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Starve a fever, feed a concussion: Speedy feeding offers hope of better healing

New research stresses the importance of a speedy intake of energy immediately after a brain injury to help mitigate damage.

blair gable The Globe and Mail

Traumatized brains need nutrients - and quickly.

A team of U.S. scientists has found that food can play a vital role in mitigating the damage done by traumatic brain injury - and that a speedy supply of specific nutrients can give hurting brain cells the energy and chemical cues they need to heal while preventing inflammation.

The study, commissioned by the U.S. Department of Defence, looked at soldiers suffering from wartime trauma. But the scientists say the findings can apply to any brain injury - including concussions.

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The scientists argue their study could create a valuable tool in fighting brain damage, whose frequency has reached epidemic proportions on sports fields as well as in battle.

The study's very existence drives home just how urgent the race to discover more about brain injuries has become. Dramatic upswings in the number of severely traumatized brains among troops overseas are forcing a once-neglected injury high on the radar - so much so that the Defence Department says it is prepared to commit millions of dollars to expensive, work-intensive research.

Canadian experts on concussions are taking note: Charles Tator, a Toronto-based brain injury and concussion specialist whose expertise is in sports-related brain injuries, says ongoing research into the role specific types of food play in healing hurt brains will be a huge boon to sports teams of the future.

"It's a useful report; it'll provide some guidelines," he said, adding that the Defence Department's interest is needed to push forward "very difficult, very costly research.

"Brain injuries are a major social and financial burden following combat. With these explosive injuries that soldiers are getting, it's turning out to be one of the most important complications of war that society is left with.

"Athletes who are in high-risk sports, who are at a high risk for concussion, might benefit from that type of research."

Recent high-profile concussions among NHL players - Sidney Crosby has not played a game since receiving two blows to the head in January; St. Louis Blues centre David Perron has been out since November - as well as new information on just how serious the injury can be despite difficulties in early diagnosis, have brought the concussion debate to the fore. This month, the NHL and the Canadian Medical Association Journal came out with a study on concussions it said was the largest of its kind, but many experts argued it grossly underestimated just how frequent the injury is.

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Wednesday's study, published by the Institute of Medicine, found that while energy and protein are vitally important immediately after an injury, specific chemicals can target brain cells to mitigate damage.

The importance of getting food to severely injured patients is already known but isn't consistently applied: The extreme trauma drastically disrupts brain metabolism because cells can't communicate properly. In that kind of hypermetabolic state, the brain needs energy quickly.

The study recommends that the speedy intake of energy and protein for traumatic brain injuries should be made common practice "immediately" - both right after an especially severe injury and for two weeks following. That means more than half a person's total energy output, and at least a gram of protein per kilogram of body weight, starting within a day of the injury.

(To put that in perspective, it means a 70-kilogram person would need the protein equivalent of 25 bowls of cereal a day.)

"This intervention is critical," the study notes, to lessen the severity of inflammation.

At the same time, the study analyzed findings that animal test subjects with traumatic brain injuries fared better when they had particular nutrients in their systems.

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Creatine, which is found in meat but is common in athletes' dietary supplements, helped give the brain an intense and immediate hit of energy needed to help cells heal right after an injury.

Significant amounts of some other nutrients - resveratrol, for example, which is found in red grapes, or curcumin, in yellow spices like turmeric - also helped keep inflammation down.

Much more research, which would likely take years, is needed before researchers would recommend taking those either to prevent injury or immediately afterwards.

"This could have a protective effect," said Wayne Askew, director of nutrition at the University of Utah and one of the study's authors. "[But]we're a long ways from saying, 'If you eat spicy curries, you would be less likely to get as severe a brain injury.' It's just not at that point."

It's a "very interesting" proposal to suggest that athletes in contact sports "pre-treat" by manipulating their nutrition, Dr. Tator said. But he cautioned against Canadian athletes stocking up on creatine supplements before a game.

"Should Sidney Crosby take some nutritional supplement prior to play? … I think once the research is done, then we would be in a good position to say, 'Yes, that particular manipulation is a good idea."

The study, conducted by 11 experts in neurobiology, psychology and nutrition, reviewed data on the effects of traumatic brain injury on U.S. soldiers and the changes caused by certain nutrients in animal-based studies.

For London, Ont.-based sports-medicine physician Paul Echlin, the report demonstrates a long overdue focus on brain injury research. He hopes the Defence Department's deep pockets will help shed light on a trauma that for too long "has been trivialized and continues to be trivialized."

"The evolving science is good: We'll find out what's working what is not. … It's a hot topic right now."

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