Nutrition and Brain Health

(from March 2022 Intrepid Voices eNewsletter)

Research has shown that dietary changes may help relieve symptoms often associated with TBI, such as chronic pain, anxiety, depression, and sleep problems. At some Intrepid Network sites, individualized nutrition plans are part of the treatment. The National Intrepid Center of Excellence (NICoE) and Intrepid Spirit Center at Fort Belvoir have registered dietitians who also happen to be military veterans. This common ground makes it easier to build rapport with patients, said Belvoir nutritionist Isa Kujawski. 

During the NICoE intensive outpatient program (IOP), dietitian Ruth Clark teaches group nutrition classes and sees patients individually to create personalized meal plans. “I focus on ways to optimize nutrition in order to maximize healing potential,” she said. Both dietitians counsel patients on the benefits of an anti-inflammatory diet, in part because traumatic brain injury (TBI) can cause brain inflammation. “Inflammation is one of the first things I educate patients on,” said Kujawski. “It’s the body’s defense mechanism but can cause damage over time. That’s why adopting an anti-inflammatory diet is so important, especially for brain health.” Anti-inflammatory foods may include fatty fish, whole grains, legumes, and colorful vegetables and fruits. Processed, package or fried foods should be avoided as they may promote inflammation. 

Many patients come in with what Clark considers overly restrictive diets, limiting both what to eat and how often. She stresses the importance of meal patterns for improved cognition. “Eating more frequently throughout the day gives the brain a steadier source of energy,” she said. She also explains how correcting nutritional deficiencies can improve a variety of symptoms, including problems with sleep quality or quantity.

“Sleep is 10 times more effective [for overall health] than any sexy supplement I can give you,” said Kujawski. Her approach is less about being on a diet and more about using food as medicine. The first step: testing micronutrient levels, especially folate and vitamins D, B6, and B12. Most of her patients have a Vitamin D deficiency, which can be associated with depression, fatigue, and anxiety.

Many also have gastrointestinal symptoms when they return from deployment. Causes are varied and hard to pinpoint, but several studies have confirmed a link between TBI and gut issues. For Kujawski, this makes sense. “The gut and brain are connected. About 90% of serotonin is made in the gut,” said Kujawski. “The state of your brain can affect the state of your digestion.” 

One Belvoir Intrepid Spirit Center patient found relief by switching from a meat-heavy, high-carb diet to a plant-based one. In an email to Kujawski months after his treatment ended, he wrote: “All of my abdominal inflammation has disappeared… [along with] the massive cramping and abdominal pain I have had for years.”


  1. Use more herbs and spices. Paprika, rosemary, ginger, cloves, and cinnamon are among many that have been shown to reduce inflammation. 
  2. Choose plant-based proteins. Animal-based proteins have inflammatory properties. 
  3. Eat the rainbow. Fruits and vegetables in darker colors tend to be more anti-inflammatory. 
  4. Include more salmon and tuna in your diet. They are good sources of Omega 3, an essential fatty acid that can also be found in whole grains, walnuts, and green leafy vegetables. 
  5. Eat dark chocolate that is at least 70% cocoa. Studies show that 1.5 ounces a day decreases inflammation.

More on the anti-inflammatory diet may be found in the VA’s Eating To Reduce Inflammation

Posted on February 20 2023 in Blog

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