(Disclaimer: Please note that I’m not a doctor or nutritionist so please do your own research on this and take into account any personal choices, circumstances and requirements you may have when it comes to nutrition. The article below is for education and information purposes only.)
You’ve no doubt heard the sayings ‘You are what you eat’ and ‘Food is medicine’. In my experience, these are very applicable when it comes to healing from a concussion or brain injury. It took me six months to realise this, and I only wish I’d figured it out sooner as making changes to my diet helped me take big steps forwards on my recovery journey. It’s very easy sometimes to overlook simple solutions, but I’ve found that they’re often the most powerful ones. If you haven’t already done so, then make good nutrition a priority and you will likely see good results too.
Before my accident, I would describe myself as having an average UK diet. I loved cooking and when I had time, I would plan meals for my family and try to make sure that we ate our five fruit and veg a day. However, as a mum of 3 young children, I would often opt for the shortcut and go for convenience and speed. We would eat fish and chips, nuggets and chips, macaroni cheese, pizza, pies - those kinds of things. I had a vague outdated knowledge of nutrition and our diet was carbohydrate heavy – lots of potatoes, pasta and rice - and I often chose low-fat options. I drank a lot of tea and coffee, and we usually drank fruit juice or squash. I loved to bake with my girls so pretty much every week we would bake cupcakes or biscuits. Having a busy life, ferrying the children around to lots of activities, we were always on the go and I would always have a few snacks on hand, like chocolate-covered cereal bars. It wasn’t unknown for me to eat an entire bar of chocolate to fuel me through the mid-afternoon slump! So, essentially, we ate well but not particularly healthily, and on reflection, I realise now that I had fallen into lots of bad eating habits.
Fast forward to my car accident in November 2016 when I sustained a concussion and soft tissue injury and my desperate attempts after that to throw everything but the kitchen sink at my recovery. For the first few months, I tried to rest as much as I could, drew back quite a lot from normal life, and used anti-inflammatory sprays and gels, painkillers and physiotherapy for my physical pain and was prescribed anti-depressants for anxiety about four months post-injury. I wasn’t really improving so I set about making it my mission to find ways to aid my recovery. It was doing some research online that made me think about addressing my diet to see if that would help at all. With a combination of dietary changes, supplements, exercise and other health practices, I was able to come off all my medications and take big steps forwards on my healing journey. Overall, I’ve been able to maintain the improvements I made though I do need to start putting things into practice in a more intense way again when I feel myself going backwards sometimes.
I dived into the topic of nutrition and brain health. Over time I’ve repeatedly come across similar principles and they’ve really helped my recovery and brain function. On its own diet will have noticeable but limited benefits. However, combined with exercise, time in nature, breathing and mindfulness practice, work on the psychological side of things, good sleep habits and following any other therapies you may be undergoing, you will really notice the benefits.
Below I will share with you some of the things I did and that you could try, and some of the foods that are widely recommended for good brain health. I would say that I have combined elements of the ketogenic, paleo and Mediterranean diets. Some of the main reasons the food recommendations below are beneficial are:
- they help to reduce inflammation in the brain and body
- they work to repair the gut lining which very often becomes permeable – ‘leaky’ – after a brain injury due to the connection between the gut and the brain (the gut-brain axis)
- they help to reduce toxic substances crossing the blood-brain barrier
- they help to reduce oxidative stress and provide more oxygen to the brain
- they improve functioning of the mitochondria, the energy batteries of our cells
- they help to improve energy overall
- they provide essential nutrients, vitamins and minerals for good health
- they help to create an internal environment within the body in which healing can better take place
So, without further ado, here are some of the beneficial nutritional changes you can implement after a brain injury to help speed up your recovery:
- You could initially try following quite a strict plan, which is what I did, and then gradually reintroduce certain foods, and see how you get on. I started off by trying it out for about three weeks. After that, you may find, like me, that you feel so much better that you don’t want to eat certain foods at all or as much. We’re all different, but for me, it’s only now over three years later, that I’m eating some of the foods I’d cut out. I find that, from what I’ve learnt and experienced, my diet is now generally much better than it used to be and there are changes I’ve stuck with or know to revert to if my symptoms are bothering me. I’ve even lost some weight!
