April 20, 2011 -- For service members wounded on the battlefield, nutrition appears to play a vital role in improving the outcome of traumatic brain injury, especially if it is administered soon after the injury occurs, according to a report by the Institute of Medicine (IOM).
The report, commissioned by the Department of Defense, urges the military to make infusions of calories and protein part of standard care in the immediate aftermath of injury.
The report also has implications for brain injuries in civilians. “The investment the military makes will cross over into the civilian population for injuries suffered by those in car accidents, in motorbike accidents, by kids on soccer fields,” says IOM panel chairman John Erdman, PhD, professor emeritus of food science and human nutrition at the University of Illinois.
Recovery From Traumatic Brain Injury
Brain injuries are commonplace among service members in both Iraq and Afghanistan. Within the U.S. military as a whole, there have been more than 200,000 cases of traumatic brain injury diagnosed since 2000, according to the Defense and Veterans Brain Injury Center; 2,124 of those cases were classified as severe.
“Across the board, the military is trying to understand how to set the stage for the recovery of these individuals,” says Erdman.
The Department of Defense asked the IOM to review the scientific literature linking nutrition to brain injury outcomes. Erdman and his colleagues -- a mix of food and nutrition specialists, neurologists, and other experts -- met several times over the past year before submitting their report to the military. While they were able to make some strong recommendations, they also had to confront the fact that the field is new and not much is known.
“We were asked what’s known and what’s close to prime time,” says Erdman. “But in most areas, we need more research. We’re a bit at the infancy of understanding which particular food components may enhance or protect someone from injury.”
The studies that they reviewed -- none of which were more than 20 years old -- offered enough evidence for the panel to conclude that infusions of calories and protein begun within the first 24 hours of injury and continued for the following two weeks significantly reduce inflammation in the brain and aid recovery. The long-term impact of nutrition was not studied.
The report also identifies several nutrients that have shown preliminary promise as aids in treating traumatic brain injury, in particular choline, creatine, n-3 fatty acids, and zinc. The panel has marked these as priorities for future research, noting as well that there are many ongoing studies that are already showing promise.
Prevention of Traumatic Brain Injury
The panel also urged the military to investigate whether nutrition can help prevent traumatic brain injury by making service members more resilient. To do so, they advised the Department of Defense to study the diets of service members and assess the types of nutrients that they are getting.
“Does the antioxidant status of a soldier prior to injury have impact on the extent of that injury?” says Erdman. “We don’t know the answer to that.”
While he acknowledges that the questions raised by the panel will take time to answer, he is hopeful that the wait for those answers will not be too long.
“This is in the fast lane, not in the slow lane,” he says.