When a patient suffers a traumatic brain injury (TBI), nutrition is extremely important for their recovery. A healthy diet is essential for a brain injury healing. The brain uses calories to function, and a lack of proper nutrients can disrupt proper brain functioning, including the ability to think clearly. When someone sustains a traumatic brain injury, it is paramount to their recovery to consume proper nutritional calories to help the brain function efficiently.
Patients can either lose or gain weight during hospitalization for a TBI. One study found that 60 percent of traumatic brain injury patients left the hospital at a higher weight than they were admitted. Researchers determined that eating disorders are common among TBI patients largely due to hyperphagia which is excessive hunger. Hyperphagia coupled with loss of brain function that impairs judgement and insight can have a significant effect on weight gain.
Nutrition Implications of TBI
After a brain injury, metabolic changes also affect recovery, including inflammation, gastrointestinal tract function, and insulin resistance. Nutrition intervention should be an integral part of therapy in TBI treatment because research shows it minimizes long-term complications.
Patients treated with enteral nutrition within 48 hours after injury have a better survival rate, and it has been shown to reduce the length of hospital stay, decrease infection and reduce loss of muscle.
Vitamins D and E, niacin, zinc, and magnesium have been shown to improve recovery, especially in patients who are deficient in those vitamins. Supplementing with ω-3 fatty acids can help the brain recover from injury by reducing inflammation and stress.
Long-term TBI Nutrition
Those who are living with a long-term TBI are at greater risk of obesity, and they are more likely to have hypertension, diabetes, heart failure, or poor health.
Nutrition recommendations for TBI patients should consider both cognitive and behavioral issues that affect eating habits and any physical limitations in activity.
Researchers agree that there is a lot to learn about the impact of nutrition on TBI recovery. One thing that is known is that malnutrition can impair recovery after a TBI and increase the risk of complications such as depression, obesity, and weight-related diseases.
When working with persons with a TBI, consider the long-term risk of neurodegenerative disease and assess for any effects of the injury that may have nutrition implications.
These effects might include anxiety, depression, sleeping problems, loss of taste or smell, or hyperphagia. An energy-balanced, anti-inflammatory diet with adequate sources of ω-3 fats, and a vitamin D supplement as appropriate, is especially important for these patients.
The brain needs energy in order to function and it is vital that a person who has sustained a brain injury gets enough calories for the brain to recover efficiently. Nutrition greatly influences how well a healthy brain functions, so it makes sense to eat a nutrient-dense diet when recovering from a brain injury.
Deficiencies in certain nutrients can lead to disruptions in the brain’s function and the ability to think with clarity. Neurotransmitters are responsible for regulating behavior are controlled by what nutrition goes into the body.
Neurotransmitters like serotonin, dopamine, and norepinephrine are responsible for moods. If a patient consumes foods that increase serotonin levels, then the patient will be less tense, and foods that encourage the production of norepinephrine or dopamine enable clarity.
An unfortunate side effect of a TBI is can be depression. Depression can disrupt a person’s ability to function as they did prior to their injury and can also interfere with their ability to recover. By making healthy food choices that combat depression and other issues after a brain injury, a TBI patient may help keep these symptoms at bay.
The Biochemical Cascade
The impact of a TBI sets off a secondary biochemical cascade within the brain that causes the majority of the problems people experience in terms of brain function. The purpose of improving diet is to impact this secondary biochemical cascade.
What exactly occurs in this biochemical cascade that may warrant a nutritional intervention?
A TBI disrupts neuronal cell membranes and causes a stretching of axons (nerve fibers) in the brain. These changes interfere with the flow of potassium and calcium to the brain and prompt the release of excitatory neurotransmitters such as glutamate.
In its efforts to reestablish equilibrium, the brain depletes its energy stores and goes into a hypermetabolic state which leads to the overproduction of oxygen radicals, causing oxidative stress.
At the same time, a neuronal inflammatory response begins soon after injury and this can continue for several weeks, and eventually damage cell membranes. The collection of these processes can result in the death of neuronal cells.
Carbohydrates are found in beans, meat, fruits, legumes, and vegetables. They are important because they help energize the cells in the brain.
Complex carbohydrates like whole-grain bread, pasta, and whole fruits after a traumatic brain injury are better than simple carbohydrates, which are found in processed foods and beverages like candy, and soda.
