Skip to main content

Military Health System

Important Notice about Pharmacy Operations

Change Healthcare Cyberattack Impact on MHS Pharmacy Operations. Read the statement to learn more. 

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...

Publication
Aug 4, 2020

TBICoE Research Review: Multiple TBI/Multiple Concussion

.PDF | 189.80 KB

Prior history of TBI may predispose an individual to increased risk of subsequent TBI, which may result from less force, and lengthier recovery from post-injury symptoms. Activities such as contact sports and military service carry particular risk for multiple TBI. In addition to acute post-injury difficulties, cumulative TBI may increase the risk of ...

Publication
Aug 3, 2020

Return to Activity Educational Guidance for Service Members with Symptoms Following a Concussion

.PDF | 375.28 KB

This guide is intended to help service members and veterans who have experienced a concussion recover as quickly and safely as possible. It outlines each stage of the recovery process, explains what affected individuals should expect throughout the recovery process, provides guidance on how to track progress and includes a table to track developments.

Publication
Jul 31, 2020

Management of Headache Following Concussion/mTBI Clinical Recommendation

.PDF | 229.14 KB

This clinical recommendation outlines the assessment and management of headache following mild TBI. It includes specific recommendations regarding how health care providers can help patients manage pharmacologic and non-pharmacologic treatment of post-traumatic headache (PTH).

Publication
Jul 31, 2020

Management of Headache Following Concussion/mTBI Clinical Support Tool

.PDF | 154.16 KB

This clinical support tool uses an algorithmic approach for health care providers to help assess and manage headache in service members and veterans who sustain a mild TBI and experience post-traumatic headache (PTH). The tool offers providers a step-by-step process to determine the type of headache following mild TBI and indications for emergency or ...

Fact Sheet
Jul 30, 2020

Ways to Improve Your Memory Following Concussion/mTBI Fact Sheet

.PDF | 158.74 KB

This TBICoE fact sheet can be used by health care providers to educate patients with concussion, or mild traumatic brain injury, on how to manage memory problems related to their injury.

Fact Sheet
Jul 30, 2020

Neck Pain Following Concussion/mTBI Fact Sheet

.PDF | 205.90 KB

Neck pain can occur together with headaches following a concussion. This TBICoE fact sheet provides information to help patients manage neck pain. Various techniques are explained, including the use of heat or cold therapy, neck stretches, proper sleep positions and common activities that may contribute to neck strain.

Fact Sheet
Jul 30, 2020

Headaches Following Concussion/mTBI Fact Sheet

.PDF | 140.00 KB

Although each headache is different, identifying common causes, or triggers, is important for health care providers and patients to determine appropriate treatment. This fact sheet provides non-drug options to help those diagnosed with a mild TBI and associated post-traumatic headache manage symptoms.

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