When we think of recovering from an accident, injury or illness, we tend to only think of working with a physiotherapist to devise a physical rehabilitation program that will optimize recovery and function. Nutrition for recovery is not always considered as critical in the process. However, research supports that nutrition should, in fact, play a key role in this recovery plan.

As both a registered physiotherapist with Propel Physiotherapy Peterborough and a certified nutritionist with Koru Nutrition, I understand that optimal nutrition is crucial for energy production, inflammation control as well as tissue growth and repair from bones and muscles to tendons and brain.

The following information is an introduction to the general principles of nutrition during rehabilitation. Nutrition prescription is not a “one size fits all” approach, and recommendations often evolve throughout the phases of recovery, but there are some basic guidelines to consider when integrating nutrition into your rehabilitation plan.

Energy Production

Energy needs increase following injury and illness, highlighting the importance of adequate intake during the recovery process. As individuals are typically less active following an injury, it is common to under fuel during this critical time, which may lead to a delayed or prolonged recovery.

In fact, basal metabolic rate (BMR) may increase by 15-20% following a minor injury or surgery, while major surgery or traumatic brain injury (TBI) may lead to a 50% increase in BMR![i] So although it may feel like you are “doing” less, your body is using more calories than usual to repair tissue and restore function.

Of course, there is the possibility of excess energy intake which can also have negative consequences (increased adipose tissue, decreased insulin sensitivity); it is therefore equally important to consider the sources of energy that are being consumed.

Key Nutrients for Rebuilding Injured Tissue

General Nutrition for Recovery

Injured tissue requires protein to repair and rebuild. It is important to ensure a consistent supply of high-quality protein when recovering from any injury or surgery.  If an injury has resulted in immobilization, this causes a decreased ability for protein synthesis to take place and therefore muscle growth (a term referred to as “anabolic resistance”).[ii] Protein deficiency can therefore exacerbate loss of muscle and tendon mass.

Generally, aim to include a complete protein at each meal/snack:

  • meat or fish
  • dairy
  • eggs
  • nuts and seeds
  • Legumes and pulses

We can also focus on specific nutrients that may be beneficial for different types of injuries or impairments;

Nutrition for Recovery of Muscle, Tendon and Skin

Muscle tissue specifically benefits from an amino acid called leucine (= “anabolic trigger”), which stimulates muscle protein synthesis.

Leucine is found in high amounts in:

  • cheese
  • meat
  • fish
  • nuts and seeds
  • tempeh

Evidence also suggests that intake of omega-3- fatty acids may prevent muscle loss during immobility.[iii],Omega-3-fatty acids also play an important role in inflammation control and brain health.

Vitamin C helps the body make collagen which is important for the integrity of bones, muscles, skin and tendon. In fact, collagen is the most abundant protein in humans, comprising about one-third of total protein.[iv] Vitamin C also has antioxidant and anti-inflammatory properties which may also lead to a quicker recovery.

Zinc is necessary for tissue repair and growth as well as immune system function. Research specifically supports the need for zinc to optimize wound healing.[v]

Nutrition for Bone Recovery

When we think bone health, we think calcium. It is true that there is an increased need for calcium following a fracture. However, calcium doesn’t act alone. In order for calcium to contribute to bone growth and strength, it needs to be balanced with magnesium, vitamin D3 and vitamin K2. These vitamins and minerals directly influence the absorption and metabolism of calcium within the body.

  • Calcium sources: dairy, sardines, leafy greens, almonds, sesame seeds
  • D3 sources: egg yolk, fatty fish, sun exposure, supplementation
  • K2 sources: pasture raised meats, eggs, full fat dairy, fish, fermented foods
  • Magnesium sources: broccoli, spinach, nuts and seeds

Nutrition for Recovery from Brain Injury

Nutrition is paramount to promote a healthy brain and therefore a crucial element to optimize recovery from a brain injury. It is generally recommended to focus on anti-inflammatory and antioxidant foods to control the neuroinflammation which follows a brain injury and to prevent neurodegeneration.

