Nutrition to Support Brain Health & Offset Brain Injuries

This newsletter is sponsored by Momentous

In the episode “Nutrition to Support Brain Health & Offset Brain Injuries,” I discuss nutrition strategies to reduce the risk of brain injuries like concussions and traumatic brain injuries (TBIs) and support recovery from them. These same strategies also enhance brain function, promote long-term health and support healthy aging. This newsletter highlights 7 key nutritional interventions.

Brain Injuries

Brain injuries are categorized into mild, moderate and severe levels based on symptom severity. Mild TBIs are the most common and involve brief confusion or amnesia (lasting 30 minutes or less). Most recreational and sports-related concussions fall into this category. Moderate TBIs are defined by loss of consciousness or amnesia (from 30 minutes to 24 hours) and result in more severe symptoms, like prolonged cognitive issues and memory loss. Severe TBIs can cause significant loss of consciousness (lasting days to weeks) and result in long-term cognitive problems, significant memory issues, mood changes and learning difficulties.

The brain's response to a TBI triggers a cascade of events, starting with the physical trauma experienced by the brain, and can lead to excitotoxicity (overstimulation), energy deficits and inflammation, all of which exacerbate neuronal damage. Cell death, oxidative stress and disrupted energy production can result in lasting impairments of the brain's ability to function efficiently and heal. Below are nutritional approaches that can support TBI recovery.

#1 – Creatine Monohydrate

You’re probably familiar with creatine. It’s been gaining steam in recent years. Creatine is stored in muscles, the liver and the brain and is a quick energy source (energy deficits are a key issue for TBIs). Creatine enhances cognition in both healthy individuals and those with brain injuries. It may reduce second-impact syndrome (repeated head trauma) and cortical damage by up to 50%, likely by preventing mitochondrial dysfunction, maintaining cell membranes and reducing oxidative stress.

Creatine Dose

  • General dose: 5 grams (g). Post-TBI recovery dose: 20 g (I suggest splitting into 4 smaller doses.)
  • Those at high risk for injury may benefit from 20-30 g/day for 1 week before an event with risk of injury.
  • A potential side effect is mild GI distress (bloating, gas, cramps), especially at high doses.
  • Creatine's benefits are gradual, so maintain a consistent dose regardless of injury risk.

Whole Food Sources of Creatine

  • Creatine is found in meats like beef, chicken, salmon, tuna and cod, but it's challenging to get enough from food alone, especially at high dosages.
    • Typical meat servings provide about (~) 0.4-0.6 g creatine per 100 g (3.5 oz). That means you’d need to eat ~2.5 lbs of cooked steak to get 5 g of creatine.
    • For vegetarians and vegans, supplementation is often necessary.

#2 – Omega-3s

​Omega-3s, particularly DHA and EPA, found in fish oil, are essential for optimal brain health. DHA constitutes ~10% of the brain and is essential for neurological function, as well as for preventing injury and neurodegeneration. EPA supports cognitive function by enhancing vascular health, as well as oxygen and nutrient delivery within the brain. Omega-3s have been well-studied for TBI, and they improve blood flow to the brain and reduce inflammation.

You can have your Omega-3 levels tested through my company Vitality Blueprint (use code PERFORM10 for 10% off), or via providers such as Quest Diagnostics, Labcorp and others.

Omega-3 Dose & Supplements

  • General dose: 2-4 g/day. Post-TBI recovery dose: 4 g/day.
  • There are no side effects, but it could cause loose stool at higher doses.
  • Daily supplementation timing is flexible; omega-3s are beneficial before & after injury.
  • Most omega-3 supplements contain both DHA and EPA.

Whole Food Sources of Omega-3

  • Fatty fish (salmon, herring, sardines, mackerel, trout) are the best sources of omega-3s.
    • Salmon provides about 2 g of omega-3s per 100 g (3.5 oz) fish.
  • Adequate omega-3 intake for brain health can often be achieved through food, but supplementation is often necessary, especially for vegans and vegetarians.

#3 – Vitamin B2 (Riboflavin)

​Vitamin B2 is crucial for DHA utilization in the brain and is involved in energy production and glutathione synthesis (the body's primary antioxidant), all of which support TBI recovery. While human studies are limited, riboflavin shows promising results in reducing recovery time after injury. Other B vitamins (B6, B9, B12) help to reduce homocysteine levels, which are linked to cognitive decline and neuropathy in TBI.

