Audio for this article, so you can listen instead of read 🙂 (plus, IMO, it’s funner 😀 )
I know you’d like to research for yourself nutrition for brain injury. But it’s hard when your brain hurts reading off a computer screen. You keep coming across some common food advice, and you wonder if it’s really worth your energy.
From online blogs, to articles in magazines, to comments on social media, you have likely seen or heard about an anti-inflammatory diet. And it sounds exactly like what you need — because you want to be against anything that sounds like inflammation… right?
You may be surprised to hear this, but inflammation can actually be HELPFUL.
I know you don’t want to make a drastic change to your diet if it’s not going to work for you in the long run. But you’re also curious. You want to learn about everything anti-inflammatory in case it’s what your recovery is missing.
So let’s get to the bottom of this inflammation information 🙂
INFLAMMATION IS LIKE A CARING GRANDMOTHER
Inflammation is like that caring grandmother you may have had. You know, the person who spoiled you with delicious homemade treats 🙂 You ate her yummy food until comfortably full. That’s when your loving grandmother would implore you to “Eat more!” because “You’re going to waste away!” You really didn’t want the extra food she piled onto your plate. But you felt pressure to be polite. So you ate more until you really didn’t feel good anymore…
Just like your grandmother was only trying to help you to grow and be strong, inflammation tries to protect and heal your body. But just like eating way too much makes you feel sick, inflammation becomes a problem when your body overdoes it.
HOW DOES INFLAMMATION WORK IN MY BODY?
Your body has built-in security. It’s your immune system! When there is an infection or an injury, the immune system sends out a team. One tactical strategy this team uses, is inflammation.
In more science-y terms, inflammation is the infiltration of white blood cells moving from the bloodstream to the area of infection or injury. Fluid might also permeate the site. This contributes to the swelling you might see on visible parts of the body. A series of reactions then cause an attack and breakdown of harmful agents. Finally, a form of immune system relief aid comes in to promote healing (Gibson & Haskey, 2018).
This strategy is very important to keep you healthy. The problem is not necessarily with inflammation itself. The problem is when this inflammatory response doesn’t shut off. Inflammation in excess is damaging. Plus it lowers the relief aid, which lessens healing (Gibson & Haskey, 2018).
DOES AN INJURY TO THE BRAIN CAUSE EXCESS INFLAMMATION?
To know if eating to lower inflammation could help in your recovery, the first question we need to answer is this: do all brain injuries cause inflammation that is damaging?
The TBI type and severity likely determine inflammation
A brain injury is, well, an injury! Any injury attracts the immune system. But how much inflammation this causes likely depends on the type and severity of TBI. Two scientists, Fraunberger & Esser (2019), note in their review that “milder forms of TBI may produce very little, if any tangible inflammation…” Do you find this shocking? There is other research in animals that shows damaging inflammation with repeated mild brain injuries (Yu et al. 2018).
So, it seems we don’t fully know what degree of injury causes what amount of damaging inflammation. And like most things with TBI, I’m sure it’s rather unique to each person. However, I think we can agree that a brain injury has the potential to cause excess inflammation. And we do have a good idea how that comes to be.
The inflammation process after head injury
A significant hit to the head can cause (Fraunberger & Esser, 2019; McKee & Lukens, 2016):
- damage to brain cells
- death of brain cells
- a fluid leak
- weakening of the blood-brain barrier
- the release of potentially damaging molecules that alert your immune system like an internal Bat Signal (sort of, not really, LOL)
In brain injury, your immune system responds with the usual inflammation that aims to protect the existing brain cells, and repair what has been harmed. What’s interesting, though, is what happens after…
McKee & Lukens (2016) talk about how in the brain, after the first responders from the immune system have come and gone, local immune responders are still active. This is unusual. When other parts of the body have injury or infection, the local immune team tends to calm down within weeks. But in TBI, this continued activity seems to cause a sort of second wave of damage with excess inflammation.
This continued response from the immune system can lead to a sort of chronic inflammation. This is a problem because it seems associated with a longer-lasting recovery, and a higher risk of neurodegeneration later in life (Fraunberger & Esser, 2019).
OK, SO WHAT’S FOOD GOT TO DO WITH IT?
To know if food can help, I’m going to focus this article on answering two solid questions:
- Can excess inflammation be tamed by food and nutrients?