Specific nutrients have demonstrated potential to be of particular benefit when recovering from a brain injury.  We have discussed the need for zinc to promote tissue repair and when it comes to brain health, diets rich in zinc have shown promise in speeding up recovery from a traumatic brain injury.[vi]

Omega-3-fatty acids are widely known to be important for brain health.  Studies show that the therapeutic use of omega-3-fatty acids may decrease axonal and neuronal damage as well as inflammation, and can even lead to improved cognitive function.[vii]

Finally, magnesium is a mineral that our bodies need for optimal sleep, energy and blood sugar balance. Depletion of magnesium is observed in human blood following a brain injury and it is therefore advised that patients ensure adequate magnesium in their diet for recovery.[viii]

Inflammation Control

Inflammation is the body’s natural (and important) response to injury or illness. However, uncontrolled or prolonged inflammation can lead to many unwanted results, including pain, stiffness, decreased function, depression and slower recovery.

Foods can either promote or inhibit this inflammatory process. Fats can play a significant role to either help or hinder this process. You have likely heard fats being referred to as “good” or “bad” fats. This often has a lot to do with their influence on the inflammatory pathways.

  • Anti-inflammatory fats (“good” fats during recovery): olive oil, avocado, fatty fish, flax seeds, nuts and seeds
  • Pro inflammatory (“bad” fats that may prolong recovery): greasy foods, processed foods, vegetable oils
  • *omega 3 fatty acids may be particularly helpful to prevent prolonged inflammation.[ix]. Try to increase omega-3 to omega-6 fatty acid ratio by consuming foods such as fish, algae, walnuts, flaxseeds and chia seeds and decreasing corn, canola, cottonseed, soy and sunflower oils.

Antioxidant rich foods (fruits and vegetables) help to control inflammation:

  • blueberries
  • tart cherries
  • dark chocolate
  • pecans
  • green tea
  • pineapple
  • turmeric
  • garlic
  • ginger

Nutrients for Recovery

nutrients for recovery nutrition for recovery infographic Propel Physiotherapy

Food for Thought

We can have a huge impact on our physical and mental functioning by considering what we are putting into our bodies as fuel. A well balanced, whole foods diet will go a long way towards setting you up for success when it comes to recovery.

There are certain nutrients that may provide added benefit in higher doses or even supplementation. I’ve highlighted some specific considerations for optimizing the rehabilitation process through nutrition in this article. However, it is important to understand that each injury is unique; as is the rehabilitation plan that works best for that individual. I encourage anyone who is interested in more specific recommendations to reach out to a nutritional practitioner for an assessment and an individualized plan.

References

[i]Frankenfield D. Energy expenditure and protein requirements after traumatic injury.  Nutr Clin Pract. 2006;21: 430-437.

[ii] Glover EI, Phillips SM, Oates BR, et al. Immobilization induced anabolic resistance in human myofibrillar protein synthesis with low and high dose amino acid infusion.  J Physiol. 2008;586:6049-6061

[iii] Smith GI, Atherton P, Reeds DN, et al.  Omega-3 polyunsaturated fatty acids augment the muscle protein anabolic response to hyperinsulinaemia-hyperaminoacidaemia in healthy young and middle-aged men and women.  Clin Sci. 2011; 121-267-278.

[iv] Shoulders MD, Raines RT. Collagen structure and stability. Annu Rev Biochem. 2009;78:929-958.

[v] Lin P-H, Sermersheim M, et al. Zinc in wound healing modulation.Nutrients. 2018; 10(1):16.

[vi] Cope, E. C., et al. Zinc supplementation provides behavioral resiliency in a rat model of traumatic brain injury. Physiol Behav. 2011;, 104(5), 942-947

[vii] Mills JD, Hadley K, bailes JE. Dietary supplementation with omega-3 fatty acid docosahexaenoic acid in traumatic brain injury.  Neurosugery. 2001; 68:474-481.

[viii] Sen AP, Gulati A. Use of magnesium in traumatic brain injury. Neurotherpeutics. 2010; 7(1): 91-99.

[ix] Calder PC, Albers R, Antoine JM, et al. Inflammatory disease processes and interactions with nutrition.  Br J. Nutr. 2009;101:S1-S45.

Written by

CHRISTINE DAVIES
CHRISTINE DAVIESRegistered Physiotherapist & Certified Nutritional Practitioner
Christine Davies is motivated by a lifelong passion for movement and wellness. She feels strongly about using functional, purposeful movement to assess, treat and ultimately help clients achieve their goals. As a registered physiotherapist, certified nutritional practitioner and yoga instructor, Christine believes strongly in a holistic approach to wellness.

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