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Family Health Magazine - NUTRITION

Prepping for Surgery?
Nutritious foods are essential, before and after

While nutritious foods and fluids always help your body, they are an essential part of preparing for and recovering from surgery. What you eat and drink at this time will affect your healing and risk of complications. Foods rich in nutrients are necessary to your recovery, so making wise choices throughout the process is important.

Before and after surgery, your nutritional intake greatly affects how quickly you recover, heal and fight infection. Choose whole unprocessed foods, eat according to your diet restrictions, and prepare ahead of time with meals in the freezer. Keep hydrated and choose water for at least half of your fluid intake. Get enough rest and eat a healthy diet based on Canada's Food Guide.

Before surgery

  • Unless you are asked to restrict your calories, avoid dieting before surgery. Restricting essential nutrients like vitamins and minerals could slow your recovery. Your calorie intake will be minimal for at least eight to 12 hours before surgery. This will likely continue for the first few days after surgery.
  • Eat adequate amounts of low-fat protein in the weeks leading to your surgery. Sources include lean beef, poultry, fish, eggs, and dairy and vegetarian sources. One of the most abundant proteins in the body is called albumin. Albumin helps reduce extra fluid in your body tissue after surgery and helps the immune (defence) system fight infection. A diet too low in protein can reduce your protein stores. People who have low albumin levels before surgery are more likely to have problems after surgery and a longer hospital stay.
  • Eat foods high in antioxidants. These natural compounds enhance the body's immune system, reduce blood pressure, and aid healing. Excellent food sources of antioxidants include berries, tomatoes, broccoli, red grapes, soy, garlic, whole grains, carrots, green tea and spinach. However, eating large amounts of these foods can reduce the blood's ability to clot, making you bruise more easily. Aim to to get no more than seven to 10 servings of foods high in antioxidants each day.
  • During surgery, you will lose some blood. Getting enough iron before surgery helps restore iron stores reduced by blood loss. Having low iron levels makes you feel tired and short of breath. Good food sources of iron are red meat, poultry, liver, pork, shrimp, turkey, enriched pastas, eggs and whole grains.
  • Be well-hydrated before surgery. Drinking the recommended amount of liquid will help with healing and the health of your skin.
  • Avoid alcohol for at least 48 hours before surgery.
  • Prepare and freeze healthy meals before your surgery. This will make it easier and faster to eat restoring food when you return home.
  • Have some easy-to-prepare foods on hand when you return from the hospital. Examples include Ensure®, Boost®, Carnation® Breakfast products, pudding, custard, soups, yogurt, juices, fruits and vegetables, tofu, canned tuna and salmon, pasta, and cream of wheat or oatmeal. Other good choices are pre-made frozen meals from the grocery store (Lean Cuisine®, Smart Ones®, and Healthy Choice® have less than 800 mg of sodium per serving), individually frozen chicken breasts, and frozen beef, chicken or vegetarian burgers.
  • Ease the stress on your bowels and digestive system by choosing low-fat foods. Foods lower in fat tend to clear the bowels more quickly, and so are a good choice in the days leading up to surgery. Often you will not be allowed to eat for eight to 12 hours before surgery. This clears your bowels and reduces the volume and acidity of your stomach contents. Anesthesia sometimes causes nausea and vomiting, so fasting helps keep you from choking on your stomach contents during surgery. Newer studies suggest there are benefits to drinking a clear liquid up to two hours before surgery, but this is up to your surgeon. Always follow your surgeon's instructions about when and what to eat before surgery.

In your first few days after surgery

  • Don't expect to eat solid food right away. Depending on the surgery you have had, you may only be allowed ice chips or water in the first few days. Most people then begin clear fluids (juice, broth, popsicles, water, ice chips and Jell-O®). Next comes a full-fluid diet (cream soups, ice cream, pudding, juice and milk), progressing to a regular diet over a few days. Nausea can be a side effect of anesthesia, so add foods as you can handle them.
  • Avoid strong odours and foods that may cause nausea. This is especially important if you have had abdominal surgery, as vomiting will make you more uncomfortable.
  • Stay away from your favourite foods while you are nauseated so that you do not associate these foods with nausea in the future.
  • Drink as much fluid as you are allowed. Extra fluids are often needed after surgery to replace blood loss.
  • Post-operative ileus (lack of bowel movements) may be a problem in the first few days, depending on the type of surgery you have had. This is caused by the surgery and medications. You may feel nauseous and bloated. Once your surgeon allows it, drinking clear fluids often helps resolve this problem.

Once you are home after surgery

  • Follow the diet restrictions recommended by your dietitian in the hospital. This allows you to heal more quickly. The limits are sometimes temporary, and sometimes long-term, depending on your surgery. Talk with your doctor and dietitian about how long you must follow a certain diet.
  • Get enough fluids, unless your fluid intake has been restricted by your doctor or dietitian.
  • Include adequate protein in your diet. Good sources are beef, poultry, pork, fish, beans, eggs, milk and milk alternatives, nut and nut butters and soy products including tofu, soy milk and edamame. Protein helps heal wounds and replaces losses from surgery. As well, high-protein foods often contain iron. Blood loss and limited food intake mean that iron stores are often reduced during and after surgery.
  • Add foods back into your diet gradually to see how your body responds.
  • Be careful of foods that may make you uncomfortable. Some people avoid foods that produce gas, such as broccoli, cauliflower, onion, and Brussels sprouts. These foods are good choices once your bowels are able to tolerate food and fluids more easily. However, they should not be the first choice in the early days after surgery.
  • Include whole foods and limit processed foods. Processed foods often are lower in nutrition, and tend to contain additives and preservatives. Whole unprocessed foods are better sources of vitamins, minerals and macronutrients that help your body heal and recover.
  • Accept offers of help with meal preparation and clean up. You may feel tired and uncomfortable, and standing for an extended time may be difficult. Helpful community food resources include supermarket food delivery, take out, and meal delivery services (Meals on Wheels, and Better Meals).
  • Keep healthy, easy-to-prepare foods on hand. Examples of simple mini meals include a smoothie made with frozen berries and yogurt, cereal with fruit and milk, scrambled eggs and tomato in a tortilla, and pre-made hummus with cut veggies.
  • Consider taking a multivitamin or supplement if your doctor recommends one. Alternately, choose a variety of food sources to obtain your vitamins and minerals. Vitamin C (found in citrus foods) helps the body fight infection and absorb some forms of iron. (Other minerals help fight infection but are best obtained from dietary sources such as lamb, beef, oysters and wheat germ.)
  • Think about including high-fibre foods in your diet if you are troubled with constipation. Some pain medications, and your reduced level of activity, can be part of the problem. Ask your doctor if you are allowed high fibre and liberal fluid intake after surgery.
  • Ask your surgeon when you can include omega-3 supplements (fish oils) in your diet. Omega-3 fatty acids reduce inflammation. However, they also have blood thinning properties, so may not be recommended in the first week after surgery.
  • Glutamine supplements (30 grams per day) may help heal wounds and reduce infection. It also reduces the unwanted movement of bacteria out of the gut to another part of the body. This can happen when the natural bacteria in the gut is reduced by antibiotic use, which is common after surgery. Check with your doctor before starting any supplements to be sure they are appropriate and to clarify the dose.
  • Wait until you have resumed a normal diet after surgery before having limited amounts of alcohol. If you are taking any medications, check to see if drinking alcohol will cause problems.
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specifid medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physican promptly. Copyright 2012, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1  [NU_FHb11]
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