- If so, does this actually slow your symptoms and speed your recovery?
Can nutrition tame excess inflammation?
I think we can mostly say ‘yes.’
In research, there are certain markers in blood and tissue that are used to measure inflammation. What we’re looking for here is proof that foods or nutrients lower these markers.
Some studies show that certain vitamins, minerals, omega-3 fats, polyphenols, and things like ginseng and curcumin (found in turmeric) can help lower inflammatory markers (Haar et al. 2016; HaB et al. 2019). You may have heard these nutrients be referred to as “antioxidants,” or “anti-inflammatory,” and it’s common to hear advice about increasing these in your diet through food or supplement.
As interesting as it is to look at individual nutrients, it’s likely that combinations work better than any one nutrient alone (#teamwork). For example, some research shows diets high in vitamins C & E are correlated with less inflammation. Another study added just 3 oz of fish five times per week, to a regular diet. This resulted in lower inflammatory markers in elderly women with high blood fats (Franz, 2014).
Because of this nutrient teamwork, researchers also look at whole “diets” and how these affect markers of inflammation. But, this is where it gets a little more confusing…
When people talk about an “anti-inflammatory diet,” they are not always referring to the same thing! There isn’t just ONE way of eating anti-inflammatory. Some diets are more restrictive than others, and some are more like a set of principles. Regardless, a number of these diets show potential for tackling inflammation (Haß et al. 2019), however not all studies have successfully lowered inflammation through anti-inflammatory eating (Zwickey et al. 2019).
Taken all together, I think it’s cool to say that a diet high in vegetables, fruits, whole grains, nuts, seeds, pulses plus some fish and lean meats can help with chronic inflammation (HaB et al. 2019, Franz, 2014).
But does anti-inflammatory eating actually help with your symptoms and recovery?
I think here we can only say ‘maybe.’
Honestly, there isn’t a lot of good evidence for fewer symptoms or faster recovery in brain injury. But there are a few studies to consider:
- Vegetables and fruit tend to be really good sources of antioxidant and anti-inflammatory nutrients. One study gave mice a diet high in vegetables and fruit for a couple of months. The mice then had repeated mild TBIs. The diet helped lower inflammation and improve some behaviours post injury (Yu et al. 2018). So some potential for prevention!
- Some studies using omega-3 supplements for different syndromes of fatigue have lowered inflammation. But there wasn’t any actual long-lasting improvement in people’s fatigue or energy (HaB et al. 2019).
- A study wth curcumin showed some improved cognitive function post-concussion. However this was just in rats (Wu et al. 2006).
- A low-inflammatory diet was shown to improve some symptoms of a specific inflammatory disease in the digestive system (Pasanisi et al. 2019).
Taking this all together, I think it’s clear that there are major gaps. Many studies have been done in animals. We need more research that can give us good results when the study is done more than once. Plus research needs to look at how this translates to a regular person with their whole diet (Haar et al. 2016)
WHAT’S MISSING FROM THE ANTI-INFLAMMATORY CONVERSATION?
We need to look at you as a whole person
There is one fact that is often left out when talking about anti-inflammatory eating. That is food isn’t the only thing linked to excess inflammation.
Even though we have some evidence that what you eat can affect inflammation, context is important. We really need to look at your whole situation to figure out how other aspects of your day-to-day life can be interacting with inflammation and food. For example, poor sleep and mental stress can raise markers of inflammation (Kiecolt-Glaser, 2010).
So theoretically, you could eat a “perfect” anti-inflammatory diet. But if following that diet stresses you because it’s hard to get the ingredients, it’s more expensive than your budget, or it prevents you from eating socially with others, then it’s likely that stress will provoke inflammation too!
All this research on inflammation has mislabeled your caring grandmother as ‘bad’
For years inflammation has been measured by individual markers in blood and tissue. Each of these markers have been labelled either “anti-inflammatory” or “pro-inflammatory” (i.e. good or bad). What we now know is that these markers can act as both pro- and anti- inflammatory! (Fraunberger & Esser, 2019)
Take the grandmother analogy from earlier. Some would view that grandma as a bad influence on nutrition, getting people to “eat more!” However, this grandma might be helping if her guest is someone loading for a big race, training for a hotdog eating contest, or struggling to pay for food. Or perhaps her guest simply enjoys these limited visits and the loving food their grandmother provides.
