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Nutrition and Resilience Post Injury

The relationship between nutrition and resilience

Nutrition represents an integral element of rehabilitation programmes following a major injury or trauma, with a balanced diet having a significant impact on a person’s health and ability to enjoy and sustain a good quality of life.

Resilience is something we can develop and continue to improve, and healthy eating can help build resilience and contribute to the achievement of important goals in a client’s therapy. Dietitians introduce increased nutritional awareness and healthy eating - with tailored recommendations aligned with the individual’s needs - as part of a wider care plan, overseeing the replenishment of the macro and micronutrients crucial in providing energy, helping to prevent disease, and allowing the body to function correctly.

Rebecca McManamon is a dietitian and expert witness at Bush & Co and explains the importance of specialist support with nutrition in building resilience:

“As experts in the field of dietetics, dietitians have a deep understanding of the complex sciences accounting for diet, nutrition, and health and adopt a proactive management approach to patient treatment. We use diagnostics to assess a patient’s biochemistry and work closely with medical teams to analyse nutritional and hormonal aspects to ensure cost-effective and sustainable diet therapy includes a diet essential to the treatment of a patient.”

The importance of nutrition

Clients recovering from injury or trauma face a range of challenges that can present as pulmonary and physical limitations, cognitive impairment, or sleep issues and often experience fatigue that affects energy levels and the motivation to engage with prescribed recovery plans.

  • Eating and digesting food can take longer, sometimes due to difficulties swallowing or the impairment of the gut-brain axis
  • Reduced mobility can lead to weight gain, with obesity common among patients following a brain injury
  • Weight gain can impair the ability to use wheelchairs and other mobility aids, restricting some patients to their homes
  • Pressure sores and other skin issues can be present
  • Sleep contributes to resilience and issues with metabolism can have detrimental effects on sleep patterns
  • Changes in taste and small can follow brain injury and are also impacted by Covid-19
  • Stress is a common trigger for increased intake of quick, easy meals we find give us comfort, but these invariably lack nutritional value and don’t address the underlying emotional and mental issues. Memory and other cognitive impacts, such as generativity can also be factors in a limited and often high energy diet post brain injury.

Dietitians are the only legally regulated nutrition professionals in the UK and a trained dietitian supports meal selection and preparation to ensure the specific needs of the individual patient are met.

  • Spinal cord injury (SCI) can often lead to gastrointestinal dysfunction and issues managing bowel movements and associated abdominal pain
  • Weight and skin condition may determine access to prosthetic limbs for patients who have experienced limb loss due to a car crash or illness
  • Cognitive function is affected following an acquired brain injury (ABI), which can cause issues with sleep
  • Gastroesophageal reflux is common in children with cerebral palsy and is known to have a high incidence of feeding difficulties

Balancing the intake of specific fluids and foods allows the control of calories and required levels of protein and vitamins to address the needs of individual patients and manage their weight and the health of their skin.

Consuming a diet that promotes specific foods to aid recovery for a specific condition, for example the ‘MIND’ diet following brain injury, with berries, nuts, green leafy vegetables, wholegrains and oily fish, can boost resilience. Conversely, foods high in fat, salt, or sugar can be counter-productive and contribute to delayed or prolonged recovery and hinder therapy or treatment.

Our needs change as we grow

Everyone needs a blend of essential amino acids, fatty acids, carbohydrates, and a range of vitamins and minerals to sustain life and health. However, nutritional needs vary from one life stage to another, and the recommended intakes of macronutrients and micronutrients change relative to body size.

Cerebral palsy is a condition caused by a brain injury that occurs before the brain is fully developed. Children diagnosed are at high risk of developing nutritional deficiencies caused by eating and swallowing disorders which hinder growth and present challenges with weight management.

Elderly clients undergoing rehabilitation need appropriate levels of energy and nutrients to avoid malnutrition, with a clear association between low nutritional status and declining functional capacity. The introduction of additional energy and protein can help with muscle mass, strength, and physical mobility and lead to improved quality of life.

A dietitian works closely with other care professionals to apply scientific research to clinical recommendations and safeguard optimal nutrition to slow the natural decline in muscle function inevitable with age and promote improvements in physical activity and sleep.

The role of a dietitian

Dietitians from Bush & Co work alongside physiotherapists, occupational therapists, nurses, catastrophic injury case managers and other professionals to deliver holistic care plans tailored to individual patients that have experienced an ABI, SCI, illness, or other major injury or trauma.

In their capacity as a nutrition care specialist, dietetic expert witness testimony can be used to assess if the standards of care or regulations have been met in the care of a patient using fact-based evidence gathered through an evaluation of medical records, biochemical results, nutritional assessments, and all other pertinent information.

Those impacted by birth injury and acquired brain and spinal injuries frequently need dietetic monitoring to adjust to care plans through the person’s lifetime, and dietetic expert witness quantum reports outline future care needs to allow lifelong dietetic support.

Nutritional interventions aligned with exercise programs help retain and develop cognitive function and engage patients in their treatment program. Good nutrition and hydration lead to enhanced health and well-being, which in turn increases a patient’s resilience and ability to recover from injury.