Undergoing surgery, whether it's a knee or hip replacement or another procedure, places significant stress on your body. Preparing for surgery is much like training for a marathon, taking a major physical and mental toll. The stress associated with surgery can lead to several challenges, including weight and muscle loss, inflammation, impaired wound healing, and an increased risk of infections. Fortunately, there are steps you can take to mitigate these effects and promote a faster, more successful recovery. Nutrition plays a vital role in pre- and post-operative care. Many hospitals are adopting surgical guidelines from organizations like the ERAS (Enhanced Recovery After Surgery) Society and the American College of Surgeons to help patients achieve a faster recovery. This article will explore diet guidelines for the day before surgery to help you optimize your body for the procedure and subsequent healing process.
The Importance of Pre-Surgery Nutrition
The impact of nutrition before and after surgery is important. A long-held belief was that patients should fast completely before surgery. Luckily, complete fasting before surgery may not always be a requirement. Today, scientific evidence and surgical guidelines recognize the benefits of perioperative nutrition. Preparing your body with the right nutrients can minimize stress-related complications and support the healing process. "Patients need to be their own advocates," says Boff.
General Guidelines for the Day Before Surgery
The best pre-surgery diet for you can vary based on your procedure and underlying health concerns. Talk to your doctor to determine what you should and shouldn't eat the day before surgery. Typically, you can eat solid foods up until the day before your surgery. However, it's generally recommended to transition to a clear liquid diet about eight hours before your scheduled hospital arrival time, according to UCLA Health. Your doctor may adjust specific guidelines, so be sure to follow their instructions.
What to Eat the Day Before Surgery
Here's a closer look at the best foods to eat before surgery, along with what to eat the night before surgery once you start to fast.
Clear Liquids
But why shouldn't you eat right before surgery? Well, it's important to undergo your procedure with an empty stomach, which is why most doctors will have you stop eating solid foods about eight hours before your hospital arrival time, according to UCLA Health. It is common to be told to arrive two hours before your scheduled surgery time. Your doctor will provide you with specific instructions based on your procedure and pre-surgical needs.
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High-Quality Proteins and Complex Carbohydrates
To support your recovery, eat more high-quality proteins and complex carbohydrates before and after surgery. For many, nausea after surgery can prevent them from eating for up to three to four days.
Immune-Enhancing Nutrition
The stress from surgery can trigger inflammation, which can lead to complications. Nutrition containing immune-enhancing ingredients, such as arginine and omega-3 fatty acids, can help.
Lean Protein
Protein is a key part of any pre-surgery diet, according to the American College of Surgeons. Protein is often referred to as the building block of life, because it's found in every cell, tissue, and organ in your body, according to The Nutrition Source. It also supports immune health, and the amino acids from protein-rich foods help make new blood and tissue.
According to the 2020-2025 Dietary Guidelines for Americans, adults should aim to eat 46 to 56 grams of protein per day - including the days leading up to your procedure. Some of the best protein-rich foods to eat before surgery include lean meats like chicken and turkey, fish, eggs, and beans.
Fruits and Vegetables
Fruits and vegetables are great light and nutritious foods to eat before surgery, according to Cleveland Clinic. They're full of vitamins and minerals that support your immune system, including vitamins A, B, C, and E. You should aim to eat at least five servings of fruits and veggies every day, especially in the weeks leading up to your procedure. If your goal is to follow an anti-inflammatory diet before surgery, fruits and vegetables can help. According to Harvard Health Publishing, some notably anti-inflammatory foods are:
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- Dark leafy greens like spinach, kale, and collards
- Tomatoes
- Berries
Whole Grains
Whole grains also make the list of what to eat before a surgery, according to the American College of Surgeons. They're rich in B vitamins, which can support your immune system during your recovery. Eat at least four servings of grains per day in the weeks prior to your procedure. One serving is:
- 1 slice of whole-grain bread
- 1/2 cup cooked grains (whole-grain pasta, brown rice, quinoa)
- 1/2 cup cooked cereal like oatmeal
- 1 cup whole-grain cold cereal
Pre-Surgery Diet Before Gastric Sleeve Surgery
Before Gastric Sleeve Surgery We will schedule an appointment with your surgeon for your pre-operative appointment within 30 days before your procedure to answer any questions you may have. Include your bariatric multivitamin and calcium during this phase. The day before surgery you must only consume liquids. Do not eat any solid food the day before surgery.
Fluids
Consume a minimum of 64 ounces of water per day. Other fluids can also be included as long as they are:
- Uncarbonated
- Sugar-free
- Caffeine-free (examples: Crystal Light, Powerade Zero, decaf unsweet tea)
Drink two high-protein, low-carbohydrate shakes per day.
