Have you ever considered what to eat prior to surgery? You probably think I am talking about the night before surgery. Your final meal before the dreaded fast. But did you know the food you eat weeks before going ‘under the knife’ can have an impact on your recovery. This is because your physical condition prior to surgery influences how well you respond to, and recover from, the stress of surgery. Our physical condition can be affected by our behaviours such as the food we eat, our physical activity levels, smoking habits, and alcohol intake.
Surgery come in many different shapes and sizes. Some are considered major surgery such as a joint replacement or open abdominal surgery. Other surgeries are more minor for example, dental surgery. The type of surgery you are having will determine the amount of stress your body will be under and will predict your recovery time. It is best to speak with your doctor and/or surgeon about the type of surgery you are having and expectations around recovery.
No matter what type of surgery you are having, there is a bunch of evidence to support the role of nutrition prior to surgery. Here are a few tips to get started.
Do not start a diet
The last thing you want to do prior to surgery is prevent your body from receiving much needed energy and nutrients. Research shows that a well-nourished person has better surgical outcomes than someone who has not been receiving adequate energy or protein. Unless you have been advised by a doctor, avoid starting any calorie restricting diets prior to surgery.
Your body is going to have higher energy and protein needs after surgery to allow it to heal. Depending on your surgery and your symptoms there will be a period where you will not be able to eat very much. Therefore, your body will be relying on its internal stores of glucose and protein for healing.
If you are looking to optimise your diet, focus on the types of food you are eating, rather than cutting calories. Eating a variety of nutrient dense foods will help build your energy and protein stores and keep your immune system healthy. Focus on including wholegrains, fruits and vegetables, lean proteins, and healthy fats such as olive oil and omega-3 fatty acids.
Eat enough protein
Protein plays an important role in preparing for surgery. Along with physical activity, protein is important for maintaining and improving our muscle mass. Often surgery is accompanied by a period of reduced physical activity. This reduction in exercise coupled with the increased protein needs for wound healing, results in a reduction in muscle mass. If you are young and healthy, this might not be a huge problem. But, if you are elderly or have other health concerns such as chronic obstructive pulmonary disease, a loss of muscle can have a big impact on your functional capacity.
Protein is also important for our immune system and to protect against post-operative complications. It is also important for wound healing. Good sources of protein include dairy foods, eggs, meat, poultry, nuts and nut butters, tofu, and supplement drinks such as Sustagen or Ensure. Aim to get around 1g of protein per kg of body weight.
You have probably heard athletes talk about carb loading before a big event. But did you know, it has benefits for surgical patients too. Carb loading is basically consuming a large amount of carbohydrates to help build up the body’s main source of energy – glucose. Glucose is stored in the liver and muscles as a molecule called glycogen. Before going under anaesthesia, you will likely be asked to fast from midnight the evening prior. This means you are going into the surgery in a ‘fasted’ state and are reliant on your body’s energy stores i.e., glycogen. Therefore, it is important to eat a carbohydrate rich meal before fasting to ensure your muscles and liver have adequate stores of glycogen.
Some doctors may allow you to have clear fluids up to 2 hours before your surgery. Evidence shows that having a carbohydrate containing clear fluid 2 hours prior to surgery improves patient well-being and reduces the incidence of insulin resistance post-operatively. In people having major abdominal surgery, these carbohydrate drinks can also reduce their length of stay in hospital. The clear fluids can be as simple as apple juice or can be a specialised pre-operative supplement drink. The evidence supports having 800mL the evening before surgery and 400mL 2 hours prior to surgery. It is important to speak with your doctor as to whether this is appropriate for you.
Alcohol can reduce your immune function and impact your response to surgery. Removing alcohol from your diet for 4-8 weeks prior to surgery can promote wound healing and reduce the risk of post-operative complications such as infections. Studies show that people who are heavy drinkers, defined as having at least 2-3 drinks per day, are at an increased risk of complications post-operatively. Previously heavy drinkers who abstained from alcohol for at least 4 weeks, were able to return their immune system to that of a non-drinker.
The same risk also applies to smoking. If you are a smoker, try to quit smoking 4-8 weeks prior to surgery. This will allow your immune system to recover and will reduce your risk of post-operative complications.
These are a few broad tips to help you prepare for surgery. It is important to remember that every person is going to have different needs depending on their health and type of surgery. It is important to talk to your doctor about any changes you are making to your diet before surgery. If you would like more personalised advice, make an appointment today.
This post was originally published by dietitian Kim Lindsay on her blog.