Prehab topics
Find out more about the eight key risk factors by visiting our Prehab topics pages.
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Nutrition
Enjoy the knowledge check, watch our video and learn more about how to improve nutrition during prehab. Keep scrolling down to see the research and useful signposts for improving nutrition…
"Nutrition literally provides the fuel for life and the building blocks to recover and rebuild following surgery."
Professor Scarlett McNally
Deputy Director, Centre for Pre-operative Care
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Watch our video
Improved nutrition plays a vital role in preparing patients for treatment, ensuring they have the nutritional reserves to help them recover quicker.
Nutrition
Preparing for treatment...
There are a number of things for patients to focus on, including trying to maintain a diet in line with the Eatwell Guide.
Eating regular meals
Patients should aim to eat regularly throughout the day. It is often best to have small meals every 3-4 hours.
Eating protein
Include a source of protein at every meal (such as eggs, fish, lean cuts of meat or meat alternatives such as tofu).
Eating starchy carbs
Include a starchy carbohydrate at each meal (such as a fist-full of wholegrain rice, pasta, new potatoes or bread).
Staying hydrated
Patients should aim for 6-8 glasses of fluid a day. Water, tea, coffee, lower-fat milk and sugar-free drinks all count.
Reducing saturated fats
Keep oils/spreads, cakes and pastries to a minimum, unless advised otherwise by appropriate healthcare professional.
Maintaining weight
In most cases, patients should aim for weight maintenance unless advised by appropriate healthcare professional.
Nutrition and exercise before surgery and/or treatment.
Carbohydrates
Exercising muscles rely on carbohydrates as their main source of energy. A low-fat, high-carbohydrate snack (banana or cereal bar) or light meal (egg on toast) should be eaten 90-120 minutes before exercise to provide enough energy.
Protein
Encourage a snack after exercising to replenish energy stores. Protein is required for building and repairing muscles. Adding protein to a post-exercise meal/snack (tuna sandwich or yogurt) helps muscle repair and recovery.
Nutritional prehab
What are the benefits of
being well nourished?
Better outcomes
Faster recovery
Reduced stress
Reduced fatigue
Increased muscle strength
Increased functional ability
Improved quality of life
Certain eating habits may be helpful to adjust during
prehabilitation to support optimal health and recovery.
Alcohol
Avoid excessive alcohol intake. Aim for less than 14 units a week.
Fat/sugar
Eat in small amounts. Reduce free sugars and saturated fats.
Carbohydrates
Choose wholegrain and non-fried varieties of carbohydrates.
Processed foods
Reduce sweets, pasties, cakes, crisps and biscuits.
Patients have the opportunity to enhance their nutritional status during prehab…
• Prioritise foods rich in protein to improve muscle strength/ability to recover.
• Eat a variety of fruits and vegetables for fibre, vitamins and minerals.
• Eat frequent meals and snacks throughout day to meet calorie needs.
• Choose wholegrain carbohydrates to increase fibre in diet (a portion is a clenched fist).
• Stay hydrated, as dehydration can affect mental and physical performance.
• Access professional advice if there are concerns or barriers achieving a balanced diet.
Malnutrition
A closer look...
What is malnutrition?
Malnutrition refers to deficiencies or excesses in nutrient intake, imbalance of essential nutrients or impaired nutrient utilisation. The double burden of malnutrition consists of both undernutrition and overweight and obesity, as well as diet-related non-communicable diseases. Undernutrition manifests in four broad forms: wasting, stunting, underweight, and micronutrient deficiencies (WHO).
What causes malnutrition?
It is caused by an inadequate diet, poor appetite or a problem absorbing nutrients and maybe caused by a health conditions such as:
- Cancer, chronic obstructive pulmonary disease (COPD), inflammatory bowel disease and dementia.
- Social issues such as poverty, knowledge and social isolation.
- Physical issues such as dentition, poor mobility or essential tremors.
What are the signs of malnutrition?
- Loss of appetite
- Weight loss – clothes, rings, jewellery, dentures may become loose
- Tiredness, loss of energy
- Reduced ability to perform normal tasks
- Reduced physical performance – for example, not being able to walk as far or as fast as usual
- Altered mood – malnutrition is associated with lethargy and depression
- Poor concentration
- Poor growth in children
(BAPEN UK)
How common is malnutrition?
In a hospital setting, studies indicate that malnutrition affects 20-50% of patients undergoing surgery, depending on the type and the criteria used to define malnutrition. For example, patients undergoing gastrointestinal surgery, cancer surgery, and major orthopaedic procedures often exhibit higher rates of malnutrition. The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%.
What are the consequences of malnutrition?
In a clinical setting, there are many negative consequences, including…
• Slower recovery
• Reduced muscle strength
• Increased risk of falls
• Impaired psycho-social function
• Impaired immune response
• Impaired wound healing
• Poorer clinical outcomes
How is malnutrition treated?
The main treatment for people diagnosed with malnutrition is dietary change. Anyone who is malnourished or at risk of becoming malnourished should visit their GP, who can refer to their local pathway for treatment of malnutrition. This may include food first advice, prescribing oral nutrition supplements or referral to a dietitian for individual dietary assessment and advice.
Links
Signposting
There are a range of screening tools, resources and websites that can help your patients improve their nutrition.
Click the tabs below
As a healthcare professional, you can help identify at-risk patients with nutrition screening tools.
Click the links on the right to see the tools.
Ask patients if they are concerned about their weight or appetite. If no concerns are raised, advise them to self-monitor if it is appropriate and provide them with a healthy eating leaflet for guidance.
Click the links on the right to see the resources.
You can also signpost your patients to existing resources designed to help them make positive changes to their diet.
Click the links on the right to see the resources.
