Guest post written by Magalie Deslauriers-Labbé, dietetic intern, edited by Krystal Merrells, RD
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Do you feel pressure to cut out all sugar to recover from your brain injury?
Do you feel guilty if you choose to eat sugary food?
Do you wonder about natural vs refined sugar?
When it comes to nutrition, there is so much conflicting information out there, especially about brain injury.
So many foods are either villanized or seen as superior to others. One particular food group that is often targeted as “bad” food is sugar.
Maybe you’ve heard that consuming sugar worsens TBI symptoms such as headaches or brain fog.
But is it true?
Specifically for brain injury, there is not a lot of research out there that looks at sugar intake and recovery.
There is no research showing that eating sugar has any effect on recovery outcomes.
Research is more often focused on blood sugar and not the sugar found in food. For example, one meta-analysis study looked at glycemic control in TBI recovery.
“Glycemic control” means a specific range of blood sugar levels. Eating sugar can influence glycemic control. But many other factors come into play, such as other nutrients (fat, protein, fibre), the glycemic index of a food, medications, etc.
In this meta-analysis, researchers looked at studies using TBI patients in ICU. They compared intensive glycemic control (4.4 – 6.7 mmol/L) to conventional glycemic control (below 8.4 – 12 mmol/L).
The researchers found no association between glycemic control and patient mortality. However, they did find a higher risk of poor neurological outcomes with the conventional control.
It’s important to note that the risk of hypoglycemia (low blood sugar – which can be very dangerous) was noticeably increased with intensive glycemic control.
Overall, the research was not able to determine a specific level of glycemic control that would help individuals recover from a brain injury in the ICU.
And once again, eating sugar is only one of the many factors that go into glycemic control.
We shouldn’t jump to conclusions and say that sugar makes recovery more difficult.
But what about personal experience?
If from personal experience you feel that eating sugar exacerbates headaches or other symptoms, your experience is valid. Everyone has a different experience with food.
You may notice you feel better when you don’t eat sugary foods. After all, you know yourself the best. However, one thing to consider is that it’s hard to make accurate associations between food and symptoms.
Do you find you get headaches and brain fog when you eat lots of sugary foods during holidays? Is it the sugar? Or is it because the holiday season can be so overstimulating?
Is it the sugar from the slice of pie you had at Thanksgiving? Or the cognitive effort it takes to go to or prepare a family dinner?
Is it the chocolate you ate in response to a low mood? Or is it the stress of the situation that’s aggravating symptoms?
A change in routine, overstimulation and cognitive effort can all contribute to headaches and brain fog post-concussion. It’s easy to blame the sugar right away, but it might be worth investigating which one it truly is.
Depending on your situation, cutting out sugar might not be worth it at all.
Sugar after all makes certain foods more palatable, like adding some sugar to oatmeal.
And cutting out sugar completely can be really stressful! One thing is for sure, stress is not helpful to brain injury recovery. It’s already a long and difficult process. You already need to limit certain activities, work, and screen time… cutting out sugar might be an unnecessary limitation.
What about natural vs refined sugar?
Does it make a difference if you eat white sugar, brown sugar, honey, maple syrup, or other kinds of “natural” sugars?
Truthfully, all types of sugars are treated very similarly in the body.
White sugar, brown sugar, honey, and maple syrup might have slight differences in terms of minerals. But for the sugar itself, our bodies treat them the same.
Refined sugars are absorbed into the body quickly, which can affect that glycemic control. This is because refined sugars don’t have fibre to slow down their metabolism. Think of a whole fruit vs fruit juice; it’s the fibre in the whole fruit that makes the difference.
Getting sugar through the foods they naturally occur in therefore has more health benefits than refined sugar. This is simply because the whole food offers more fibres, vitamins and minerals than just the sugar itself.
Does sugar make a concussion worse?
Overall, there are many confounding factors when it comes to sugar and brain injury symptoms.
We don’t know exactly if or how much sugar might be impacting your recovery. But here is what we do know can make things worse:
That is why completely cutting out sugar might actually be harming you.
You might feel more stressed when you are craving something sweet but are not allowing yourself to honour your cravings. It takes a lot of mental energy to disregard your cravings. That mental energy could be going towards your recovery instead of restriction.
You could also be missing important nutrients such as carbohydrates, vitamins, and minerals if you unnecessarily remove foods that have sugar. Your brain needs that energy and those nutrients to heal!
Can you have sugar when you have a brain injury?
I would say it’s good to be mindful of sugar intake, without stressing out about it.
Focus on nutrient dense foods that promote healing while still enjoying the occasional treat to satisfy your cravings.
When it comes to good nutrition, your overall eating pattern is more important than stressing over the grams of sugar you get in a day.
You could actually be helping your recovery by focusing on including more brain-friendly foods instead of restricting others.
At the end of the day you know yourself better than anyone else. If eating sugar doesn’t feel good to you, then you are free to make the decision that is right for you.
This post was written by Magalie Deslauriers-Labbé, a dietetic intern with the University of Ottawa who spent a six-week rotation working with Krystal in TBI nutrition. Once graduated, Magalie hopes to open her own private practice helping those with vegetarian/ vegan lifestyles expand their food repertoire and overcome disordered eating. You can find her on Instagram at @magalieskitchen.
Hermanides J, Plummer MP, Finnis M, Deane AM, Coles JP, Menon DK. Glycaemic control targets after traumatic brain injury: a systematic review and meta-analysis. Crit Care. 2018 Jan 19;22(1):11. doi: 10.1186/s13054-017-1883-y. PMID: 29351760; PMCID: PMC5775599.