Nutrition for Healing

RENO ORTHOPEDIC CLINIC

nutrition for healing

Healing: What you can do to support your recovery

What you eat can help you recover from injury and/or surgery, heal wounds, and strengthen bones and muscles. There are 2 phases of recovery from injury or surgery and both must be addressed nutritionally for a rapid and successful recovery.

Phase 1:

After injury or surgery, treatment may require resting your bone or joint and using medicines or specific treatments advised by your doctor. You may need to take pain medicines and may get side effects such as constipation from those medicines. Additionally, the lack of movement required to promote initial recovery will result in loss of muscle mass and strength, and the time required for recovery may take several months.

Eating foods that help your body to decrease inflammation, minimize muscle mass loss, heal wounds and manage your weight will help you toward a rapid recovery.

• Manage inflammation by eating foods that lower inflammation.
• Minimize muscle mass loss by eating high-quality protein foods and creatine.
• Manage weight by eating enough calories to help you heal but avoiding weight gain.
• Heal wounds and prevent infection after surgery by eating foods that promote tissue healing.
• Eat high fiber to combat constipation.
• Eat enough calories to support walking on crutches, and physical therapy but less than what you ate when you were active and exercising daily.

Phase 2:

The second phase of recovery requires rehabilitation (muscle strengthening, muscle and tendon flexibility and neuro-motor control/agility) to return to activity and limit recurrent injuries. To reach these goals we recommend eating high-quality protein foods, creatine monohydrate 5 grams daily and continuing to get adequate Vitamin C, Zinc, Calcium and vitamin D.

Nutrition Goals in Phase 2

• Regain muscle mass by continuing to eat high-quality protein foods and creatine monohydrate 5 grams daily.
• Help your body continue to heal by including foods that are high in vitamin C 500mg daily, zinc, vitamin D 1000-5000IU daily, and calcium 1200mg daily.

Foods That Lower Inflammation

• Fruits and vegetables
• Legumes (beans and peas)
• Whole grains
• Fish that are rich in omega-3 fats (salmon, halibut, scallops, tuna, sardines, herring, anchovies, oysters, trout, mackerel)
• Plant foods that are rich in omega-3 fats (walnuts, flaxseed oil, canola oil)

High-Quality Protein Foods

You should aim to eat 1 to 1.2 grams of protein per kilogram body weight. For example, a 200 pound man should consume 90 to 110 grams of protein each day (200 lbs/ 2.2 kg = 90 kg x 1.2 grams protein = 110 grams protein).

Protein is needed to heal wounds, repair broken bones, build healthy blood cells, keep your immune system strong, and support muscle protein growth and strength. If you’ve had surgery, it is normal for your appetite to be low, so eat a small amount of protein at each meal and snack. You may also consider starting low dose creatine monohydrate (5grams daily) and/or a protein supplement to prevent further muscle loss.

Examples:
• Eggs, egg whites, and egg substitutes
• Low-fat cheese and cottage cheese
• Low-fat yogurt (regular and Greek)
• Low-fat milk
• Low-fat soy milk
• Lean meats (beef, pork, chicken, turkey, lamb, buffalo)
• Fish
• Soy foods (tofu, tempeh, miso, soy nuts, soy vegetable protein)

Fiber

It may sound odd to mention fiber with healing foods, but the pain medications that are commonly prescribed after injury or surgery cause constipation. Prunes or prune juice (along with drinking plenty of water) have a natural laxative effect that can alleviate constipation while on pain medications. Other good fiber sources include fresh fruits and vegetables, high-fiber whole grain cereals, and legumes.

Vitamin C and Zinc

While all nutrients are important in healing, vitamin C and zinc are superstar nutrients for their roles in healing. Vitamin C is needed to make a protein called collagen and for repairing tendons, ligaments, bones and skin. Citrus fruits are high in vitamin C, but don’t overlook other sources of vitamin C such as strawberries, kiwifruit, baked potatoes, broccoli, and bell peppers. We recommend 500mg of vitamin C daily in both phase 1 and phase 2 of healing. Zinc is a mineral found mostly in animal foods such as meat, fish, poultry, and dairy foods. Zinc is also found in whole grain breads and cereals, legumes (dried beans and peas), and nuts. It is better to get zinc from foods than supplements. High-dose zinc supplements can cause nausea and vomiting.

Calcium and Vitamin D

Calcium and vitamin D are nutrients associated with healthy bones, so if you have a broken bone, a stress fracture or have had a joint replacement, make sure to get plenty of these nutrients to strength your bones. The best sources of calcium and vitamin D are low-fat dairy foods. Fat-free (skim) milk has slightly more calcium than full-fat or low-fat (1%) milk and is fortified with vitamin D to help your body absorb the calcium. Yogurt, a good source of calcium, is not always fortified with vitamin D, so check the nutrition label of your favorite yogurt to make sure you are getting vitamin D also.

Nutrition for Healing

Advice about food and supplements

You’ve been injured or will be having surgery. Now you must prepare your body for the healing process ahead. Your body needs nutrients (carbohydrates, protein, fat, vitamins, minerals and water) to support the repair process. Here are a few tips to speed your recovery and make things a little easier to handle.

