Nutrition

Nutrition is an important part of brain injury recovery because both the brain and body need proper nutrients in order to heal. The food we eat supplies us with energy and nutrients that our brain and body use to complete physical, cognitive, and mental activities. When we eat well, our body obtains all the protein, vitamins, and minerals we need, improving both our overall health and our brain function. Healthy eating means eating a variety of high nutrient foods such as vegetables, fruit, legumes, meats, milk products and whole grains. Drinking water is also important.

Foods and drinks that are high in salt, sugar or caffeine should be limited for the person with a brain injury. They should also avoid taking any drugs, substances or medications that have not been prescribed to them and avoid/limit alcohol.

Please note: Dietitian is a protected term in Canada, which means they need to have professional certification. Nutritionist is only a protected term in Alberta, Quebec and Nova Scotia. This means that someone may be a nutritionist in British Columbia but not have the same credentials as someone in Alberta. Dietitians of Canada has an explanation and a chart of protected titles by province/territory that can help identify what kind of health professional to consult for dietary needs.

Topics in this section include:

How nutrition can impact brain injury recovery

Brains use approximately 20% of the daily calories consumed. When someone sustains a brain injury, they need to be eating enough calories to help the brain function well, especially in the first few days after injury [1]. Good nutrition will be important for the rest of their life.

In addition to getting enough calories, it is important to also get the specific nutrients that will help their brain recover and function. Brains need amino acids, protein, omega 3 fats, vitamins and minerals, and many other nutrients.

Are there brain healing foods?

At present, there is no evidence that eating specific foods can affect brain recovery from injury, beyond the need for enough calories and proper nutrition. Many different substances have been tested in animal studies – like Omega-3 and Vitamin D – but so far none of these have shown positive effects in humans [2]. Brain injury recovery takes time, patience, rehabilitation, and a commitment to learning coping strategies. This includes proper nutrition.

A healthy diet after brain injury should include [3]:

Caloric intake
How often a person eats and how many calories they take in has been shown to contribute to brain function. This is entirely dependent on the person and their dietary needs. A dietitian can work with them to identify an appropriate eating schedule.
Anti-inflammatory foods
Inflammation can occur following a brain injury. Studies have shown that anti-inflammatory diets can be helpful in improving pain, mood, and sleep [4]. Anti-inflammatory diets are made up of foods like fatty fish, healthy oils, flaxseed, fruits, vegetables, and lean proteins. For a more comprehensive anti-inflammatory diet plan, speak with a dietitian.
Healthy fats
Studies have shown diets with a lot of saturated fats aren’t good for the brain [5]. Foods such as oils, nuts and natural nut butters, and some fruits and vegetables (such as avocados) have unsaturated fat that is better for us (in moderation).

Did you know: 60% of our brain is made up of fat

Omega-3 fatty acids, a special form of fat, most commonly found in fish, has been shown to improve cognition and recovery of neurons after a traumatic brain injury. Evidence suggests that docosahexaenoic acid  (DHA), an important form of omega-3 fatty acid can help improve neuronal function [6]. Our bodies don’t naturally produce DHA, so this needs to be included in our diet.

A dietitian will be able to tell the person with a brain injury what kinds of foods they should be eating (and how much) to supplement their diet with healthy fats.

Proteins and amino acids
Amino acids, the small components of protein, are used for the growth, repair and maintenance of nearly every tissue in the body. The brain needs amino acids as well. People can get protein from fish, lean chicken and meats, eggs, legumes, some grains, nuts and seeds. A dietitian can recommend ways to incorporate protein into meals and snacks.
Fruits and vegetables
Fruits and vegetables are the best source of the vitamins and minerals the body requires.  Each type of fruit and vegetable contains a unique blend of vitamins and minerals, so it is best for the person with a brain injury to try and get a variety of each throughout the day.
Whole grains
Whole grains contain a lot of the B vitamins that our bodies need to keep our brains functioning well. They are important for sending messages to and from the brain and controlling muscles. Whole grains, like brown or wild rice, multigrain breads and cereals should be eaten by the person with a brain injury more often than highly processed breads and cereals.
Blood sugar (glucose) balance
Proper glucose (blood sugar) levels are extremely important. In some cases, the brain’s ability to convert glucose into energy doesn’t work as well after a brain injury. The brain needs more energy after an injury as well, and this can result in more damage to the brain [7].

