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Anti-inflammatory diets and brain injury: a casual conversation

Above is a recording of a session I call “Brain Bites.” These are short casual conversations held online. Each one explores a topic in concussion and brain injury nutrition. The goal is to review the research and put it into the context of our lived experience with TBI.

🌟 This is for your information and education only! Review with your healthcare provider before making any decisions about your health. 🌟

In March 2024, we talked about “anti-inflammatory diets.” I had help putting together this research and content by my dietetic intern from the University of Ottawa, Quynh Chi Le 🙂 Here is a summary of what was discussed:

What is inflammation and why are we “anti-” it?

Inflammation isn’t all bad! It plays an important role in our body’s response to injury and illness. It’s excess & chronic inflammation that’s the problem (1).

We don’t fully know how much inflammation an injury can cause, but it seems like a brain injury has the potential to cause inflammation (2,3).

A so called “anti-inflammatory diet” can be beneficial in managing inflammation, improving your brain health and promoting overall well-being.

Points to consider:

  • Brain injuries can cause some inflammation in the brain. This likely contributes to persisting symptoms.
  • Nutrition is one way to help bring down that inflammation.
  • Current research on the anti-inflammatory diet is mostly on animals, none of which is specifically for TBIs
  • When people talk about an “anti-inflammatory diet,” they are not always referring to the same thing! Each research study may define the “anti-inflammatory diet” differently. For example, some studies actually use supplements as an intervention instead of foods when talking about an anti-inflammatory diet. (4,5)
  • Studies don’t often look at food from different cultures. Other foods around the world have anti-inflammatory properties, even if they haven’t been studied yet.
  • About current research: Traditional markers of inflammation, once thought to be indicative of damaging inflammation, can also have beneficial roles. In other words, what research is measuring when it measures “inflammation” may not always reliably predict health outcomes, so it’s sometimes hard to interpret the results. (2,13)
  • Food isn’t the only thing that contributes to inflammation! Poor sleep & stress are also major contributors (12).

What is Anti-Inflammatory Eating?

  • There isn’t a single definition of an “anti-inflammatory diet.” Various ways of eating show potential for reducing inflammation. 
  • Basically, anti-inflammatory eating focuses on consuming foods that help reduce excess inflammation in the body. These foods are rich in nutrients and antioxidants that combat oxidative stress and support a healthy immune system. 
  • Generally, diets high in vegetables, fruits, whole grains, nuts, seeds, pulses, fish, and lean meats are beneficial for chronic inflammation. (6,7)
  • Some examples of anti-inflammatory eating are the MIND diet, Mediterranean diet, and DASH diet.

The MIND pattern of eating encourages these foods:

  • Green leafy vegetables, 6 or more times a week
  • Other vegetables, 1 or more a day
  • Berries, 2 or more times a week
  • Nuts, 5 or more times a week
  • Whole grains, 3 or more servings a day
  • Fish, 1 or more times a week
  • Beans, 4 or more times a week
  • Poultry, 2 or more times a week
  • Olive oil is the primary oil of choice

Potential Benefits of Anti-Inflammatory Eating

  • Reduced Inflammation: By incorporating anti-inflammatory foods into your diet, you may lower chronic inflammation levels, which is beneficial for overall health. 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. (6,8)
  • Improved Brain Health: Anti-inflammatory eating may support cognitive function. (9,10)

Can nutrition tame excess inflammation?

  • Certain vitamins, minerals, omega-3 fats, polyphenols, ginseng, and curcumin can help lower markers of inflammation.
  • Combinations of nutrients often work better than individual nutrients alone.
  • Diets high in vitamins C & E, as well as including fish, can reduce inflammation. (7)

Does anti-inflammatory eating help with TBI symptoms and recovery?

  • It’s not known whether lowering inflammation through nutrition in TBI will actually lower symptoms or speed up recovery (this doesn’t mean it’s not possible – it just hasn’t been studied yet).
  • The available evidence is somewhat limited but indicates potential benefits, including the improvement of pain, mood, and sleep. Additionally, research has demonstrated reductions in inflammatory mediators and neuropathic pain among individuals with chronic spinal cord injuries who follow an anti-inflammatory diet. (11)

Our lived experience

People who attended the live conversation shared some of their own experiences summarized here.

Anti-inflammatory eating in different cultures

  • Not all foods with anti-inflammatory properties have been thoroughly studied in research. The majority of research on anti-inflammatory diets has been conducted in Europe or North America, focusing on the most common food groups in these regions. However, foods in other cultures also have anti-inflammatory properties.
  • We can make anti-inflammatory eating more familiar to us by using our favourite food preparation techniques or choosing foods from our culture that work with the eating pattern. For example, stir-fried bok choy can be included as a dark leafy green.
  • Here are some ways to incorporate more leafy greens into our meals (without making a salad!): stir-frying, steaming, adding them to vegetable soups, roasting, etc.

