If you're planning on an elective surgery, make sure to increase your protein intake and exercise beforehand

COURTESY: PROVIDENCE HEALTH & SERVICES - Terese Scollard (left), dietitian and regional clinical nutrition manager for Providence Health & Services, checks in the with health unit coordinator on one of the patient floorsGetting enough nutrients is critical in order to have a strong and healthy body. However, as anyone approaches an elective surgery, nutrition becomes even more critical.

Terese Scollard, who is a registered dietitian nutritionist in charge of outpatient and inpatient clinical nutrition programs at Providence Health & Services in Portland, said the body is stressed during major operations.

"It (nutrition) is really important because you cannot heal unless your body has the resources to heal and recover," Scollard said. "With surgery, especially, there is a significant metabolic change in how the body deals with itself in recovery."

According to Scollard, the body (with surgery) goes through what is called metabolic stress.

"The way the cells use the nutrients (carbohydrates, fats and proteins) is completely different than when you and I are not in metabolic stress," Scollard said. "The body doesn't know that you're having surgery in a controlled environment, with fluids and physicians and sanitary techniques. Your body thinks you've been injured by a wild animal or seriously hurt. This physiological stress, plus going weeks before or after without eating enough calories and protein foods, can result in malnutrition."

SCOLLARDScollard said during this type of stress, your cells switch from using fat and carbohydrate stores for energy to overusing and breaking down protein in the muscle and the organs, to turn it into carbohydrates for energy.

"When you have that happening, those organs and tissues can't do what they're supposed to do," Scollard said. "They're being destroyed."

To help prevent this stress reaction, nutrition (and steps taken by surgeons and nurses) is important, even before elective surgery.

"What you have to do, to mitigate all of this, is start early," she said. "You have to take care of your nutrition and build your body (and muscles) up before that procedure whenever possible."

While it's always a good idea to ask your health care provider about your particular nutrition needs before and after surgery, Scollard has some advice as you approach an elective surgery.

"We're talking eating from all of the food groups, not leaving these major food groups out," Scollard said, adding you should have several meals a day. Protein foods are important at every meal, especially for senior citizens.

"I am dumbfounded that people — especially seniors — are not eating protein food at breakfast, lunch and dinner," Scollard said, noting that protein foods, and exercise, can help reduce muscle wasting in seniors.

COURTESY: PROVIDENCE HEALTH & SERVICES - High-protein foods such as edamame, beans, eggs, chicken, fish, cottage cheese and yogurt can all help prepare your body for surgery.There are many good protein sources, according to Scollard.

"There are vegetarian and animal proteins," Scollard said. "Dairy foods and eggs are really good — fish is exceptional. On the vegetarian side, we're talking tofu and soy beans." Nuts are also a good choice and you can mix these sources.

"Vegetarian folks need to make sure they're combining their protein sources during the day, like beans and rice or beans and corn," Scollard added.

"All of your needs (nutrition) go up when you are undergoing a big surgery," Scollard said. "Calorie needs, protein needs, vitamin and mineral needs. A one-a-day-type multi-vitamin is OK but you want to get most of your vitamins and minerals from food. Taking a lot of vitamin, mineral or herbal supplements does not help and may cause harm, in addition to the financial burden. Only take them if prescribed by your medical doctor or registered dietitian."

Scollard has an added concern: overweight patients facing the surgical knife.

"People think that if somebody is overweight, or obese, that they have lots of calories and they don't need to worry when they have surgery," Scollard said. "That's profoundly erroneous. You can end up with a very overweight person who is emaciated as far as muscle and protein inside their own body. Unintentionally or intentionally going on a diet after a major surgery is a really bad idea."

Scollard emphasized that before surgery, it's very important to eat a healthful diet (and exercise), even if you're overweight.

If you're facing a surgery, it's a good idea to bring up nutrition needs with your health team. It's really a team effort, according to Scollard.

"It really needs to be a partnership with their health care team," she said. "They need to start conversations with their team. Some of those patients will need to see a dietitian."

Scott Keith is a freelance writer with the Portland Tribune and the Pamplin Media Group. If you have a health tip, or a story idea, contact Scott at: This email address is being protected from spambots. You need JavaScript enabled to view it.

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