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Archive March 2020 XXI, No. 3

Healthier Eating Is Within Reach

Patients who optimize their pre-op nutrition are rewarded with better outcomes.

Daniel Cook

Daniel Cook, Editor-in-Chief

BIO

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WEIGHT-LOSS GOAL Lowering BMIs and building lean muscle mass puts less strain on joints and reduces the body's inflammatory response to surgery.

The surgeons at Excelsior Orthopedics in upstate New York understand that what patients eat and drink before surgery impacts how well they'll recover afterward. Their group, which owns and operates the Buffalo Surgery Center in Amherst, N.Y., recently hired Melinda Yoder, RDN, CDN, as manager of nutritional services to optimize the nutritional status of patients before they arrive on the day of surgery. The surgeons in the group used to cross paths with Ms. Yoder as she worked independently to ensure patients were physically prepared to endure the physical stress of surgery. They were intrigued, asked about her services and ultimately decided to make her an offer.

"We're aligned in our goals, so the relationship made sense," says Ms. Yoder.

Hiring a dedicated nutritional expert of your own would be ideal. At the very least, educate patients about the importance of eating and drinking right as they prepare for surgery.

Losing to gain

Patients in a suboptimal nutritional state are at increased risk of being hyperglycemic and experiencing insulin resistance brought about by the trauma of surgery, according to Elizabeth Goldenberg, MPH, RD, CDN, a registered dietician at Weill Cornell Medicine in New York, N.Y. "They're also more likely to have more GI symptoms and experience PONV," says Dr. Goldenberg. She points out optimizing pre-op nutrition puts patients in an anabolic state, during which the body builds lean muscle mass, instead of a catabolic state, which involves the loss of body mass.

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