Complex carbohydrates that should be eaten sparingly are bread, rice, cookies or cake as they can contribute to weight gain and obesity.
Proteins are essential for brain growth and recovery but also provide the body with the necessary energy, all while helping with the formation of antibodies, enzymes, hormones and tissues.
The body breaks protein down into amino acids, which are important when it comes to building muscle. If a TBI patient’s body is lacking essential amino acids, it can stop building protein altogether and have a negative effect on the brain’s ability to properly heal. Complete proteins are found in fish, poultry, other meat, eggs, cheese, milk and even hummus.
Fat is important for healing a TBI and is vital when it comes to normal brain development. Not all fat is created equal and some fats are better than others. It is recommended to read nutrition labels and eat less saturated fat and instead choose foods higher in monounsaturated fat, and omega-3s, and omega-6s.
Water is used in every function in the human body and works to transport nutrients to every cell and take waste away. Water helps maintain body and brain temperature and is vital for digestive actions, proper absorption of nutrients, and circulatory functions. The recommended amount of water for a non-injured person is least eight to ten 8-ounce glasses of water every day. Patients should consult with their physician on the amount of proper water intake that is right for them and their recovery.
What a TBI patient eats greatly influences healing and normal brain functions. Eating a healthy diet that is nutrient rich when recovering from brain injury is a great value to recovery. Does this paragraph belong here as the section is about water?
Foods to avoid
• Salty foods
Avoid inflammatory foods after a traumatic head injury TBI such as highly processed or refined foods, red meat, and alcohol. Alcohol can further impair existing cognitive issues and negatively impact mood. According to Today’s Dietician, “essentially all the things alcohol does normally are amplified as the brain is in a sensitive state post injury.”
Instead of processed foods, eat fresh fruit and vegetables, especially green leafy vegetables that have contain a lot of the vitamins and minerals that are important for head injury recovery.
Nutritional Tips for TBI
• Eat small meals every 3-4 four hours.
• Keep small bags of healthy snacks readily available all day to boost energy, like nuts, trail mix, apples, cheese, hard-boiled eggs, and low calorie granola bars. Ask someone to make them for you and take them with when away from home. Maybe…Prepare the snacks beforehand and they will be ready when you need them.
• Balance meals with a combination of protein, healthy fats and oils, and carbohydrates like fish, lean meats, nuts, and eggs, avocados, seeds and nuts.
• Avoid eating carbohydrates if there is a blood sugar concern. Many individuals report that sugar increases headaches.
• Do not overeat as it causes sleepiness and over time, can result in other health issues.
• Eat at the same time every day. Set a timer to alert you that it’s time to eat. Since weight gain is common following brain injury, this is a good reason to stick to eating at a specific time every day. The brain and body does do best when they are on a routine schedule.
Grocery Shopping and Menu
Shopping and cooking both consume a lot of mental and physical energy. The grocery store is a can be a difficult environment to navigate when you have a head injury because of the sounds, and visual stimulation and the complex cognitive skills required to shop.
• Use a notepad or Post It note on the refrigerator to write down food items to purchase as you remember them before your next trip to the grocery store for better organization and to avoid forgetting things you need.
• Plan your list to follow the order of the aisles, like fresh foods, then packaged, canned, and frozen foods in the center aisles. This will help conserve your energy so you won’t have to make trips back and forth across the store.
• If you have to go the grocery store, choose a time when it is less crowded and less noisy.
• Enlist the help of neighbors or friends to pick up food on your list when they are making a trip to the grocery store.
• If you are sensitive to noise and light, wear earplugs or sunglasses when shopping.
• Don’t shop when you are hungry. You’ll make smarter food choices when you are not hungry because your focus and attention will be sharper.
• Develop a list of your favorite meal ideas posted on your refrigerator for easy access.
• Keep menus simple and avoid elaborate recipes with many steps or unusual ingredients that aren’t familiar to you.
• When cooking, always make extra for the next day or two, or to put in the freezer. Put small portions of foods into freezer containers for storage. Remember to label them with the date.
• Throw protein-based food out after three days in the refrigerator.
• Some people lose their sense of smell after a TBI and it is very important know the expiration dates on food. Check your refrigerator one time per week and dispose of anything that is expired.
• Visit http://www.foodsafety.gov to practice safe food handling.
Consider consulting a nutritionist for an individualized program of supplementation. By eating well, you are developing a good foundation for the recovery of your body and brain.