Improving Recovery Before and After Surgery Through Exercise and Nutrition

Improving recovery before and after surgery through exercise and nutrition

Surgery places a major physiological and psychological load on the body, and every stage from pre-operative preparation to post-operative recovery affects the final result. Studies have shown that good nutritional status and fitness are important factors in a successful operation, associated not only with fewer post-operative complications but also with a faster recovery.

The core of prehabilitation

Prehabilitation means using exercise and nutritional interventions before surgery to improve a patient’s physical function so the body can cope with the stress that surgery brings. The goals of prehabilitation include:

1. Improving metabolic reserve: optimizing muscle mass and function
2. Reducing the surgical stress response: helping patients return to daily activities sooner
3. Lowering the risk of post-operative complications: such as infection and muscle wasting

Nutrition: the pre-operative energy reserve

1. High-protein diet:
   • Start stepping up nutritional intake 7 to 10 days before surgery
   • A daily protein intake of about 1.2 to 1.5 g/kg of lean body mass may help maintain muscle mass.
   • Smaller, more frequent meals can be used, with 20 to 40 grams of protein per meal, from sources that should include lean meat, dairy, and plant protein
2. Carbohydrate loading:
   • For 3 to 4 days before surgery, take about 60% of total energy as carbohydrates.
   • On the night before surgery, about 100 grams of carbohydrate is suggested, with 50 grams 2 hours before surgery on the day (if pre-operative fasting is required, follow your physician’s instructions)
3. Other nutrients:
   • The fiber and antioxidants from fruit, vegetables, and whole grains may help reduce inflammation

Exercise: improving the body’s adaptability

1. Aerobic exercise:
   • Carry out a 3-week block of pre-operative training
   • 3 sessions per week of 30 minutes of moderate-to-high-intensity aerobic exercise may improve cardiorespiratory endurance
2. Resistance training:
   • Targeting large muscle groups, 2 to 3 times per week using strength training with 8 to 12 repetitions
3. High-intensity interval training (HIT):

• Patients short on time may choose HIT alternating 15 seconds of high-intensity exercise with 15 seconds of rest, which was associated in studies with improved pre-operative fitness

Post-operative recovery: keys to returning to health quickly

The goals of post-operative recovery are to speed up healing, reduce complications, and restore function. Beginning appropriate activity early and avoiding prolonged bed rest allows exercise intensity to be increased gradually; pairing this with nutritional support can optimize training effects, and it is worth paying attention to the timing of nutrition before and after exercise. Below are the post-operative nutrition and exercise strategies.

Nutrition: the cornerstone of recovery

1. Early feeding:
   • Starting solid food within 24 hours after surgery is suggested, which may reduce infection and hospital stay
2. Continued high-protein intake:
   • A daily protein intake of 1.6 to 3.0 g/kg of lean body mass may help reduce muscle loss
   • The post-operative diet should include essential amino acids (EAAs).
3. Timing of nutrition:
   • Spread the daily intake across several meals to ensure absorption efficiency

Exercise: the key to rebuilding function

1. Progressive exercise:
   • Start with low-intensity walking or stretching, then gradually increase the load
2. Targeted rehabilitation exercise:
   • For example, after joint replacement, focus on range of motion and muscle strength training
3. Dynamic training:

• Includes balance and core strength training, which may help restore the ability to carry out daily activities

An integrated surgical recovery plan

Nutrition and exercise before and after surgery need to be adjusted for the type of surgery and individual conditions, such as protein intake for patients with poor kidney function, or exercise after heart-related surgery that must be tailored to wound healing and cardiopulmonary status. It is recommended to discuss with your surgical team or attending physician, post-operative rehabilitation physician, dietitian, and others.

Modern surgical recovery emphasizes an integrated multidisciplinary care model, bringing professionals such as dietitians and physical therapists into the pre- and post-operative care team. This Enhanced Recovery After Surgery (ERAS) pathway has been associated in studies with:

• A shorter hospital stay of 2 to 3 days
• Fewer post-operative complications
• Better overall recovery quality
• A faster return to daily activities

A successful operation depends not only on surgical technique itself but also on appropriate nutritional support and exercise training to improve the patient’s overall tolerance. When considering surgery, patients are encouraged to start preparing actively, using nutrition and exercise to optimize their physical state and create the best conditions for surgery and recovery. This is a process that takes patience and persistence, but the time and effort invested in pre-operative preparation tends to pay off during post-operative recovery. Actual planning still depends on your condition and a physician’s assessment.

References

ACSM’s Health & Fitness Journal 27(6):p 26-32, 11/12 2023.