Traumatic Brain Injury Center of Excellence, Silver Spring, MD, USA.
CICONIX LLC, Annapolis, MD, USA.
NeuroRehabilitation. 2024;55(3):281-294. doi: 10.3233/NRE-230241.
Veterans Affairs and the Department of Defense (DOD) acknowledge that nutrition may be a modifier of mild traumatic brain injury (TBI) sequelae. Military clinicians are considering nutritional supplements and dietary interventions when managing patients with mild TBI. Therefore, clinicians should be familiar with the current evidence for nutritional interventions in mild TBI and special considerations related to the military lifestyle.
This narrative review aims to summarize the existing evidence surrounding the role of special diets and select nutrients in mild TBI outcomes, gut microbiota changes, and special considerations for Service members and Veterans recovering from mild TBI.
We conducted a literature review in PubMed and Google Scholar limited to nutritional interventions and nine topics with primary focus on mild TBI, although we included some articles related to moderate-to-severe TBI where relevant: 1) ketogenic diet, 2) Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, 3) omega-3 fatty acids, 4) creatine, 5) vitamin D, 6) weight management, 7) gut microbiota, 8) caffeine, and 9) alcohol. We summarized key findings and safety factors where appropriate for each intervention. We also identified nutritional supplement safety and operational rations considerations and areas in need of further research.
Preclinical studies and early human trials suggest that the specific nutrients and diets discussed in the current article may offer neuroprotection or benefit during mild TBI rehabilitation. Omega-3 fatty acids, creatine, and vitamin D are generally safe when taken within recommended guidelines.
More evidence is needed to support nutritional recommendations for enhancing neuroprotection and mitigating mild TBI symptoms in humans. The DOD's Warfighter Nutrition Guide recommends a whole food diet rich in antioxidants, phytonutrients, omega-3 fatty acids, micronutrients, probiotics, and fiber to optimize long-term health and performance.
退伍军人事务部和国防部（DOD）承认，营养可能是轻度创伤性脑损伤（TBI）后遗症的一个修饰因素。当管理轻度 TBI 患者时，军事临床医生正在考虑营养补充剂和饮食干预。因此，临床医生应该熟悉轻度 TBI 营养干预的现有证据以及与军人生活方式相关的特殊考虑。
本叙述性综述旨在总结围绕特殊饮食和选择营养素在轻度 TBI 结果、肠道微生物群变化以及从轻度 TBI 中恢复的军人和退伍军人的特殊考虑方面的现有证据。
我们在 PubMed 和 Google Scholar 上进行了文献综述，仅限于营养干预和九个主要关注轻度 TBI 的主题的文献，尽管我们在相关的情况下包括了一些与中度至重度 TBI 相关的文章：1）生酮饮食，2）地中海- DASH 干预神经退行性延迟（MIND）饮食，3）欧米伽-3 脂肪酸，4）肌酸，5）维生素 D，6）体重管理，7）肠道微生物群，8）咖啡因和 9）酒精。我们总结了每个干预措施的关键发现和安全因素。我们还确定了营养补充剂安全和作战口粮的考虑因素以及需要进一步研究的领域。
临床前研究和早期人体试验表明，当前文章中讨论的特定营养素和饮食可能在轻度 TBI 康复期间提供神经保护或益处。欧米伽-3 脂肪酸、肌酸和维生素 D 在遵循建议的指南内使用时通常是安全的。
需要更多证据来支持增强神经保护和减轻人类轻度 TBI 症状的营养建议。DOD 的作战人员营养指南建议食用富含抗氧化剂、植物营养素、欧米伽-3 脂肪酸、微量营养素、益生菌和纤维的全食物饮食，以优化长期健康和表现。
