Nutrition to Help Concussions

By Britni Vincent, RD, LD
November 4, 2024

According to the CDC, in 2022, 2.3 million children and adolescents under 17 years old had been diagnosed with a concussion or brain injury, which is 3.2% of the population. 

Concussions are the cause of more than half of ER visits for children aged 5–18 in the US.

The percentage of children and adolescents who have been diagnosed increases with age and is higher for boys than girls. Experts estimate that 1–3 million people, not just children, visit the emergency room with a concussion each year. 

As more and more concussion research is coming out, experts are finding out all the potential effects of even just one concussion.

Historically, not much was known about what happens to the brain after a concussion since it's very difficult to study the brain. Concussions can lead to long-term health problems, affecting more than just the brain. Nutrition interventions can help prevent further damage and, in some cases, even reverse damage.

For more information on nutrition and supplement listen to this great podcast episode:

What Is A Concussion?

First, let's start by understanding that a concussion is a type of traumatic brain injury (TBI) that happens when the brain experiences a sudden temporary loss of function after being hit or bumped. Consequently, a concussion will affect how your brain works.

Concussions are the most common type of TBI.

Picture this – the brain is made of soft tissue and is cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain and sometimes, it literally causes it to move around in your head.

Concussions are usually caused by being hit on the head or shaking the head and upper body. You might assume that you lose consciousness when you have a concussion, but that's not always the case.

After a concussion there can be bruising, damage to blood vessels, damage to nerves, an increase in free radicals, cell death and a reduction in blood flow to the brain.

Concussion Symptoms

Concussion symptoms, severity and length of time the symptoms last can vary greatly from person to person. Effects are usually temporary but can include:

• Headaches

• Problems with concentration

• Balance

• Memory problems

• Dizziness

• Ringing in the ears

• Nausea

• Slurred speech

• Fatigue

• Coordination issues

Keep in mind that some concussion symptoms may be delayed for hours or days after the concussion occurs; these symptoms may be cognitive problems such as:

• Poor concentration and poor memory

• Mood changes

• Sensitivity to light and noise

• Sleep disturbances

• Psychological adjustment problems

• Disorders of taste and smell.

Some individuals develop post-concussion syndrome, a complex disorder in which various symptoms last for weeks and sometimes months after the injury occurred.

A less talked about effect from concussions is gut health.

Maybe you’ve heard the term your gut is your second brain. Well – it is very true! Concussions cause systemic inflammation throughout the body, which can affect the gut barrier, leading to leaky gut, slowing gut motility as well as negative changes in your microbiome. This means that you may have more bad bacteria and inflammation in your gut as well as impaired gut motility after a concussion.

A recent study from 2022 with Division I college football players over the course of one season, found a post-concussion drop-off of two bacterial species normally found in abundance in stool samples of healthy individuals. It also found a correlation between traumatic brain injury linked proteins in the blood and one brain injury-linked bacterial species in the stool (1).

This change in your gut health could result in nausea, acid reflux, constipation, diarrhea, bloating, gas and abnormal weight loss or weight gain. These symptoms could persist until you focus on gut healing.

Learn More: Symptoms of Poor Digestion & How To Fix It

Nutrition For Concussion Recovery

Most people are surprised to learn that food choices can have a big impact on concussion symptoms but it really makes sense, as the brain is the most nutrient-dependent organ in the human body. The focus during recovery is nutrition for brain healing.

I have seen clients with post-concussion syndrome so severe it seriously impacted their quality of life and ability to function at school or work. It has been amazing to watch as nutrition and proper supplementation made a huge difference in their symptoms and they were able to start living their old life again.

Just recently a client had post-concussion syndrome and within two months of making some dietary changes and implementing some key supplements she told me “I feel like my old self again”. I highly encourage you to start thinking about your food choices as brain food. What you put in your mouth should nourish and optimize brain health and brain function.

While more research is needed on concussions I wanted to share some general nutrition recommendations for concussion recovery.

Worst Foods for Concussion Recovery 

Sugar and Processed Carbohydrates

Since concussions cause inflammation in the brain the goal is to reduce that inflammation, which you can with your food choices. It's probably no surprise that sugar and processed carbs will only exacerbate that brain inflammation. To reduce inflammation it’s best to significantly reduce or eliminate them.

