Nutrition and traumatic brain injury : improving acute and subacute health outcomes in military personnel / John Erdman, Maria Oria, and Laura Pillsbury, editors ; Committee on Nutrition, Trauma, and the Brain, Food and Nutrition Board, Institute of Medicine of the National Academies.

Includes bibliographical references.

Military personnel, especially those in combat zones, face a distinct risk of traumatic brain injury (TBI). The injuries can range from mild to severe, and their effects can appear within minutes or hours, or sometimes weeks or even years later. Although estimates of incidence and prevalence are elusive, some estimates suggest that TBI has accounted for up to one-third of combat-related injuries. TBI also is a major problem among civilians, especially those who engage in certain sports, with an estimated 1.6 to 3.8 million sports-related TBIs occurring annually. Despite such health tolls, the mechanisms and damaging effects of TBI on the brain are not fully understood. While some research has explained these mechanisms of injury, new information suggests that nutritional interventions could help in treating or even providing resilience against TBI. In this light, the Department of Defense (DoD) asked the IOM to review the potential role of nutrition in the treatment of and resilience against TBI. Given the complexity of TBI and the current gaps in scientific knowledge, the IOM could identify only one action that can immediately improve treatment efforts: early feeding to patients with severe TBI. Research has shown that feeding the severely injured soon after an injury is known to help in decreasing mortality. In addition, new information suggests that nutritional interventions could help in treating or even providing resilience against TBI. The IOM identified a number of other possible benefits for specific nutritional interventions and recommends that the DoD and other collaborates conduct more research.

This study was supported by Contract No. W911QY-10-C-0010 between the National Academy of Sciences and U.S. Army Medical Research and Materiel Command, Department of Defense.

Part I: Background -- 1. Introduction -- 2. Nutrition in Clinical Practice Guidelines for Traumatic Brain Injury -- 3. Understanding Pathophysiological Changes -- Part II: Nutrition and TBI -- 4. Approach for Selecting Nutritional Interventions: Mechanistic Targets -- 5. Acquiring Resilience to TBI Prior to Injury -- 6. Energy and Protein Needs During Early Feeding Following Traumatic Brain Injury -- 7. Antioxidants -- 8. Branched-Chain Amino Acids -- 9. Choline -- 10. Creatine -- 11. Ketogenic Diet -- 12. Magnesium -- 13. Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) -- 14. Polyphenols -- 15. Vitamin D -- 16. Zinc -- Part III: Recommendations -- 17. Summary of Recommendations -- Appendixes -- Appendix A: Agenda -- Appendix B: Evidence-Based Guidelines for Traumatic Brain Injury -- Appendix C: Workshop Speakers' Papers -- Appendix D: Glossary -- Appendix E: Acronyms -- Appendix F: Committee Member Biographical Sketches.

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