All this to say, what we once thought were markers of damaging inflammation, can sometimes be indicative of helpful inflammation. As such, no one can use these markers to %100 predict a disease or recovery (Minihane et al. 2015).
OH MY GOSH. THAT WAS A LOT. NO WONDER THERE’S CONFLICTING INFORMATION OUT THERE. BUT WHAT DO I DO NOW??
I’m sorry if all this information tired your brain. It fatigued mine as well!
So let me wrap it up with some takeaways:
1) Some inflammation is good. But some people post brain injury may have too much. This affects recovery.
2) There isn’t any ONE anti-inflammatory diet. Different ways of eating work for different people.
3) A diet of vegetables, fruits, whole grains, nuts, seeds, pulses plus fish and lean meats helps with chronic inflammation. The Mediterranean eating pattern (“diet”) is an example that is generally healthy for most people who have the privilege to follow it.
4) If your diet is stressing you out, stress causes inflammation too! Food isn’t the only focus. If you have a choice, choose an eating style that allows you to still eat with your grandmother 🙂
Some of this is easier said than done. This was, believe it or not, just a brief on anti-inflammatory eating! There’s lots more information to consider.
Are you tired of trying to figure it out yourself?
If you want a humble guide to lead you on your anti-inflammatory way, send me a message. I’d be happy to chat with you.
Best in brain health to you and yours,
Fraunberger & Esser (2019) Neuro-Inflammation in Pediatric Traumatic Brain Injury—from Mechanisms to Inflammatory Networks. Brain Sci. 9, 319
Franz, M. (Feb 2014) Nutrition, Inflammation, and Disease. Today’s Dietitian. Vol. 16 No. 2 P. 44
Gibson, D., Haskey, N. (Nov 21 2018) Gut microbiome: linkages to immunity, health and disease. Dietitians of Canada webinar.
Kiecolt-Glaser, J. (2010). Stress, Food, and Inflammation: Psychoneuroimmunology and Nutrition at the Cutting Edge. Psychosomatic Medicine, 72(4), 365-369.
Haß et al. (2019) Anti-Inflammatory Diets and Fatigue. Nutrients. 11, 2315
Minihane, A., Vinoy, S., Russell, W., Baka, A., Roche, H., Tuohy, K., Teeling, J., Blaak, E., Fenech, M., Vauzour, D., McArdle, H., Kremer, B., Sterkman, L., Vafeiadou, K., Benedetti, M., Williams, C., & Calder, P. (2015). Low-grade inflammation, diet composition and health: current research evidence and its translation.. The British journal of nutrition, 114(7), 999-1012.
Pasanisi et al. (2019) A Pilot Low-Inflammatory Dietary Intervention to Reduce Inflammation and Improve Quality of Life in Patients With Familial Adenomatous Polyposis: Protocol Description and Preliminary Results. Integr Cancer Ther. Published online 2019 May 4.
McKee & Lukens (2016) Emerging Roles for the immune System in Traumatic Brain injury. Frontiers in Immunology. Vol 7; 556
Haar, C., Peterson, T., Martens, K., & Hoane, M. (2016). Vitamins and nutrients as primary treatments in experimental brain injury: Clinical implications for nutraceutical therapies. Brain Research, 1640, 114-129.
Wu A, Ying Z, Gomez-Pinilla F. (2006) Dietary curcumin counteracts the outcome of traumatic brain injury on oxidative stress, synaptic plasticity, and cognition.Exp Neurol. Feb;197(2):309-17. Epub 2005 Dec 20.
Yu, J., Zhu, H., Taheri, S., Mondy, W., Perry, S., Kindy, MS. (2018) Impact of nutrition on inflammation, tauopathy, and behavioral outcomes from chronic traumatic encephalopathy. Journal of Neuroinflammation, vol. 15, no. 1,
Zwickey, H., Horgan, A., Hanes, D., Schiffke, H., Moore, A., Wahbeh, H., Jordan, J., Ojeda, L., McMurry M., Elmer, P., Purnell, JQ. J (2019) Effect of the Anti-Inflammatory Diet in People with Diabetes and Pre-Diabetes: A Randomized Controlled Feeding Study. Restor Med ; 8(1)