Nutrition Hotline

By Reed Mangels, PhD, RD

QUESTION: My vegan daughter plays high school soccer and is recovering from a sports-related concussion. She's following all of her pediatrician's advice about limiting activity. I wondered if anything nutrition-related could help.

S.M., MA, via email

ANSWER: General recommendations to eat well and to drink fluids for hydration apply when recovering from a concussion. Limiting or avoiding caffeinated drinks like soft drinks, coffee, and tea can make it easier to get needed rest. Nausea, which is sometimes an issue in the early days post-concussion, may be helped by eating bland food.1

Other suggestions are based on limited research and are only speculative. Creatine (also known as creatine monohydrate) is an amino acid made by our body and found in meat and fish. The International Olympic Committee's (IOC) consensus statement about supplement use mentions that creatine supplements are associated with decreased damage and improved recovery post-concussion, although data are not conclusive.2 One trial in children and adolescents who were given 0.4 g/kg creatine for six months after concussion found less headache, dizziness, and fatigue.3 We don't know if a lower dose would also work. Depending on your daughter's weight, the amount of creatine used in the trial may exceed the 3-5 grams of creatine daily which appears to be safe for long-term (two to six months) use by children and teens.4 Vegan creatine supplements are available from Vegan Essentials and other online retailers.

The National Athletic Trainers Association endorses increasing the intake of the omega-3 fatty acids EPA and DHA post-concussion.1 DHA, specifically, may reduce inflammation and oxidative stress following a concussion.5 Although some DHA is produced from another omega-3 fatty acid, ALA, that is in vegan diets, a more efficient way to get DHA is to use a vegan DHA supplement derived from microalgae. A dose of 200-300 milligrams daily appears to be safe. We don't know how much is needed to support concussion recovery or for how long DHA needs to be taken. A research study examining these questions is in progress.

Always discuss any use of supplements with your child's health care provider.

References

1 Weidman C, Knappenberger K, Vance C. 2016. Nutrition for Concussion Recovery. www.nata.org/sites/default/files/nutrition-for-concussion-recovery.pdf

2 Maughan RJ, Burke LM, Dvorak J, et al. 2018. IOC Consensus Statement: Dietary supplements and the high-performance athlete. Int J Sport Nutr Exerc Metab. 28:104-125.

3 Sakellaris G, Nasis G, Kotsiou M, et al. 2008. Prevention of traumatic headache, dizziness and fatigue with creatine administration. A pilot study. Acta Paediatr. 97:31-34.

4 U.S. National Library of Medicine. 2018. Creatine. www.medlineplus.gov/druginfo/natural/873.html

5 Barrett EC, McBurney MI, Ciappio ED. 2014. w-3 fatty acid supplementation as a potential therapeutic aid for the recovery from mild traumatic brain injury/concussion. Adv Nutr. 5:268-277.