Remember, all carbohydrates break down to sugar in the body so this doesn't just mean the obvious processed sugar foods like candy, but also includes all kinds of cereal, granola bars, pizza, sugary drinks, and the list can go on and on. These foods create a blood sugar spike, which creates inflammation.

If your blood sugar spikes, 2-3 hours later it’s going to dip, often causing sugar and carbohydrate cravings, brain fog, headaches, nausea, feeling light headed or shaky, anxiety.

That dip in blood sugar is very stressful for the body so naturally your body wants the quickest pick me up – more carbohydrates or sugar. Grabbing more sugar or processed carbohydrates will create the spike again and now you can see the blood sugar roller coaster that so commonly occurs.

Refined Oils

Avoid the refined oils that are inflammatory such as corn, soybean, canola, vegetable, and cottonseed oils. By looking at the ingredient list on any food product you'll find these oils in so many foods. If you see any of these refined oils in the ingredient list, just put it back on the shelf.

These oils are not made from a naturally fatty substance, so they need to be highly processed to turn them into an oil which leads to a very inflammatory oil with little to no nutritional value.

Dairy, Gluten and All Grains (For Extreme Cases)

Some individuals who have a lot of symptoms or have post-concussion syndrome may need to take it a step further and eliminate all dairy, gluten, and sometimes all grains.

I have had clients with post-concussion syndrome notice a significant difference in their symptoms once they eliminated dairy, gluten and in some cases grains. This includes cheese, heavy cream, milk, yogurt, rice, bread, quinoa, and corn because it's a pseudo-grain (meaning our body responds to it like a grain).

It may be helpful to think of this as doing an experiment on your body. So, do an experiment and eliminate the grains and dairy from your diet for a month and see if your concussion or post-concussion symptoms reduce. If they do, I guarantee you'll be highly motivated to steer clear of those foods during your post concussion recovery process. It's possible that once your brain does some healing and you reduce inflammation, you may be able to safely re-introduce some of those foods. You could eliminate one or the other first if it feels too overwhelming to do both at the same time.

Learn More: What Gluten Does to Your Body and Why a Gluten-Free Diet Might Be Right for You (link when article is on website)

What To Eat After A Concussion: Best Food For Concussion Recovery

Many of you reading may be thinking, well what's left to eat if I eliminate dairy and grains? I think it's always a good idea to focus on the foods to incorporate in your diet versus focusing on the ones that you're eliminating.

Good news is there are still plenty of yummy foods left if you're grain and dairy free: healthy fats (avocado, olives, olive oil, coconut milk, raw or dry roasted nuts and seeds and avocado oil), vegetables, starchy vegetables like sweet potato and winter squash, fruit (berries are best because they're foods high in antioxidants and low in sugar), and protein (eggs, chicken, beef, turkey, fish and seafood are great protein sources).

We have many delicious recipes that fit these criteria or can be easily tweaked to make them dairy and grain free.

Protein

Protein is critical for brain healing, specifically healing any damaged brain tissue and brain cells. When your body is healing from any injury (in both your brain and the rest of your body) your protein needs are higher.

Protein is also important after a concussion because meat specifically is a great source of magnesium. Research has shown that magnesium levels in the brain drop significantly after a concussion which can slow down the healing process (2).

How much protein to eat during concussion recovery?

I would recommend four to seven ounces at meals and two to three ounces at snacks (men should consume the upper amounts of these ranges). Start increasing your protein right after the brain injury.

Focus on animal sources of protein such as: eggs, beef, chicken, fish, seafood, turkey, and yogurt and cottage cheese (if you are not dairy sensitive). Choosing organic, grass fed, pasture raised, free range animal sources is best as they are higher in beneficial fats, lower in inflammatory fats and are overall more nutrient dense.

If you're struggling with nausea or lack of appetite, try our delicious smoothie recipes that are packed with protein. They are a great way to help your brain heal even when you struggle with your appetite.

Healthy Fat

The numbers speak for themselves: about 60% of your brain is made up of fat!

Since most of the brain is made up of fat, imagine how an already inflamed brain is going to function on a low-fat diet or consuming refined oils that are inflammatory … not very well. Healthy fat is brain food and helps in reducing inflammation.

Healthy fats are avocado, raw or dry roasted nuts, avocado oil, coconut oil, olives, olive oil, avocado oil mayonnaise, coconut milk, and grass-fed butter.

