Nutrition for Injury Recovery: Part 3

Nutrition for Injury Recovery:
Part 3

By John Berardi, Ph.D.

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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 3 of Nutrition for Injury Recovery.  (Click here for part 1, part 2, part 4, and part 5). The video is about 8 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.

Calorie needs during recovery

In the previous video, we looked mostly at managing Stage 1 of injury recovery. Today, we’ll look at two important factors that affect Stage 2 and 3 injury recovery: adequate calorie and micronutrient intake.

Activity costs energy. Thus, we need more energy when training for sports, or following an exercise program.

Yet some athletes, especially female athletes, intentionally (to lose body weight) or unintentionally (due to improper nutrition education) under-eat.

This can lead to more repetitive stress injuries such as stress fractures or ligamentous injury. Thus, too few calories when healthy can lead to injury; too few calories during recovery can prevent an athlete from getting healthy.

Energy needs increase during acute injury repair. In fact, basal metabolic rate (BMR) may increase by 15 to 50% based on the severity of the trauma.  For example, sports injury and minor surgery may increase BMR by 15-20% ,while major surgery and burn injury may lead to a 50% increase in BMR.

Of course, comparatively speaking, an athlete or exerciser will have to eat less during injury recovery than during training and competition. Yet if they return to baseline intake, they may be under-eating.

Thus, nutrition coaches must balance the increased energy and nutrient needs of injured and recovering clients with the reality of less activity.

One example of calorie needs

Let’s take the example of a young male athlete. He’s 14 years old, 5’6″ and 140 lb.

  • Basal Metabolic Rate – 1611 kcal/day (mean of 3 predictive equations)
  • Energy needs when sedentary – 1933 kcal/day (activity factor of 1.2)
  • Energy needs with daily training/competition – 2739 kcal/day (activity factor of 1.7)
  • Energy needs during recovery – 2319 kcal/day (activity factor of 1.2 and a 20% increase in metabolism due to injury)

As you can see, during injury repair, energy intake should decrease (2319 kcal) relative to training and competition (2739 kcal).  However, returning to sedentary baseline (1933 kcal) will lead to underfeeding.

This is important both clinically and practically.

Less physical activity means lower appetite. If an athlete is eating based on hunger cues, s/he may under-eat during recovery. S/he might lose lean mass, heal poorly, and progress slowly.

Thus while injured athletes should eat less during periods of injury, remember: They’re still athletes, and should eat as such. This includes things like eating every few hours, getting enough protein, balancing macronutrients, and getting enough important micronutrients.

Macronutrient needs during recovery

Protein

Injury repair requires more protein. Injured athletes should aim for 1.5-2.0 g/kg, up from the usual 0.8 g/kg. Many already do this.

To ensure a quick recovery, make sure to get this higher protein intake consistently. At minimum, injured athletes should be taking in 1 g of protein per pound of body weight.

Fat

We covered dietary fat in a previous video — you’ll recall that we recommended balancing dietary fat by getting about 1/3 of total fat intake from each of the three types of fat. Most importantly, aim for more omega-3s and cut down omega-6s, to get an omega-6 to -3 ratio that’s at least 1:1 and preferably closer to 3:1.

Carbohydrate

While athletes need glucose for athletic injury healing, no specific carbohydrate recommendations have been established for injury periods. However, you should probably include enough dietary carbohydrate to ensure adequate micronutrient intake and stable insulin concentrations (which, as an anabolic hormone, may affect wound healing). In some athletes accustomed to a higher intake of carbs, not getting enough will be an additional — and unwanted — stressor.

Macronutrient needs summary

Here’s how to implement these recommendations in treating injuries nutritionally:

Meal frequency

Eat every 3-4 hours.

Protein

Each meal/snack should contain complete protein including lean meats, lean dairy, eggs, or protein supplements (if whole food is unavailable).

Vegetables and fruit

Each meal/snack should contain 1-2 servings of veggies and/or fruit (1/2 – 1 1/2 cups or 1-2 pieces) with a greater focus on veggies.

Starches

Get additional carbohydrates from whole grain, minimally processed, high-fiber sources like whole oats, yams/sweet potatoes, beans and legumes, whole grain rice, quinoa, etc. Eat fewer starches when not training (such as during injury recovery), but don’t cut them too low, especially if an athlete is not already well adapted to using fat for fuel.

Fats

Eat each of the following good fats each day — avocados, olive oil, mixed nuts, fatty fish (such as salmon), flax seeds, and flax oil. Add 3-9 grams of fish oil daily, taken in divided doses if necessary.

Wrap-up and today’s takeaways

That’s it for part 3 of Nutrition for Injury.

For now, here are some key points.

  • Athletes and exercisers need to eat enough — when training and when recovering.
  • When you’re injured and recovering, you should eat less than you did when you were training hard… but more than you would if you were completely sedentary.
  • Eat at least 1 g of protein per pound of body weight; balance dietary fats (and get more omega-3s than -6s); get some (but not a lot of) starchy, high-fiber carbohydrates; and eat a lot of vegetables (with occasional fruit).  We’ll discuss micronutrient needs in part 4 of the video series.

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