Nutrition Before Surgery

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       In the January issue of Today’s Dietitian, dietitian Dr. Denise Webb highlights the future of clinical dietetics and the role dietitians can play in enhancing recovery of patients after surgery (ERAS).  50% of patients enter the hospital malnourished and only about 20% receive a nutritional consult.  These results also play a role into patient recovery post surgery.  Malnutrition significantly increases risk of death after surgery, complications, and readmission.  At the Academy of Nutrition and Dietetics Food and Nutrition Conference and Expo in Atlanta, Georgia this past October, David Evans, MD stated, “Traditional beliefs still persist among surgeons to delay nutrition support, despite recommendations to the contrary.”  The ERAS recommends incorporating preoperative nutrition intervention and urge use of prebiotic/probiotic administration, limiting preoperative fast to two to three hours instead of the traditional 12 hours, and immediate fluid and diet initiation after surgery. 

       It was also interested how Evans also highlighted the recommendations of hydration, carbohydrate loading, and muscle strengthening pre-surgery!  Carbohydrate loading pre-surgery is a procedure in other countries and not yet in the U.S.  Carbohydrate loading could prevent insulin resistance and hyperglycemia, as well as increase anabolic state post-surgery.  Studies have shown the importance of hydration pre-surgery to prevent nausea and pain with caution to assure aspiration does not occur.  Building lead muscle mass prior to surgery can also help with recovery.  

-DH

Webb, D. (2015). Optimizing nutrition before surgery. Today’s Dietitian, 17(1), 10-11.

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