Nutrition for Injury Recovery: Part 2
By John Berardi, Ph.D.
The right food and supplements can speed injury recovery. This is important — but often ignored.
Most trainers, coaches, nutritionists, therapists understand that nutrition can play a role in injury recovery. However, in lecturing around the world, I’ve found that very few of them really know how to use food and supplements in this way.
Aside from recommending more water, topical homeopathic creams and gels, and glucosamine/chondroitin combinations, there’s really not much else on the menu when a client or athlete goes down with an acute injury.
That’s why we’re sharing this 5-part video series, filmed live at the 2012 Fit Pro Convention in Loughborough, England.
In this video series, we’ll teach you how the body repairs itself after an injury.
Then we’ll share the food and supplement protocols we use to get injured clients back in the game more quickly and completely.
To learn more, click the play button below to get started with Part 2 of Nutrition for Injury Recovery. (Click here for part 1, part 3, part 4, and part 5). The video is about 11 minutes long.
To download an audio or a video version of this file, click here.
Please be patient as downloads may take a few minutes.
Three physiological targets
Once we understand how healing works, we can look for different therapies to help the process along, using a three-pronged approach:
- Inflammation support (and management) through nutrition
- Immune system support through nutrition
- Regeneration and anabolic support through nutrition
Let’s start by talking about inflammation.
Treating acute injuries requires a tricky balance of managing inflammation while allowing it to do its important job.
Don’t try to avoid the inflammatory process in the acute phases of an injury. It’s critical for Stage 1 recovery.
But don’t make inflammation worse, either. Excessive inflammation could increase total tissue damage, slowing down the repair process.
While managing inflammation in the early stages, we want to reduce pain, as this can cause biomechanical compensations and changes that may lead to secondary injury.
However, again, strategies that eliminate pain often target inflammation. Rushing to eliminate inflammation (and pain) too soon may also reduce healing. Again, it’s a tight balancing act.
Dietary fat for inflammation control
A diet high in trans-fats, omega-6 rich vegetable oils, and saturated fat will be pro-inflammatory (in other words, it’ll worsen inflammation). A diet high in monounsaturated fats and omega-3 fats will be anti-inflammatory.
The ratio of omega-6 to omega-3 in the diet is important for overall inflammation in the body — especially during normal periods of healthy living when we definitely want to keep inflammation under control.
In these circumstances, the omega-6 to 3 ratio should be anywhere from 3:1 to 1:1, which should lead to a balanced inflammatory profile.
Of course, overall fat balance is important here. With a good balance of saturated, monounsaturated, and polyunsaturated fats (about 1/3 of total fat intake each), the body’s inflammatory profile will look pretty good.
However, purposely decrease omega-6 fats and increase omega-3s (specifically fish oil). High omega 6:3 ratios reduce collagen production while a low 3:6 ratio supports healing.
Even though relatively higher omega-3s create an anti-inflammatory response in the body, this response doesn’t interfere with repair; rather, it only helps with injury healing and collagen deposition.
Unfortunately, we haven’t yet determined the exact omega 6:3 ratio, nor the amount of fish oil supplementation required to manage inflammation during injury.
Studies with low dose fish oil (~450 mg to 1 g/day) have shown no effect on inflammatory or immune markers while other studies have shown that high dose fish oil (12-15 g/day) may reduce immune cell function in certain populations.
As a result, some authors have recommended anywhere from 3-9 grams of fish oil (salmon oil, sardine oil, menhaden oil, krill oil, etc.) per day.
In addition to the omega 6:3 ratio, research has shown that increased nut and seed consumption, as well as olive oil consumption, can mildly reduce inflammatory biomarkers.
Nuts, seeds, and olive oil likely share a common mechanism. The monounsaturated fats found in all three contain compounds that can mildly reduce COX enzyme activity (something these foods share with ibuprofen). But again, be careful. Too high a dose of any anti-inflammatory may reduce acute healing.
Thus: Improve omega 6:3 ratio while adding in healthy monounsaturated fats and balancing saturated, polyunsaturated, and monounsaturated intake. Here are some simple strategies to do this:
To balance your fats:
Increase intake of olive oil, mixed nuts, avocados, flax oil, ground flax and other seeds, etc. Get some of each fat source each day. These foods will balance out the saturated fats naturally present in your protein sources, leading to a healthy profile without needing a calculator. (Bear in mind that you may need to reduce overall portion sizes if you are inactive because of the injury.)
To balance your 6:3 ratio:
Add 3-9 grams of fish oil each day while reducing omega-6 fats like vegetable oils such as corn oil, sunflower oil, safflower oil, cottonseed oil, and soybean oil, etc. This strategy should take care of your omega 6:3 ratio.
Dietary herbs and phytochemicals for inflammation
Beyond healthy fat balance, certain dietary herbs can help manage inflammation.
A flowering plant in the ginger family, turmeric has long been used as an anti-inflammatory agent and in wound healing. Current research shows that the active ingredient, curcumin, is responsible for some of the benefits of turmeric. While adding turmeric to food every day is a good strategy, using 400-600 mg of supplemental turmeric extract 3x per day (or as described on the product label) is probably more manageable for most people.
Garlic has been shown to inhibit the activity of the inflammatory enzymes cyclooxygenase and lipoxygenase and affect macrophage function. Again, though, while eating additional garlic is likely a good strategy, garlic extracts may be required for more measurable anti-inflammatory effects. Typically recommended dosing is 2-4 g of whole garlic clove each day (each clove is 1 g) or 600-1200 mg of supplemental aged garlic extract.
Bromelain is another anti-inflammatory plant extract from pineapple. While best known for its digestive properties, bromelain is an excellent anti-inflammatory and analgesic compound although its mechanism of action is poorly understood.
Read more here: Precision Nutrition