Nutrition for concussion recovery: what athletes need to know

How many of you have had a concussion? Raise your hands!

According to the CDC: “In 2019, about 15% of all U.S. high-school students self-reported one or more sports or recreation-related concussion within the preceding 12 months.”

That’s a lot of concussions!

You don’t have to be an athlete to experience a concussion. But if your sport involves a ball or puck or any sort of contact, your chances are higher than the rest of of us. 

What you eat while recovering from a concussion can impact your ability to heal. That’s I’m writing about here.

** Note: this post contains affiliate links. As an Amazon associate, I earn from qualifying purchases.

Also note: This post is for general information purposes. Never ever use advice from the internet in place of advice from your own healthcare provider. For more information, read the Disclosures and Terms of Service.

Concussion basics

You know me and the science. Let’s (briefly??) discuss what a concussion is, exactly.

Concussion definition

A concussion is a type of traumatic brain injury, or TBI. In sport these are usually caused by a blow to the head, but concussions can also be caused by anything that makes your brain move quickly inside your skull.

For example, you can get a concussion as a result of whiplash or some type of explosion.

After the injury, electrolyte movement into and out of your brain cells causes your blood vessels to constrict, and your brain gets less blood than it needs. 

Now add the fact that your brain requires more energy than usual in order to repair itself.

This extreme mismatch between energy requirement and energy supply is referred to as an “energy crisis.” There is a lot more going on, but nutritionally, the energy crisis is the most relevant.

At this point, your brain cells are more easily damaged, so it’s important to be very careful and follow all instructions from your medical healthcare providers. 

I will write that part again, loudly, because it’s so important.

FOLLOW ALL INSTRUCTIONS FROM YOUR HEALTHCARE PROVIDERS.

Concussion symptoms

Sometimes, if you hit your head or fall, you might feel just fine. I recommend seeing your provider to get checked out, just in case.

If you do experience symptoms, they likely fall into these categories:

Notice how these symptoms are similar to symptoms of other conditions, or even just symptoms of being a teenager? That’s why I want you to see your doctor, even if you’re not sure your injury was serious. Let a professional decide.

Concussion treatments

I’m not going to spend much time on this, because this isn’t my area of expertise.

See a medical professional immediately. Even if you feel fine. You will be given a plan of care. Follow it.

Typically, concussion treatment will begin with rest. The actual definition of “rest” is going to depend on how serious your condition is. It might mean chilling out for a few days, or it might mean staying in a dark room with no screens and little movement.

At some point, you’ll likely participate in some physical therapy with a specialist.

As you participate in more activities, you’ll want to note how it makes you feel. Don’t participate in any activities without explicit instructions to do so.

At some point, you’ll be given the ok to return to regular activity. Once this happens, stay alert for anything out of the ordinary, just in case you’re not completely healed.

Why all of this matters more in teens

During the teen years, human brains are developing a lot and developing quickly. These brains can be more susceptible to injury than fully developed brains.

Teenagers may also experience greater symptoms when they are injured. This means the symptoms may feel worse or last longer, or both.

One of the areas affected by concussion, the frontal lobe, is responsible for much of the brain activity in reading and math. So your schoolwork is likely to be affected.

And not least of concerns, it can be common for teens to minimize uncomfortable sensations (physical or emotional) when talking to their parents, doctors or coaches. Please don’t do this. You don’t want to miss any symptoms that could be important!

Nutrition for concussion recovery

So, now that we’ve covered a lot of info about concussions, you’re probably wondering when I’m going to get to the actual topic of this article. Here we go.

Why does it matter what I eat when I have a concussion?

When you are concussed, your body is trying very hard to both heal its injury and protect itself from further injury. Your job is to help it along. Do this by simply eating at all, or by trying to maximizing your nutrition for concussion recovery.

So, of course, follow the activity and rest instructions of your healthcare provider. (Yes, you have read that a lot in this article. And you will read it more! That’s how important it is.)

And then you need to provide your body with the nutrition it needs to recover fast and well.

The first 24 hours

The first thing you’re going to do is make an appointment with a healthcare provider.

Okay, now that you’ve done that, you need to eat. I know you might feel unwell. You still need to eat.

Make sure you get some nutrition into your body soon after your accident, for sure within the first day.

What you eat during this time is less important than making sure you eat something.

If you take vitamins or other supplements, now is the time to ask your healthcare provider whether you should continue those or pause while recovering.

