nutrition and surgery references

Research shows that certain nutritional factors (Seth et al) are associated with improved wound healing (NIH Stat Pearls) and immune function (NIH Immune function page): 

  • good glycemic control

  • good hydration

  • Vitamins (A, B, C), Zinc and other minerals, Polyphenols (only in plants)\

  • Omega 3

  • Adequate protein (especially arginine and glutamine)

  • Good carbohydrates (complex carbs like fruit and vegetables, legumes, whole grains)

Wound Healing Informational Sheet References

1.     Barchitta M, Maugeri A, Favara G, et al. Nutrition and Wound Healing: An Overview Focusing on the Beneficial Effects of Curcumin. Int J Mol Sci. 2019;20(5):1119. Published 2019 Mar 5. https://doi:10.3390/ijms20051119

2.     Barnard, N. D., Cohen, J., Jenkins, D. J., Turner-McGrievy, G., Gloede, L., Jaster, B., Seidl, K., Green, A. A., & Talpers, S. (2006). A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes. Diabetes care, 29(8), 1777–1783. https://doi.org/10.2337/dc06-0606

3.     Klemm, S. (n.d.). Nutrition tips to promote wound healing. Academy of Nutrition and Dietetics: eatright.org. https://www.eatright.org/health/health-conditions/diabetes/nutrition-tips-to-promote-wound-healing

4.     Pulapaka, J. (n.d.). How does a whole-food plant-based (WFPB) diet work in wound care? Seven WFPB nutrition tips to remember in wound care. Home. https://aawconline.memberclicks.net/index.php?option=com_dailyplanetblog&view=entry&year=2021&month=05&day=31&id=99%3Ahow-does-a-whole-food-plant-based-wfpb-diet-work-in-wound-care-seven-wfpb-nutrition-tips-to-remember-in-wound-care-#:~:text=However%2C%20eating%20a%20balanced%20diet,high%20omega-3%20fatty%20acids.

5.     Seth, I., Lim, B., Cevik, J., Gracias, D., Chua, M., Kenney, P. S., Rozen, W. M., & Cuomo, R. (2024). Impact of nutrition on skin wound healing and aesthetic outcomes: A comprehensive narrative review. JPRAS Open, 39(39), 291–302. https://doi.org/10.1016/j.jpra.2024.01.006

6.     Song, M., Fung, T. T., Hu, F. B., Willett, W. C., Longo, V. D., Chan, A. T., & Giovannucci, E. L. (2016). Association of Animal and Plant Protein Intake With All-Cause and Cause-Specific Mortality. JAMA internal medicine, 176(10), 1453–1463. https://doi.org/10.1001/jamainternmed.2016.4182

7.     Struijk, E. A., Fung, T. T., Rodríguez-Artalejo, F., Bischoff-Ferrari, H. A., Hu, F. B., Willett, W. C., & Lopez-Garcia, E. (2022). Protein intake and risk of frailty among older women in the Nurses' Health Study. Journal of cachexia, sarcopenia and muscle, 13(3), 1752–1761. https://doi.org/10.1002/jcsm.12972

8.     TRIPATHI, P., KADAM, N. S., SHARMA, B., VYAWAHARE, A. R., GANLA, M. H., MAYURIKA DAS BISWAS, & SABOO, B. D. (2023). 1790-PUB: Effectiveness of an Intensive Lifestyle Modification Program on Type 2 Diabetes Remission in Indian Population. Diabetes, 72(Supplement_1). https://doi.org/10.2337/db23-1790-pub

9.     U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - dietary supplements for immune function and infectious diseases. NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/ImmuneFunction-HealthProfessional/

10.  Vu, T.-H. T., Van Horn, L., Achenbach, C. J., Rydland, K. J., & Cornelis, M. C. (2022). Diet and Respiratory Infections: Specific or Generalized Associations? Nutrients, 14(6), 1195. https://doi.org/10.3390/nu14061195

11.  Wallace HA, Basehore BM, Zito PM. Wound Healing Phases. [Updated 2023 Jun 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470443/

Many factors can lead to impaired wound healing.

  • Vitamins and Minerals such as: from Seth article

  • systemic illness, such as diabetes, or chronic conditions, such as malnutrition.

  • Local factors such as pressure, infection, or dehydration. 6

Here are some ways to put your patients on a path for better wound healing and better long-term health.

1. Hydration

  • Maintain fluid intake of water at least 4-7 cups for women and 5-9 cups for men.

  • This decreases risk of developing chronic diseases and leads to healthy aging.

2. Vitamins and Minerals

  • Vitamins A, B, C, D, and E support growth of epithelial cells, contain antioxidant properties, play a critical role in collagen synthesis, and angiogenesis. 5

  • Omega-3 polyunsaturated fatty acids influence the inflammatory response in skin, while mono-unsaturated fatty acids aid in angiogenesis and in regulating blood sugar control. 3  

  • Gut bacteria of vegans produce neuroactive molecules like GABA which in turn reduces cortisol levels and counters high glucocorticoid levels, which impair wound healing.

  • Zinc and other minerals attribute their roles as essential enzymatic components, metalloenzymes, and antioxidants to mitigate risk of infections.

  • Polyphenols (e.g. curcumin), only found in plants, modulate inflammatory processes and reduce proinflammatory cytokine TNF-alpha effectively reducing inflammation, an essential step in wound healing promotion. 1

3. Adequate Protein

  • Plant-based protein options help with post-surgical wound repair, skin integrity preservation, fluid and electrolyte balance, and facilitating immune response activation. 4

  • Amino acids like arginine and glutamine help with the inflammatory response, collagen synthesis, growth hormone secretion, and T cell activation.

4. Better Glycemic Control

  • Control blood sugar levels to help prevent wounds from developing and to support healing and recovery. 2