Summary: Studies suggest that malnutrition is present in the majority of those undergoing surgery. Surgery causes a hypermetabolic-catabolic state, which means increased demand for nutrients and muscle wasting. Malnutrition in surgical patients increases the risk of postoperative complications, and nutrition therapy can help lower the risk.
How well will one recover after surgery depends on the person’s nutritional status. However, most people undergoing surgery have nutritional deficiencies. Even worse, most individuals do not take adequate steps to overcome these nutritional deficiencies. Interventional pain management specialists often focus on managing pain and improving recovery through various approaches, but ensuring proper nutrition therapy before surgery should also be an essential part of the pre-surgical plan.
Focusing on issues like correcting blood glucose levels and blood pressure before surgical interventions is common practice for chronic pain specialists. However, managing other nutritional deficiencies like those of proteins, vitamins, and minerals does not get sufficient focus. All this results in a greater risk of post-surgical complications, muscle wasting, and prolonged weakness. This even increases the risk of chronic pain and fatigue in those who have undergone surgery.
Further, such a risk of complications and muscle atrophy is greater in older adults. In older adults, nutritional deficiencies may even increase mortality risks.
Although exact figures are missing, studies suggest that as many as 65% of those undergoing surgery are malnutrition. Those are massive numbers; it is easy to imagine how much can be achieved through nutrition therapy from a reputable chronic pain specialist before surgery.
Further, researchers think that one of the most significant issues is the under-consumption of proteins. They estimate that those undergoing surgery consume 22-36% less protein than ideal. Here, it is vital to understand that these estimates are conservative. Those undergoing surgery have much higher protein intake requirements than healthy adults. Thus, to prevent postoperative complications, it is insufficient to correct those nutritional deficiencies, and it is important also to boost the intake of these nutrients.
After surgery, there is a significant increase in the body’s requirement for proteins. To fulfill these increased requirements for proteins or amino acids, the body has to resort to catabolism. Which essentially means breaking down muscles. This is the reason that muscle loss and resulting weakness is a significant issue in the post-surgical phase.
So, why this happens? It is not just due to surgery-related trauma or tissue regeneration. This increased requirement is for numerous reasons. It is also due to inflammation and a massive immune response. It is also due to stress response. This whole process that occurs after surgery is called a hypermetabolic-catabolic state. This means that metabolism is hyper or increased, and the body starts breaking muscles (muscle catabolism) to meet these higher demands of nutrients.
This increased metabolic rate and, thus, the demand for nutrients continue for a few weeks after major surgery or trauma. This also means that muscle catabolism continues for a long time. When it comes to older adults, things are even worrisome as they might not be able to recover from sarcopenia or muscle wasting that occurs due to surgical interventions.
Figure 1 Pre-operative nutrition therapy
We are discussing all this to raise awareness that although this hypermetabolic state is unpreventable, it helps the body recover faster, and muscle catabolism can be significantly reduced.
How severe muscle catabolism or muscle wasting due to surgical interventions or trauma depends significantly on the total energy and protein supply. So, what people can do, and doctors can recommend to patients, is significantly boost their intake of various nutrients, particularly proteins.
Thus, for example, as shown in the image, one can boost intake of whole foods 7-10 days before the intervention. This can boost the body’s stores of carbs, proteins, antioxidants, vitamins, minerals, and various vital nutrients.
Additionally, one can also boost the intake of proteins before surgery. This may be achieved by consuming high-protein foods or, even better, by taking protein supplements. Although one cannot consume much food before surgery, but one may benefit from taking essential amino acids. Studies suggest that such simple measures may significantly alter surgical outcomes, reducing the risk of postoperative complications.
Before undergoing surgery, ensure you are addressing your nutritional needs. Consult with our specialist in Interventional Pain Management to get a customized nutrition plan that prepares your body for a smoother recovery and reduces postoperative complications.
