By Raquel Lannes-Sherrill, MA, CSCS
We may all be aware that the rest, ice, compression, and elevation (RICE) protocol prescribed by most physicians, therapists, and athletic trainers is important during an injury; however, most practitioners fail to recognize the importance of nutrition during the recovery process. Did you know that if you have an acute injury or a chronic injury that nutrition can accelerate the healing process? Let’s start with macronutrient intake such as protein, fat, and carbohydrates.
Protein intake (1 gram per kg of body weight) is essential if a rapid return to normal function is desired (Berardi and Andrews, 2015).
Also amino acids have also been well documented to exert strong effects on injury healing. Since the body is under stress during an injury, arginine and glutamine become conditionally essential amino acids. This means that these amino acids are not normally essential (Berardi and Andrews, 2015).
With respect to fat, a diet high in omega-3 fats will also have an anti-inflammatory effect and speed up the recovery process. One should intentionally decrease omega 6 (vegetable oils and saturated fat ) intake and increase omega 3 intake especially in the form of high quality fish oil aiming for 3-9 g or 3000—9000mg (Berardi and Andrews, 2015).
In an non-injured state, one physician recommended 2000 mg of omega 3’s per day is what the average adult should be consuming to reap the amazing benefits (listed below). Before we dive into the benefits, let’s understand what omega 3 fats are.
The most important omega 3 fats are the following:
- alpha-linolenic acid (ALA): found in flax and walnuts
- docosahexaenoic acid (DHA): found in marine sources such as fish/algae
- eicosapentaenoic acid (EPA) found in marine sources such as fish/algae
Aside from promoting wound healing, it is important to note that an entire research paper can be dedicated to the benefits of omega 3’s. In a nutshell, omega 3’s play a role in almost every part of the body including but not limited to cardiovascular function, nervous system function, joint health, and immune system function.
It is very interesting to note that recent research has documented that low levels of omega 3’s are associated with Alzheimers’ disease, difficulty focusing, mood disorders, and other memory loss health concerns (Berardi and Andrews, 2015).
If that isn’t enough to convince you of the importance of consuming omega 3’s, then this may: Did you know that fish oils increase fat breakdown? In other words, fish oil consumption will help you burn more fat. Without getting too detailed, it breaks down fat through peroxisomes which requires more energy (or technically ATP) production. Thus, more fat is burned to do the same daily activities. (Berardi and Andrews, 2015). Like I previously mentioned, an entire essay can be written on the benefits of omega 3’s which is beyond the scope of this article/blog post.
If you are a vegan or do not eat fish, you can substitute with 1g of algae oil. Research studies have documented that a balance of a 6:3 ratio of omega-3 to omega 6 supports injury healing (Berardi and Andrews, 2015).
With respect to carbohydrates, it is best to avoid processed carbohydrates of any kind since it will trigger further inflammation. Unprocessed carbohydrates should be included which will keep insulin levels stable. Personally, I recommend that you decrease your simple sugar intake across the board with the exception of dark colored fruits like berries and pineapple (explained in further detail below). From my own personal experience, sugar exacerbates inflammation.
VITAMINS & MINERALS
- enhances white blood cell activity which help fight the infection during the acute phase of an injury.
- helps promote formation of collagen fibers
- if deficient in vitamin C, collagen fibers will form abnormally and the tissue will be weak due to poor adhesion (Berardi and Andrews, 2015).
- research suggests that Vitamin C is important for injury repair especially in people recovering form surgery, injury, and ulcers
- 1-2 g/day is the recommended dose
- assists in red blood cell formation and works synergistically with vitamin C to form connective tissue specifically elastin.
- 2-4 mg/day is the recommended dose
- involved in over 300 reactions in the body
- plays a role in DNA synthesis and protein synthesis: both necessary for tissue repair
- deficiency in zinc has been associated with poor wound healing
- one of the most common micronutrient deficiencies
- if deficient, it reduces T cell (a form of a white blood cell) development and function
- 15-30 g/day is the recommended dose during initial stages only of healing
Calcium and Iron:
- plays a larger role in prevention especially in stress fractures in athletes
- intake should come from food sources
- higher doses via supplication can be toxic or interfere with other vitamins/minerals like zinc and copper mentioned above
DIETARY HERBS AND OTHER FOODS
Moreover, other dietary herbs/foods can significantly accelerate wound healing and decrease inflammation. Listed below are five main herbs/foods are can help mitigate inflammation:
- Turmeric: a root in the ginger family that is a very strong anti-inflammatory agent. As a bonus, turmeric is also anti-viral and anti-bacterial. I call it nature’s Advil. I start my day off every morning with a thumb size chunk of turmeric in my kale smoothie.
- Garlic: an anti-inflammatory herb, but you will get the most benefit from garlic extract.
- Bromelain: an enzyme derived from pineapple which is also an anti-inflammatory as well as analgesic (pain reliever)
- Boswella: a tree that produces resin which is an anti-inflammatory agent
- Flavonoids: plant chemicals that are primarily found in dark colored fruits (like berries) and vegetables
***It is important to note that during the acute phases of an injury
(0-4) days, suppressing inflammation is not a good thing.
Any attempt to eliminate inflammation during the acute phase is a mistake (Berardi and Andrews, 2015).
Without getting too technical, the inflammatory response sends chemicals to the injured site to take care of injury by removing cellular debris and begin the repair process. This is your body’s initial method of tissue repair. The aforementioned herbs are ONLY recommended post acute phase.
Last but not least, most athletes and the common population will under-eat when injured. Did you know your body is working harder to recover from an injury; thus, your basal metabolic rate increases between 15-20%? It takes energy to repair an injury. You should give your body the right fuel via nutrition to get back on track as soon as possible. Under-eating can also lead to an increase in stress fractures, ligament, and other connective tissue injuries. So if you don’t consume enough calories while injured, you may prevent an injury from fully recovering (Berardi and Andrews, 2015). Choose wisely what you eat, and the road back to recovery will be shorter.
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The Essentials of Sport and Exercise Nutrition: Certification Manual second edition: Precision Nutrition, Inc. 2015.