How many calories should I be consuming since I will be inactive?

Now is NOT the time for weight loss! When people are immobilized, they worry about gaining weight. However, you should NOT decrease your calorie intake because you will be inactive. In fact, your calorie needs are now greater than usual because your body requires energy from nutritious foods to fuel the healing process. You will need to consume about 15-20 calories per pound (using your current body weight). If your overall energy and protein needs are not met, body tissues such as muscles and ligaments will begin to break down. This will compromise healing and may prolong your recovery period.

How much water should I be drinking?

Normally, it is important to drink at least 8 cups of water or non-caffeinated, non-alcoholic beverages every day. If you do not drink this much fluid each day, now is the time to get into the habit. Drinking enough fluid is essential for maintaining adequate hydration and allowing your body to heal. You may need more fluid depending on the type of medication you are taking or the extent of your injury. Don’t wait until you’re thirsty. By then, you’re already dehydrated! Have a water bottle handy and plan for plenty of refreshing beverages throughout the day to keep your body in fluid balance.

What types of food should I be eating?

Eat well-balanced meals and a wide variety of foods to obtain all the nutrients your body needs for tissue repair. Your body requires more protein and calcium during this time, so take careful note of the daily recommendations and food sources listed below. Compare your diet with the Food Pyramid to see if you’re meeting your daily nutrient requirements (see additional handout). Consider taking a multi-vitamin/mineral supplement if you do not get the recommended balance of foods each day. Cut back on junk food. You want most calories to be packed with nutrition value.

Here are a few essential nutrients that your body will need before and after surgery or injury:

NutrientsHelps with:Found in:Per dayProteinhealing, tissue repair and regrowthmeat, poultry, fish, eggs, milk, cheese, legumes, soy products, nuts, seeds Carbohydratesenergy for healing and preventing protein/muscle breakdownfruits, vegetables, legumes, breads, cereals, rice, pasta, grains Lipids (Fats)absorption of fat-soluble vitamins, immune response, energyoils (e.g., olive, canola, sunflower), nuts, seeds, avocado, salad dressings, margarine, butter Calciumbuilding/maintaining bones and muscle contractionmilk, cheese, yogurt, soy products, turnip and mustard greens, collards, kale, broccoli, almonds1500mgIronforming hemoglobin and carrying oxygen
**best when eaten with vitamin C rich foodsliver, lean red meat, poultry, fish, iron-fortified cereals, legumes, dark leafy greens, dried fruit18mg men
15mg womenZinchelps in wound healing, component of enzymesmeat, liver, eggs, oysters and other seafood15mgVitamin Ahelps in wound healing and growth, maintenance of skincarrots, sweet potatoes, dark yellow or green leafy vegetables, milk, cheese, liver, egg yolk5000 IUVitamin Dhelps in bone healing and calcium absorptionfortified milk, butter, margarine, fortified cereals, liver, fatty fish, egg yolk400-800 IUVitamin Eantioxidant/disease-fighting properties
(do NOT take supplements 7-10 before surgery)vegetable oils (e.g., corn or sunflower), beef liver, milk, eggs, butter, green leafy vegetables, fortified cereals30 IUVitamin Khelps wound healing response and blood clottinggreen leafy vegetables, fatty fish, liver, vegetable oils80µ men
65µ womenVitamin Cbuilding connective tissue, essential nutrient for healingcitris fruits, strawberries, tomatoes, peppers, greens, raw cabbage, melon60mg

Are there special recommendations for patients having surgery?

Increase your calcium intake to 1500 mg/day, especially if your surgery or injury involves bone.
Do NOT take vitamin E supplements 7-10 days before your surgery.
Be sure to meet your daily protein needs (about 6-12 ounces per day). Several factors (ie, weight, activity level and type of injury) affect individual protein requirements, so you may want to consult a nutritionist for more information.
Avoid weight loss/crash dieting before and after surgery to ensure adequate nutrients and energy for recovery.
Eat well-balanced meals to lower the risk of infection after your surgery. Vitamin C, zinc, and vitamin A are especially important in preventing infections.
If you lose your appetite for a day or two after surgery, nutrient-rich drinks/shakes can help you get enough nutrients and calories (Carnation Instant Breakfast, Ensure, Boost and Sustacal are good choices).

Now that I have limited mobility, what can I do to make life a little easier?

If you're having surgery, plan ahead. If you’ve been injured, ask for help with these suggestions:

Make sure you have plenty of water, juice, milk, or other drinks available.
Prepare food ahead of time and place in the freezer to be reheated later.
Consider stocking up on healthy low preparation foods, such as fruit, pudding, yogurt, low-fat frozen dinners, canned or instant soups, instant cereals, shredded cheese, pull-top tuna or other canned foods.
Make sure you have a variety of takeout menus if you plan to have food delivered to your home.
If you’re on crutches, realize that carrying food will be hard for you. Small milk cartons, juice boxes, or water bottles may be helpful instead of having to carry a glass.
If your arm is or will be in a sling, consider buying precut food or individual servings of food. You may also want to practice daily tasks with your opposite hand before surgery.

Updated: 10/2/2009

Authors

Women's Sports Medicine Center,
Hospital for Special Surgery