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A man with an acquired brain injury making coffee as part of breakfast illustrating the role of nutrition to people who have brain injuries

Sheri Taylor is a specialist rehab dietitian who works with people who have sustained a brain injury. She is often asked the question, do people with a brain injury need a special diet?

The answer to this is no, they don’t need a special diet per se, but eating a healthy diet containing lots of vegetables, fruit, whole grains, olive oil, fish and foods which promote a diverse gut microbiome is advised. That having been said, this style of diet, often referred to as a Mediterranean style diet, is something that almost everyone would benefit from.

Through her work, Sheri has found that most of her clients who have sustained a brain injury are not eating a healthy balanced diet and tend instead to eat a high proportion of fast food, takeaway, ready meals, biscuits, chocolate, crisps and energy drinks, which are known to cause weight gain, increase the risk of heart disease, increase inflammation and increase certain types of pain. This kind of unhealthy diet can result in a person being prescribed laxatives for gut dysfunction caused by lack of fibre.

Factors that may influence food choices for someone with a brain injury

There are a number of reasons why those who have sustained a brain injury may choose less nutritious food, these can include a lack of knowledge around nutrition, difficulty planning their meals, food and shopping due to their brain injury, fatigue or feeling overwhelmed by the task of planning and cooking meals. For those who have support workers to assist with meals, their support worker may have limited nutritional knowledge or cooking skills.

It is common for clients referred to a dietitian to be deficient in one, or more nutrients, and often are not having enough of the most basic nutrients to be able to help their bodies and brains to heal. It can be a balancing act, ensuring that the client is well nourished so they can get the most out of their therapy and rehabilitation, whilst being realistic with what they are able to manage on a day to day basis.

Clients who have a brain injury often have other medical conditions that also need to be considered, most commonly diabetes and pre-diabetes, diarrhoea, constipation, irritable bowel syndrome, reflux, dysphagia or weight problems.

Unfortunately many people either do not meet the criteria to be referred to a dietitian under the NHS or they slip through the net and do not receive a referral.

When to refer to a dietitian

So when should a referral to a dietitian be considered? Generally the following guidelines should be followed:

  • Has the client had unintentional weight gain or weight loss, of 10% of more, in the last 3 to 6 months?
  • Does the client have a diagnosed medical condition such as diabetes or pre-diabetes?
  • Does the client have dysphagia and if so, are their family or support workers struggling with a nutritious and varied diet?
  • Is client having regular episodes of constipation, diarrhoea, abdominal pain or bloating?
  • Does the client suffer severe fatigue?
  • Does the client have grade 3 or 4 pressures sores?
  • Is there a loss of sense of taste or smell?

If any of the above circumstances exist, a referral to a dietitian should be considered.

About Sheri Taylor

Sheri is a registered dietitian and has over 23 years of experience improving the nutritional health of people in a community setting (in both the United Kingdom and Canada). As the director of Specialist Nutrition Rehab, Sheri specialises in the nutritional needs of people after a catastrophic injury, including traumatic brain injuries/cerebral palsy, spinal cord injuries and orthopaedic injuries. She regularly works with clients who are trying to lose weight, gain weight, resolve gut or bowel related symptoms, as well as those people experiencing dysphagia and/or taste and smell loss.

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