Effects of Chocolate Milk on MTBI in Youth Football Athletes

Slide Note

Mild Traumatic Brain Injuries (MTBIs) are common in sports, especially youth football. This study investigates the potential benefits of a chocolate milk product, Fifth Quarter FreshTM, in aiding recovery from MTBIs among young athletes. Chocolate milk is known for its protein, carbohydrate, and electrolyte content, which are essential for post-injury recovery. Previous studies on the role of BCAA supplementation in brain injury recovery provide the basis for exploring the efficacy of dairy products containing BCAAs. The study aims to assess the impact of chocolate milk consumption on cognitive function and healing processes post-MTBI.

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MIPS Project Report Effects of a Chocolate Milk Product on Mild Traumatic Brain Injury (MTBI) in Youth Football Athletes

INTRODUCTION

Background MTBI, also known as concussion, is a type of traumatic brain injury caused by a bump, blow, or jolt to the head that causes negative consequences to brain function, specifically, in cognition and movement control by the brain. MTBI can also occur from a blow to the body that causes the head and brain to move back and forth, which is often observed in almost all sports. Sports are associated with incredibly high numbers of MTBI incidents, especially in youth and collegial sports. MTBIs in children and young athletes can cause serious health-related issues, such as memory lapses and brain swelling, which can sometimes lead to fatal consequences. Institute of Medicine estimates that the MTBI risk for males in football is about 75% and the risk for females in soccer is about 50%.

Background Because of the importance of BCAAs in energy metabolism and neurotransmitter synthesis in the brain, previous studies investigated the effects of the intravenous supplementation (Aquilani et al. 2005) and dietary supplementation of BCAAs (Cole et al. 2010) on the cognition of patients with brain injuries and observed the improved cognition in the injured patients with the supplementation. Previous studies showed that mice with brain trauma exhibited faster improvement in cognitive function following the oral consumption of BCAAs immediately after the injury. The efficacy of brain healing following concussions in humans is currently under investigation in the scientific community. In these study, BCAAs are being administered orally to subjects to assess their ability to improve healing. However, the efficacy of the dairy products containing BCAAs has not been studied and is not currently under investigation to our knowledge.

Chocolate Milk Chocolate milk has been shown to be an effective post-workout recovery drink. Its balance of fast-absorbed and sustained-released proteins provides a quick burst of amino acids followed by a continuous supply over several more hours. Chocolate milk also provides a sustained source of carbohydrates and calcium which are critical for the recovery process after brain injuries. Fifth Quarter FreshTM (FQF), a natural fat-free chocolate milk recovery drink, was used for this study. The protein in FQF contains a natural blend of fast absorbed whey protein and sustained release casein protein that are the essential amino acids muscles require for quick muscle repair and muscle fiber building. FQF is also pasteurized at a normal temperature to preserve all of its amino acids. FQF differs from most protein recovery drinks that use whey products, which are Ultra-High Temperature (UHT) pasteurized and dried at high heat. The high heat damages protein and makes it less absorbable by the body. FQF also contains higher levels of calcium, magnesium, potassium, and sodium than regular chocolate milk. These electrolytes are critical to helping the body replace lost nutrients and to retain the fluids that are needed for recovery of muscle and brain cells.

PROJECT DESCRIPTION

Research Site & Facilities The Neuromechanics Laboratory (NML) at the University of Maryland, College Park, conducted the study The NML (6,500 sq ft) is equipped with two Kincom machines; Noraxon 18-channel electromyography system; Kistler, Bertec, and AMTI six- component force plates and load cells; 12-camera Vicon motion capture/analysis system, Visual 3D, and Kwon3D motion analysis systems; electro-goniometers; three treadmills; and a stationary metabolic analysis system. This research space is well equipped with computers and software necessary for data collection and analysis