- Cut down on sugar, pretty much completely if you can, in the early days. Check food labels – become a label detective. Sugar has lots of different names. Surprisingly large quantities of sugar are in so many foods – cereals, sauces, even supposedly healthy snacks such as some cereal bars. You may find this really hard – sugar is increasingly believed to be addictive. I certainly did and even had almost withdrawal-like symptoms for a few days. Push through if you can, it’s worth it.
- Cut out or significantly reduce your intake of processed foods – essentially those foods that contain lots of ingredients. Many processed foods are inflammatory – especially fast food – and not very nutritious. As much as possible, you want to eat real whole foods that are nutritionally dense. Well-known US functional doctor Dr Mark Hyman writes in his book, ‘Food: What The Heck Should I Eat?’ about the difference between a manmade Twinkie cake - which contains 37 different ingredients - and a real food such as lettuce, which has no nutritional facts label, it’s just real food, i.e. lettuce. Try to pack as much nutritional value as you can into each mouthful.
- For about three weeks, I cut out dairy and gluten completely as they can be inflammatory and can cause food sensitivities. Instead, I used milks such as coconut and oat and I ate gluten-free bread (which generally isn’t very nice!). Feta is supposed to be one of the healthier cheeses. Greek yoghurt is generally considered OK because it has been strained many times so that the whey and much of the lactose in it has been broken down. I gradually returned to eating milk, cheese and food with gluten in, but I don’t eat as much as I used to, and I still opt for alternatives when I can or if I’m feeling more symptomatic.
- Increase your intake of healthy fats, avoid trans fats and limit consumption of saturated fats. Our brains are approximately 60% fat, and they need good fats to function well. We should aim to have a good quantity of omega-three fatty acids in our diet because these are the essential building blocks of the brain and help with both learning and memory. It’s fairly easy to swap out unhealthy fats for healthier alternatives. For cooking, try using olive oil, coconut oil, avocado oil or ghee. Butter is fine but don’t eat too much but avoid margarine. Beneficial fats also exist in seeds and nuts (though you’ll obviously have to avoid nuts if you have a nut allergy). These can be sprinkled on cereals or salads. Avocados are a wonderful source of healthy fats. I can’t eat enough of them.
- Try to avoid so-called ‘low fat’ foods because they invariably contain lots of sugar or sweeteners to improve flavour. Also, as our brains need healthy fats to function properly, we shouldn’t deprive them by eating lots of low-fat foods.
- Eat plenty of oily fish such as salmon, tuna, trout, sardines and mackerel as they contain omega-three fatty acids. I would aim for at least 2 or 3 portions a week. I also take a daily fish oil capsule. Fish oil is great brain food. It contains EPA and a high level of DHA. EPA helps to regulate cellular inflammation while DHA helps to maintain nerve cell structure and function. Fish also contains protein which is necessary for healthy function of neurotransmitters which send messages throughout the brain.
- Good quality meat, such as chicken, beef and lamb, contains protein which is necessary for every cell in our bodies and particularly for healing and repair. We also use protein to make enzymes, hormones and other chemicals in our bodies. Meat also contains folate and B vitamins. Meat can be inflammatory, though, so it’s best not to have too much and try to avoid or limit eating processed meats, such as ham, salami, sausages and bacon as they are widely believed to contain certain harmful chemicals. Bone broth - drunk like a soup or used as stock - is supposed to be very beneficial for healing, especially of the gut lining, which is commonly compromised after a brain injury. There are lots of recipes for nourishing bone broth on the Internet. If you’re a vegetarian, then make sure you’re getting enough of the beneficial nutrients, vitamins and minerals that are in meat from other sources and try vegetable broth instead.
- Eggs are good for brain health as they contain protein and choline, which is an essential nutrient needed for synthesis of the neurotransmitter acetylcholine that helps regulate memory and mood. Eggs also contain vitamins B6 and B12 and folate, which are beneficial for the brain. Although eggs contain cholesterol, some cholesterol is necessary in our diets to do things like build cells and make hormones, and eggs are one of the healthier sources of it.
