Concussion & Traumatic Brain Injury (TBI) Prevention: An Inside Out Approach
A concussion is a mild traumatic brain injury (MTBI) that people often associate with contact and collision sports such as ice hockey, football, lacrosse, soccer, basketball, and wrestling (Waltzman, 2019) (Baldwin, 2018) . However, concussions and more severe traumatic brain injuries (TBIs) can also occur in response to other common causes like motor vehicle accidents (MVAs), bicycle accidents, falls and assaults (Hon, 2019) .
When it comes to concussions and traumatic brain injury, prevention truly is the key to maintaining optimal brain health. It remains the best point of intervention as it can be difficult to repair and reverse any brain damage incurred from those incidents, not to mention the increased susceptibility to secondary injuries.
There is a lot of research on the topic of concussion and TBI prevention, mostly revolving around the use of protective equipment such as headgear and face shields, especially as it relates to contact sports. Concussions and TBIs do occur outside of those scenarios and protective equipment isn’t always a viable option nor does it completely prevent brain injuries from happening. Protective equipment, as important as it is, help to reduce the impact to the brain but may not actually prevent the injuries. Protective equipment is certainly a worthwhile first-line preventive option, but there are also some lifestyle and dietary modifications as well as other natural health strategies that you can employ to further protect your brain’s health, from the inside out.
Sleep & Melatonin
Sleep is one of the most important pillars of health. It is the foundation upon which we can build up our well-being. Sleep has so many benefits from detoxification to muscle and cell repair, reducing inflammation and encouraging healing all around. All of these factors have a direct positive impact on your brain’s physiology serving as protection. Furthermore, sleep is known to increase memory and cognition, in turn allowing for quicker reflexes. Enhanced brain function could also indirectly contribute to preventing brain injuries such as concussions by allowing the brain to react quicker to avoid accidents, such as dodging a football player’s tackle or the oncoming vehicle drifting into your lane on the highway.
To enhance the protective power of your brain, make sure you are aiming to optimize both the quantity and the quality of your sleep. Part of your bedtime routine should include dimming the lights and reducing your exposure to blue light to allow and encourage appropriate melatonin production. Melatonin is your main sleep hormone functioning as a hypnotic to help regulate your circadian rhythm. It also functions as an antioxidant, anti-inflammatory and neuroprotective. Melatonin has a protective effect on the brain and could very well contribute to the prevention of concussions and TBIs and the preservation of our brain health for more reasons than one.
Hydration
Your brain is made up of approximately 75% water, which is more than your body’s average hovering at about 60% (DENT Neurologic Institute, 2019). Your brain’s increased 
water requirement is in large part due to cerebrospinal fluid (CSF), which is made mostly of water and serves as a protective mechanism for your brain, comparable to that of a cushion (University of Windsor, 2014) . Dr. Kevin Milne and Craig Harwood, two researchers in the field of human kinetics and kinesiology, note that a small decrease of even just 2% in hydration levels is enough to greatly reduce the amount of CSF available to protect the brain (University of Windsor, 2014) . Additionally, dehydration can lead to a dramatic change in electrolytes such as sodium, which are necessary for optimal brain function in memory and attention (DENT Neurologic Institute, 2019) .
Omega-3 Essential Fatty Acids
Your brain is made up of about 60% fat and is consequently the fattiest organ in your body (DENT Neurologic Institute, 2019) . Essential fatty acids (EFAs) like omega-3s, form the
cellular membranes of all the cells in your body. These EFAs are found in food sources such as fish (salmon, mackerel, etc.) and nuts (walnuts) and seeds (flax, chia). An appropriate dose for the maintenance of good health is approximately 2.5 grams per day of omega- 3s per day, with a ratio of EPA to DHA of about 3:1. Even the oiliest and fattiest fish rarely ever exceed 2g per serving. You would have to consume quite a bit of seafood and nuts and seeds to even just reach your daily requirement for maintaining good health, and that isn’t even the dose for additional therapeutic benefits. Therefore, supplementation is often recommended.
Fish oil is indicated for many conditions across all body systems. Particularly relating to the nervous system, fish oils are used to help with mental health such as depression and anxiety, memory and cognition which can all result from concussion and TBIs. Omega-3 fatty acids are clearly vital to maintain brain health and definitely offer protection to the brain from injury and insult.
Conclusion
TBIs are a leading cause of morbidity and mortality and is the most common cause of long-term disability and death among young adults (Hackenberg, 2016) (O'Leary, 2018) . The World Health Organization estimates that TBIs are responsible for over 5 million annual deaths worldwide (O'Leary, 2018) . Not only do we want to prevent TBIs and concussions for the sake of the individual’s health but also to address and reduce the socio-economic and health burden this poses worldwide. More research needs to be conducted on this topic, beyond the limits of public health initiatives such as seatbelts and airbags and policy and rule changes in sports (O'Leary, 2018) (Waltzman, 2019) . More can be done in every day health by individuals to optimize their brain health and reduce their chances of injury. Not all accidents are preventable, but using these health strategies, among others, may help to improve your brain’s resilience.
