Heart surgery is a critical intervention typically pursued when other treatments have been exhausted. To optimize the conditions for a successful heart surgery, adherence to preoperative and postoperative guidelines is crucial, with diet playing a significant role. The American College of Surgeons Strong for Surgery program emphasizes preoperative checklists to ensure patients are well-prepared for their procedures. Eating well before surgery helps build up nutritional reserves, providing essential micro- and macronutrients that act as building blocks for every cell in the body. Adequate intake of calories, protein, vitamins, and minerals can contribute to a quicker and smoother recovery.
Pre-Surgery Dietary Considerations
The Importance of Weight Management
Obesity can significantly complicate heart surgery, making recovery more challenging. Therefore, pre-surgery diets often focus on weight loss. The more time a patient has to focus on this goal before surgery, the better the outcome is likely to be.
Dietary Recommendations
If a patient has at least two weeks before surgery, they should emphasize fruits, vegetables, low-fat protein, whole grains, and low sodium in their diet to help lose weight and lower blood pressure as much as possible. A diet designed to help prepare a person for heart surgery is often focused on losing weight.
Caloric Intake and Food Choices
The recommended average daily caloric intake before heart surgery is fairly low, ranging from 1,200 to 1,800 calories. Diet recommendations suggest more servings of fruits and vegetables than whole grains, proteins, or healthy fats. Restrictions are advised for sweets, alcohol, and artificial sweeteners.
Post-Surgery Dietary Considerations
The Importance of Nutrition After Surgery
Continuing a healthy diet after surgery is vital for a swift recovery. Surgery can place a lot of stress on the body, and neglecting nutrition after surgery can have consequences. Poor eating habits during surgical recovery can lead to delayed wound healing, impaired immune function, and interference with heart, liver, and kidney functions.
Read also: Comprehensive Guide to the Miami Heart Institute Diet Plan
General Dietary Guidelines
As with the pre-surgery diet, post-surgery eating should be focused on a leaner, heart-healthy approach. A diet rich in omega-3 fatty acids, folate, vitamin K, magnesium, and unsaturated fats is recommended. Conversely, saturated and trans fats, high sodium foods, processed sugar, and cholesterol should be limited. It is common after surgery to have a poor appetite at first. If this is the case, try to eat smaller, more frequent meals. Your appetite should return within the first few weeks. If it does not, contact your doctor.
Specific Food Recommendations
- Protein: Protein plays an important role in helping the body rebuild tissue after surgery. Red meat tends to be high in saturated fat and should be avoided, but lean meats or non-meat proteins (eggs, tofu, or beans), along with fish and other seafood, are excellent choices to ensure adequate protein intake.
- Vitamin C: Incorporating foods high in Vitamin C-the vitamin that promotes healing-in a post-surgery diet is another important step toward effective recovery. Leafy green and orange vegetables, eggs, pumpkin seeds, and lentils provide these nutrients.
- Other beneficial foods: Eat more whole grains and fish, and fry foods in olive oil. Find ways to add foods with antioxidants to your meals, including ingredients like pecans, blueberries, artichokes, and kale.
Foods to Limit or Avoid
It is not recommended that saturated and trans fats, high sodium foods, processed sugar, and cholesterol be included.
The Cardiac Diet
The cardiac diet is an eating plan that can help you minimize the impact of your diet on your heart health. The overall goal is to reduce sodium and fat intake. Too much sodium can increase your blood pressure, leading to hypertension. Hypertension is a major risk factor for heart attacks and other heart problems. Other names for the cardiac diet include the heart-healthy diet, the low-sodium diet, and the DASH diet. If you are following the cardiac diet, the major foods to watch are salt and saturated fat. The most common complaint among people on the cardiac diet is the lack of salt.
Tips for Reducing Sodium Intake
- Use as little salt in cooking as possible.
- Check with your doctor before using any salt substitutes. These products contain large amounts of potassium that your doctor may not want you to have. In particular, people with kidney problems or those taking potassium-sparing diuretics need to take care with potassium.
- A burst of acidity can brighten a dish.
- Dry or fresh herbs add flavor. Try basil, bay leaf, dill, rosemary, parsley, sage, dry mustard, nutmeg, thyme, and paprika.
- Black pepper, red pepper flakes, and cayenne pepper can spice up your meals without adding sodium.
- Buy a sodium-free seasoning blend.
Strengthening the Heart Through Diet
Foods for a Stronger Heart
Certain dietary changes can help the heart pump blood more efficiently. A healthy diet for a stronger heart includes skim milk, leafy greens, berries, yogurt, and oatmeal. Good sources include fish, poultry, eggs, and Greek yogurt.
Reducing Cholesterol
Reducing the amount of cholesterol in your diet also helps. One way to do that is to stop using mayonnaise. That doesn’t mean you have to eat dry sandwiches - just find something else that’s a healthier substitute. If it’s too hard to do without entirely, then try reducing the amount that you use as much as possible.
