vitamin D||With sunscreen-free sun exposure, your body makes vitamin D between March/April and October (in the northern hemisphere). You can also obtain some vitamin D from foods such as fortified milk products, and fortified plant-based beverages.|
|Vitamin E||Foods such as nuts and seeds, dark green leafy vegetables, avocado, wheat germ, fish, and eggs.|
It’s important to note that it can be challenging to consume enough vitamin D in your diet. For vitamin D, most of us likely need to take a supplement.
Melatonin is a hormone released from the brain that helps control your sleep and wake cycles. You can buy it as a supplement, and it is commonly used as a home remedy for sleep issues. Melatonin is of interest in concussion management as it may be neuroprotective, which essentially means it protects the neurons – the specialized cells of the brain that transmit nerve impulses – from injury or degeneration.
Animal studies have proven promising. In rodents, melatonin supplementation reduces brain oedema and pressure in the skull as well as improves brain response to oxidative stress. Is the same true for people? Good question! There is an ongoing study, called the
Is the same true for people? Good question! One study hopes to find out. The Play Game Trial is looking at the use of melatonin in children who have suffered a concussion and have continuing sleep issues. The end date for this study is 2019 so until then, do not use this as a supplement for children for concussion management. We don’t have guidelines for dosing or whether it is useful. You should only do so under the direction of a sports physician and concussion specialist.
Similar to melatonin, resveratrol is neuroprotective. Resveratrol is a polyphenol found in nuts, grapes and grape juice, blueberries, cranberries and dark chocolate. Again, resveratrol has only been studied in animals. Here it improves motor performance, visual-spatial memory, and behaviour after a concussion. One human study,
Again, resveratrol has only been studied in animals. Here it improves motor performance, visual-spatial memory, and behaviour after a concussion. One human study, the REPAIR study, is looking at resveratrol’s use for concussion management in boxers. It will be interesting to see the results because not all previous studies using resveratrol have found it beneficial.
Resveratrol-containing foods tend to be rich in other nutrients as well. They can be an amazing addition to your diet regardless of whether or not you have a concussion, and whether or not the studies pan out. In the meantime, it is harmless to include foods that are high in resveratrol in your snacks and meals and consider using more of them if recovering from a head injury. Time will tell if resveratrol will be an essential component of the post-concussion nutrition regime.
#1 Omega-3 Fatty Acids
The best researched nutritional strategy is omega-3 fatty acids. Omega-3 fatty acids support brain development and cognitive function. Docosahexaenoic acid (DHA) is an omega-3 fatty acid that is found in fish and seafood. When DHA is given before or after a concussion studies show it improves spatial learning and recovery. As such, it is used both as a preventative measure in high-risk sports such as American football and for treatment post-injury.
We need more research and clinical trials to provide good recommendations about recommended doses for DHA supplementation. There are a couple of ongoing studies that are may shed light on this question.
The first supplements NCAA division athletes with 2200 mg/d DHA for 30 days after head injury. The second, out of the University of Texas Southwestern Medical Centre, supplements children (14-18 years of age) with 2000 mg/d DHA for three months and looks at their return to competitive play.
In the meantime, the best approach is to encourage your children to intake fatty fish, omega-3 eggs and margarine during concussion recovery. If you want to try omega-3 supplements for their children, consult your paediatrician or pharmacist for appropriate dosage.
Each of these nutritional strategies shows promise for promoting faster concussion recovery. However, the most essential component of post-concussion nutrition management, whether for your child or for yourself, is to eat a wholesome, well-balanced diet.
Nutrition planning is integral to achieve your optimal athletic performance. Gazelle Nutrition Lab delivers one-on-one or group nutrition counselling and consulting to both recreational and high-performance athletes. In addition, the Gazelle Blog is a free resource for healthy recipes and health tips. Have questions? We’d love to hear from you! Get in touch!
Ashbaugh A. et al. The role of nutritional supplements in sports concussion treatment. Head, Neck, and Spine. 2015;15:16-9.
Cernkovich Barrett E. et al. w-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 2014;5:268-77.
Rutland-Brown W. et al. Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil. 2006;21:544-8.