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Nutritional Support for Injury Recovery

May 17, 2016

As many of you know, I sprained my ankle in April.  As many of you might not know, I was a fool and sprained it again three weeks after the first sprain (or 1.5 weeks ago).  For some reason I didn't take the first sprain seriously.  I thought: heck, I always roll my ankles, I always have, this can't really be all that different, it just hurts a little more.  Well, that's where I lost the diligence to actually nurse the darn thing back to good health; or, I should say, I never found the diligence to nurse the darn thing back to good health.

 

Isn't that how it always goes?  So the second time was really the charm.  I finally took the advise of...everyone...and had an MRI taken (thanks Dad :)) and sought out a visit with the physical therapist (thanks Tyler Murray!).  With care, diligence, and patience, I'll be back running before too much longer.

 

In the midst of my misery after the second sprain I tried to think about all the things I could possibly do to make this thing heal and heal well, if not fast (quickly, I suppose, would be the grammatically-correct term there, but who's counting?).

 

Well, duh, it dawned on me: food!  hello!

 

I knew Vitamin C was critical for the growth and development of connective tissue, and I was also aware of the importance of zinc in making reactions go (we call those reaction-activators enzymes; zinc plays the role of "key" to turn the switch for a lot of enzymes to do their job), especially reactions involved in tissue development (cell division) and protein synthesis.  So, I started popping some pills.  And then it occurred to me to share these fun facts with all ya'll.

 

 

And what I mean by "popping pills" isn't all it's cracked up to be.  Some research has shown that, actually, in the case of wound-healing, supplemental Vitamin C (so, yes, a pill, or a powder) can have a greater effect on wound healing than just food alone (see references at the end).  The reason for this is not necessarily because the synthetic (or pill) form is better for you (because it's not!) it's just that your body will use so much Vitamin C to repair the wounded body tissue that it would be very difficult to eat enough Vitamin-C-rich foods to supply all of that C baby.  So, the supplement.  Personally I use a powdered form of ascorbic acid (Vitamin C) dissolved in water with a splash of lemon or lime juice.  The recommendation is to take at least 2,000 mg per day during wound-healing (of course this will vary depending on the injury; for my ankle sprain I plan to supplement the Vitamin C for at least a few weeks).

 

It is also critical to note that much research has shown that ascorbic acid (as well as just about every nutrient under the sun) has a much more powerful effect when ingested as a component of a whole food.  By and large, it is not just a singular nutrient, vitamin, or mineral that has an effect on the body.  Generally speaking, each little molecule acts as a component of a larger group of molecules that interact with each other to produce an effect in the body.  Nutritional science is a very young science, and, for the most part, we have hardly figured out any of it.  So, again, the push for whole foods.  We simply do not fully understand these "miraculous" interactions between the molecules in our foods that cause them to be health-giving nutrients or nutrient complexes.  Thus, by simply eating the whole food, you can ensure that you get the most out of your nutrients for a fraction of the cost of the supplement. :) :)

 

And this note on the topic of supplementing versus whole-foods nutrition:

I operate on the following mentality: Eat whole, real foods; and everything in moderation, including moderation (you could apply this to more than just eating, of course).

Hmm, no mention of pills...when I do find myself taking vitamin or mineral supplements, I never take them daily :)  Usually because I forget and because I hate swallowing pills.  But also importantly because I don't believe swallowing those little glycerin capsules every day is the best thing for my body; so I give it a break.  I'll usually supplement 5 days out of 7, if I'm supplementing at all.

 

As for the real-food option: regarding Vitamin C, I think we're all familiar with the notion that the lovely citrus fruits are very rich in Vitamin C.  Lots of tasty veggies are also good food sources of the water-soluble vitamin: broccoli, kale, Brussels sprouts, bell peppers.  Yummm!

 

 

 

As for zinc, like I said, it plays a super important role in generating new tissue.  You could take a supplemental form of zinc - and I do, currently, to nurse this ligament regeneration that's happening down in my left ankle.  I am currently taking 50 mg most days.  This is a fairly high dose, so it would be wise to not take it every day.  A more moderate dose would be 15-30 mg per day (especially if you were going to take it every single day).