Aim to eat healthy fat every single time you eat.

Omega-3 Fatty Acids

As mentioned, about 60% of your brain is fat, and 20% of that is made up of omega-3 fats. Omega 3s post-concussion can help to reduce inflammation in the brain and regenerate the brain that was damaged.

Omega-3 fatty acids are essential fatty acids, meaning your body doesn't just make them; you must get them from food or supplementation. Focus on two kinds of omega-3s that provide the most therapeutic benefits, EPA and DHA. DHA helps to build strong, flexible cell membranes in neurons, and EPA helps to reduce the inflammatory response after a brain injury.

The best food sources of omega-3s are fatty fish such as salmon, mackerel, sardines, herring, anchovies, oysters and trout. People generally don't consume enough fatty fish to get the amount of omega-3s needed, and that's where supplementing comes in.

Omega-3 supplementation immediately following a concussion has been found to be extremely beneficial to the healing process. We've witnessed this with many of our clients, and in research reviews, Dr. Michael Lewis suggests that there are benefits of aggressively adding omega-3 fatty acids to optimize the healing of TBIs, concussions and post-concussion syndrome (3,4).

Dr. Michael Lewis has years of clinical experience working with patients who have had a TBI, concussion or post-concussion syndrome. We had him on our Dishing Up Nutrition podcast. In addition to Dr. Lewis' findings, other research has shown the capacity of omega-3 fatty acids to counteract some of the effects of TBI by normalizing levels of molecular systems in the brain (5,6).

Suggested Omega-3 Protocol

Dr. Lewis has developed an omega-3 protocol to follow after a concussion which we have used with good success many times (7). His recommendation is to have three omega-3 capsules with each meal the first week, three omega-3 capsules with two meals the second week and then the third week reduce to a maintenance dose of three capsules per day. If symptoms return after reducing one of the dosages, increase the dose for another week or two then try to reduce again.

It is crucial you are using a high quality omega-3 supplement to aid in the brain's recovery. Ideally you follow this protocol right after a concussion happens, but we have had many clients follow this protocol years after a concussion happened and it does reduce their post-concussion syndrome symptoms. This protocol would be contraindicated if you’re on a blood thinning medication.

Vegetables

By increasing your vegetable consumption you're increasing your antioxidant intake. This may help to reduce your symptoms. Swapping the processed carbohydrates (bread, pasta, crackers, muffins, etc) for real food carbohydrates will significantly reduce inflammation.  

Try spaghetti squash or zucchini noodles instead of pasta, have berries with your afternoon snack instead of candy, have a piece of fruit and/or veggies with your eggs in the morning instead of a piece of toast.

What About Alcohol With Concussion Recovery?

If you’ve experienced a concussion recently or you’re struggling with post-concussion syndrome it’s best to significantly reduce alcohol or, better yet, eliminate it all together at least until you get better.

Alcohol is seen as a toxin to the body and increases inflammation. Drinking alcohol can exacerbate your symptoms and if you’re drinking regularly may delay your healing process.

Prioritize Sleep For Brain Function & Brain Health

Sleep is crucial for concussion recovery. Aim for at least 7 ½ - 8 hours of sleep each night. Your brain actually heals itself while you’re sleeping. Difficulty sleeping may be part of your concussion symptoms. If you’re having difficulty falling or staying asleep I would first assess your sleep hygiene.

Ideally avoid electronics for an hour before bed. Maybe you just start with 15 minutes before bed and work your way up to that hour.

The reason is, electronics stimulate your body to produce more cortisol. Based on cortisol’s optimal biorhythm cortisol should be at the lowest point at night. It reduces when it’s dark out and has an inverse relationship with melatonin, your sleep-wake cycle hormone. This means if you’re watching tv before bed your cortisol is likely elevated and your melatonin production is reduced, making it more difficult to fall and stay asleep.

Tips for improving your sleep habits:

Instead of watching television or scrolling on your phone before bed, think about what would be relaxing to do before you crawl into bed.

Some ideas could be:

• reading a book or magazine (paper versions instead of electronic versions are ideal)

• meditation

• prayer

• take a warm bath (bonus – add Epsom salt to your bath, which is a form of magnesium and offers mild detoxification)

• gentle stretching

Bedroom temperature:

Adjust the temperature in your bedroom. Your body’s internal temperature should actually reduce when you’re sleeping, which helps put you into a deeper sleep.

