• Physical Wellbeing
  • Surgery

ARTICLE

Surgery

ARTICLE

  • Physical Wellbeing
  • Surgery

Surgery

Surgery

Whitepaper: Benefits of Dairy Proteins in the Nutritional Support of Cancer Patients

Surgery

Surgery

Concept Card: Medical Protein Powder

Surgery

Surgery

Concept Card: Medical Protein Beverage


Surgery and trauma have a major role in modern medicine with more than 300 million surgical procedures estimated to be undertaken each year.1

Optimal nutritional status is important for all patients undergoing surgery because the body has an increased demand for resources to support recovery and tissue healing. 

Lean tissue loss can occur after surgery if a patient does not receive adequate nutrition. Therefore, nutritional support is important both pre-and post-surgery to minimize the risk of catabolism, help patients return to an anabolic (muscle-building) state that supports a faster recovery, and to reduce the risk of post-surgical complications such as slow recovery, infection, longer hospital stay, etc..

Post-operative recovery can be challenging because bed rest, reduced appetite, nausea, fatigue, or poor pain management can impair dietary protein intake. Accordingly, loss of muscle mass can be a significant contributor to post-surgical complications if protein intake is not sufficient to support tissue healing and recovery. 

 

Patients undergoing elective surgery with no complications lose an average of 2 kg of lean body mass because of the catabolic, inflammatory effect of surgical stress.2

 

In particular, the amino acid leucine stimulates muscle growth and repair.3,4 Therefore, any nutritional supplement offered to a patient after surgery should contain at least 2.5 grams of leucine to support tissue healing and recovery.5-7 Leucine levels in whey protein are relatively high, making whey protein an effective option for fortifying normal foods and supplements for people preparing for, or recovering from, surgery.3.4

The evidence-based multi-disciplinary Enhanced Recovery After Surgery (ERAS) guidelines recommend avoiding pre-operative fasting, and reintroducing oral fluid and food intake as soon as possible after surgery. The European Society for Clinical Nutrition and Metabolism (ESPEN) also recommends that patients who are unable to meet their energy needs are administered oral nutritional supplements (ONS), regardless of their nutritional status.8 Use of ONS can significantly increase protein intake, reducing the length of hospital stay for patients who have undergone surgery, and lowering the risk of infection.3

Fluid and electrolyte balance are also key factors for patients undergoing surgery. Therefore, maintaining proper hydration is critical. 

 

40–50% of patients undergoing surgery experience a degree of malnutrition.9

 

Appropriate nutritional support is essential for maintaining and recovering lean body mass after surgery, faster recovery, and a reduction post-operative complications and hospital stay durations.


 
Are you looking for product solutions for the dietary management of surgery patients?

Concepts: 

Nutiani has a range of market-ready products, including low osmolarity beverages. Our dairy proteins allow us to create unique solutions through relentless innovation providing formulation flexibility for manufacturers to include additional minerals and nutrients that help to further enhance recovery.

ONSs are Foods for Special Medical Purposes designed and developed according to strict guidelines to provide energy and nutrient-dense solutions in liquid or powdered form. ONSs are developed using scientific and clinical evidence to modify the levels and sources of nutrients to meet the special requirements of specific patient groups.

In addition to the usual technical challenges (feasibility, nutritional validation, shelf-life stability), to improve the total nutritional intake it is crucial to develop ONS products that are well tolerated and accepted by consumers.

                 

                 

1. Meara JG, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015;386:569–624.

2. Phillips BE, et al. Effect of colon cancer and surgical resection on skeletal muscle mitochondrial enzyme activity in colon cancer patients: a pilot study. J Cachexia Sarcopenia Muscle 2013;4:71–77.

3. Yeung SE, et al. Protein intakes are associated with reduced length of stay: a comparison between Enhanced Recovery After Surgery (ERAS) and conventional care after elective colorectal surgery. Am J Clin Nutr 2017;106:44–51.

4. Tang JE, et al. Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. J Appl Physiol 2009;107:987–992.

5. Witard OC, et al. Protein considerations for optimising skeletal muscle mass in healthy young and older adults. Nutrients 2016;8:181.

6. Phillips SM. Nutritional supplements in support of resistance exercise to counter age-related sarcopenia. Adv Nutr 2015;6:452–460.

7. Bauer J, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc 2013;14:542–559.

8. Weimann A, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr 2021;40(7):4745–4761.

9. Bruun LI, et al. Prevalence of malnutrition in surgical patients: Evaluation of nutritional support and documentation. Clin Nutr 1999;18(3):141–147.

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