August September 2024 - 25

ASPDA Nutrition Focus
do not work in isolation. Dietary measures should remain
the focus of the nutrition treatment.
DIETARY CONSIDERATIONS
Consuming a diet rich in complex carbohydrates (brown
rice, oats, whole-grain bread/pasta, quinoa), protein, low-fat
dairy, fruits, vegetables, and healthy fats (avocado, olive oil,
and nuts/seeds) should make up the majority of an athlete's
diet during the recovery process. The most important
aspect of concussion recovery is simply consuming enough
calories per day to meet one's energy needs. Daily energy
needs vary based on many factors including activity level,
muscle mass, height/weight, and genetics.
Weight maintenance or a slight weight gain is
recommended during the healing process to ensure the
athlete is consuming enough energy to facilitate the healing
process. It has been shown that brain injuries, dependent on
the severity, can increase whole-body energy expenditure
(Factors Associated With Energy Expenditure and Energy
Balance in Acute Sport-Related Concussion, 2021).
Depending on the severity of the concussion, an athlete
may need to consume more calories per day to maintain
their weight. If an athlete is comfortable seeing their
weight, asking them to weigh themselves first thing in the
morning, after using the bathroom, one time per week is a
simple strategy to evaluate this.
ANTIOXIDANT-RICH FOODS
Foods high in antioxidants can help reduce the burden of
added inflammation that occurs because of a concussion.
Fruits that are high in antioxidants include, but are
not limited to, blueberries, strawberries, raspberries,
blackberries, oranges, and grapes. Vegetables high in
antioxidants include, but are not limited to, spinach,
asparagus, broccoli, beets, carrots, bell peppers, and kale.
An athlete should aim for a minimum of two servings
of fruit and 3-4 servings of vegetables per day (Dietary
Guidelines for Americans, 2020). Eight ounces of tart cherry
juice 1-2 hours before bed may also contribute positively to
concussion recovery due to its high level of antioxidants and
can be practical if appetite is a challenge.
OMEGA-3 FATS
Omega-3 fatty acids are essential fatty acids prominent
in fatty fish, nuts/seeds, and plant oils. The three types
of omega-3 fatty acids are alpha-linolenic acid (ALA),
eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).
In the area of brain health, DHA and EPA are omega-3 fatty
acids of importance due to their anti-inflammatory properties
(Neuroprotection by Docosahexaenoic Acid in Brain Injury,
2014). On average, most people, including athletes, do not
consume enough omega-3 fatty acids (Dietary and Biological
Assessment of the Omega-3 Status of Collegiate Athletes:
A Cross-Sectional Analysis, 2020). Because of its role in
reducing brain inflammation and physical nerve cell damage
post-concussion, choosing foods that are rich in DHA and EPA
is a great strategy for optimizing recovery. Salmon, canned
tuna, mackerel, and sardines are excellent options. Due to
its low prevalence in food, an omega-3 supplement (with
EPA and DHA12) is also warranted until an athlete is cleared
to fully participate in the competition. For NCAA Division 1
athletes, NSF Certified for Sport or Informed Sport-Certified
supplements are recommended. Generally recognized as
safe amounts of omega-3s (up to 5000 mg/day) should be
considered following a concussion (U.S. Department of Health
and Human Services, 2023).
CREATINE MONOHYDRATE
Creatine Monohydrate's role in cognitive function is an
up-and-coming area of research due to the uniqueness
of its chemical structure and potential role in brain injury
recovery. Creatine is naturally produced in the body, but
after a concussion production may be reduced, while
energy demand from ATP is also increased. Creatine
supplementation can play a role in replacing those lost
creatine stores (Decrease in N-acetyl aspartate following
concussion may be coupled to a decrease in creatine, 2013)
and replenishing ATP. Creatine has also been shown to
have the potential as a neuroprotective when used before
or after more severe brain injuries. Given creatine's unique
function at the cellular level, it is theorized that it can
reduce the burden of metabolic changes that happen after
a concussion (Potential for use of creatine supplementation
following mild traumatic brain injury, 2017).
While more research trials in athletes with concussions
are needed, creatine monohydrate is among the most
researched performance supplements on the market, with
no known negative side effects other than weight gain
(International Society of Sports Nutrition position stand:
safety and efficacy of creatine supplementation in exercise,
sport, and medicine, 2017). Therefore, supplementation
(0.1g/kg/day)6 of an NSF Certified for Sport or Informed
Sport-Certified brand is a safe and potentially effective
supplement for the concussed
athlete (Neuroprotection for the
warrior: dietary supplementation
with omega-3 fatty acids, 2011). n
Written by an American Sports
and Performance Dietitians
Association Registered Dietitian
(RD). To learn more about sports
nutrition and ASPDA, go to www.
sportsrd.org.
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August September 2024

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