Traumatic brain injury (TBI) accounts for up to one-third of combat-related injuries in Iraq and Afghanistan, according to some estimates. TBI is also a major problem among civilians, especially those who engage in certain sports. At the request of the Department of Defense, the IOM examined the potential role of nutrition in the treatment of and resilience against TBI.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON NUTRITION, TRAUMA, AND THE BRAIN
• Reviewers
• Preface
• Summary
• Part I. Background
  • 1. Introduction
    • PURPOSE AND SCOPE OF THE STUDY
    • TRAUMATIC BRAIN INJURY
    • STUDY APPROACH AND ORGANIZATION OF THE REPORT
    • REFERENCES
  • 2. Nutrition in Clinical Practice Guidelines for Traumatic Brain Injury
    • EVIDENCE-BASED CLINICAL GUIDELINES
    • DEVELOPMENT OF EVIDENCE-BASED GUIDELINES
    • EBGS FOR SEVERE TBI IN THE ACUTE STAGES
    • EBGS FOR MODERATE OR MILD TBI AND CONCUSSION
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 3. Understanding Pathophysiological Changes
    • EXPERIMENTAL MODELS OF TBI
    • MODERATE, SEVERE, AND PENETRATING TBI
    • BIOMARKERS OF INJURY AND OUTCOMES
    • ENDOGENOUS NEUROPROTECTIVE TARGETS
    • REPAIR AND RECOVERY MECHANISMS
    • MILD TRAUMATIC BRAIN INJURY
    • RECURRENT MILD HEAD INJURIES/CONCUSSIONS
    • BLAST INJURIES
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
• Part II. Nutrition and TBI
  • 4. Approach for Selecting Nutritional Interventions: Mechanistic Targets
    • GENERAL APPROACH FOR SELECTING NUTRITIONAL INTERVENTIONS
    • NUTRITIONAL MODIFIERS OF TBI: PROMISING TARGETS
    • SUMMARY
    • REFERENCES
  • 5. Acquiring Resilience to TBI Prior to Injury
    • INTRODUCTION
    • MILITARY NUTRITION STANDARDS
    • DEVELOPMENT OF MENUS
    • DIETS OF MILITARY PERSONNEL
    • DIETARY SUPPLEMENT USE BY THE MILITARY
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 6. Energy and Protein Needs During Early Feeding Following Traumatic Brain Injury
    • GLUCOSE HOMEOSTASIS
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 7. Antioxidants
    • VITAMIN E (ALPHA-TOCOPHEROL)
    • VITAMIN C (ASCORBIC ACID)
    • COMBINATION OF ANTIOXIDANTS
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 8. Branched-Chain Amino Acids
    • BRANCHED-CHAIN AMINO ACIDS AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 9. Choline
    • CHOLINE AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 10. Creatine
    • CREATINE AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 11. Ketogenic Diet
    • KETOGENIC DIET AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 12. Magnesium
    • MAGNESIUM AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 13. Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA)
    • EPA AND DHA AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE SUGGESTING INCREASED RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 14. Polyphenols
    • FLAVONOIDS
    • CURCUMIN
    • RESVERATROL
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 15. Vitamin D
    • VITAMIN D AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
  • 16. Zinc
    • ZINC AND THE BRAIN
    • USES AND SAFETY
    • EVIDENCE INDICATING EFFECT ON RESILIENCE
    • EVIDENCE INDICATING EFFECT ON TREATMENT
    • CONCLUSIONS AND RECOMMENDATIONS
    • REFERENCES
• Part III. Recommendations
  • 17. Summary of Recommendations
    • RECOMMENDATIONS
• Appendixes
  • A Agenda
  • B Evidence-Based Guidelines for Traumatic Brain Injury
  • C Workshop Speakers’ Papers
  • D Glossary
  • E Acronyms
  • F Committee Member Biographical Sketches

This study was supported by Contract No. W911QY-10-C-0010 between the National Academy of Sciences and the Department of Defense. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

Suggested citation:

IOM (Institute of Medicine). 2011. Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel. Washington, DC: The National Academies Press.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.