Brain Injury: How Dietary Patterns Impact Long-Term Outcomes

Abstract

Purpose of Review Individuals with a history of traumatic brain injury (TBI) are at a much greater risk for developing cardiovascular disease (CVD) compared to the general population. This review discusses dietary patterns as a means of addressing modifiable risk factors following TBI exposure. Evidence-based resources for practicing Physiatrists and Brain Injury Medicine specialists pertaining to nutrition education and counseling are also provided. Recent Findings We examined Mediterranean, Dietary Approaches to Stop Hypertension, plant-based, ketogenic, and intermittent fasting dietary patterns through publications of clinical trials and systematic reviews. While many reviews had significant positive findings, some were limited by generalizability. Summary While there is extensive literature on the immediate nutrition goals in the inpatient setting following an acute TBI exposure, there is limited literature discussing the nature of diet and nutrition in the post-acute setting. Fortunately, most individuals with TBI exposure survive their initial injury and continue into the recovery phase. The scientific literature supports increased morbidity and mortality with chronic TBI exposure compared to matched counterparts, most notably with CVD. A diet rich in fiber and nutrients but limited in added sugars, saturated fats, and excess calories would likely have the greatest cardiovascular and related neurologic protection. Future studies are needed to assess the specific impact of dietary interventions in the chronic phase of brain injury recovery.

An objective neurophysiological study of subconcussion in female and male high school student athletes

“…Finally, the current study did not track important biological factors that differ between female and male athletes. These factors include but are not limited to menstrual cycle phase at time of exposure or in the case of multiple exposures, when the majority of exposures occurred (menstrual phase has been a predictor of mild TBI outcome (Wunderle et al 2014) and progesterone shows neuroprotective as a TBI treatment (Wright et al 2007)); body fat percentages given recent understanding of fat being a major endocrine organ (Musi and Guardado-Mendoza 2014); and diet given the understanding of diet impact on inflammation and brain function (P. R. Patel et al 2023; Markovic et al 2021). With clear neurophysiological differences identified between females and males, future work must include expanded characterization of these key biological factors to understand change that may affect results at the time of evaluation.…”

Conservative Management of Acute Sports-Related Concussions: A Narrative Review

“…There is an increasing interest in the impact of diet on concussion outcomes [108,137,138]. Diets rich in red meat, saturated and trans fats, refined sugars, and carbohydrates are associated with neuroinflammation, while neuroprotective and anti-inflammatory effects are linked to diets high in unsaturated, polyunsaturated, and monounsaturated fats, as well as ketogenic and Mediterranean diets, and intermittent fasting [139].…”