Problem solving in nutrition for concussion recovery

If you have an appetite, ideas for maximizing your nutrition can be found below, but first here are some ideas for eating when it feels difficult.

No appetite

If you don’t have an appetite, eat anyway. Aim for at least half of the amount of food you usually eat.

Don’t wait for hunger to kick in. Eat on a regular schedule, every 2-3 hours if you can only manage small amounts at a time.

Eat things that are easy and familiar.

If you simply can’t eat, consider drinking something. A sports drink perhaps. Or a nutrition supplement – Orgain, ** for example, has vegan options that are easy on the stomach, and Kate Farms ** brand is entirely vegan.

Nausea

If you’re feeling nauseated from your accident, please tell your medical professional! 

And now, again, you need to eat. 

Eat whatever tends to sit well when you’re feeling generally yucky. When you are nauseated, your goal is not optimal nutrition. Your goal is to eat enough that your body can begin its important job of healing.

Try the traditional bland BRAT diet recommended for upset bellies: bananas, rice, applesauce, toast. Try a sports drink (*not* an energy drink) for calories.

If water doesn’t seem appealing, use a sports drink, soft drinks, or herbal teas.

Now is probably not the time to try a new-to-you food. Eat something familiar.

If you’re looking for ideas, choose something from this list that sounds like it would be ok:

• crackers
• bananas
• toast, dry or with a topping that you enjoy: butter/margarine, jam, peanut butter, whatever
• rice – stick with white if brown rice feels like “too much”
• applesauce
• sports drinks – small sips at first
• herbal teas – nothing with a medical claim, just something that sounds good
• homemade or ready-to-drink smoothie or shake

Fatigue

A common symptom of concussion is fatigue. This can make it hard to prepare foods, hard to eat, and also hard to remember to eat. This means you need options that are easy to prepare and easy to eat. 

If you’re preparing food yourself, perhaps stick to convenience foods. If chewing feels like too much work, consider a drinkable supplement with calories and protein, and maybe also some vitamins and minerals.

When lying down, use a bendable straw so you don’t have to sit up every time you take a sip. Here is a good choice for a reusable bendable straw. 

(Please don’t eat lying down though, especially if you’re by yourself. Choking is a real thing that happens!)

Maximizing nutrition for concussion recovery

Please please please. The most important thing is just to eat. If that’s what you can manage, and reading about specific nutrients will stress you out, don’t read this part.

However, if you’re interested, here are some things you can do to optimize your nutrition for concussion recovery.

Calories

While recovering from a concussion, continue to eat as much as you usually do. 

What if your activity level is lower? I don’t care. Your body is healing and needs energy to do so. And as you read above, your brain is in an energy crisis. 

Eat.

Protein

While recovering from a concussion, eat at least as much protein as you usually do, or more if you can. 

If you like math, here it is explicitly: I want you to eat 1.0-1.5 grams of protein per kilogram of body weight. There are 2.2 pounds in a kilogram.

So, if you weigh 150 pounds, that’s 68 kg. Which means you should aim for 68-102 grams of protein per day while recovering from a concussion.

What does this look like? Maybe cereal with soy milk and fruit for breakfast (8-12 grams), bean salad on greens for lunch (30-40 grams), tofu stir fry on brown rice for dinner (15-20 grams) plus protein bar, toast and nut butter, and fruit for snacks (20-30 grams).

Should you use a protein supplement if you’re having trouble reaching these protein goals through food? Yes. Use what you usually use, or if you need ideas, try something like Orgain ** (vegan options) or Kate Farms ** (all vegan).

Omega-3 fatty acids

Omega -3 fatty acids are well known for reducing inflammation, and this applies to the brain as well. 

And they have been studied specifically for their role in concussion recovery. Research indicates that they can reduce learning difficulties after concussion.

Omega-3 fatty acids are also well known for being in fish. And the important omega-3 fatty acids, DHA and EPA, aren’t found in plant products. What’s a concussed vegan to do? 

ALA is another omega-3 fatty acid that our bodies can convert to DHAS and EPA. We don’t convert it very well, though, so you’ll need to eat foods with ALA every day. 

Eat walnuts, flax seeds, hemp seeds, and chia seeds – at least 2 tablespoons per day.

