I wrote previously regarding the importance of nutrition before and after surgery. You can find that information here, I think you might enjoy reading it. The point of this post is to take a bit more of a deeper dive into specific recommendations. I did not receive formal nutritional education in medical school, which I think is a shame. However, I have a background in sports nutrition in undergrad, which I have blended with my knowledge of medicine to help my patients.
Nutritional status is a crucial foundation to our body's healing, and here are some main categories to consider:
Protein and Amino Acids
Proteins are made up of amino acid building blocks, with arginine and glutamine being talked about as specific important amino acids. There are many studies published now highlighting proteins and amino acids as a key building block to healing bone and skin. Although the literature is unclear on the duration necessary to improve healing, having adequate protein levels before, during, and after surgery can strongly impact your rate of healing, almost 13 times better odds! The recommended amount of protein needed is 1.5 grams of protein/kg/day. Since we in the United States use the imperial system, let me help you with that math.
Take your weight (lbs.)/2.2 to get your weight in kg. Now this number can be multiplied by 1.5 to get the total amount of grams of protein needed per day. For example, a 170-pound person would require 116 grams of protein per day.
Good sources of protein can be found in lean meats, poultry, fish and seafood, eggs, seeds, nuts, and legumes.
Calories
Think about electricity for a battery or gas for a car, your body needs calories for energy. If you search the internet, you will find lots of information about calories restrictive diets, or the number of calories needed to lose or gain weight. That is not what the goal is here. The goal is providing enough fuel for your body to heal!
Research has explored this issue, and the current recommendation of minimum calories required to maximize healing during the surgery process is 30 calories/kg/day or 13.6 calories/pound. Again, with the math, so if a 170-pound person were having surgery, I would recommend to them that they need a minimum of 2300 calories/day during the perioperative period.
Vitamins & Minerals
There are many Vitamins and minerals available, and having a well-rounded diet should provide your body with those requirements. You may even consider taking a multi-vitamin as a supplement, it will not hurt, but most certainly can help with your healing. The specific ones that are important to us and are crucial in collagen healing include: Vitamins A, C, D, E, calcium, zinc, and magnesium.
- Vitamin A: 900 mcg/day (Men), 700 mcg/day (Women). Just like Vitamin E, Vitamin A has antioxidant properties, but also is important in growth and cell division. Vitamin A can be found in anything green or orange, like spinach, carrots and cantaloupe.
- Vitamin C: 90 mg/day (Men), 75mg/day (Women). Also known as ascorbic acid, is a water-soluble vitamin that helps your body absorb iron and aids in healing and development. Common foods sources that are high in vitamin C, oranges, strawberries, chopped red peppers, or broccoli.
- Vitamin E: 15 mg/day (Men/Women). Vitamin E is a fat-soluble vitamin which protects cells from free radical damage. Common foods that are rich in Vitamin E are nuts, spinach, broccoli, mangos, and tomatoes.
- Vitamin D: 600 IU (Adult), 800 IU (People over 70 years). Vitamin D isn't naturally found in many foods, but you can get it from fortified milk, salmon, sardines, or mackerel. The main way to make Vitamin D is when with direct sunlight!
- Calcium: 1000 mg/day (Male), 1,200 mg/day (Women). Vitamin D is required for calcium to be absorbed into the blood. Your body uses calcium to build and maintain strong bones. If you have low calcium levels, your body will take from that reservoir, ultimately weakening it. Some food sources that are rich in calcium include: dairy foods, fruits, leafy greens, beans and nuts.
- Zinc: 11 mg/day (Men), 8 mg/day (Women). Adequate zinc is needed to create new cells, such as collagen. Zinc is often combined with protein, vitamin C, and L-arginine as a nutritional shake to help with healing. Some foods that are rich in Zinc are shellfish, beef, poultry, pork, legumes, nuts, and whole grains.
- Magnesium: 320 mg/day (Women), 420 mg/day (Men). Magnesium is an abundant mineral in the body and is vital to the structural development of bones. Pumpkin seeds, chia seeds, almonds, spinach, cashews, peanuts, edamame are amongst the selected foods that contain the highest amount of magnesium.
Polyunsaturated Omega-3 Fatty Acids
Polyunsaturated Omega-3 Fatty Acids play a vital role in the body's healing process. Numerous studies have looked at its ability to modulate acute inflammation therefore creating an environment that is beneficial for healing. The current dietary guidelines recommend 500 mg/day. This amount increases to 1 gram, in those patients who have coronary heart disease.
Probiotics
In a recent study that looked at skin healing, those candidates who had perioperative supplementation of probiotics accelerated skin healing due to increased type I collagen deposition. The most common probiotics include members of the lactobacillus spp, bifidobacterium genera, and yeasts.
Collagen
Collagen is one of the foundational proteins found in the body and is essential in providing strength, structure, and support to bones, muscles, joints, tendons, ligaments, and skin. The daily recommended amount to consume is around 15 grams of collagen/day. You can take collagen powder by mixing it into smoothies or even enjoy it with your coffee or tea. Bone broth, chicken, red meat, fruits and vegetables, and aloe vera are amongst those food sources with high levels of collagen.
The main point I am trying to drive home here is that what you consume is an important part of your recovery.
It is common to experience nausea after your surgery, but once you can consume food, you should go ahead and do so. Make sure you have a game plan prior to your surgery so you are well equipped. Consider the use of supplements, as well as powders, if you have a medical condition that makes it difficult for you to have solids after your surgery.