A bang on the head - nutritional strategies for concussion and head injury in young athletes

Are you a young athlete who has sustained a head injury while playing sports? Are you a worried parent of a sporty kid who has had a nasty bump to the head or a sports coach who continually sees young athletes experience concussions? Besides keeping the injured child off sports and waiting to recover, knowing what else to do is challenging. It becomes even more worrying when a loved one doesn’t seem to be themselves after a nasty knock, and they are foggy-brained, exhausted, and zoned out. But, you can do some really positive things via nutrition to help prevent the impact of a head injury and to help get back to playing sports, being active, and feeling brain sharp again.

Often, a child bounces back quickly and soon forgets about a sports head injury. However, the ramifications of concussions and other sports-related brain injuries are a growing concern amongst sports coaches and professionals as well as parents. Whether it is a concussion from rugby, repeated headers in football, or a fall from a bike or a pony or a skiing accident; a blow to the head poses a risk for both short and long-term cognitive problems that can affect both mental acuity and mood.

Feeding your kids lots of brain-boosting foods may well be the key to protecting the brain from damage. Research is catching up to the idea that nutrition plays a critical role in both preventing these injuries, as well as accelerating recovery. This blog delves into the significance of specific nutrients, and food supplements that can help prevent the far-reaching consequences of a sports-related mild traumatic brain injuries (mTBIs) which are alarmingly common these days.

Writing this blog reminds me of a story of a young girl, whio I will call Sarah. Aged 9, she fell off her pony and hit her head against a stone wall. This head injury triggered a state of chronic fatigue and severe brain fog which lasted several years. I met her first when she was about 14 years old, and at that time, she spent most of her day in bed and was not at school. We discovered through lab tests that she had some very critical nutrient shortfalls, and once these were optimised she was soon out of bed and back riding and she eventually got back to school again. The good news is that that is all behind her now, she is in her early twenties, and runs her own equine business and is happy and flourishing.

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Why are knocks to the head so dangerous?

The emerging consensus amongst brain trauma researchers is that knocks to the head result in mild to severe brain injury, and every hit harms as it contributes to brain damage that can potentially result in neurodegeneration later in life.

Brain injuries due to a bash to the head are described as ‘now’ and ‘later’ diseases – those that affect the child immediately and then those that can affect them across their lifetime.

‘Now’ brain injuries: include head injuries that require immediate removal from play, medical examinations, and a considerable amount of recovery before the person can return to play. This is usually due to concussion. Some of symptoms can last from weeks to years known as post-concussion syndrome and can include pain, headache, dizziness, difficulty sleeping, feelings of PTSD such as flashbacks as well as a foggy brain.

Balance and coordination can be affected in children immediately following even just a few blows to the head. And these head injuries may also lead to cognitive processing issues such as impaired learning, memory issues and mood disorders.

Three or more mild traumatic brain injuries among rugby players have been associated with significant long-term cognitive deficits in memory, processing speed, and attention as well as heightened impulsivity. Head injuries have also been linked to the onset of depression and low mood.

‘Later’ brain diseases: these include disease-states caused by repeated traumatic brain injuries, and they may also occur due to repetitive minor hits to the head that are not enough to cause a concussion. Later brain diseases are usually related to cognitive and neurological damage sustained over time rather than due to one specific injury. These may include regularly heading the ball in football, tackling in rugby, being hit by the boom while sailing or being struck in the head in fighting sports like boxing.

Regular sub-concussive brain injuries from impact sports can potentially lead to neurodegenerative disease and are linked to a condition called Chronic Traumatic Encephalopathy (CTE), which is a form of early onset dementia. Progressive brain atrophy, together with other forms of dementia, motor neurone syndrome, Parkinson’s and other conditions are also linked to regular hits to the head through high-impact sports.

This is partly why researchers have been looking (in addition to safer practices in sport) for other practical ways to prevent any repercussions from head injuries and to help recovery when a child does sustain a nasty bump to the head. Nutrition is one angle that has gained quite a bit of traction and educating parents and youngsters in the importance of diet and food supplements is key for long-term brain health and cognitive function.

Why does nutrition count?

A striking example of why nutrition counts comes from studies on athletes entering the National Football League (NFL) in America, where common deficiencies in omega-3 fatty acids, vitamin D and magnesium levels have been found. Even though they are high performing athletes, these deficiencies pose a higher risk of slower recovery from concussion. It was also cited that shortfalls in these key nutrients may affect brain health and cognition as well as posing a higher risk for sports related injuries.

Which nutrients can help when they have had a blow to the head?