Participants ImPACT? Test High? Schools Soccer? Team Comments Usable? N W/O? Concussion W/? Concussion Comments Usable? N Milk? Use Initial? N Milk Milk Initial? N W/O? Concussion W/? Concussion Boonsboro Williamsport South? Hagerstown Milk North? Hagerstown No? Milk Smithsburg Hancock Clear? Spring Total 66 62 109 No? post? tests 70 No? post? tests 68 33 66 474 No? Milk No? Milk No? Milk Milk No? Milk 198 276 80 95 7 9 11 11 10 11 1 Sway? Balance? Test High? Schools Soccer? Team Comments Usable? N W/O? Concussion W/? Concussion Comments Usable? N Milk? Use Initial? N Milk Milk Initial? N W/O? Concussion W/? Concussion Boonsboro Williamsport South? Hagerstown No? Milk North? Haerstown Smithsburg Hancock Clear? Spring Total 66 62 109 No? post? tests 70 No? post? tests 68 33 66 474 Milk No? Milk No? Milk No? Milk Milk No? Milk 198 276 61 11 11 10 11 1 104 138

Participants & Experimental Design Subjects High school football players in Washington Co., MD 7 schools (n=66, n=62, n=70, n=109, n=68, n=33, n=66; Total=474) Experimental Design & Statistics Repeated-measures design 2-Way Repeated-Measures ANOVA 1 within-subject factor: Pre-season vs. Post-season 1 between-subject factor: Milk group vs. Non-milk group Significance level: p<.10 9

Tests: High School Football ImPACT Test Word Discrimination: Evaluates attentional processes and verbal recognition memory utilizing a word discrimination paradigm Design Memory: Evaluates attentional processes and visual recognition memory using a design discrimination paradigm X's and O's: Measures visual working memory as well as visual processing speed and consists of a visual memory paradigm with a distractor task that measures response speed Symbol Matching: Evaluates visual processing speed, learning and memory Color Match: Represents a choice reaction time task and also measures impulse control and response inhibition Three Letter Memory: Measures working memory and visual-motor response speed 10

RESULTS #1 High School Football Players without Concussion

NomilkMilk p PrePost p PrePostXNomilkMilk 0.078 No? decrease? in? Milk? &? Decrease? in? NoMilk Increase? in? Milk? &? Decrease? in? NoMilk p Composite? Scores VerbM v1 v2 v3 v4 v5 v6 v7 v8 v9 v10 v11 v12 v13 0.087 0.062 Memory? (Visual) Vis.? motor? speed Reaction? time Impulse? control Total? symptom? Score Conitive? Effeciency? Index Hours? slept? last? night Hits? (immediate) Correct? distractors? (immediate) Learning? percent? correct Hits? (delay) Correct? distractors? (delay) Delayed? memory? percent? correct v14 Total? percent? correct Hits? (immediate) Correct? distractors? (immediate) Learning? percent? correct Hits? (delay) Correct? distractors? (delay) Delayed? memory? percent? correct v21 Total? percent? correct Total? correct? (memory) Total? correct? (interference) Average? correct? RT? (interference) v25 Total? incorrect? (interference) Avg.? incorrect? RT? (interfer.) Total? correct? (visable) Avg.? correct? RT? (visable) Total? correct? (hidden) Avg.? correct? RT? (hidden) Total? correct Avg.? correct? RT Total? commissions Avg.? commissions? RT Total? sequence? correct Total? letters? correct Pct.? of? total? letters? correct Avg.? time? to? first? click Avg.? counted Avg.? counted? correctly No? change? in? Milk? &? Increase? in? NoMilk 0.084 Individual? Scores 0.070 0.068 0.057 0.043 0.011 0.009 More? decrease? in? Milk? (cross) More? decrease? in? Milk? (cross) 0.005 0.040 More? decrease? in? Milk? (cross) 0.017 More? decrease? in? Milk? (cross) 0.003 More? decrease? in? Milk? (cross) More? decrease? in? Milk? (cross) More? decrease? in? Milk? (cross) 0.014 0.013 0.004 0.062 0.003 0.001 v15 v16 v17 v18 v19 v20 0.053 v22 v23 v24 More? decrease? in? Milk? (cross) 0.009 v26 v27 v28 v29 v30 v31 v32 v33 v34 v35 v36 v37 v38 v39 v40 v41 More? increase? in? Milk? (cross) 0.087 0.079 0.098

