Ketosis and Traumatic Brain Injury: A Former Athlete’s Perspective by Ryan Lowery
Here is my traumatic brain injury story: It was a moment that every kid has dreamed of: preparing for (what I felt like at the time) was the biggest game of my life with some of my best friends and teammates. It was a cold, snowy night in December at MetLife stadium, home of the New York Giants. We were competing for the high school football championship against our much bigger rivals, Mountain Lakes. My 165-pound self (though the stats books claimed I was 185 pounds) decided to be “tough” and not wear sleeves for what felt like the coldest day of my life.
It was the first play of the game. The ground was rock hard, and slush lined the field, so running the ball seemed like the best option. We were in a “Cover 3,” and I was playing safety. Toss left. Our defensive end got blocked, our linebacker slipped and lost his footing, and our cornerback couldn’t get off a block either. I read the play and made a dash towards the sideline to cut the running back off. At this point, I was the last line of defense. I could see him clearly. I thought, “I’m definitely going to tackle this guy,” “truck-stick” him nonetheless, to send a message. And then…. WHAM!! The next thing I knew, I was lying on the ground looking down the sideline as the running back ran into the end zone for a touchdown. It was the first play of the game, and they scored a touchdown. Some of my teammates came over to help me up, and I soon realized that something wasn’t right.
Not only could I not feel my right shoulder, but I was dizzy and couldn’t put much pressure on my right leg. It wasn’t until I was over at the sideline that I found out that not one but two of the 270-pound lineman came around, and blocked my 165-pound scrawny self from the side to spring the running back into the end-zone. Needless to say, I was hurting bad, and the game had just begun. Our trainer looked at me and said, “you have two options: either you can come out of the game and we can get you rested for basketball season, or we can do what we can to make sure you can finish out this last game.” No brainer. Five minutes later, I felt like a science experiment with a wrap extending from my shoulder down to around my leg and knee. I had torn my MCL, gotten a bad stinger, and without a doubt suffered some serious head trauma from the hard hit straight on the ground. Eight aspirin later, a correct guess at some fingers he was holding up, and I made my way back out on to the field.
We ended up getting blown out and lost by a large margin, but nonetheless it was an incredible experience. I planned to be sidelined from basketball (basketball season started the following week) for several weeks after in order to rehab my MCL, but that wasn’t even the major setback for me. No one other than my parents knew at the time that I could hardly sleep at night, had constant headaches, and frequently left class due to nausea and eventual vomiting throughout the next week. Looking back, there was no doubt that I had a concussion/mild traumatic brain injury following that game. That wasn’t the first time I had experienced a concussion throughout my young career, but it was the one that was most vivid for me.
It is clear that a TBI results in an energy crisis in the brain and impaired metabolism immediately and for up to several months following the insult. Research suggests that correcting the energy crisis may assist in recovery from the insult and may restore cellular energy to the brain. Adolescents placed on a ketogenic diet before and following injury may benefit tremendously. However, adults seem to need a longer period of time on the diet to increase the “tunnels” (MCT1, MCT2 transporters) and ketone production. As a protective measure, adults may need to keto-adapt for a longer period of time even prior to receiving TBI. For this reason, it may be efficacious for athletes in contact sports to consider being on a ketogenic diet more permanently. More recent articles are showing that once keto-adapted, performance does not appear to be impaired, even in high level CrossFit athletes.
Research with traumatic brain injury and other neurological disorders like Alzheimer’s, Parkinson’s, etc. all seem to tie back to impaired brain energy metabolism (primarily derived from an inability to effectively utilize glucose). The current rates of concussions and TBI in sports are certainly alarming, and no one is more aware of this problem than the NFL. The current NFL settlement results in hundreds of millions if not billions of dollars being paid to former NFL athletes who have experienced brain trauma and are dealing with the repercussions and aftermath, or as some call it, “life after the game.” There is a strong interest from the NFL in ways in which these injuries could be minimized prior to, during, and following incidence. We are excited about some potential research and collaborations that we have been discussing with many of these organizations to test novel strategies in athletes in the near future. At the end of the day, if we could save just one kid, one son, one father from the aftermath and repercussion of something as brutal as CTE, then it is all worth it.