The U.S. military has made great strides in improving protection and treatment of injuries of their personnel. These advances have enhanced survival but, with wide use of improvised explosive devices in recent combat experiences, have also resulted in a higher number of nonpenetrating head and neck wounds, particularly traumatic brain injuries (TBIs).

The military defines TBI as a traumatically induced structural injury or physiologic disruption of brain function resulting from an external force that is indicated by a new onset or worsening of symptoms involving level of consciousness, memory, mental or neurological state, or intracranial lesion.

The Institute of Medicine (IOM) was requested by the Department of Defense through its Military Nutrition Division, based in the U.S. Army Research Institute of Environmental Medicine, to review the role of nutrition in providing resilience or treating acute or subacute effects of TBI in all ranges of severity, from mild concussion to severe, penetrating, and blast injury. This report did not review the potential for nutrition in ameliorating long-term effects, such as neurodegenerative or psychiatric disorders.

A committee of 11 experts in relevant fields, including neurology, neuropathology, basic and clinical nutrition, physical medicine and rehabilitation, neurochemistry, and epidemiology/experimental methodology, was appointed by the IOM. During its 18-month effort, this committee conducted information-gathering public workshops that were supplemented by a review of the literature and discussions at subsequent closed meetings.

The final report was externally reviewed by an independent group of experts in accordance with the procedures of the National Research Council.
Although a number of exciting and potentially valuable roles were identified where nutrition could play an adjunctive role that called for further research, it was only in the area of energy and protein needs in the acute phase of severe TBI that concrete recommendations for immediate adoption were made.