Skip main navigation

Military Health System

Clear Your Browser Cache

This website has recently undergone changes. Users finding unexpected concerns may care to clear their browser's cache to ensure a seamless experience.

Brain-Boosting Meal Plans Help Service Members with TBI

Image of During the NICoE intensive outpatient program (IOP), staff nutritionist Ruth Clark teaches hands-on classes in the on-site patient kitchen. (Photo: Tahira Hayes (Ctr), NICoE/WRNMMC, NSA Bethesda). During the NICoE intensive outpatient program (IOP), staff nutritionist Ruth Clark teaches hands-on classes in the on-site patient kitchen. (Photo: Tahira Hayes (Ctr), NICoE/WRNMMC, NSA Bethesda)

Nutrition is one of eight domains of Total Force Fitness. 

Most of us know that changing the way you eat can improve energy, weight, heart health, and other physical issues. But did you know that it can also affect brain health? 

Research has shown that dietary changes may help relieve symptoms that might complicate recovery from a traumatic brain injury (TBI), such as chronic pain, anxiety, depression, and sleep problems. 

The Defense Intrepid Network for TBI and Brain Health (Intrepid Network), a group of 13 TBI clinics that includes two OCONUS sites, treats these symptoms using a comprehensive interdisciplinary model of care. This patient-centric approach includes traditional rehabilitation, neurological, and behavioral health treatments combined with integrative medicine interventions and skills-based training. 

At some Intrepid Network sites, individualized nutrition plans are part of the treatment. The National Intrepid Center of Excellence (NICoE) and the Intrepid Spirit Center (ISC) at Fort Belvoir have registered dietitians on staff who are also military veterans. This common ground makes it easier to build rapport with patients, said Fort Belvoir nutritionist Isa Kujawski, a Navy reservist who spent 10 years on active duty. 

NICoE dietitian Ruth Clark, an Army veteran, describes her approach as “focusing on ways to optimize nutrition in order to maximize healing potential.” During the NICoE intensive outpatient program (IOP), a four-week treatment program for active duty service members diagnosed with mild-to-moderate TBI and associated health conditions, Clark teaches group nutrition classes and sees patients individually to create personalized meal plans. 

Both Clark and Kujawski counsel patients on the benefits of an anti-inflammatory diet, in part because TBI can cause brain inflammation. 

“Inflammation is one of the first things I educate patients on,” said Kujawski. “It’s the body’s defense mechanism but can cause damage over time. That’s why adopting an anti-inflammatory diet is so important, especially for brain health.” Studies suggest that fatty fish, whole grains, legumes, and colorful vegetables and fruits all have anti-inflammatory properties. Processed, package or fried foods should be avoided as they may promote inflammation. 

Many patients come in with what Clark considers overly restrictive diets, limiting both what to eat and how often. She stresses the importance of meal patterns for improved cognition. “Eating more frequently throughout the day gives the brain a steadier source of energy,” she said. 

Military personnel posing in a kitchen Isa Kujawski, nutritionist at Intrepid Spirit Center Fort Belvoir, teaches TBI patients about how diet affects brain health. An anti-inflammatory diet that includes some of the foods pictured can help with common symptoms of TBI, studies suggest (Photo by: Isa Kujawski (Civ), Intrepid Spirit Center, Fort Belvoir).

She also explains how correcting nutritional deficiencies can improve a variety of symptoms, including problems with sleep quality or quantity. 

Sleep is 10 times more effective for overall health than any sexy supplement I can give you, explained Kujawski. 

Her approach is less about being on a diet and more about using food as medicine. The first step: testing micronutrient levels, especially folate and vitamins D, B6, and B12. Most of her patients have a vitamin D deficiency, which can be associated with depression, fatigue, and anxiety. 

Many also have gastrointestinal symptoms when they return from deployment. Causes are varied and hard to pinpoint, but several studies have confirmed a link between TBI recovery and gut health. For Kujawski, this makes sense. “The gut and brain are connected. About 90% of serotonin [a neurotransmitter associated with mood] is made in the gut,” she said. “The state of your brain can affect the state of your digestion.” 

One Fort Belvoir ISC patient found relief by switching from a meat-heavy, high-carb diet to a plant-based one. In an email to Kujawski months after his treatment ended, he wrote: “All of my abdominal inflammation has disappeared … [along with] the massive cramping and abdominal pain I have had for years.” 

Tips for Reducing Inflammation 

  • Use more herbs and spices. Paprika, rosemary, ginger, cloves, and cinnamon are among many that have been shown to reduce inflammation.
  • Increase plant-based proteins. Nuts, beans, and other plant-based proteins are rich in fiber, nutrients, and bioactive compounds that can help reduce chronic inflammation. 
  • Eat the rainbow. Fruits and vegetables of various colors contain different phytonutrients which play varying roles in lowering inflammation. For example, red foods contain lycopene, while green foods contain sulforaphane. 
  • Include more salmon and tuna in your diet. They are good sources of Omega 3, an essential fatty acid that can also be found in whole grains, walnuts, and green leafy vegetables. 
  • Eat dark chocolate that is at least 70% cocoa. Studies show that 1.5 ounces a day decreases inflammation. Dark chocolate contains plant compounds called flavanols, which can lower inflammation by acting as a rich antioxidant while also promoting healthy blood flow.

For more information on the anti-inflammatory diet, see “Eating to Reduce Inflammation,” a resource from the Department of Veterans Affairs.

You also may be interested in...

Video
Feb 25, 2021

Progressive Return to Activity After Concussion Video

Progressive Return to Activity Provider Video

The PRA is an evidence-based, easy-to-use approach to help providers return service members with mild TBIs back to duty safely. TBICoE researchers have found that, if medical providers completed a two-hour, in-person training on the use of the PRA, their patients saw an overall reduction in symptoms after one week, one month, and three months, when ...

Infographic
Feb 24, 2021

Returning to Duty After Concussion

What's the best way to recover from a concussion? Returning to duty too soon after a concussion can lead to prolonged symptoms, decreased readiness, poor marksmanship, accidents and falls, and increased risk of more concussions. Progressively increasing activity in a step-wise manner can help you resolve your symptoms and return to duty safely. Ask your primary health care provider about TBICoE's Progressive Return to Activity to help you return to duty as quickly and safely as possible. Visit health.mil/TBICoE.

This TBICoE infographic gives an overview of the risks of returning to duty too soon after a concussion and explains how a progressive increase in activity can help get you back to duty safely. Returning to duty too soon after concussion can lead to prolonged symptoms, poor marksmanship, decreased readiness, accidents and falls, and increased risk of ...

Publication
Feb 23, 2021

Progressive Return to Activity Following Acute Concussion/Mild TBI Provider Training

.PPTX | 7.22 MB

The TBICoE revised the Progressive Return to Activity Following Acute Concussion/Mild Traumatic Brain Injury Clinical Recommendation (PRA) and this updated provider training slide deck. The trainings objectives will help providers to identify the key changes to the updated 2021 PRA; explain the rationale for using a PRA protocol for service members ...

Video
Feb 17, 2021

Total Force Fitness Reintroduction

Total Force Fitness Reintroduction

The Military Health System is reintroducing Total Force Fitness. The Total Force Fitness concept focuses on a service member’s entire health throughout their career, connecting eight dimensions of fitness to optimize health, performance, and readiness holistically.

Skip subpage navigation
Refine your search
Last Updated: December 01, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery