HomeHealthNutritionDR MEGAN ROSSI: What to eat to prepare yourself for an operation

DR MEGAN ROSSI: What to eat to prepare yourself for an operation

We talk about getting our bodies “beach-ready” or even ready for the party season, but we rarely hear of people getting themselves “surgery-ready,” despite millions of surgeries each year.

Still, being in good shape leading up to a scheduled surgery can make a big difference, with studies showing it can help you get out of the hospital and heal faster.

Even simple adjustments to your diet can help. Research in the American Journal of Clinical Nutrition in 2017 showed that patients who were advised what to eat – and who received nutritious protein supplements in addition to their normal diet – not only had fewer infections, but also left the hospital an average of four days earlier than those who didn’t.

I’ve seen this effect myself: I worked in a hospital with patients undergoing surgery for head and neck cancer, and we compared the process of preparing for surgery to preparing for a marathon, because both put enormous strain on the body.

We talk about getting our bodies “beach-ready” or even ready for the party season, but we rarely hear of people getting themselves “surgery-ready,” despite millions of surgeries each year, writes Dr. Megan Rossi (pictured)

Because with surgery you often have to fast for hours before the surgery, the trauma of the surgery itself – and then there’s the intense energy requirement of healing.

The body also has to feed an immune system that is hungrier than usual as it fends off inevitable attacks, all the while creating more tissue as you heal. The bottom line is that before any surgery you really need to eat to build up your reserves.

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At this point, it’s more important than ever that you feed your gut microbes with the foods that help them thrive, because you’ll be relying heavily on them to keep you healthy after surgery. Ideally, you will start in the weeks leading up to your surgery.

Try to eat four different types of plants every day – think whole grains, vegetables, fruits, legumes (such as chickpeas and lentils), nuts and seeds. They will repay you by reducing inflammation that could interrupt the healing process and help fight infection – particularly by helping to protect against leaky gut that often occurs around surgery (a leaky gut is when the barrier of tight connections along the intestines become weak, allowing pathogenic substances to enter the blood).

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Another reason to build up the microbes now is that you will likely be given antibiotics – sometimes before, but also after your surgery, which can knock out not only the harmful bacteria, but also some of the beneficial bacteria in the gut. This can open the door for infections like C. difficile – which can wreak havoc in your gut and make hospital patients really sick (with fewer beneficial gut bacteria, the more harmful ones can take hold and take over).

Then, seven to 10 days before surgery, it’s worth increasing the amount (and quality) of carbohydrate-rich foods in your diet to improve your energy and micronutrient stores for what’s ahead.

Carbohydrates are stored in the liver and muscles as glycogen, a ready-to-use source of energy.

Having that energy supply can slow the body down from breaking down muscle for energy and can help fight fatigue and a feeling of weakness.

However, not all carbohydrates are created equal – excess glycogen is stored as fat, so now is not the time to feast on refined carbs like white bread and cookies. Instead, look to nutritious starchy vegetables, grains such as quinoa, oats and barley, legumes such as butter beans and whole fruit. This provides the fuel you need in addition to important nutrients such as B vitamins, zinc and vitamin C for wound healing.

As a general guideline, you should add one or two additional servings to your diet at least three to four days prior to surgery.

At the same time, you also want good quality proteins, because they provide amino acids, the building blocks needed for new tissue and to keep the body in good working order.

Protein quality is based on several factors, including the types of amino acids it contains and how easily the body absorbs them.

Try to eat four different types of plants every day - think whole grains, vegetables, fruits, legumes (such as chickpeas and lentils), nuts and seeds.  They will repay you by reducing inflammation that could interrupt the healing process and help fight infection - particularly by helping to protect against leaky gut that often occurs around surgery (a leaky gut is when the barrier of tight connections along the intestines become weak, allowing pathogenic substances to enter the blood)

Try to eat four different types of plants every day – think whole grains, vegetables, fruits, legumes (such as chickpeas and lentils), nuts and seeds. They will repay you by reducing inflammation that could interrupt the healing process and help fight infection – particularly by helping to protect against leaky gut that often occurs around surgery (a leaky gut is when the barrier of tight connections along the intestines become weak, allowing pathogenic substances to enter the blood)

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Typically, the highest quality protein comes from animal products such as chicken, fish, eggs and dairy products. If you’re a vegetarian or vegan, you can still get enough from plants (see my recipe, right), you may need to up your portions a bit.

I would focus on your intake of the amino acid arginine (found in fish, poultry, soy and oats) and glutamine (found in eggs, beef and firm tofu). These are ‘conditionally essential’ amino acids – the body can make them, but it depends on the circumstances, and the stress of surgery probably means production can’t keep up with requirements.

Aim to eat a high-quality source of protein with every meal — the recommendation is 1.2g to 2g of protein per kilogram of body weight per day (so if you weigh 62kg, that would be 75g to 124g of protein per day), which best spread throughout the day in portions of 20g to 40g to maximize absorption.

Some of my favorite protein and nutritional sources for pre- and post-recovery include:

  • 200g yogurt (20g protein)
  • 100g salmon (20g protein)
  • 2 eggs (11g protein)
  • 50g nuts (20g protein)
  • 200 g lentils (18 g protein)
  • 100 g firm tofu (17 g protein)

After surgery, try to eat two or three servings per week of foods containing omega-3 fatty acids, such as oily fish (salmon, sardines, and mackerel), as these fats have an anti-inflammatory effect.

However, if you lose your appetite, eat what you feel like – this is a situation where something is better than nothing. After surgery, the sedatives, pain relievers, and immobility can lead to constipation, as they slow down the normal muscle contractions of the gut.

When that happens, 50g of prunes a day should help restore your normal functioning. If you’re not a fan of prunes, try eating a few kiwis a day — another great source of gut-stimulating fiber, especially if you eat the skin.

Another thing to consider is increasing your physical activity in the three months leading up to your surgery. Surgery often leads to a loss of muscle mass — largely from decreased activity — so you want to start in a good place. Studies also show that those who are fitter seem to recover faster.

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Before surgery you could go to the gym more often, or try to take 10,000 steps a day – people with more limited mobility can walk up and down the stairs a few times a day – or use cans from the kitchen cupboard as weights to lift daily.

A 2017 study from King’s College Hospital in London found that even this exercise style-based prehab can really make a difference to the speed of your recovery. The goal is to make yourself the best you can be. It will pay dividends.

Ask Megan

How harmful to our good gut bacteria are the chemicals in tap water (e.g. chlorine) likely? Is it advisable to invest in a water filter?

Ed Bowater.

Great question! First, it’s worth noting that chlorine is added to water to prevent the growth of pathogens, making it safe to drink. The low levels added to tap water in most countries have been deemed safe by international authorities.

However, as you rightly suggest, these safety checks preceded our understanding of the importance of our gut microbiota.

Researchers at the University of California recently measured the impact of non-chlorinated and chlorinated drinking water on 130 children in urban Bangladesh.

Interestingly, the results reported an increase in some beneficial gut bacteria, such as Akkermansia spp, in those who drank the chlorinated water, possibly related to lower rates of infection due to chlorination.

They also found that the chlorinated water had no impact on gut bacteria diversity, often used as a measure of gut health.

Now, this study didn’t compare filtered water, but from my experience in the clinic, when it comes to water, it’s more important for most of us to make sure we’re drinking enough whether it’s filtered or not.

Try this: ‘Snickers’ smoothie bowl

Move over ultra-processed protein shakes, which not only provides 18g of protein and 10g of fiber, but also tastes like a Snickers bar – without the added sugars and additives.

Serves 1

  • 60 g silken tofu
  • 50 g live, thick yogurt
  • 1 tbsp unsweetened cocoa
  • 1 very ripe banana, frozen
  • 1 tbsp nut butter of your choice
  • 40 g zucchini, frozen
  • 2 Medjool dates, pitted

Toppers (optional):

  • 5g coconut flakes
  • 15g granola with no added sugars

Puree the smoothie ingredients in a high-powered blender for about a minute until smooth (stir in the frozen ingredients first for a smooth blend). Pour into a bowl and add a topper of your choice.

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