Q I am having knee-replacement surgery. I wonder if nutrition has anything to do with success? — R.P., Winterville
A You know I will say yes. Not only is good nutrition important for healing, weight management both reduces the risk for the need for knee replacement and contributes to success. I asked Chelcie Kurzontkowski, an ECU dietetic student, to answer your question. Here is what she wants you to know.
Your body depends on you to consume all the nutrients it needs to do its job healing and repairing itself daily. When having surgery, your body needs additional nutrients, such as lean proteins, vitamins and minerals and whole-grain carbohydrates to aid in your recovery. Proteins such as arginine and glutamine from lean meat sources also are beneficial to wound healing and reducing inflammation.
Omega-3 fatty acids from salmon, tuna, walnuts and canola oil help to decrease inflammation. Vitamin A from dairy, dark green, leafy vegetables and deep yellow or orange produce helps with the formation of skin and bone cells. Vitamin C from citrus fruits, tomatoes and strawberries is packed with antioxidants and aids skin cells with healing. Whole-grain carbohydrates help keep you feeling fuller longer, maintain blood glucose levels, support healthy GI functions and are an excellent source of the antioxidant vitamin E.
Sadly, we often hear about nutrition after we develop a problem or a disease. However, nutrition is key to preventing chronic diseases, weight gain and reducing risks for orthopedic surgeries. According to the Arthritis Foundation, for every pound of extra weight we carry, our knees are supporting an additional 4 pounds of pressure. For instance, if you are 25 pounds overweight, your knees are supporting an additional 100 pounds of pressure.
So working toward a healthy weight both before and after surgery is important. You’ll want to start by looking at what you eat every day and limit the amount of added fats and sugars to prevent weight gain and encourage weight loss — if you are overweight — before surgery.
It might be helpful to keep a food journal to identify areas where you could make improvements in your diet. You might benefit from a consultation with a registered dietitian nutritionist to help you make healthier choices. For example, every day at lunch you pack a sandwich, a bag of chips, an apple and a bottle of soda. Having it written down will help you recognize an opportunity to replace the bag of chips with a 100-calorie pack of almonds and the bottle of soda with water. You may find this checklist from the USDA MyPlate website helpful in knowing what are good with serving sizes: www.choosemyplate.gov/MyPlate-Daily-Checklist.
If you can’t get all the nutrients you need from the food you are eating, consider taking a USP-verified multivitamin supplement that offers 100 percent of the RDA to ensure you have all the vitamins and minerals you need for healing. But before you do, just as with any dietary supplement, check with your doctor to make sure it’s OK. Make sure you get enough water, an essential part of a healthy diet. Water helps distribute the nutrients throughout the body.
Planning for surgery and recovery doesn’t change the need to follow your special diet if you have a chronic disease like diabetes. Keep as physically active as your knee will allow. Dr. John D. Willson, associate professor and director of the Human Movement Analysis Lab in ECU’s department of physical therapy, recommends you consult with a physical therapist prior to surgery to become familiar with the exercises you will experience after surgery.
If you have not already had physical therapy, you may also benefit from preoperative exercises to increase quadriceps strength and range of motion prior to surgery, as well. Willson says most strengthening exercises prior to and after surgery are very beneficial to knee replacement and that physical therapists can advise patients how to perform these activities with the least discomfort possible. He added that intense, lasting pain in the knee during physical activity or swelling after exercising is not normal and that if these symptoms occur, you should discontinue the activity and consult your doctor.
Physical activity will not only lower your blood glucose, it also keeps your muscles moving and aids in your recovery. After surgery, you’ll want to continue your healthy eating plan, taking your daily multivitamin, drinking plenty of water and resume physical activity as soon as your doctor allows. Committing to these small lifestyle changes will help your body heal optimally, assisting in your recovery.
Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an affiliate professor in the Brody School of Medicine at ECU. Contact her at email@example.com.
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