The preparation for both before and after surgery is often overlooked. When done correctly, nutritional support can dramatically change surgery outcoms. Optimum nutrition in pre and post-surgery via food and/or supplementation facilitates quicker recovery times and reduces associated risks such as infections and poor wound healing.

It has been shown that as many as 50% of those undergoing replacement surgeries are malnourished before surgery, heavily impacting recovery outcomes (Somanchi et al. 2011). This statistic highlights the importance of engaging in thorough assessment well in advance of surgery to reduce any potential complications and to optimise recovery.

Preparing for Surgery

The process of surgery initiates a stress response in the body resulting in an inflammatory cascade, significantly impacting metabolism (Burgess et al. 2018).

Stress and inflammation deplete the body of various nutrients, especially vitamins B, C, E and A and minerals iron, zinc and selenium which can alter the body’s immune response. An altered immune response can increase the risk of post-surgery complications such as infection and delayed wound healing (Hegazi et al. 2014).

Adequate protein intake, fruit, vegetable, wholegrain and water consumption and limited sugar, caffeine and alcohol consumption aid in providing the body with the necessary building blocks for optimal healing and recovery.

Anaesthesia

Undergoing anaesthesia places a significant burden on the body, particularly the liver. During this time, the liver requires increased antioxidant and nutrient support to facilitate the detoxification process. An antioxidant rich diet and supplementation of a high-quality multivitamin containing activated B vitamins is recommended for at least 2 weeks in the lead up to surgery and even longer after surgery. Your practitioner may also recommend glutathione supplementation to further assist the detoxification process.

Antioxidant rich foods to support the liver include:

Brightly colored fruits and vegetables – berries, oranges, grapes, carrots, tomatoes, capsicum, pumpkin
Garlic, onions and leek
Cruciferous vegetables – Cabbage, cauliflower, broccoli, brussel sprouts and rocket

What to AVOID before surgery

Vitamin C can reduce the effectiveness of anaesthesia, so it is therefore important to avoid any vitamin C containing supplements for at least 24 hours prior to surgery. Avoiding supplements containing CoQ10, fish oil, vitamin E in doses higher than 400IU per day, ginger and turmeric is vital for at least 5 days prior to surgery, as they thin the blood.

Foods to avoid

Due to the role that vitamin K plays in the formation of blood clots, it is recommended to avoid the following foods at least 2-3 days post-surgery.

Soy, green and garbanzo beans
Lentils
Cruciferous vegetables – Broccoli, cauliflower, brussel sprouts, cabbage and kale
Liver

Nutrition and Wound Healing

After surgery, inflammatory and coagulation processes begin within the body, which increases the need for nutrients. Inadequate nutrition in this period can delay wound healing due to structural proteins such as collagen having reduced function, immunity is compromised, and new blood vessels struggle to form. To optimise recovery, the body needs to be provided with sufficient amounts of the nutrients required for these processes.

Increased intake of the following foods to facilitate recovery

Protein

Adequate intake is required for new blood vessel formation, collagen synthesis and enzymes involved in wound healing. Inadequate intake increases the risk of post-surgery infection, delays wound healing, reduces skin and fascia strength. It is recommended to increase intake from lean sources such as eggs, chicken, turkey, nuts and seeds. In addition, a practitioner quality protein and collagen powder combined is recommended.

Zinc

Plays a key role in immune function and wound healing. Increase intake of red meat, eggs, nuts and seafood.

Vitamin C

Plays a key role in immune function, collagen synthesis and wound integrity. Increase intake of berries, leafy greens, citrus fruits, tomatoes, capsicum, and other red/orange colored foods

Vitamin A

Plays a key role in reducing the risk of infection, improving skin strength and growth and encourages wound healing. Increase intake of oily fish, eggs, orange fruits and vegetables and dark green vegetables.

Selenium

Plays a key role in immune function and is a cofactor for the function of the master antioxidant glutathione. Increase intake of brazil nuts, wholegrains, poultry and eggs.

Arginine

An amino acid which plays a key role in promoting wound healing and is essential in times of wound induced stress. Increase intake of almonds, brazil nuts, cashews, barley, beans and garlic.

Vitamin E

Plays a key role in reducing inflammation, speeds wound healing, increases skin thickness and can reduce pain. Increase intake of almonds, sunflower seeds, wheat germ, egg yolk and apricot oil.

Iron

Plays a key role in fighting infection, collagen formation and needs are greatly increased to prevent anaemia associated with surgical blood loss. Increase intake of almonds, apricots, avocado, seeds, red meat and parsley.