Protein – consuming enough protein is key as the amino acids (which are the building blocks of protein) help to repair injuries in the body and the brain. Think meat, fish, dairy, eggs, beans and pulses, nuts and seeds. Those people who eat enough protein soon after a mild traumatic brain injury may need a reduced hospital stay and improved recovery outcome.
Omega-3 fatty acids – as well as ensuring your youngster eats plenty of oily fish, shellfish, walnuts, flax seeds and chia seeds, it is good to supplement with a fish oil or a vegan marine algae supplement. A study on Canadian elite rugby 7s, found that dietary intake of omega-3 fatty acids alone may not be enough to prevent the long-term consequences of concussion and brain injury during sports activities; and that athletes often need to take omega-3 supplements to mitigate any neurological risks. Participants in studies receiving the DHA form of omega-3 became symptom-free and able to return to sport faster than those in placebo groups.
Magnesium – supplementation with magnesium has shown potential benefits in the acute treatment of concussions. Magnesium-rich foods include dark leafy green salad leaves and vegetables, cacao/chocolate, nuts and seeds. Magnesium bisglycinate is one of the most neuroprotective forms of magnesium that is easily available in supplement form.
Vitamin D – every cell in the body has a vitamin D receptor including our brain cells. Vitamin D comes from sun exposure and eating oily fish such as mackerel and salmon. It has natural anti-inflammatory properties as it is a naturally occurring steroid so it may play a role with the body dealing with the inflammation from a blow to the head. People living in the northern hemisphere are recommended to take a Vitamin D supplement from October to March due to lack of sun during the winter months.
Choline – foods such as liver, egg yolks, chicken, fish, shiitake mushrooms, peanuts, and milk contain choline which is a key brain food. One study found that people who experienced the worst post-concussive symptoms had shortfalls in their choline levels. Not enough choline was also associated with more prolonged somatic symptoms such as distressing pain, weakness and shortness of breath.

Other more novel approaches to supporting brain injuries and concussion include:

N-acetyl cysteine (NAC), a supplement known for its antioxidant properties, has shown promising results in the treatment of concussions, particularly in reducing post concussive symptoms and support for traumatic brain injury. The studies suggest that NAC in supplement form can help mitigate the oxidative stress and neuroinflammation typically associated with TBI, leading to improved outcomes. Dietary cysteine is found protein-rich foods including chicken, turkey, yoghurt, cheese, eggs, beans, sunflower seeds and peanuts.
Pine needle extract (pinus radiata) contains antioxidants that seem to be very healing on the brain and has a great deal of research on cognitive acuity, focus and processing. It has been the focus of multiple studies, showing promising results for persistent post-concussion symptoms. This comes in a tasty tea or as a supplement.
Palmitoylethanolamide (PEA) works on the endocannabinoid system helping to reduce inflammation and pain and is neuroprotective to the brain which may help to prevent future neurological damage. Dietary PEA is found naturally in egg yolks, beans, coffee, cocoa/cacao, peanuts and soya beans.

The importance of good sleep hygeine

Enough good quality sleep is particurlarly important for a young athlete with any kind of brain injury, and this may be partly due to the action of a hormone called melatonin we naturally make to help us get to sleep each night. Melatonin is both anti-inflammatory and neuroprotective, as well as aiding us to wind down and get to sleep.

Natural ways to create enough melatonin at night is to work on the circadian rhythm by spending time outside at the start of the day and getting some natural light and then cutting back on screen-time in the evening one to two hours before bedtime. Food-wise, feed your young athlete plenty of cherries which naturally contain melatonin. The amino acid tryptophan helps to produce serotonin which binds with specific enzymes to produce melatonin. So encourage foods containing tryptophan include turkey, chicken, bananas, avocado, cashew nuts and peanuts. Melatonin is a prescribed medication in the UK but can be bought over the counter in other countries.

Round up

Accidents are inevitable when young athletes are involved in contact and combat sports, and equally kids and teens can easily tumble from their bike or pony. We never know when a youngster is going to sustain a head injury, so as a preventative it is important for young athletes to learn to feed themselves as much of the good stuff as possible. Weaving in more nutritious foods as part of their day to day eating habits can equal greater resilience and better potential for recovery. Even if you are an elite athlete performing at the top of your game through your natural talent, you still need to keep well focused on your nutrition and integrate enough protein, omega-3, magnesium, vitamin D and choline into your diet. And you may want to take professional advice and consider adding in a supplement regime to help soften the blow if you do unfortunately experience a head injury.

If you or a child under your care has been concussed or had a nasty bump to the head then also consider putting in NAC, pine needle extract and/or PEA until things are better stabilised. Encouraging a better circadian rhythm and optimising melatonin through good sleep hygiene is also key for optimal recovery from a head injury.

If you or a your child has sustained a significant blow to the head or are involved in a high-level elite sport that has a high risk of head injury and you want to protect both short and long-term brain health, then be in touch with our NatureDoc clinical team who can run some laboratory testing to identify and advise on their specific nutrient needs.

Please remember to forward this blog to your children’s sports coaches or local sports clubs and anyone overseeing activities that involve a high risk of head injury. Thanks for spreading the word.

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A bang on the head – nutritional strategies for concussion and head injury in young athletes