- Eat lots of fresh fruit and vegetables and eat a variety. Dr Mark Hyman says to ‘eat the rainbow’. They are largely anti-inflammatory and provide plenty of vitamins, minerals, phytochemicals and antioxidants, which are good for both brain and body. Fruit contains quite a lot of naturally occurring sugars, but although it’s good to keep an eye on consumption, the benefits usually outweigh the negatives. Some fruits have a lower Glycemic Index (GI) score, i.e. they cause a lower, slower rise in blood sugar. Lower GI fruits include apples, bananas, blueberries, cherries, grapefruit, pears, oranges, nectarines, raspberries and strawberries. It’s good to eat a variety of leafy green vegetables such as kale, romaine lettuce, spinach and watercress; cruciferous vegetables such as broccoli and cauliflower; alliums like onions and garlic and colourful vegetables such as beetroot and radishes. Cooked mushrooms, classified as fungi, are also good brain food. Frozen fruit and vegetables are great for making smoothies.
- Some carbohydrates are necessary as they provide energy for the body, but it’s best to avoid or limit refined carbohydrates such as white bread, white rice, white pasta, pastries, cakes and biscuits. You could try to cut down on portion size too if your meals tend to be carbohydrate heavy. Swap to wholegrain versions of foods, such as wholemeal bread, pasta, couscous and brown rice. Also, try different types of carbohydrates, such as quinoa or buckwheat. Fruit, vegetables, seeds and legumes are also good sources of carbohydrates.
- Legumes such as beans, peas and lentils are good to eat because they contain protein, B vitamins and a number of minerals and provide fibre. They contain lectins though, a type of protein, which can affect the cells of the gut lining and cause inflammation for some, so it’s always good to rinse them thoroughly and soak for some time or overnight if possible before cooking thoroughly and eating.
- Try to include lots of herbs and spices in your diet, including turmeric, paprika, ginger, parsley, coriander, basil, thyme, oregano and cinnamon.
- Always have healthy snacks on hand. If your brain is working hard, it gets tired quickly and needs fuel. It’s easy to forget that eating something at those times can help. Some suggestions are blueberries, grapes, seaweed thins, avocados (with apple cider vinegar) hummus, carrot sticks, celery sticks and small squares of dark chocolate, quinoa or lentil crisps or protein bars. You’ll be glad to know that dark chocolate is good for you in moderate amounts – choose ones that have at least 70% cocoa content.
- It’s important to drink lots of water as our bodies are made up of approximately 45-75% water. It’s recommended for adults to drink a minimum of 1.5 litres of water a day. Speaking from my own experience, it does seem to help – I seem to have fewer headaches and feel less tired when I drink enough. I’ve swapped fruit and sweet drinks for water and only have the occasional glass of real fruit juice. Coffee and tea are supposed to be OK in small doses, so a cup here, and there is fine unless you feel that it’s causing headaches or not helping. I like certain teas because of the health benefits and because they generally contain less or no caffeine, for example, green tea, chai tea and herbal teas like camomile tea. It’s best not to drink alcohol, or only have it occasionally, at least for a while. I can hardly drink alcohol since my brain injury as it makes me feel pretty terrible, though I do still enjoy a very occasional glass of wine.
Good nutrition is an important piece of the brain injury recovery puzzle. Having said that, it’s good not to become too obsessive about it (even though I did for quite a while!). It’s not the end of the world if you break the rules sometimes or lapse here and there. And you may find that you come across conflicting advice – for example, a strict ketogenic diet may restrict some fruits, but in my mind, those fruits contain beneficial nutrients, so I generally choose to eat them anyway. See what works for you and develop a self-awareness about how you feel after eating certain foods. Try to notice, for example, if you’re eating comfort foods or high sugar foods for emotional reasons, and work to substitute these for healthier options. You will soon start to notice when you feel more energetic or brighter or if you feel tired and sluggish. Also, you don’t need to make all the changes all at once! Even just making one change at a time will help. If you follow at least some of the suggestions in this article, then I’m pretty certain that you will see benefits and rewards for your health and you will want to keep going with maintaining a brain-healthy diet.
For further reading, I recommend the book ‘How to Feed a Brain’ by brain injury survivor, Cavin Balaster.
Nothing in this blog should be taken as providing medical advice or recommendations. Please always consult your doctor for medical advice and before taking any medication or supplement. Any opinions expressed in this article are of the author and not CFG Law Limited.