Patients/clients in recovery often neglect their diet, but it is important they are encouraged and reminded how important nutrition is to their recovery. 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 and drinking plenty of water. Vegetables, fruits, legumes, meats, milk products, and whole grains contain the important nutrients the body needs to heal and stay healthy. Foods and drinks that are high in salt, sugar, or caffeine should be limited.
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.
How nutrition can impact brain injury recovery
The brain uses approximately 20% of daily caloric intake. After someone sustains a brain injury, they need to be eating enough calories to help the brain function well [1]. Good nutrition will be important for the rest of their life. In addition to getting enough calories, it is important they also get the specific nutrients that will help the brain recover. The brain needs amino acids, protein, omega 3 fats, vitamins and minerals, and many other nutrients to keep the brain working well.
Are there brain healing foods?
Studies have shown that specific nutrition-based diets and exercise can impact the brain in positive ways, such as improving cognitive function [2]. There are foods that are better for brain health than others because they contain important nutrients – but there are no foods that will heal a brain injury. Brain injury recovery takes time, patience, rehabilitation, and a commitment to learning coping strategies. This includes proper nutrition.
Here is a brief overview of the components of a healthy diet that you can share with your patient/client [3]. If they have more questions, you should refer them to a dietitian or nutritionist.
- Caloric intake
- How often a person eats and how many calories they take in have been shown to contribute to brain function. This is entirely dependent on the person and their dietary needs. A dietitian can work assist 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]. Diets should be higher in good-quality fats (unsaturated fats). 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).
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]. The body does not naturally produce DHA, so this needs to be included in a diet.
A dietitian will be able to assist with 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. Protein can come from fish, lean chicken and meats, eggs, legumes, 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 to become and stay healthy. Each type of fruit and vegetable contains a unique blend of vitamins and minerals, so it is best to try to get a variety of each throughout the day.
- Whole grains
- Whole grains contain a lot of the B vitamins that the body need to keep the brain functioning well. They are important for sending messages to and from the brain, controlling muscles, and allowing us to function. Whole grains, like brown or wild rice, multigrain breads, and cereals should be eaten more often than more 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 than usual, and this can result in more damage to the brain [7].
Food such as fruits with naturally high sugar (such as grapes or raisins) or fruit juices can help. There are also glucose medications available by prescription. Patients/clients will need to work with a dietitian or healthcare specialist that is able to identify what is causing the problems in blood sugar levels. Once that problem is identified, treatment can be recommended.
- 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, patients/clients can use a large water bottle with time markings or get a smartphone app that sends reminders.
There is also some evidence that Vitamin E and curcumin may also be helpful. 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 is a yellow curry spice that has also been suggested to help recovery after brain injury, particularly in helping preserve cognitive abilities [9]. Although they would need a lot to have the results shown in the studies, even small amounts may help.
Patients/clients should work with a dietitian for 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 develop a specific and effective nutrition plan after injury. Each person’s body will have different needs than someone else based on factors such as age, weight, gender, and activity, and a tailored plan is the best way to ensure that they’re getting the nutrients they need.
Factors that can impact nutrition after brain injury
- Changes in taste and smell
- Some individuals living with brain injury experience sensation changes, including to their senses 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.
- Memory problems affecting eating
- People with a brain injury may experience memory problems. This can make it difficult to remember to eat, or all the steps needed to make a meal. If your patient/client is forgetting to eat or drink, they may not be getting the proper nutrients they need. Alternatively, if they can’t remember if they ate and make another meal, they may be eating 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 they ate
- 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 help patients 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, they’ll 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 they try to eat. Remind them that food is like medicine and they need it to recover and heal.
