Concussion is a serious health risk for athletes participating in many sports including but not limited to contact disciplines. Learn how to protect yourself with nutrients to prevent and treat concussion.
What is concussion?
Concussion is an injury caused by direct or indirect impact to the head (1, 2), rapid acceleration or deacceleration, such as in motor vehicle accidents or intense changes in pressure (2). A concussion is a type of mild traumatic brain injury (mild TBI or mTBI) which causes short-term impairment in neurological function (1, 2).
Concussion affects approximately 1 to 6 in 1000 people per year (2).
Effects and symptoms of concussion
The effects of a concussion might be visible through imaging techniques, but are most certainly evident as functional disturbances. This includes a dysregulation in the balance of ions surrounding the brain (more on this later), production of reactive oxygen species (ROS), tau protein tangles (also present in other neurological disorders such as Alzheimer’s Disease – my note) and inflammation (1).
Impacts to the head regardless of a diagnosis of concussion can still produce brain damage. Moreover, repeated head trauma can lead to neurological impairments and chronic neurodegenerative diseases (1).
Symptoms can be acute or chronic and include cognitive impairment, issues with balance, headaches, fatigue, dizziness, irritability and difficulty sleeping (3).
In most cases, symptoms last for 7-10 days. Repeated concussions can result in symptoms that last longer (2).
Concussion and sports
Sports-related traumatic brain injury account for up to 1 in 5 traumatic brain injuries. However, this proportion varies depending on the study populations (3).
The top sports associated with concussions are rugby, American football, soccer, off road vehicles (including cycling), basketball, wrestling and equestrian sports (1, 3).
Concussion by age and gender
Although the literature is not complete, it seems that most sports-related concussions happen in younger athletes (1, 3). Unfortunately, children and adolescents also recover at a slower rate than adults (1).
Males are at a greater risk of concussion than females, with percentages ranging from 66.1% to 75.6%, depending on the country (3).
Nutrients to prevent and treat concussion
There are a few nutrients that can be used by athletes at risk of concussion in order to minimise the effects of an event.
Creatine has been studied, among other things, for its ability to maintain energy levels in the brain. Animal studies have shown that creatine supplementation helped maintain energy levels in the mitochondria and reduce reactive oxygen intermediates, among other beneficial effects. Dietary sources of creatine include meat and fish, however supplementation provides a more accurate dosage because it’s not susceptible to cooking processes (1). For more on creatine supplementation read my previous article Supplementing creatine.
The brain contains a high level of polyunsaturated fatty acids (PUFAs), which are susceptible to damage. This is exacerbated by the production of ROS, as discussed earlier. Oxidation of these fragile fats can be prevented by antioxidants such as curcumin, which also has anti-inflammatory properties. Curcumin is not easily absorbed and metabolised by the body, so supplements designed to overcome its shortcomings are probably the best option (1). Read my previous article What is turmeric latte? for more information about curcumin.
One of the most abundant and important components of neurons are omega-3 fatty acids, specifically DHA or docosahexaenoic acid. The amount of DHA in neurons decreases after concussions and is normally low in Western diets. As shown in animal and clinical studies, DHA supplementation can help mitigate the damage inflicted by concussions. Good dietary sources of DHA are cold water algae and fish (1).
DHA deficiency may also lead to increased toxicity of glutamate, poor cognitive performance, amyloid deposits in the brain, among other deleterious effects (4).
Curcumin + DHA
Combining curcumin and DHA seems to be more effective than either nutrient alone (1).
Following a TBI, the brain requires energy to repair itself. This energy is normally supplied by glucose; therefore injuries are followed by a period of increased glucose uptake followed by a period of decreased glucose metabolism (1, 2). These and other alterations in glucose uptake and metabolism post-injury make it a potentially unreliable fuel. This is why scientists have investigated the use of ketones as an alternative fuel post-TBI, among other neurological disorders. While there are several caveats with existing research (e.g. animal studies, unrealistic fat:carbohydrate ratios, acute TBI vs concussion), there seems to be a potential avenue for the use of a ketogenic diet (or exogenous ketones) in the treatment of concussion (2).
Sulfur deficiency might lower melatonin levels (important for sleep, which is important for the cleanup of cellular debris) and impair the function of DHA in neuron membranes, among other effects (4).
Magnesium deficiency can increase inflammation, lower glutathione and increase generation of free radicals (4).
Zinc deficiency is associated with aggregation of misfolded proteins in the brain and production of ROS (4).
B-vitamin deficiency is associated with increased oxidative stress and increased homocysteine, a risk factor for cardiovascular disease (4).
Summary and recommendations
If you participate in sports that might lead to concussions, it might be smart to supplement with creatine, curcumin and DHA. In addition, make sure you are meeting micronutrient levels, particularly of sulfur, magnesium, zinc and B vitamins. A ketogenic diet might be useful in mitigating effects of concussions but it is best to do it under the guidance of an experienced dietitian. Finally, make sure you have your gut health under control, as it will affect nutrient absorption and metabolism.
- Oliver JM, Anzalone AJ, Turner SM. Protection Before Impact: the Potential Neuroprotective Role of Nutritional Supplementation in Sports-Related Head Trauma. Sports Medicine. 2018;48(1):39-52.
- Morley WA, Seneff S. Diminished brain resilience syndrome: A modern day neurological pathology of increased susceptibility to mild brain trauma, concussion, and downstream neurodegeneration. Surgical neurology international. 2014;5:97.
- Theadom A, Mahon S, Hume P, Starkey N, Barker-Collo S, Jones K, et al. Incidence of Sports-Related Traumatic Brain Injury of All Severities: A Systematic Review. Neuroepidemiology. 2020:1-8.
- Prins ML, Matsumoto JH. The collective therapeutic potential of cerebral ketone metabolism in traumatic brain injury. J Lipid Res. 2014;55(12):2450-7.
[Photo by Tom Roberts]