Are you craving sugar after your TBI? Is your sense of smell and taste off since the accident? Has your appetite diminished? Are you battling fatigue and mood swings? Well, these are just a few of the changes you may experience after a mild traumatic brain injury.

However, eating a balanced diet and taking the right supplements because of your changing nutritional needs after a mTBI are some of the things you can do to combat these and other symptoms as panel members revealed at the June 8, 2018, Brain Injury Survivor Series luncheon at Rocky Mountain Human Services. The luncheon is part of a series presented by the Brain Injury Hope Foundation through a grant from the Spalding Hospital Volunteer Foundation.

“You’ve heard the phrase – the gut is the second brain,” said Jess Sorci of Integrated Health Systems. “It’s pretty typical after a brain injury to have gut issues. The vagus nerve connects the brain and the gut. So you need to consider support for the gut. You can supplement with probiotics and prebiotics. And we have found more success with prebiotics. You need to get your gut clean with the support of not just one or two strains of probiotics, but also by adding prebiotics.”

“Onions, garlic, asparagus, raw bananas, fruits and veggies are some good sources of prebiotics,” said Aaron Wiener of Craig Hospital.

Other sources of prebiotic foods include dandelion greens, artichokes, chicory root, oats, apples, flaxseeds (grind before use), cocoa beans. WAIT,chocolate?

Yes, chocolate is not only a good prebiotic, it is especially good for your brain, according to the New England Journal of Medicine and Frontiers in Nutrition. However, the chocolate you choose must be dark chocolate, high in cocoa, not milk chocolate. So check your cocoa content to make sure it’s 70 percent or higher.

EAT OFTEN AND THE RIGHT FOODS

Now that you got chocolate on your plate and you are flourishing your gut with prebiotics and probiotics, what else can you do to aid your recovery from mTBI?

“Eat every three to four hours” said Deb Finegold, amTBI survivor/”thriver” and panel member. “Your cognitive processing decreases without fuel, so feed your brain throughout the day. Smaller meals with snacks in between.”

Not just any snack will do, choose whole foods that Mother Nature intended, not the processed food varieties that invade the American diet.Also adding protein in the form of eggs, lean meat and nuts will help keep the brain fueled.

“It’s not just what you add to your diet, it’s what you take out,” said Terry L. McArthur of McArthur Nutrition Consulting whose philosophy is -- keep it simple, some assembly may be required. “You have to stop eating the pro-inflammatory foods – processed foods such as bacon, sausage, hot dogs, and deli meats.

“Add more variety by adding colors to your plate. Mix pigments to get a variety of antioxidants. Start with cutting back on saturated fats and adding walnuts, avocados, ground flaxseed… And do work with a nutritionist.”

ANTIOXIDANTS AND SUGAR CRAVINGS

Antioxidants are especially helpful as the brain consumes more oxygen than any other organ in your body. When the body uses oxygen it creates free radicals that can damage cell DNA and membranes, and cause inflammation (See Craig Hospital article and recipe). Foods high in antioxidants inhibit the production of free radicals.

Some foods high in antioxidants according to the U.S. Department of Agriculture include:

• Blueberries
• Blackberries
• Cranberries
• Strawberries
• Beans, red kidney, pinto
• Spinach
• Raspberries
• Brussels sprouts
• Plums
• Broccoli
• Beets
• Avocados
• Oranges
• Coffee beans

Craving sugar can be one of the “odd” results of a TBI, however, your brain uses more energy than any other organ in the body, so it is fairly common. A study from UCLA found that “the level of brain glucose use in people who suffer mild concussions is similar to that in comatose,severely brain-injured patients. Even mild head injuries result in major changes in the brain’s metabolism.” (Making a Good Brain Great, By Dr. Daniel G. Amen)

Soinstead of reaching for simple sugars such as gummy bears and soft drinks grab some fiber-rich fruit – apples, berries, peaches, plums -- and pair it with proteinand fat to avoid a sugar rush.

CHANGES IN TASTE, SMELL

Sometimes with a head injury the sense of smell and taste are diminished, so in order to bring some joy back to your eating add foods with texture.

“Texture more so than taste can help with bringing back the joy of eating,” Wiener said. “Peanut butter is great for this. It’s also the sense of smell that changes the taste in food. So pick potent sources of food – minty, acidic, and use spices.”

For the crunch factor choose nuts, seeds and popcorn instead of potato chips and pretzels to up the nutritional factor.

One thing to remember with a loss of taste and smell is to keep a handle on your food and the expiration dates. And label leftovers to make sure you are not eating food that has spoiled. And when in doubt, throw it out.

DIET: MEDITERRIAN, KETOGENIC, PALEO?

Which diet is best after a brain injury? The one that works best for you. Yes, it sounds simple, but remember what works for your friend may not work for you as every brain injury is unique. So try different diets.