- Shakes should be limited to 10 grams of carbs or less per serving.
- Shakes should have at least 20 grams of protein per serving.
- Wean off caffeine-containing drinks over these two weeks. You will need to avoid caffeine for the first two weeks after surgery (until the Soft Food Diet stage starts).
Solids
Eat one meal per day. Follow the Pre-Op Diet meal guide below. Eat 1-2 snacks per day. Limit to no more than 10g of carbs per snack (example:½ cup fresh berries, ¼ cup nuts, or string cheese with 2-3 crackers). Reduces the size of the liver, which lies over the upper stomach. Reduces abdominal fat, making access to the stomach safer and easier. Thins out the wall of the stomach, making the stapling portion easier. All of this adds up to an easier and safer surgery, and results in a tighter sleeve for you!
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Pick a 4-6 oz protein, add up to ½ cup of starchy vegetables, and fill in with unlimited non-starchy vegetables.
Pick a lean protein (4-6 oz)
- Fish
- Chicken
- Turkey
- 2-3 large eggs
- ¾ cup liquid egg whites
- 93/7 ground meat
- Venison (deer)
- Extra firm tofu
Add a starchy vegetable (up to ½ cup)
- Potatoes
- Sweet potatoes
- Corn
- Beans (not BBQ-style)
- Peas
Add non-starchy vegetables (unlimited)
- Carrots
- Leafy greens (spinach, lettuce, kale)
- Green Beans
- Peppers
- Tomatoes
- Asparagus
- Broccoli
- Cabbage
- Celery
- Radishes
- Eggplant
- Brussels sprouts
- Squash / zucchini
- Mushrooms
- Cucumbers
- Cauliflower
Protein Shakes (two per day)
Protein shakes should be low carbohydrate (10g carbs or less) and should provide at least 20 grams of protein per serving. Options may include ready-to-drink bottles or powders that mix with water to make a shake. Here are a few options to consider:
- Premier Protein® Milk-based protein, lactose free 30 grams of protein per serving; 4-6 grams of carbohydrates per serving
- Pure Protein® 100% Whey Protein Powder or Shakes Whey Protein/Milk Protein Isolate 30 grams of protein per serving; 6 grams of carbohydrates per serving
- Fairlife® Nutrition Plan Milk-based protein, lactose free 30 grams of protein per serving; 3-4 grams of carbohydrates per serving
- Muscle Milk® (various options) Milk-based protein 20-40 grams of protein per serving; 7 grams of carbohydrates per serving
- Vital Proteins® Collagen Peptides Unflavored: 20 grams of protein per serving; 0 grams of carbohydrates Chocolate: 20 grams of protein per serving; 4 grams of carbohydrates
Provides less than 900 calories and 75-95 grams of protein. Does not include your water goal of 64 ounces or more per day.
Snack
Celery with 1 Tbsp peanut butter, string cheese with ½ cup fresh berries
Dinner
4-6 oz grilled chicken breast, ½ cup baked sweet potato, small salad of spinach, tomatoes and shredded carrots with light drizzle of infused olive oil dressing (~2tsp)
Additional Considerations
Besides dietary adjustments, other factors can influence your surgical outcome and recovery.
Medication Changes
Talk with your doctor about how to adjust medications, including insulin, during this low calorie, low carbohydrate diet phase. Follow your doctor’s directions for taking medicine. Follow any specific instructions given by your doctor. Bring a list of your medicines with you to the hospital. Include prescription and over-the-counter medicines, vitamins and herbals.
Avoid Nicotine
Smoking, vaping, dipping chewing tobacco or any form of nicotine are strictly prohibited, due to the increased risks of surgical complications. You will undergo nicotine testing for confirmation before surgery will be scheduled. You will be required to commit to avoid nicotine completely after surgery as well, due to the increased risks of stomach ulcers.
Discontinue Certain Medications and Supplements
Discontinue all hormonal therapy (testosterone, birth control pills) one month before surgery to reduce the risk of blood clots. If you have implantable birth control or an IUD, you do not have to have this removed. Thyroid medication should continue to be taken. Discontinue phentermine, Ozempic®, or any other diet medication 2 weeks before surgery due to potential interactions with anesthesia. Discontinue all herbal supplements other than vitamins two weeks before surgery. Start bariatric vitamins at least two weeks before surgery.
Other Pre-operative Instructions
Bring any forms given to you by your doctor. Remove all jewelry (including rings) and body piercings. Please arrive at the hospital as directed before your surgery.
Post-Surgery Recovery
That's why getting up and moving as soon as possible following surgery can help patients preserve their lean muscle, and stay strong and make a faster transition back into their regular routine. But you can't do it alone - and nutrition can help.
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