If you’re not eating enough of these items, talk to your healthcare provider about a supplement. ** There are vegan ALA supplements that can be effective; if your doc okays supplements, follow the manufacturer instructions.

Vitamins and minerals

If you’re eating your usual balanced diet, there is no need to supplement specific vitamins and minerals just because you have a concussion. 

If you’re not eating your usual diet, consider taking a multivitamin. This can cover any nutritional deficits you have temporarily while recovering.

Note! if you’re using a protein supplement, check the label before adding a multi vitamin. Some protein supplements contain other nutrients as well.

You may have heard about specific nutrients that are good for healing from a concussion. I’ve covered some of those below. 

The upshot is, if you’re eating well or taking a multivitamin, don’t take extra vitamin or mineral supplements unless your healthcare provider has told you to do so, or at least okayed it.

Zinc

Some specialists theorize that zinc is important for concussion recovery, but there is no current evidence to suggest that zinc supplementation is necessary or even a good idea. So don’t run out and buy a zinc supplement!

However, zinc is an important part of your diet and vegans can trend low in zinc consumption. Please be sure to eat a wide variety of whole gains, nuts and seeds. 

If this is difficult, please consider a multi-vitamin (because if you’re not getting enough zinc from these sources, you’re likely also low in other nutrients). 

There is no need for a specific zinc supplement unless your healthcare provider indicates that this is something you should do.

Magnesium

Magnesium plays an important role in healing. There are many vegan sources of magnesium, including legumes, leafy greens, tofu, and whole grains. 

So, again, as long as you’re eating your usual balanced diet there is no need to take extra magnesium.

And if you’re not eating your usual balanced diet, you likely need other nutrients as well as magnesium so consider taking a multi-vitamin.

Vitamin C and other antioxidants

Antioxidants are excellent for overall health, neutralizing damaging free radicals in the body. Several of them also play an important role in healing, including vitamins A, C and E. 

Once again, if you’re eating your usual balanced diet, you are probably getting plenty of antioxidants. 

If you’re not eating much or eating different things, as mentioned for other nutrients above, you might want to take a multivitamin.

Vitamin D

I don’t know what it is about vitamin D. Everyone wants to suggest you take a vitamin D supplement for everything!

Actually, I do know what it is. Vitamin D can be neuroprotective, which means it can help protect the brain and the rest of the nervous system from damage and assist is recovery from damage. 

Your concussion symptoms might last a shorter period of time if you’re getting enough vitamin D.

The trick with vitamin D is that many people don’t get enough. If you usually take a vitamin D supplement, check with your doctor about continuing that while you recover. If you don’t, ask whether you should start.

Creatine

Creatine is used by the brain to increase energy production in the cells. Research shows that it might help preserve brain function after concussion.

However, creatine is not vegan! What do we do? 

Creatine is made in human bodies from just three amino acids: glycine, arginine, and methionine. These amino acids are easily found in plant foods.

Some foods contain all three amino acids required to make creatine. These include soybeans, white beans, green peas, and seaweed.

Here are some sources of the individual amino acids:

Methionine

Lots of legumes, nuts, and whole grains contain some methionine. The very best plant sources are wheat gluten, Brazil nuts, oats, hemp seeds, spinach, sunflower seeds, and sesame seeds. 

Arginine

Look for pumpkin seeds, pine nuts, almonds, walnuts, peanuts, and quinoa. 

Glycine

Beans, spinach, asparagus, and quinoa are good sources of glycine. 

Creatine supplements

If you feel you aren’t getting enough of the foods listed above, and aren’t taking a generic protein supplement, you might consider a creatine supplement. Please check with your healthcare provider first, as creatine supplements can be associated with GI and kidney issues.

There are vegan creatine supplements. The creatine is these products is made in a lab, not derived from animals, and the products avoid animal-based additives. 

I have personally never used a creatine supplement. Here are a few that I found **, but again, no personal experience:

Hydration

Let’s state it simply:

You can’t get better if you’re not hydrated.

Make sure you’re drinking plenty of liquids. If water doesn’t appeal, try a sports drink, juice, alt-milks, even soda. 

Things to avoid while recovering from a concussion

Caffeine

I could (and might!) write an entire article on the effects of caffeine on the body. But for our purposes, talking about concussions, here is what you need to know.

Caffeine affects many body systems, some in positive and some in negative ways. 

