Prior to surgery, there’s a laundry list of dos and don’ts you need to follow carefully to make sure your procedure goes well.
Now, a new study suggests that in addition to these guidelines, watching what you eat before surgery can have a significant impact on how you heal.
The study, conducted by researchers at Brigham and Women’s Hospital in Boston, is published in the April 2013 issue of the journal Surgery.
During an invasive surgical procedure, doctors typically need to cut through layers of fat under the skin to reach the procedure site. This fat, or adipose tissue, is always traumatized during major surgery, and the trauma affects the balance of adipose tissue chemicals that communicate with other tissues through molecular signals.
“Dietary modification is an easy, economical, and potentially effective way to mitigate the stress undergone by the body during surgery.”
Researchers examined how modifying the preoperative diet would have an impact on post-surgery recovery. To do this, they fed one group of mice a high-fat diet with about 60% of the calories derived from fat, making them obese. The control group was fed a more normal diet, with about 10% of the calories derived from fat.
The mice on the high-fat diet showed an amplified, imbalanced response in adipose tissue communication. To offset this, about three weeks prior to surgery, some of the mice being fed high-fat diets were then switched to lower-fat diets.
When the surgeries, modeled after typical surgical procedures, were performed, researchers found that the surgical trauma immediately affected the adipose tissue around and far-removed from the trauma site. Conditions such as increased inflammation and decreased specialized fat hormone synthesis were observed, particularly in young adult mice and mice in which researchers had simulated wound infection.
Inflammation was also increased in the obese mice, but reduced food intake before surgery seemed to reverse this effect in both fat and lean mice, as well as mice of all age groups and those with simulated infections.
The results suggest that although fat is a major tissue in the body, its ability to change rapidly can be used to minimize complications during procedures like surgery, which cause tremendous stress on the body.
Dr. James Mitchell, assistant professor of Genetics and Complex Diseases at the Harvard School of Public Health collaborated on the study. In an accompanying review article, he suggests that restricting diet in humans before an operation would allow for a rare chance to assess the effectiveness of this dietary modification in impacting surgery-related complications due to inflammation and other stressors.
Mitchell’s review article particularly targets patients slated to undergo vascular surgery, as this population is at an increased risk of complications from surgery. If applicable, the study findings could minimize occurrences of prolonged wound-healing problems, heart attack and stroke common to vascular surgery patients. He also notes that dietary modification is an easy, economical, and potentially effective way to mitigate the stress undergone by the body during surgery.
Lead researcher C. Keith Ozaki, MD, Director of Brigham and Women’s Hospital Vascular Surgery Research, states, “Our results and those of others highlight that the quality of your fat tissues appears to be important, along with the total amount of body fat when it comes to the body’s response to an operation.” He concludes, “The current results point to potential approaches to alter the outcomes of elective operative procedures.”
The Bottom Line
We’ve always said that going into surgery with optimal nutrition helps patients heal faster. This study reinforces that long-held belief. Given that two-thirds of the population is overweight or obese, it’s safe to say that many of us are overfed yet undernourished. Preparing for surgery by eating healthfully in the weeks prior to and following a procedure is just one of many ways patients can take an active role in their healing.
With many of us, recovery is the most stressful part of any procedure. For other ways to optimize surgery, see our Recovery Guidelines for clear, comprehensive information on what to do and what to avoid.
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.