Post- Concussion Diet Therapy- Case Study

The brain! It is SUCH an important part of our body and we should protect it through any means possible. I can't believe that I used to snowboard with nothing to protect my head, or that I was "too cool" to wear a helmet when biking around the streets of Bali (also didn't want helmet hair). Once we see the damage that a head knock can do it can really change the way we look after our noggins moving forward.

Over the past couple of weeks I have been working with a patient who has suffered many concussions over the past ten years (10+ ). Recently his head suffered 2 brutal knocks in the space of one month- leaving him with memory loss, fatigue, headaches, sleep issues, and absolutely no recollection of the accidents that caused his injuries.

Diet therapy for concussion/ traumatic brain injury (TBI) patients?

As health professionals, it is often assumed that we know everything there is to know in our field of expertise. But alas! This was not something that I had worked with before! I have spent the past week looking at either a book, an article, or flicking emails to and fro with other experienced dietitians in the area of diet therapy and brain injury. There is an abundance of research linking the benefit of certain diet changes and brain recovery and repair. Alot of this is based on the changes to the way our brains use fuel following an injury.

I have started my patient on "diet therapy" to aid in the recovery and repair of his brain. At some point in his journey I will give a bit more insight into what the diet involves- but for now I want to keep things pretty non-specific.

The bonus is that he is incredibly compliant! I offered to ease him into the diet by having a week of "transition" as his previous diet did not match up with the macronutrient goals I had in mind for him AT ALL. His response was- "What's the point in that? I just want to do it straight away so that it works faster". I have also offered him some tweaks to make life easier in social situations BUT warned him that it could reduce the effectiveness of the diet- his response "I honestly don't care if I have to turn down food at shared lunches- I will do anything that you think will help my brain and thats all". Amazing!

I asked him to send me a spiel describing how he is feeling on day 4 of his first ever meal plan:

"To my amazement, I haven’t felt hungry since I started. My breakfast is nutty cereal and milk- keeping me full until around 1pm- compared to the usual 3 eggs on toast-normally lasting until 10.

The biggest challenge is the craving for sweet- often at work we have morning teas and lunches provided at meetings and morning teas - we have had 4 this week. Not eating the cakes/ biscuits or pizza has shown me how often I usually would eat these foods- even though I considered having a pretty good diet. But the greatest challenge is not having my 3-4 pieces of fruit each day- I would always have fruit in the car for when I got hungry and the refreshing feeling.

My key take away is that I have to be organised- I can’t rely on toast for lunch or shooting down to the bakery.

Current post-concussion symptoms; blurred/ cloudy vision, on/off headaches- and the biggest; memory/ concentration. Making work much more difficult."

The plan for his diet therapy is to work hard for 2-3 months then work on re-introducing some of his previously enjoyed foods. When we reintroduce things as a "trial" we are testing how we respond. If his head injury symptoms have fully resolved prior to reintroduction, then begin to return when he adds in a certain food, then this is a fairly clear indication that we have a bit more work to do. Of course there are other variables to consider at any sort of diet trial- and these will be discussed in future articles.

Stay tuned for more!

NB: He has fully consented to me publishing this article and is really keen to spread the word about diet therapy for concussion patients.