 

Rather than pump the zinc pill, those of us who don't mind the occasional flesh could focus on eating a few ounces of red meat (beef, lamb) a few days a week.  Note: "few" usually refers to about three.  So three ounces of red meat not much more than three days a week.  Non-meat sources of zinc include lentils, seeds (pumpkin, sesame), garbanzo beans, cashews, and spinach.

 

 

 

A couple of other important nutrients for wound healing include Vitamin A, protein, omega-3 fatty acids, bromelain, and glucosamine.  There are definitely more nutrients, or molecules, involved in tissue repair than just these, but in an effort to not overwhelm us all, I'll keep it to a short-er list.

 

Vitamin A plays a role in increasing the number of wound-healing molecules involved at the site of injury (an aspect of inflammation) and is involved in tissue development.  Vitamin-A-rich foods include leafy green veggies (spinach, kale, collard greens, mustard greens, carrots, sweet potatoes, and most orangy-yellowy-reddish foods).  We often overlook the leafy greens as a great source of Vitamin A; interestingly the chlorophyll in the green vegetables has a stronger influence on color than the carotenoids (the vitamin-A precursors that give carrots and sweet potatoes their color).  So, if spinach, for example, didn't have chorlophyll in it, it would likely be a yellow or orange leaf because it also contains carotenoids! (Think of the foliage change in the north east in the fall!  That's what's happening, the cholorphyll is dying and the leaves change color!)

 

Protein of course is important to take in during injury rehab because it is these little protein building blocks (amino acids) that are used to create new tissue and new cell structures (called organelles)!  We all know food sources of protein, hopefully: legumes, lentils, nuts, seeds, (most veggies, even!), and of course, animals; my recommendation is to please know your farmer when choosing where to buy your meats.  Feel free to ask me more about this any time!

 

Omega-3 fatty acids are also critical for creating new cells.  All cells in the human body have a membrane that is made up of fats!  And omega-3 fats play a role in quelling inflammation when the time is right (as in, after an episode of acute inflammation to begin healing the injury).  While inflammation is good and necessary, we don't want to live in a state of chronic inflammation, thus it is very important to have an adequate intake of omega-3 fats so that your body can turn off the inflammatory process after it's run its course.  The best sources of EPA (eicosapentanoic acid) and DHA (docosahexanoic acid) - two omega-3 fatty acids that our bodies use a whole lot of - are smaller, cold-water, salt-water fish (salmon, mackerel, black cod, sardines).  Pasture-raised, hormone-free, antibiotic-free, unpasteurized whole animal milk can also be a great source of omega-3 fats.  Green leafy vegetables also contain small amounts of these vital nutrients, as do walnuts, flax seeds, and soy beans.

 

The following diagram on omega-3-rich foods is taken from a site that I like to refer to when searching for foods rich in certain nutrients: www.whfoods.com.

Bromelain is an enzyme found in pineapples (mostly the stem, so this is usually taken as a supplement) and functions to break down proteins (the ones that were damaged by the injury: damaged cells and tissues = damaged proteins).  It is necessary for the body to be able to clear these damaged proteins so that new, healthy proteins, cells, tissues can be synthesized.  Taking a bromelain supplement can help the swelling clear faster.

 

Last, but certainly not least, glucosamine is a popular supplement in the competitive athlete world.  This molecule plays a big role in the synthesis of new collagen (or connective tissue).  Especially in the first few days post-injury, concentrations of glucosamine at the site of injury are much higher than normal.  If supplementing with glucosamine, it would be pertinent to supplement in period immediately following the injury (aka the first few days post-injury).  Glucosamine is typically found in the hard, outer shell of crustaceans; thus, it is typically taken as a supplement.

 

Lot's to think about and digest :)  As always, focus on eating a variety of seasonal, fresh, whole foods, and if nothing else that alone will provide you with an excellent foundation for health and for wound-healing :)

 

 

If you are interested in reading more about these and other nutrients that are critical in wound healing, check out these articles:

 

McKay, Douglas, and Miller, Alan L.  Nutritional Support for Wound Healing.  Alternative Medicine Review, 2013; 8:4. pp 359-377.

 

Trauma and Wound Healing: Targeted Nutritional Strategies.  Life Extension Magazine.

 

Antioxidants: Beyond the Hype.  The Nutrition Source.  Harvard T.H. Chan School of Public Health.

 

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