Riboflavin Dose

  • General dosage: 400 milligrams (mg) per day. Post-injury dose: 400 mg once per day for 2 weeks.
  • Multivitamins contain insufficient riboflavin, so a dedicated supplement is often needed.
  • Timing isn’t critical — mornings may be preferable if you find it boosts energy.
  • Riboflavin is well-tolerated with very few side effects.

Whole Food Sources of Riboflavin

  • Riboflavin is found in beef liver (3.4 mg per 100 g), whey protein (2 mg per serving), or fortified cereals.
  • Supplementation is often needed, as food alone requires impractically large portions.

#4 – Choline

​Choline enhances brain health by supporting the blood-brain barrier and is a precursor to acetylcholine (a key neurotransmitter) and glutathione (an important antioxidant). Higher choline intake is linked to reduced Alzheimer’s and dementia biomarkers. Choline levels in the brain decrease with repeated head impact, likely contributing to second-impact syndrome and cumulative damage. Meta-analyses generally report positive benefits of choline for TBI recovery, though further research is needed to understand its full benefit and mechanisms.

Choline Dose & Supplements

  • General dose: 500 mg/day. Post-injury dose: 1-2 g/day.
  • Higher doses post-injury will likely require supplements such as Alpha-GPC and phosphatidylcholine. (Vitamin B complexes typically only provide 20-30 mg of choline.)
  • Take supplements earlier in the day to avoid potential sleep disruption.

Whole Food Sources of Choline

  • Meat, poultry, fish, eggs, dairy, beans, beef liver and cruciferous vegetables are good sources of choline. You can reasonably meet baseline choline needs with whole foods.
    • Beef liver provides around 400 mg/100 g. Eggs provide about 150 mg per egg.

5 – Branched-Chain Amino Acids (BCAAs)

​BCAAs consist of 3 amino acids: leucine, isoleucine and valine. BCAAs act as nitrogen donors in the brain to produce glutamate and GABA, key neurotransmitters involved in TBI pathology. After a TBI, symptom severity correlates with BCAA suppression in the brain. Evidence suggests BCAAs may improve sleep quality and reduce cognitive deficits in TBI patients.

BCAAs Dose

  • Post-injury dose: Up to 55 g/day in the case of severe TBI.
  • If you are consuming enough dietary protein (about 1 g per pound of body weight), you are likely getting enough BCAAs for general health.

Whole Food Sources of BCAAs

  • Protein-rich foods like meat, poultry and dairy are high in BCAAs (3-4 g per 100 g serving of meat).
  • Reaching higher doses post-injury through food would require eating ~40-50 ounces of meat daily, which makes supplementation more practical for TBI recovery.

#6 – Magnesium

​Magnesium is involved in 600+ processes in the body, including cell signaling, energy production, learning and memory. Deficiencies are linked to conditions like diabetes, migraines and heart disease. After a TBI, brain magnesium levels drop significantly, correlating with injury severity and symptoms. After an injury, magnesium helps reduce brain excitotoxicity to help alleviate some memory, mood, and sleep issues.

Magnesium Dose

  • Recommended dose: 400 mg per day.
  • It may improve sleep in some individuals when taken at night, depending on the form.
  • Available in different supplement forms (e.g., bisglycinate, malate, threonate).
  • GI distress is the main side effect; bisglycinate and malate are more well-tolerated.
  • Magnesium is very safe with little risk of harm.

Whole Food Sources of Magnesium

  • Found in foods like pumpkin seeds, chia seeds, almonds and spinach.
  • Pumpkin seeds are one of the richest sources, offering about 200 mg per 100 g of seeds.

#7 – Blueberry Anthocyanins

​Anthocyanins, found in berries, are part of the flavonoid family and have many health benefits. Animal research shows that blueberry extracts post-TBI can increase brain-derived neurotrophic factor (BDNF) to support memory and cognition. They also protect against oxidative stress due to their antioxidant properties.

Anthocyanins Dose & Whole Food Sources

  • Recommended dose: 500 mg.
  • Blueberries are an easy and effective way to incorporate anthocyanins into your diet.
    • About 1 cup of blueberries contains ~500 mg of anthocyanins.
  • Other berries like strawberries, raspberries and cranberries also contain anthocyanins and likely offer similar benefits.

Remember: in the words of Bill Bowerman, “If you have a body, you are an athlete.”

-Andy