Glutamine

Plays a key role in facilitating antioxidant function and is a key source of energy for the immune cells involved in the inflammatory response. Increase intake of legumes, beans, cottage cheese, protein and oats.

Water

Adequate hydration is essential for detoxification and wound healing. Increase intake to a minimum of 2 litres of bottled or filtered water per day.

Nutritional noms for healing!

Incorporating smoothies and bone broths and eating a diet rich in antioxidant and anti-inflammatory foods is a great way to consume maximum nutrition whilst the body is healing.

Salmon with healing and detoxifying salad

1 x Salmon fillet per person baked in the oven

Ingredients

2 cloves of garlic, chopped and fried
1 medium onion, copped and fried
1 tin of organic lentils
1 large beet, peeled and shredded
1 head green cabbage, finely chopped
1 fennel bulb, chopped
1 bunch of kale, de-stemmed and shredded
1/2 cup fresh coriander, finely chopped
Zest of 1 lemon

Dressing

1/4 cup lemon juice
1/3 cup tahini
1 Tbsp. fresh ginger, grated
1/4 cup raw unfiltered apple cider vinegar
1 Tbsp. raw honey or 5 drops for stevia

Instructions

Combine all the first set of ingredients in a large mixing bowl.

Healing Booster Smoothie

1 serve of protein and collagen powder
2 tbsn of oats
1 cup of leafy green vegetables
1 tbsn pumpkin seeds
5 x almonds
2 x brazil nuts
½ cup berries
½ tsp of turmeric
1 cup of almond milk

Detox Salad Dressing

Combine lemon juice, tahini, ginger, apple cider vinegar and honey in a food processor or blender and blend for 1-2 minutes, or until smooth and creamy.
Toss the salad ingredients with the dressing. Plate and top off with a generous sprinkling of the fresh lemon zest.

Bone Broth

Bones from raw or cooked meat (avoid chicken frames)
2 carrots
2 celery sticks
2 brown onions
1/4 cup of apple cider vinegar
Water (enough to cover bones and a bit more)

Method

Place all ingredients (veges to be chopped) in a crock pot and simmer for 24 hours on low
Remove bones and strain
Consume half a cup per day

Nutrition and blood loss

Blood loss during surgery is inevitable and it is therefore vital to provide the body with the required nutrients needed for new blood formation. Foods rich in B vitamins 6, 9 and 12 and iron assist in replenishing blood stores. These include:

Beans and legumes
Red meat
Nuts and seeds
Leafy greens – consumed with a citrus source for maximum absorption.

Iron supplementation may be required when large amounts of blood is lost, and this can be determined via testing through a qualified practitioner.

Natural anti-inflammatories and pain relief

Post-surgery pain is a result of trauma to the bone and its surrounding tissues and the inflammation that occurs as the wound begins to heal. NSAIDs can provide relief, however it is important to keep in mind that they only mask the symptoms and delay the body’s natural healing process. There are several natural alternatives which can both reduce pain and facilitate the body’s natural healing process.

To learn more about nutritional support for surgery, contact a nutritionist in Adelaide now!

Optimal nutrition well before surgery is the best way to ensure that you will have the greatest surgical outcome with a quicker and complication free recovery.

References

Burgess L, Phillips S and Wainwright T 2018, ‘What Is the Role of Nutritional Supplements in Support of Total Hip Replacement and Total Knee Replacement Surgeries? A Systematic Review’, Nutrients 2018, vol. 10, no. 820, pp. 1-5, viewed 24^thSeptember 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073268/

Hegazi R, Hustead D and Evans D 2014, ‘Preoperative standard oral nutrition supplements vs immunonutrition: results of systematic review and meta-analysis’, Journal of American College of Surgeons’, vol. 219, no. 5, pp. 1078-1087, viewed 24^thSeptember 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902354/

Somanchi M, Tao X and Mullin G 2011, ‘The facilitated early enteral and dietary management effectiveness trial in hospitalised patients with malnutrition’, Journal of Parenteral and Enteral Nutrition,vol. 35, no. 2, pp. 209-216, viewed 24^thSeptember 2018,https://www.ncbi.nlm.nih.gov/pubmed/21378250

Looking for a Functional Medicine practitioner or a Chronic Fatigue Specialist in Adelaide? Contact Elemental Health and Nutrition to help you with your needs. We’re committed to empowering you on your wellness journey. Our holistic approach focuses on integrating nutritional medicine with cutting-edge testing techniques.

Nutritional Support for Surgery