“Food and nutrition should be enjoyable,” Wiener said. “Eating is one of the simple pleasures we get out of life. Sometimes when we add too much stress on getting nutrition it becomes unfun. There’s something to be said about eating a meal that you truly love. There is too much stress put on food, and it can be polarizing. Paleo vs. plant-based diet. … I’m in the center.”

The Mediterranean diet emphasizes (Mayo Clinic):

• Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
• Replacing butter with healthy fats such as olive oil and canola oil
• Using herbs and spices instead of salt to flavor foods
• Limiting red meat to no more than a few times a month
• Eating fish and poultry at least twice a week
• Enjoying meals with family and friends
• Getting plenty of exercise

**We all ate a Mediterranean meal prepared specifically for us by Biscuits and Berries that was also gluten and dairy free and participants LOVED it:  Lemon Rosemary Chicken, Quinoa Casserole, and Vegetables. The Brain Injury Hope Foundation and CTAT, LLC wanted to make sure we “modeled the way” and ate a healthy meal that was consistent with our topic and fed our brains in the best way possible!

Paleo diet consists of (Mayo Clinic):

• Fruits
• Vegetables
• Nuts and seeds
• Lean meats, especially grass-fed animals or wild game
• Fish, especially those rich in omega-3 fatty acids, such as salmon, mackerel and albacore tuna
• Oils from fruits and nuts, such as olive oil or walnut oil

What to avoid on Paleo diet:

• Grains, such as wheat, oats and barley
• Legumes, such as beans, lentils, peanuts and peas
• Dairy products
• Refined sugar
• Salt
• Potatoes
• Highly processed foods in general

Ketogenic diet consists of (Ketodash.com):

• Meats - fish, beef, lamb, poultry, eggs
• Leafy greens - spinach, kale
• Above ground vegetables - broccoli, cauliflower
• High fat dairy - hard cheeses, high fat cream, butter
• Nuts and seeds - macadamias, walnuts, sunflower seeds
• Avocados and berries
• Other fats - coconut oil, high-fat salad dressing, saturated fats, etc.

Foods to avoid on keto diet

• Grains - wheat, corn, rice, cereal
• Sugar - honey, agave, maple syrup
• Fruit - apples, bananas, oranges
• Tubers - potato, yams
• Legumes

The ketogenic diet was created in the 1920s to help kids with epilepsy, but the diet is not for everyone according to this Mayo Clinic video. Ketosis is the result of the diet where you burn fat instead of carbs for energy. There are side effects with this diet that can include constipation, fatigue, headaches, dizziness and muscle cramps.

“The research is in the infancy,” Sorci said.

However, she said the ketogenic diet has been effective in treating acute cases.

SUPPLEMENTS AND WORKING WITH A NUTRITIONIST

All the panelists agreed that food is the best way to get your nutrition; however, adding supplements can fill in the gaps, especially after a brain injury. One of the supplements recommended is fish oil, but with a word of caution as it can affect the patient’s medications and thin the blood. So make sure your fish oil has been treated to remove any mercury, PCBs and dioxins, which should be listed on the label.

According to Dr. Amen in his book Making A Good Brain Great a large portion of the brain’s gray matter is made up of DHA, which is found in fish oil. Neurons are also rich in omega-3 fatty acids that are in fish oil.

Other supplements mentioned at the seminar and in the handouts include:

• Multivitamin
• Glutathione
• Resveratrol
• Turmeric / curcumin
• Magnesium
• Antioxidants: Vitamins E, C, D3
• B vitamins
• CoQ10
• Acetyl L-carnitine
• Phosphatidyl serine (PS): Aids in the proper release and reception of neurotransmitters in the brain and helps memory.
• GlyceroPhosphoCholine (GPC):  Helps to sharpen alertness, reasoning, information processing and mental performance.
• Brain Vitale: Consists of PS and acetyl L-carnitine.

Before going “hog wild” by adding all of these supplements, all the panel members recommended you work with your doctor and/or a nutritionist to avoid conflicts with medications, to find the correct dosage of supplements and to find the right diet for you and your recovery.

“Don’t give up hope,” Sorci said. “It’s a rough battle, but keep on fighting, take breaks and listen to your intuition.”

“Yes, don’t give up,” Finegold said. “You know your body better than anyone else.”

“Celebrate little successes,” McArthur said. “And carry on.”

And as Wiener emphasized: Enjoy your food.

HANDOUTS

Brain Foods

Grocery Shopping and Meal Planning Tips with MTBI

Feed Your Body, Feed Your Brain: Nutritional Tips to Speed Recovery

Brain Foods and Nutrition Tips for TBI Survivors: Eat to Thrive

By Eliza Marie Somers