Food such as grapes, raisins and fruit juices are naturally high in sugar. There are also glucose medications available by prescription. The person with the brain injury will need to work with a dietitian or healthcare specialist that is able to identify what is causing the problems in their blood sugar levels. Once that problem is identified, treatment can be recommended.

Vitamin E
Vitamin E is found in certain oils, nuts, and spinach. Vitamin E functions as an antioxidant, which helps make sure neurons can function as well as possible. Studies have shown a link between Vitamin E and neurological performance [8].
Curcumin
Curcumin is a yellow curry spice that has also been suggested to help recovery after brain injury, particularly in helping preserve cognitive abilities [9].  Although the person would need a lot to have the results shown in the studies, even small amounts may help.
Water
Water is an important part of healthy living for everyone. Dehydration can impair brain function and can even change the brain’s structure. Drinking water regularly throughout the day can reduce the risk of becoming dehydrated. If remembering to drink water is a challenge for the person with a brain injury, they can use a large water bottle with time markings or get a smartphone app that sends them reminders.

Work with a dietitian for the best results

Rehabilitation schedules, cognitive struggles, fatigue, and other effects of brain injury can make planning out a nutritious diet difficult for someone with a brain injury. A dietitian is the best person to help them develop a specific and effective nutrition plan after their injury. Their body will have different needs than someone else based on factors such as age, weight, gender, and activity. A tailored plan is the best way to ensure that the person with a brain injury is getting the nutrients they need. Dietitians can help identify what the person should be eating and assist them in developing a diet plan that takes away the guesswork. They can also make recommendations on how to get those proper nutrients and liquids safely if the person is experiencing problems with chewing or swallowing.

Factors that can impact nutrition after brain injury

Changes in taste and smell
Some individuals living with brain injury experience sensation changes, including the sense of smell and taste. These senses can be altered or lost on a temporary or permanent basis. This can be a difficult adjustment: it can change the kinds of foods and beverages a person wants to eat and can greatly impact their enjoyment of food and eating. Working with a dietitian to create a tailored meal plan can help address these changes.

You may also be able to help your friend or family member with these changes by introducing them to new foods and keeping a food tracker: this will help identify what the person likes/dislikes and how their tastes change.

Memory problems affecting eating
People with a brain injury may experience memory problems. This can make it difficult to remember eating, or all the steps needed to make a meal. If they forget to eat or drink, they may not be getting the proper nutrients they need. Alternatively, if they can’t remember eating and make another meal, they may eat too much.

  • Ways to cope with memory problems in relation to eating include:
  • Creating a meal plan, including step-by-step instructions for preparation
  • Setting alarms for when to start meal preparation
  • Keeping a food journal to document when and what the person ate. This can be kept in the place they eat their meals

If it is unsafe for the person with a brain injury to prepare their own meals, this may be a task that falls under your position as caregiver. Creating a meal plan and tracker will help you stay organized. You may also need to help your friend or family member eat their meals as well. If that is the case, healthcare providers (including the dietitian) will make sure you are properly trained in how to feed someone safely.

Not feeling full or hungry
In some cases, a person may not be able to feel the sensations associated with being full or being hungry. This can impact eating habits, which in turn can impact nutrition. Some ways to cope with these changes are:

  • Identify the problem. While some people don’t feel hungry because their brain doesn’t process that sensation, others may be experiencing false fullness because of something such as constipation. By identifying the cause and addressing it, you will both understand why it’s happening
  • Scheduling meal times, including portion sizes so they won’t eat too much or too little
  • Keeping a food journal to document when and what they ate

Even when they don’t have much of an appetite it is important that the person with a brain injury eat consistently. Food is an essential part of healing and being healthy.

Research and resources

There is also research being conducted on how supplements, vitamins, and minerals may be helpful in brain injury recovery. You should work with a dietitian to determine if supplements or an increase in certain vitamins and minerals would be best for you.

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