From The Desk of Josh Gitalis

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Sometimes surgery is necessary in an emergency situation as a life-saving act. Usually for these types of surgeries there is little or no time to prepare.

Many surgeries however, are planned procedures, leaving ample time to prepare.

It is amazing that 50 percent of people admitted to hospital for surgery are malnourished. 1  A malnourished body will be at a greater risk for complications, and have a prolonged recovery and healing time.

The following recommendation may be applied both pre and post-surgery.

Broad Spectrum Multi-vitamin-mineral

All known vitamins and minerals are essential before, during and after surgery either to promote healing, enhance immunity or both. By including a good quality multivitamin you cover the basic requirements of all essential nutrients. (It is essential that you use a good quality multi, as some multi’s on the market may be more harmful than beneficial).


Proteins are the building blocks of all our body tissues. They are used to repair and build damaged tissue.

In times of rapid growth (i.e. pregnancy, children, body-building and surgery) we require a greater amount of protein to avoid breaking down more tissue (catabolic) than is being built up (anabolic). In fact, under stressful conditions the body actually loses its ability to manufacture certain amino acids (the building blocks for protein). 2 3

Fish Oils and Omega 3s

Every single cell in our body is surrounded by a double-layer of fats. Thus, when new cells are required, the demand for fats increase.

The omega-3 fatty acids offer another very important feature for patients recovering from surgery; they are the precursors to anti-inflammatory compounds in the body.

The importance of getting inflammation under control post-surgery is two-fold. First, if inflammation can be reduced, pain can be controlled a lot more effectively and second, by controlling inflammation, the healing process is bolstered.

The most potent omega-3 fatty acids for decreasing inflammation are from fish oils. They offer the long EPA form of omega-3 which is easily converted into anti-inflammatory prostaglandins (PG3).

Fish oils also:

  • Reduce infection rates and shorten hospital stays 4
  • Improve liver and pancreatic function 5
  • Decreases deaths from surgery 6

Vitamin C

The most abundant protein in the body is collagen. It is the base protein for all of our connective tissue and bones. In order for collagen to be produced in the body we need both ample amounts of vitamin C and protein (already discussed). Surgery greatly enhances the need for collagen production.

Studies show that vitamin C speeds up the healing of fractures. 7


Zinc is another key player in the production of collagen.

Animals that are deficient in zinc have greatly compromised wound healing as compared to those with adequate zinc status. 8


One of the biggest dangers of being in a hospital, is exposure to pathogens. Combine a pathogen with a compromised immune system (as seen with trauma, i.e. surgery), and you’ve got the perfect combination.

Common infections that people catch while in hospital are c. difficile and MRSA. These are both notoriously difficult to treat and can be potentially life-threatening.

Prevention is the the most important strategy when going into a hospital. A simple course of probiotics can prevent unwanted sickness and subsequent slowing of the healing process. One of the best probiotics for this is called saccharomyces boulardii.

Important Guidelines

  • All supplements should be discontinued 2 weeks prior to surgery, except for the probiotic. Supplements can be commenced once the patient can eat solid food.
  • Each patient requires a specific combination of supplemental nutrition. Consult a qualified health care practitioner to determine the appropriate regimen.

Surgery is sometimes a necessary treatment, but there are many ways we can improve success of the surgery, decrease side-effects and speed healing.

– Josh

  1. Patel GK. The role of nutrition in the management of lower extremity wounds. Int J Low Extrem Wounds. 2005 Mar;4(1):12–22.
  2. Kendler BS. Supplemental conditionally essential nutrients in cardiovascular disease therapy. J Cardiovasc Nurs. 2006 Jan;2(11):9–16.
  3. Sole MJ, Jeejeebhoy KN. Conditioned nutritional requirements: Therapeutic relevance to heart failure. Herz. 2002 Mar;27(2):174–8.
  4. Heller A, Koch T. [Immunonutrition with omega-3-fatty acids: Are new anti-inflammatory strategies in sight?]. Zentralbl Chir. 2000;125(2):123–36.
  5. Heller AR, Rossel T, et al. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients. Int J Cancer. 2004 Sep 10;111(4):611–6.
  6. Tsekos E, Reuter C, et al. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery. Clin Nutr. 2004 Jun;23(3):325–30.
  7. Sarisozen B, Durak K, et al. The effects of vitamins E and C on fracture healing in rats. J Int Med Res. 2002 May;30(3):309–13.
  8. Kaplan B, Gonul B, et al. Relationships between tensile strength, ascorbic acid, hydroxyproline, and zinc levels of rabbit full-thickness incision wound healing. Surg Today. 2004;34(9):747–51.