Health & Fitness

Nutrition that ensures recovery after surgery

You need to ensure that your body is getting
You need to ensure that your body is getting required nutrients at all times. FILE PHOTO | NMG 

When planning for surgery, patients are advised against eating or taking drinks hours before the procedure.

People are asked to refrain from food and certain drinks for about six to eight hours before surgery.

While it is important to such recommendations so as to avoid related complications that are often life threatening, experts note that discussions shouldn’t just be about what not to eat or drink.

Instead, doctors should also focus on what to eat after surgery to improve treatment outcomes.

A study published in The Journal of Parenteral and Enteral Nutrition notes that most patients awaiting surgeries may be malnourished or at risk of malnutrition when they are admitted to hospital but they may be unaware of it.

This is due to the fact that malnutrition is mostly an invisible condition which does not present with obvious symptoms unless it is severe. Yet, people’s nutrition status plays a key role in their recovery process after surgery.

Malnutrition occurs when the body does not get the nutrients it needs. This can happen whether a person is obese, underweight or of normal weight. This is because good nutrition is determined by the quality of food people eat and not the quantities consumed.

The new research, conducted at Advocate Health Care system in the United States, showed that poor nutrition could have major health implications on patients’ surgical outcomes.

The health body implemented a nutrition care programme at four of its Chicago area hospitals to help ensure that their patients were nourished during their hospital stay and after being discharged.

This initiative looked at the role of nutrition care for surgical and other medical patients that were malnourished or at risk of the condition.

Researchers found that the more than 300 malnourished surgical patients who received nutrition care, had reduced hospital readmission rates by nearly 50 per cent after 30 days of being discharged. Their average length of stay in hospital was about two to three days.

''By prioritising nutrition, care providers can significantly enhance the recovery process and deliver better value for patients and their families,'' said Dr Krishnan Sriram, the principal investigator of the study and a tele-intensivist who manages patients in ICUs at Advocate Health Care.

The researchers noted that because surgeries take a large toll on a patients’ bodies, nutrition was key to recovery. ''The research shows when we screen, feed and follow patients' nutritional status in the hospital and after they are discharged, we are helping them have the best chances of a successful recovery,'' said Dr Suela Sulo, one of the study authors and researcher at Abbott, which funded the research.

Previous studies have found that that malnourished patients undergoing surgery could experience delayed wound healing, infections after surgery, longer hospital stays and higher readmission rates.

The researchers recommend that hospitals put in place guidelines that promote routine pre-surgery nutrition screening. This will enable them to identify patients in need of nutrition interventions before operations take place.

If their scheduled surgery dates are far, affected patients can be given appropriate supplements or advised on the kinds of food to consume as they await the medical procedure.

But if the surgeries need to be performed urgently, the nutrition interventions can begin immediately after the operation and continue even after the patients are discharged (as part of their post-operative care). ''Malnutrition is a silent epidemic in our healthcare system. As an anaesthesiologist, I have seen first-hand the impact that addressing malnutrition can have on patients and their recovery,” said Paul Wischmeyer, an anaesthesiologist and critical care specialist at Duke University Hospital.

He is the lead author of new guidelines for surgery related nutrition that were recently developed by a team at the American Society for Enhanced Recovery and Perioperative Quality Initiative at a recent conference.

“No patient should ever have elective surgery without being screened for malnutrition. Something that may take five minutes for us as doctors to do can have a long-lasting impact on patients, keeping them out of the hospital and making a big difference in their quality of life at the end of the day.''

Gladys Mugambi, head of nutrition and dietetics at the Ministry of Health (MOH) said to avoid malnutrition, it is important for Kenyans to eat a balanced diet: healthy carbohydrates, proteins and lots of fruits and vegetables. "There is no start or finish date for good nutrition. You need to ensure that your body is getting required nutrients at all times.”