Are there any foods I should avoid?

It’s interesting how many of us have experienced advice around “anti-inflammatory eating” that focuses on what NOT to eat instead of what TO eat. Here, we will focus on what foods to ADD and INCLUDE.

  • No foods are completely off limits: It is true that the MIND pattern of eating suggests limiting some foods, such as saturated fats or sugar. However, it doesn’t say to completely avoid these foods. Instead, it describes a type of “moderation.” For example, people who sometimes eat fried foods or sweets still have a lower risk of dementia if other parts of their diet match the MIND pattern.
  • So, instead of only focusing on what NOT to eat, it’s best to focus on what TO eat by increasing the variety of nutrients in your diet with plenty of vegetables, fruits, nuts and seeds, healthy fats and lean protein. 
  • Gluten is NOT inflammatory for everyone: Gluten doesn’t seem to affect cognitive function outside of celiac disease or gluten-related disorders. Whole grains, even those that contain gluten, are actually associated with lower inflammation. Therefore, you don’t have to cut out gluten unless you have a gluten-related disorder. Though you can get more variety in your diet by exploring different types of grains!
  • Sugar and artificial sweeteners in drinks: Sugar doesn’t always increase your risk of dementia. It tends to be more of a problem when it comes from sugar-sweetened drinks, such as sodas, or artificially sweetened soft drinks.

Explore some other facts about foods you “should avoid” HERE

Foods the MIND pattern suggests limiting:

  • Butter and margarine, less than 1 Tbsp per day
  • Cheese, less than once a week
  • Red meat, 3 or fewer times a week
  • Fast-fried foods, less than once a week
  • Pastries and sweets, 4 or fewer times a week
  • Wine, one glass a day, but not more (and not needed if you don’t drink alcohol)

3 Simple Ways to Incorporate Anti-Inflammatory Foods into Your Diet

You can find that HERE if you want some more of the nitty gritty details.

Want to work with me?

Feel free to set up a free call with me HERE.

Best in brain health,

Krystal Merrells, Registered Dietitian in Ontario, Canada

References:

  1. Gibson, D., Haskey, N. (2018) Gut microbiome: linkages to immunity, health and disease. Dietitians of Canada webinar.
  2. Fraunberger & Esser (2019) Neuro-Inflammation in Pediatric Traumatic Brain Injury—from Mechanisms to Inflammatory Networks. Brain Sci. 9, 319
  3. 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.
  4. Braidy, N., Essa, M. M., Poljak, A., Selvaraju, S., Al-Adawi, S., Manivasagm, T., Thenmozhi, A. J., Ooi, L., Sachdev, P., & Guillemin, G. J. (2016). Consumption of pomegranates improves synaptic function in a transgenic mice model of Alzheimer’s disease. Oncotarget, 7(40), 64589–64604. https://doi.org/10.18632/oncotarget.10905
  5. Scrimgeour, A. G., Condlin, M. L., Loban, A., & DeMar, J. C. (2021). Omega-3 fatty acids and vitamin D decrease plasma T-tau, GFAP, and UCH-L1 in experimental traumatic brain injury. Frontiers in Nutrition, 8, 685220. DOI: https://doi.org/10.3389/fnut.2021.685220
  6. HaB et al. (2019) Anti-Inflammatory Diets and Fatigue. Nutrients. 11, 2315.
  7. Franz, M. (2014). Nutrition, Inflammation, and Disease. Today’s Dietitian. Vol. 16 No. 2 P. 44.
  8. 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.
  9. Berendsen, A. M., Kang, J. H., Feskens, E. J., de Groot, C. P. G. M., Grodstein, F., & van de Rest, O. (2018). Association of long-term adherence to the MIND diet with cognitive function and cognitive decline in American women. The Journal of nutrition, health and aging, 22(2), 222-229.
  10. Seo, Y., Gang, G., Kim, H. K., Kim, Y., Kang, S., Kim, H., … & Go, G. W. (2024). Effect of MIND diet on cognitive function in elderly: A narrative review with emphasis on bioactive food ingredients. Food Science and Biotechnology, 33(2), 297-306.
  11. Allison, D. J., Thomas, A., Beaudry, K., & Ditor, D. S. (2016). Targeting inflammation as a treatment modality for neuropathic pain in spinal cord injury: a randomized clinical trial. Journal of neuroinflammation, 13(1), 152. https://doi.org/10.1186/s12974-016-0625-4
  12. Kiecolt-Glaser, J. (2010). Stress, Food, and Inflammation: Psychoneuroimmunology and Nutrition at the Cutting Edge. Psychosomatic Medicine, 72(4), 365-369.
  13. 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.