The Importance of Surgical Nutrition

The following is a conversation with Andrew Larson, MD, FACS. Dr. Larson is a board certified general, laparoscopic, and bariatric surgeon, one of only a couple hundred physicians in the world currently directing an internationally certified “Center of Excellence” program offering weight loss surgery. He is an Affiliate Clinical Assistant Professor at the Schmidt College of Biomedical Science at Florida Atlantic University and a Voluntary Assistant Professor of Surgery for the Miller School of Medicine at the University of Miami. Dr. Larson presently works in Palm Beach County, Florida where he serves as medical director for JFK Medical Center’s Bariatric Wellness and Surgical Institute. Along with his wife, Ivy Larson, he has authored four national top selling books to date. He runs the website http://cleancuisineandmore.com/ with his wife.

1. Define the phrase "surgical nutrition" to laypeople that may not understand what this terminology means and entails.

Surgical nutrition can mean more than one thing. It can mean optimizing nutrition for patients who are in the hospital and cannot eat themselves, such as cancer patients or stroke victims. This type of surgical nutrition involves intravenous nutrition, tube feeding and, if necessary, surgery to place the feeding tubes. However, more relevant to the general public, surgical nutrition means optimizing a person's health and nutritional status prior to and in preparation for major surgery.

2. When we think of preparing for a major surgery (or any type of surgical procedure), how much importance should patients place on getting "prepped" nutritionally?

Studies have clearly shown people who are underweight and malnourished, protein deficient or overweight have a more difficult time recovering from surgery. Without a doubt, a healthy, well-nourished person will heal and recover much faster. The stress of surgery and the healing process that follows requires additional nutrients above and beyond what your body normally needs. You should pay close attention to your diet both before and after surgery. It is best to get the nutrients your body needs to heal from unrefined whole foods. Getting plenty of fresh fruits and vegetables, protein-rich plant based foods such as nuts, seeds and beans are also important. Essential fats also expedite the healing process and help your body deal better with surgical stress.

3. How far in advance does this preparation go (or should it ideally be lived out day by day)?

Ideally, it should be lived out day to day. However, even 2 weeks of optimizing nutrition will put your body in a better position to handle the stress of surgery and also help expedite the healing process.

4. What are the implications for patients who have not taken care of themselves prior to a surgery as far a wound healing and overall ability to regain their strength?

Complications increase (and in some cases, dramatically) as one becomes further away from being in optimal health. Also, it is much more difficult for a surgeon to perform surgery on someone who is obese. Simply losing weight will help make the surgeon's job much easier. However, if you can't lose weight before surgery, by adopting an anti-inflammatory whole foods diet prior to surgery can reduce post surgical inflammation reducing the risk of complications.

5. What would be the five top practical steps all people and potential patients should apply to their daily lives to live strong and healthy?

1. Exercise 3 days per week (combining cardio with resistance training). Specifically, cardio exercise is very important to improve heart and lung function and this helps your body deal better with the stress of surgery and anesthesia

2. Take multi-vitamin containing zinc & B-complex (this helps with wound healing) and a whole-foods based vitamin-C rich "green" powdered drink (such as Green Vibrance).

3. Eat more fruits and vegetables to increase the antioxidant status of your body (this helps with healing) ---specifically aim to eat 1 huge serving of dark, leafy greens each day, 2-3 fruits and 2 additional vegetables.

4. Make an effort to eat more protein rich plant-based "whole"' foods (such as beans, nuts, legumes, seeds, "whole" soy such as tofu or tempeh) and less animal foods (such as beef, dairy, eggs, chicken, etc).

5. Aim to drastically reduce the top 4 empty calories; 1) sugar, 2) refined flour, 3) trans fats and 4) processed vegetable oils (soybean, corn, cottonseed oil, etc).