Read also: The Ultimate Guide to Heart and Diabetes Diet
Additional Considerations
Vitamin K and Blood Thinners
If you have been prescribed a blood thinner, such as warfarin (Coumadin®, Jantoven®), be sure to eat foods rich in vitamin K on a daily basis. This will help prevent blood clots and bleeding. Leafy green vegetables, including kale, spinach, and collards, are the best sources of vitamin K.
Fiber Intake
Increase your viscous (soluble) fiber intake with foods such as Brussels sprouts, sweet potatoes, turnips, apricots, mangoes, oranges, legumes, barley, oats, and oat bran. Aim for 5 to 10 grams daily. As you increase your fiber intake gradually, also increase the amount of water you drink.
Healthy Fats
Monounsaturated fats and omega-3 polyunsaturated fats are good for your heart’s health. Choose nuts, avocados, olives, or olive oil to get monounsaturated fat.
Alcohol Consumption
Drink alcohol in moderation: one serving per day for women and two per day for men. Alcohol consumption can dehydrate the body, which can hinder the healing process.
Eating Regularly
If you don't eat regularly, your metabolism slows down and your body absorbs and stores more of the food you eat, including cholesterol and fat. If you eat more frequently, your metabolism speeds up because your body "learns" that more food will be on the way, thus burning off calories instead of storing them and absorbing less cholesterol and fat. Eating breakfast is a great way to jumpstart your metabolism each day. It's also a good idea to consume most of your food during daylight hours because that's when you're most active.
Read also: Comprehensive Guide: Low Sodium Meals
The "3-Day Cardiac Diet"
A diet called the “3-Day Cardiac Diet” promises to help you lose up to 10 pounds (4.5 kg) in 3 days. However, it is not a medically approved or recommended diet. It’s been criticized for being restrictive, ineffective, and potentially risky.
The Importance of a Well-Rounded Diet
Each of the basic food groups supplies a different combination of nutrients, vitamins and minerals. Remember, variety is the key to good nutrition.
Basic Food Groups and Recommended Servings
- Lean meat, skinless poultry and fish: No more than 6 oz. (cooked) per day; fish twice a week
- Vegetables and fruits: 5 or more per day
- Fat-free milk and low-fat dairy products: 2-4 per day (depends on age)
- Breads, cereals, pasta and starchy vegetables: 6 or more per day
- Fats, oils, nuts and sweets, eggs: Use sparingly
Menu Planning
Good menu planning is based on balancing the foods you eat. When choosing foods, consider how many calories are in each serving. You should also learn about the amount of saturated fat, total fat, cholesterol and sodium these foods may add to your daily menu. Choose foods low in saturated fat, trans-fat, cholesterol and sodium. Read labels and ingredient lists to find out what a product contains.
Lifestyle Adjustments
Exercise
Regular daily exercise is another key component of a heart-healthy lifestyle. However, talking to your doctor about exercising before heart surgery is critical, especially if you haven’t been physically active. Your doctor may recommend waiting until you’ve healed from surgery and your heart is healthier. When you get the green light on exercise, aim for about 30 minutes of moderately paced activity most days of the week. If you’re starting an exercise routine, you might find it more enjoyable if you do it with a friend or neighbor.
Occupational and Physical Therapy
Occupational therapy (OT) helps cardiac patients regain self-care skills and adapt activities after surgery so they can be as independent and as safe as possible during their recovery. Occupational therapy is designed to help patients perform activities of daily living, such as bathing, dressing, grooming and more. Physical therapy (PT) focuses on helping patients build strength and improve coordination, balance, endurance, flexibility and mobility. Cardiac rehabilitation is different from OT and PT. Cardiac rehabilitation focuses on helping patients make healthy lifestyle modifications to reduce risk factors for coronary artery disease.
Resuming Activities
Gradually increase your activity. Do not lift objects greater than 20 pounds (your doctor may give you a different number if appropriate). It is OK to perform activities above shoulder level, such as reaching for an object or brushing your hair. You may climb steps unless they have been restricted by your doctor. You may need to rest part of the way if you become tired. Do not climb up and down stairs several times during the day, especially when you first arrive home. Pace yourself - spread your activities throughout the day. Walk daily. Get a good night’s sleep. If you feel tired, go to bed early. Your doctor will tell you when you may resume driving, after your sternum has healed and your reflexes have improved. This usually occurs about six to eight weeks after surgery, however, you may resume driving quicker if you had minimally invasive surgery. During this time, you may be a passenger as often as you like. You will need to take time to recover, usually about six to eight weeks (may be earlier with minimally invasive surgery). Your doctor will tell you when you can return to work. If you have the flexibility at your job, ease back to your work schedule.