Navigating the area of nutrition for concussions can be tricky. There’s not as much direct human research as we’d like on concussions. It is, obviously, ethically challenging to study.
But clearly, nutrition can help with overall brain health, including the prevention and management of concussions.
The following post will be based on a combination of theoretical thinking and focusing on the evidence that we DO have.
At a minimum, there will be some useful things in this post that have a high likelihood of helping.
General Theme – Overall Healthy Diet
As a general theme, having an overall healthy diet is a good idea for both concussion prevention and management.
Many key nutrients are beneficial from this perspective. And having a type of diet that fits into the anti-inflammatory type of category is also a good idea too.
That is a very broad overview, but the next sections will be dedicated to specific nutrients and approaches.
There is only one human study and it has shown beneficial outcomes. It didn’t reach statistical significance due to the small sample size, but recovery time was 14 days vs 19.5 in the placebo group.
Rodent research has shown benefits and the theoretical reasons make sense.
At a minimum, consuming fatty fish regularly is a good idea. But if concerned, 2g/day of combined EPA and DHA should get most people to >8% within 12 weeks.
Creatine is one of the most hyped-up options for concussion prevention/management. Once again though, we have less research in this space than you would expect.
Theoretically, it makes sense though.
Concussions have been shown to reduce the creatine content of the brain. Theoretically, supplementing creatine should help.
In a perfect world, you would be taking creatine regularly PRIOR to the concussion at a standard dosage (3-5g for most people).
But if you have not done that, the next best move is to immediately start a loading phase of 20g per day (split over 4 dosages).
Low vitamin D is associated with cognitive decline and increased inflammation, which may be relevant for concussions.
High-dose vitamin D supplementation to address a deficiency has led to beneficial outcomes in those with acute mild-moderate traumatic brain injury.
The high dose used in that study was 100,000IU injected. For context, a normal vitamin D supplement consumed orally is 1000IU.
Maintaining good levels before concussion is likely more beneficial though.
That same research was a retrospective study of 345 patients, and they found that ~95% of patients were deficient in vitamin D.
It would be silly to read too much into a single study with that type of sample size. But that is such a high percentage that it makes sense to stay on top of vitamin D levels year-round.
Vitamin B2 (Riboflavin)
As per usual we do not have a bunch of human research on riboflavin and concussion. But we DO have a specific and potentially helpful study.
A double-blind RCT with 52 participants found that taking 400mg riboflavin taken daily for 14 days significantly outperformed placebo if taken within 24 hours of a concussion.
It shortened the duration of symptoms (9.9 days vs 22 days) in this study.
The logic is largely based on the role riboflavin plays in the following:
- Energy production
- Antioxidant and anti-inflammatory activity
- Mitochondrial function.
When consumed within 48 hours of a concussion, magnesium supplementation has human research supporting that it helps to improve symptoms.
There is not a lot of research on this, once again. But it is another option worth considering.
A polyphenol-rich diet is likely a good idea.
Polyphenols can help protect neurons, reduce inflammation and help cognitive function.
There is no direct human research on this, but the mechanisms make sense.
Melatonin has research supporting its ability to help with sleep in those who have suffered from sleep disturbances in the weeks following concussions.
Getting better sleep can likely also have benefits for other areas of concussion management.
Malnutrition is common after concussions due to a combination of increased metabolic rate, nausea and loss of appetite.
This could also potentially make concussion symptoms and recovery worse, so managing this where possible is a good idea.
Prioritising consuming sufficient calories and micronutrient-rich foods where possible makes sense.
There can be logistical challenges to getting this in, so you may need to prioritise higher-calorie foods that are easy to digest.
Research has found adverse outcomes with caffeine consumption after mild traumatic brain injury.
So right now, the recommendation is to limit caffeine post-concussion.
There are many potential reasons why this might be relevant, but some of them include:
- Caffeine could contribute to sleep issues.
- Caffeine increases blood flow to the brain. Even though this is short-term, it could exacerbate headaches and dizziness.
- People are often more sensitive to stimulants post-concussion. This could trigger headaches, dizziness, anxiety and irritability.
While we do not have heaps of research on concussions, it makes sense to make the most of the research we do have.
Even without the full picture, implementing some of the approaches listed above likely significantly improves the recovery timeframes.