All Composite Scores

ImPACT: Verbal Memory Composite Score A higher score indicates better performance on the Verbal Memory Composite No change in Milk & decrease in No Milk (p=.087): positive result

ImPACT: Visual Memory Composite Score A higher score indicates better performance on the Visual Memory Composite Increase in Milk & decrease in No Milk (p=.062): positive result

ImPACT: Processing Speed Composite Score A higher score indicates better performance on the Processing Speed Composite No statistical differences

ImPACT: Reaction Time Composite Score A higher score indicates better performance on the Reaction Time Composite No statistical differences

ImPACT: Impulse Control Composite Score A lower score indicates better performance on the Impulse Control Composite No changes in Milk & increase in No Milk (p=.084): positive result

Individual Scores with significant statistical interactions

ImPACT: Correct distractors (immediate)

ImPACT: Learning Percent Correct

ImPACT: Correct Distractors (delay)

ImPACT: Delayed Memory Percent Correct

ImPACT: Total Percent Correct

ImPACT: Hits (Immediate)

ImPACT: Correct Distractors (Immediate)

Summary High school football players who consumed FQF during the season improved their individual ImPACT scores after the season as compared to the players who did not consume FQF: Positive results overall

RESULTS #2 High School Football Players with Concussion

NomilkMilk p PrePost p PrePostXNomilkMilk p Composite? Scores VerbM v1 v2 v3 v4 v5 v6 v7 v8 v9 v10 v11 v12 v13 Memory? (Visual) Vis.? motor? speed Reaction? time Impulse? control Total? symptom? Score Conitive? Effeciency? Index Hours? slept? last? night Hits? (immediate) Correct? distractors? (immediate) Learning? percent? correct Hits? (delay) Correct? distractors? (delay) Delayed? memory? percent? correct v14 Total? percent? correct Hits? (immediate) Correct? distractors? (immediate) Learning? percent? correct Hits? (delay) Correct? distractors? (delay) Delayed? memory? percent? correct v21 Total? percent? correct Total? correct? (memory) Total? correct? (interference) Average? correct? RT? (interference) v25 Total? incorrect? (interference) Avg.? incorrect? RT? (interfer.) Total? correct? (visable) Avg.? correct? RT? (visable) Total? correct? (hidden) Avg.? correct? RT? (hidden) Total? correct Avg.? correct? RT Total? commissions Avg.? commissions? RT Total? sequence? correct Total? letters? correct Pct.? of? total? letters? correct Avg.? time? to? first? click Avg.? counted Avg.? counted? correctly 0.099 Individual? Scores 0.084 No? change? in? Milk? &? decrease? in? NoMilk 0.084 v15 v16 v17 v18 v19 v20 Increase? in? Milk? &? decrease? in? NoMilk 0.025 Increase? in? Milk? &? decrease? in? NoMilk Increase? in? Milk? &? decrease? in? NoMilk 0.018 0.051 v22 v23 v24 v26 v27 v28 v29 v30 v31 v32 v33 v34 v35 v36 v37 v38 v39 v40 v41 0.018 0.08 0.053

All Composite Scores

ImPACT: Verbal Memory Composite Score A higher score indicates better performance on the Verbal Memory Composite No significant differences

ImPACT: Visual Memory Composite Score A higher score indicates better performance on the Visual Memory Composite No significant differences

ImPACT: Processing Speed Composite Score A higher score indicates better performance on the Processing Speed Composite Significant Group effect: Milk < No Milk (p=0.098)