Finnegan Emma, Daly Ed, Pearce Alan J, Ryan Lisa
Department of Sport, Exercise and Nutrition, Atlantic Technological University (ATU), Galway, Ireland.
College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia.
Front Nutr. 2022 Oct 14;9:977728. doi: 10.3389/fnut.2022.977728. eCollection 2022.
When mild traumatic brain injury (mTBI) occurs following an impact on the head or body, the brain is disrupted leading to a series of metabolic events that may alter the brain's ability to function and repair itself. These changes may place increased nutritional demands on the body. Little is known on whether nutritional interventions are safe for patients to implement post mTBI and whether they may improve recovery outcomes. To address this knowledge gap, we conducted a systematic review to determine what nutritional interventions have been prescribed to humans diagnosed with mTBI during its acute period (<14 days) to support, facilitate, and result in measured recovery outcomes.
Databases CINAHL, PubMed, SPORTDiscus, Web of Science, and the Cochrane Library were searched from inception until January 6, 2021; 4,848 studies were identified. After removing duplicates and applying the inclusion and exclusion criteria, this systematic review included 11 full papers.
Patients that consumed enough food to meet calorie and macronutrient (protein) needs specific to their injury severity and sex within 96 h post mTBI had a reduced length of stay in hospital. In addition, patients receiving nutrients and non-nutrient support within 24-96 h post mTBI had positive recovery outcomes. These interventions included omega-3 fatty acids (DHA and EPA), vitamin D, mineral magnesium oxide, amino acid derivative -acetyl cysteine, hyperosmolar sodium lactate, and nootropic cerebrolysin demonstrated positive recovery outcomes, such as symptom resolution, improved cognitive function, and replenished nutrient deficiencies (vitamin D) for patients post mTBI.
Our findings suggest that nutrition plays a positive role during acute mTBI recovery. Following mTBI, patient needs are unique, and this review presents the potential for certain nutritional therapies to support the brain in recovery, specifically omega-3 fatty acids. However, due to the heterogenicity nature of the studies available at present, it is not possible to make definitive recommendations.
The systematic review conducted following the PRISMA guidelines protocol was registered (CRD42021226819), on Prospero.
当头部或身体受到撞击后发生轻度创伤性脑损伤（mTBI）时，大脑会受到干扰，导致一系列代谢事件，这可能会改变大脑的功能和自我修复能力。这些变化可能会增加身体对营养的需求。关于营养干预措施对mTBI患者实施是否安全以及是否能改善恢复结果，目前知之甚少。为了填补这一知识空白，我们进行了一项系统综述，以确定在mTBI急性期（<14天）对被诊断为mTBI的人类开具了哪些营养干预措施，以支持、促进并实现可测量的恢复结果。
检索了CINAHL、PubMed、SPORTDiscus、Web of Science和Cochrane图书馆数据库，从数据库建立至2021年1月6日；共识别出4848项研究。在去除重复项并应用纳入和排除标准后，本系统综述纳入了11篇全文。
在mTBI后96小时内摄入足够食物以满足其损伤严重程度和性别所特有的热量和宏量营养素（蛋白质）需求的患者，住院时间缩短。此外，在mTBI后24 - 96小时内接受营养和非营养支持的患者有积极的恢复结果。这些干预措施包括ω-3脂肪酸（DHA和EPA）、维生素D、氧化镁矿物质、氨基酸衍生物 - 乙酰半胱氨酸、高渗乳酸钠以及益智药脑蛋白水解物，对mTBI患者显示出积极的恢复结果，如症状缓解、认知功能改善以及补充营养缺乏（维生素D）。
我们的研究结果表明，营养在急性mTBI恢复过程中发挥着积极作用。mTBI后，患者的需求是独特的，本综述提出了某些营养疗法在支持大脑恢复方面的潜力，特别是ω-3脂肪酸。然而，由于目前现有研究的异质性，无法做出明确的推荐。
按照PRISMA指南方案进行的系统综述已在Prospero上注册（CRD42021226819）。
