Studies show that most people have some level of nutrient depletions. For example, 1 in 4 Americans are at risk for a malabsorption nutrient deficiency, meaning that the food you eat does not get digested and absorbed normally. Many more Americans are at risk for nutrient depletions because of food choices and our Standard American Diet (“SAD”). Both fast food and processed foods (essentially any food that is packaged and has an ingredients list) contain “empty calories”, which are nutrient-poor.

So, what are nutrients and why is this information important? Peak health occurs at the level of your cells. Your cells are a complex system of biochemical (biologically active chemical molecule) reactions.

(This 8 minute clip is a very good basic example of these chemical reactions – look at 2 minutes in:

and this is a diagram of the known biochemical cellular reactions: http://www.uz.zgora.pl/~jleluk/animacje/show_thumbnails.pl.htm

Health happens when, and only when, all of the biochemical molecules are present in the optimal amounts. Nutrients are these specific chemical substances that your cells need in order to do their jobs properly. Macronutrients are healthy carbohydrates, lipids and proteins and micronutrients are vitamins and minerals. In addition, there are many antioxidant and anti-inflammatory chemicals i.e. bioflavinoids, etc. in whole (non-processed) foods.

The importance of having optimal nutrition is so that your systems work at their peak efficiency. If you are undergoing surgery, you want peak immune function to prevent infection, peak clotting function to reduce bleeding and bruising, peak protein synthesis for collagen formation and repair and many other functions. Studies show adequate nutrition is critical for immune function and wound healing. Deficiencies of even single micro- or macro-nutrients results in altered immune responses even when the deficiency is mild. Obesity, diabetes and other chronic disease of metabolic and nutrition imbalance can have a significant negative impact on surgical outcomes and complications. The majority of Americans are malnourished. If you are overweight, have diabetes, atherosclerosis, high blood pressure, heart disease, or any other chronic disease, your metabolism is not functioning optimally and are highly likely to have a nutritional deficiency. As one example, both zinc deficiency and vitamin D deficiency are implicated in the development of type 2 diabetes. Both these nutrients are vital to immunity and wound healing.

Undergoing surgery with a nutrient deficit increases your risk. Surgical patients with malnutrition are 2 – 3 times more likely to have both minor & major surgical complications such as decreased wound strength, increased rates of infection, impeded or delayed wound healing, increased inflammation, increased bruising and increased risk of death. The length of hospitalization can be extended by 90% compared with the length of stay of well-nourished patients. Major surgery itself increases the risk of malnutrition because of the stress and resulting increase in metabolism using up nutrients to rebuild. This is made much worse if the surgery is on your digestive tract because digestion and absorption are further diminished. This is especially true for obese and overweight patients who are having bariatric (stomach bypass) surgery, because studies show the presence of nutritional deficiency (due to unhealthy diet) before surgery, which is made worse by bypass surgery. Plastic surgery outcomes are also profoundly affected by pre- and post-operative nutritional status. The number of patients with pre-existing nutritional deficiencies and health problems who are seeking cosmetic surgical procedures is growing.

So, what is pre- and post-operative IV nutrient therapy?

Pre- and post-operative IV nutrients supply your cells with the biochemicals (nutrients, cofactors, vitamins and minerals) necessary for their peak functioning, so that your risk of complications is diminished and your healing is optimal. It generally consists of one nutritional IV pre-operatively and one post-operatively as, well as, supplementation by mouth. The specific components and possibly the number of nutritional IVs will vary depending on your pre-operative health, nutritional status and other considerations. Are there studies showing the specific benefits? Yes, in addition to study results noted above that point up the risks of surgical outcomes associated with malnutrition, there are numerous reports that show significant improvement in surgical outcome with pre- and post-operative nutritional IVs. In one study, 30 surgical patients who received nutritional support had an 85% reduction in infections compared to 30 surgical patients given placebo. Because these patients were randomized, there was no preoperative distinction in their nutritional status. In another study, wound healing in nutritionally deficient patients given nutritional IVs was better than wound healing in healthy surgical patients that did not get IVs. These results alone have profound implications for all patients undergoing surgery.

Some of the benefits include:

• Reduced bruising, swelling and inflammation
• Faster wound healing – a nutrient & energy intense process beyond our normal everyday nutritional needs
• Enhanced immunity and reduced infections
• Less oxidative damage generated by surgery and anesthetic agents
• Reduced post-operative complications
• Less damage to surrounding healthy tissue

What should I do if I or someone I know is having surgery?

Nutritional IVs have been utilized for decades. This is, however, a growing area of medicine, and so your doctor may not yet be aware of its value. You may want to discuss this with your surgeon or primary care doctor. If so, here are some questions you may wish to ask:

• “How does pre-operative nutritional status affect surgical outcome?”
• “What do you know about pre- and post-operative nutritional therapy?”
• “How does pre- and post-operative nutritional therapy affect post-operative infection rate?”
• “How does pre- and post-operative IV nutrient therapy affect wound healing?”

If your doctor wishes to learn more (s)he can call our office and ask to speak with Dr. Cole. Should you wish to have your doctor contacted; Dr. Cole can do so at your request. For an appointment or to ask questions please use the contact information below and ask for Dr Cole’s nurse. As with all your health care decisions, this decision is yours to make.

If you have questions or would like to make an appointment, please call Dr. Cole in one of our convenient locations.