Nutrition and Traumatic Brain Injury: Improving Acute and Subacute Health Outcomes in Military Personnel

摘要

This report reviews nutritional approaches that show promise in providing resilience or treating the acute and subacute effects of TBI. The committee was not asked to evaluate the role of nutritional therapies in the rehabilitation phase or the potential role of nutrition in ameliorating long-term effects of TBI. It is important to note that the chronological boundaries of acute, subacute, and long-term effects are not clear. For example, an event such as angiogenesis, which is typically associated with long-term wound healing, is initiated within the brain during the acute phase. This report therefore includes some studies that also evaluate seemingly long-term outcomes that may be initiated in the acute and subacute phases of the disease. This report does not address other outcomes such as neurodegenerative (e.g., Alzheimers disease, Parkinsons disease), neuroendocrine, psychiatric, and other nonneurological disorders that appear later in life and may be associated with TBI but for which a causal relationship with the original injury has not been clearly established. In spring of 2010, the IOM appointed a committee of 11 experts with extensive knowledge in the areas of neurology; nutritional sciences, clinical nutrition, and dietetics; physiology; physical medicine and rehabilitation; psychiatry and behavioral science; biochemical and molecular neuroscience; epidemiology/methodology; and the pathobiology of TBI. Two public workshops featuring presentations by civilian and military subject matter experts in TBI provided important information for the committee. A review of the scientific literature was conducted to examine physiological sequelae and metabolic responses to TBI, with the purpose of identifying mechanistic interventions.