Caffeine can:

• increase alertness
• lower inflammation
• improve your mood
• improve your memory and attention
• lower risk of diabetes and cardiovascular diseases

But it can also:

• interfere with your sensations of hunger and fullness
• alter your GI function
• activate your sympathetic nervous system (that’s the “fight, flight or freeze” one, not the “rest and digest” one)
• reduce adenosine, which your body releases after brain injury to help healing 
• increase blood pressure by constricting blood vessels
• alter hormones
• affect your response to certain medications
• be addictive

I strongly recommend avoiding caffeine while recovering from a concussion. 

If you’ll get an extra headache without caffeine, please consume only enough to keep the headache at bay – probably the equivalent of a half cup of coffee.

Alcohol

Yes, this is a blog for teens. 

Regardless, I will say it:

You should absolutely, 100% avoid alcohol while recovering from a concussion.

Advice from family, friends and the internet on nutrition for concussion recovery

There is a lot of information out there about the best things to do for concussions and about nutrition for concussion recovery. The internet is a wild and weird place. And as I’m sure you know, people have opinions.

If you’re interested in trying any supplements (yes, even if they’re “natural”) or unusual foods as treatment, or cutting out certain foods, double check with an expert first. It doesn’t have to be me. Please just make sure that what you’re doing is safe.

Bottom line

Make sure to eat within 24 hours of your accident. If you feel nauseated, eat bland foods or whatever appeals. Focus on protein and omega-3 fatty acids. Check with your healthcare provider before trying anything that’s new to you, even if it’s something mentioned in this article on nutrition for concussion recovery. And follow all instructions from your care team!

About the Author

Sarah Skovran, RDN LD ACE-PT, is a Registered Dietitian Nutritionist, ACE certified personal trainer, mom of a teen athlete, and is mostly vegan. She writes about sports nutrition, plant based eating, and adolescent nutrition at Plant Powered Teens, and sees in-person clients at her private practice in Maine.

References

Al Moutaery K, Al Deeb S, Khan HA, Tariq M. (2003). Caffeine impairs short-term neurological outcome after concussive head injury in rats. Neurosurgery,  53(3), 704-11. DOI: https://doi.org/10.1227/01.neu.0000079487.66013.6f

Carre E, Ogier M, Boret H, Montcriol A, Bourdon L, Risso J-J. (2013).  Metabolic crisis in severely head-injured patients: is ischemia just the tip of the iceberg? Frontiers in Neurology. DOI: https://doi.org/10.3389/fneur.2013.00146

Centers for Disease Control and Prevention. (2021, May 13). Traumatic Brain Injury & Concussion. Retrieved from https://www.cdc.gov/traumaticbraininjury/ on 12/05/2021

Churchill NW, Hutchison MG, Richards D, Leung G, Graham SJ, Schweizer TA. (2017). The first week after concussion: Blood flow, brain function and white matter microstructure.  Neuroimage: Clinical, 14, 480-489. DOI: https://doi.org/10.1016/j.nicl.2017.02.015

Dean PJA, Arikan G, Opitz B, Sterr A. (2017). Potential for use of creatine supplementation following mild traumatic brain injury. Concussion, 2(2). DOI: https://doi.org/10.2217/cnc-2016-0016

Dolan E, Gualano B, Rawson ES. (2018): Beyond muscle: the effects of creatine supplementation on brain creatine, cognitive processing, and traumatic brain injury. European Journal of Sport Science. DOI: https:.doi.org/0.1080/17461391.2018.1500644

Giza CC, Hovda DA. (2014).  The New Neurometabolic Cascade of Concussion. Neurosurgery, 75(4), S24–S33. DOI: https://doi.org/10.1227/NEU.0000000000000505

Weidman C, Knappenberger K, Vance C. (2016).  Nutrition for concussion recovery. Northwestern University Performance Nutrition. Retrieved from https://www.nata.org/sites/default/files/nutrition-for-concussion-recovery.pdf on 12/05/2021

Wikoff D, Welsh BT, Henderson R, Brorby GP, Britt J, Myers E, Goldberger J, Lieberman HR, O’Brien C, Peck J, Tenenbein M, Weaver C, Harvey S, Urban J, Doepker C. (2017). Systematic review of the potential adverse effects of caffeine consumption in healthy adults, pregnant women, adolescents, and children. Food and Chemical Toxicology, 109(1), 585-648. DOI: https://doi.org/10.1016/j.fct.2017.04.002