Research has shown that 60 – 67 degrees Fahrenheit is the optimal bedroom temperature to stabilize REM sleep.

Make sure you’re not going to bed hungry.

Some individuals wake during the night because they have a dip in blood sugar. Ensure you’re eating enough throughout the day and if you need a snack after dinner to help you sleep then aim for a little bit of carbohydrate and some healthy fat.

A small apple and peanut butter is a favorite. Another idea is berries with heavy cream, if you don’t tolerate heavy cream you can use canned coconut milk instead or put some shredded coconut on top of your berries.

 

What Vitamins Are Good For Concussions?

In addition to supplementing with omega 3 fatty acids, supplementing with a B complex or a multivitamin with B vitamins would be beneficial to support brain healing and overall brain function.

B vitamins are critical for optimal brain function – supporting neurotransmitter production, energy for brain cells, nerve repair, among many other functions.

B12 is particularly beneficial during recovering from a concussion. The best food sources of B12 are animal proteins, specifically meat.

Check out a recent podcast we did on foundational supplements. These foundational supplements are beneficial for anyone, but especially someone who is recovering from a concussion or any type of injury.

Depending on your symptoms there may be other supplements, such as CoQ10 that may be beneficial for you during recovery. Working with a nutritionist will help you determine what your individual needs are.

Learn More: Basic Supplements For Overall Health

Get Expert Help

If you're feeling overwhelmed after reading this, that's alright; we're here to help!

If you feel like you need additional support during this healing process or if you're struggling with post-concussion syndrome I'd highly recommend making an appointment with a licensed and registered dietitian or nutritionist (available in-person or by phone).

These are general recommendations, and there may be additional supplements and food modifications that would be beneficial for you.

For more information on brain health, check out these resources:

READ: Eat This, Not That For Brain Health

LISTEN: Concussion Rescue with Guest Dr. Chapek

TAKE: Building A Better Working Memory online class for only $25

References:

1. Soriano, S., Curry, K., Sadrameli, S.S., Wang, Q., Nute, M., Reeves, E., Kabir, R.,Wiese, J., Criswell, A., Schodrof, S., Britz, G.B., Gadhia, R., Podell, K., Treangen, T., Villapol, S. (2022) Alterations to the gut microbiome after sport-related concussion in a collegiate football players cohort: A pilot study, Brain, Behavior, & Immunity – Health. 21 ( 100438) https://doi.org/10.1016/j.bbih.2022.100438.

2. Institute of Medicine (US) Committee on Nutrition, Trauma, and the Brain; Erdman J, Oria M, Pillsbury L, editors. Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. Washington (DC): National Academies Press (US); 2011. 12, Magnesium. Available from: https://www.ncbi.nlm.nih.gov/books/NBK209305/

3. Lewis, M. (2016) Concussions, Traumatic Brain Injury, and the Innovative Use of Omega-3s. Journal of the American College of Nutrition. 35(5):469-75. doi: 10.1080/07315724.2016.1150796

4.   Patch C.S., Hill-Yarden E.L., Lewis, M., Ryan, L., Daly, E., Pearce, A.J. (2021) The More, the Better: High-Dose Omega-3 Fatty Acids Improve Behavioural and Molecular Outcomes in Preclinical Models in Mild Brain Injury. Current Neurology and Neuroscience Reports.

5.      Lin, L., Zheng, S., Lai, J., Ye, D., Huang, Q., Wu, Z., Chen, X., Wang, S. (2023) Omega-3 Polyunsaturated Fatty Acids Protect Neurological Function After Traumatic Brain Injury by Suppressing Microglial Transformation to the Proinflammatory Phenotype and Activating Exosomal NGF/TrkA Signaling. Molecular Neurobiology. 60(10):5592-5606. doi: 10.1007/s12035-023-03419-3.

6. Wu, A., Ying, Z., Gomez-Pinilla, F. (2007) Omega-3 fatty acids supplementation restores mechanisms that maintain brain homeostasis in traumatic brain injury. Journal of Neurotrauma. 24(10):1587-95. doi: 10.1089/neu.2007.0313. 

7. Lewis, M. Omega 3 Protocol For Brain Health. Brain Health Education. http://www.brainhealtheducation.org/resources/brain-injury-protocol/