Concussion is getting a lot of press in recent years. Rightfully so, since brain function is of utmost importance for quality of life. Concussion, or mild traumatic brain injury (MTBI) results from anything that causes the brain to be jolted around inside the skull. It could be from a blow to the head or body or a whiplash injury. Acute symptoms of a concussion are headache, nausea, poor memory and confusion, mood swings (ie crying unexpectedly) and sleep issues. It is estimated that there are 2-3 million concussions in the US each year related to sports and that 6% result in a visit to the emergency department. Competitive high school sports account for the majority of concussions in youth with football being the most common cause for concussion in boys and soccer in girls. A high school student who has had a concussion has an increased risk of getting a second concussion because of the already-sensitive inflammation around the brain. Having multiple concussions can lead to serious long-term consequences for brain health. For this reason it is very important to seek medical attention right away if a concussion is suspected. If a concussion is diagnosed it is vital to remove your child from sports play until they are cleared. Rest following a concussion is necessary for the brain tissue to heal and return to a non-inflammatory state. 48 hours of strict rest is recommended post trauma which means; no school, no work and no practice. After 2 days you can slowly increase effort as tolerated. Many are motivated to get back in the game and this can lead to a child returning to play too soon, putting themselves at risk for long term brain consequences. Recovery for adults is typically 7-10 days, but can be longer for kids depending on severity of the injury. Having a professional reassess memory, balance, eye movement and delayed recall will help parents and coaches make a good decision about when to allow an athlete to return to sports play. I don’t recommend medication for several reasons. We don’t want to cover-up symptoms of brain inflammation resulting in return to activity too soon. Pain relievers, like acetaminophen, have unknown effects on the brain and there are natural ways to reduce inflammation that are not toxic and can help to prevent another severe concussion in the future.
That word brings me to the point of this blog. Concussion prevention with nutrition. I enjoy playing sports and I especially love watching my kids play. I even love football, both of my boys have played tackle football. I want to emphasize that I would not let them play a contact sport like soccer, lacrosse, football or hockey without protecting their brains with proper nutrition and supplementation. Prevention is the best way to avoid the long-term brain health consequences of mild traumatic brain injury (MTBI) concussion. It is well-known that chronic inflammation in the body is degenerative. Like, really really bad. This is particularly true for the brain. Certain foods are found to “up-regulate” (increase) inflammation in the body and others are found to “down-regulate” (reduce) inflammatory pathways in the body. I would suggest that the majority of american kids (and people) today eat a highly inflammatory diet. The sort of diet that lacks the essential nutrients required to balance the inflammation caused by injury. The main inflammation offenders are: refined sugar, High fructose corn syrup, sugary snacks, refined grains, eating sugar too often which releases insulin, unhealthy fats (ie fats found in processed food and animal products where the animal ate grains) aaand sugary drinks. Did I mention sugar? This elevated base-line inflammatory state can lead to an increased susceptibility for concussion, increased severity of those concussions, increased healing time for concussions and increased risk for long-term detrimental effects from concussion. Previous generations did not consume as much sugar as kids do now and they had a healthier fat content in the meat, dairy and eggs they consumed (even if they didn’t consume fish). In the past animals were raised on grass, now they are mainly grain fed which leads to a deficiency in Omega-3 fat content. Unless we are consuming wild caught fish (which can have heavy metal concerns depending on source) or being very intentional about eating organic, grass-fed animal products, the average american child’s diet will contain little to no omega-3 fatty acid. Omega-3 DHA is an important essential nutrient for brain health.
I strongly recommend kids get exercise for good health. I strongly recommend kids stop eating sugar for good health. And I strongly recommend kids supplement their healthy diet with a high-quality omega-3 supplement for good health, particularly if the activity they participate in is a contact sport. Studies are showing that high-dose omega-3 supplements may be speeding brain healing and reducing the negative effects of a concussion. A study conducted by Dr Barry Sears (leading authority on anti-inflammatory nutrition, creator of Zone-Diet) and published in the Journal of Neurosurgery found that rats who were given Omega-3 / DHA supplementation after head trauma had reduced concussion symptoms compared to rats who were not given the supplementation.
“Animals receiving the daily fish oil supplement for 30 days post concussion had a greater than 98 percent reduction in brain damage compared with the animals that did not receive the supplement,” Dr. Sears said. “It is hypothesized that the omega-3 fatty acids in the fish oil reduced the neural inflammation induced by the concussion injury.”
Immediate high-dose fish oil is therefore recommended as a safe and effective way to reduce swelling post traumatic injury. I would like to take it a step further to say that supplementation on a regular basis can help reduce the severity of concussion symptoms to begin with. Animal studies have shown that daily DHA Omega 3 supplementation for 6 weeks prior to injury resulted in less disruption of the blood-brain barrier, reduced brain edema and less of the detrimental inflammatory cascade that results from trauma to the brain. The study also showed an increase in “anti-oxidative capacity” which means the cellular stress that DID result from the trauma could be cleaned up quicker. Even more, the animals who were supplemented showed greater improvement in functional tests and on imaging scans 6 weeks post-injury. The animals that were supplemented before AND after head trauma showed the greatest improvement. It seems that the inflammation in the brain that is present before a trauma acts as fuel for a fire. With the fire being a cascade of cytokine activity that results in brain cell damage. Supplementing with Omega-3 DHA will normalize the baseline inflammatory state of the body and allowed the body to heal normally and naturally. It is a nutritional deficiency syndrome we are dealing with in children and the increasing severity of mild traumatic brain injury is one very serious symptom of that deficiency. In my office we use liquid or capsular fish oil from Carlson or Standard Process. I recommend 1600-2400 mg (Up to 3000mg post injury for 2-4 weeks) Omega-3 EPA/ DHA daily depending on body weight. (There are algae based Omega 3 supplements available if you are vegetarian.)
Team sports are an effective and fun way to keep kids active and fit, outside and off their devices. Team sports can teach teamwork and resilience and can help balance postural muscles. My hope is that we can address the underlying issues of nutritional deficiency in kids in order to maintain an important part of childhood and I hope to watch my grandchildren play football.
Neuroprotection for the Warrior: Dietary Supplementation With Omega-3 Fatty Acids Michael D. Lewis, MC USA, Julian Bailes, MDMilitary Medicine, Volume 176, Issue 10, October 2011, Pages 1120–1127,https://doi.org/10.7205/MILMED-D-10-00466
The Journal of Neurosurgery High-Dose Fish Oil Emerges as New Treatment for Brain Trauma From Concussions in Study by Barry Sears, M.D.
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