Preparing for My Surgery

Joint replacement and repair is your opportunity. It’s an opportunity to look at this as a step forward rather than a step backward. Have you ever wondered what it would be like to eat in a way that aligns with your goals for health, well-being, and self-care? Do you have goals in these areas? If not, it’s time to kickstart your health and get nutritionally fit before surgery.

Being nutritionally fit going into surgery of any kind can help improve the quality and the rate of your recovery. It can also reduce your risk of infection and rehospitalization. What does it mean to be nutritionally fit for surgery? Well, it’s you working on being better, being healthier. A healthier body weight, healthier blood sugar, more balanced blood sugar, and being nutritionally full instead of insufficient.

Hi, I’m Tara, your ortho nutrition dietitian. I’m here to tell you that joint replacement and repair is a great time to work on achieving a healthy body weight. If you are overweight, just a small amount of weight loss can make a big difference on all of your joints. Did you know that 10 pounds of extra weight can add 40 pounds of pressure to your knees and your lower body? That weight simply wears down the joints before their time. Not only that, it can cause inflammation to tissue, which causes damage to all tissues over time. Losing that small amount of weight and keeping it off helps to reduce your risk of arthritis.

There are also a whole host of other benefits to losing just 5 to 10% of your total body weight. Losing that 5 to 10% can improve your cardiovascular health by helping lower your blood pressure, your cholesterol, and reduce your risk of heart disease. It can also help with your metabolic health, improving your insulin sensitivity and your body’s ability to balance its blood sugar. Your respiratory health by opening the airway may help reduce sleep apnea symptoms. It can improve your energy and use of your energy during physical activity by delaying fatigue. And your mental well-being, just increasing your overall confidence and your perception of your own body.

How should you eat to achieve a healthy body weight? Start simply. Picture a plate and make half of that plate a colorful variety of vegetables, different textures, different flavors, cooked or raw, whatever. Just make half that plate vegetables. Those are your protectors and your preventers. They have all sorts of nutrients your body needs. Make a quarter of your plate come from carbohydrate. Carbohydrates provide energy. They provide gas in your tank to fuel your muscles and to fuel your brain. They’re also the precursors to those happy hormones that make us feel good, so you need carbohydrate. The other quarter of your plate can come from protein. Protein is absolutely imperative, especially after surgery, because it helps to repair and build your immune system. Drizzle all of that with a little bit of healthy fat, a side of hydration, and top it off with fruit, and that’s your balanced eating plate. Do the best you can, do it three times a day, and you’ll be on the right track.

Let’s take a closer look at the nutrients I just talked about on that plate. There are three macronutrients we need to get all three from our food. I will introduce you to these three. You probably already know what they are. Carbohydrates are the first one, and they’re your source of energy for your muscles and your brain. Do you know what foods have carbohydrates? There’s a variety of different ones illustrated in this photo: grains, beans, fruit, starchy vegetables, pasta, flour, to name a few. Potatoes, peas, corn, rice, those are all forms of carbohydrates. Surgery is like recovering from a marathon. Your body needs carbohydrates to heal, repair, and put your body back together. Carbohydrates provide you energy for optimal function during and after surgery. Eating enough carbohydrates spares muscle breakdown and also improves your immune function.

So what is enough? Three to four servings of fruit per day, five to eight servings of high-fiber grains. When I say high-fiber grains, I mean three grams of fiber or more.

The next macronutrient I’m going to talk about is protein. Protein is necessary to build and repair all the tissues of the body. Do you know what foods contain protein? Sources of animal proteins are beef, chicken, pork, poultry, seafood, fish, dairy, eggs. All contain protein. You want to get a variety in your diet because they all contain a variety of different amino acids that work to build and repair all the different tissues in your body, particularly bones, muscles, and tendons. Those are the ones really relevant to joints.

Why is it important after surgery? It’s to build and repair those tissues. Protein also helps give your immune system a boost after surgery. Like I said, it’s a marathon, and you’re at risk for different respiratory illnesses and infections, so you want to make sure you’re getting enough protein and enough carbohydrate. How much protein is enough? Take a look at your palm. This is about three ounces. You want to have about this much protein three times a day and then one to two ounces, about a quarter of your palm, as a snack between meals once or twice a day.

Fat is your third macronutrient. Fat is a source of stored energy for the body. It contains nine calories per gram versus carbohydrate and protein, which contain four calories per gram. Why is fat an essential part of our daily nutrition? Healthy fats like fatty fish, olive oil, nuts, seeds, and avocados provide the body with essential fatty acids that are important anti-inflammatories. Fat helps the body absorb the fat-soluble vitamins A, D, and E. Fat also gives the body energy, protects our organs, satiates our hunger longer, and when combined with carbohydrate and protein, provides that extra satiation.

How much fat should you eat each day? About 25 to 30% of your total calories should come from fat. When you think about that plate, think about adding fat for flavor, adding flavor to the vegetables, adding flavor to the starch, and drizzling that healthy fat throughout your plate. Then we also have naturally occurring fat in dairy, meat, cheese, nuts, and seeds. That helps you get to that 25 to 30% of your total calories without having to weigh and measure.

What does that mean when we’re talking about adding fat to our diet in the form of salad dressings, oil, butter, or things like that? Limit it to about five to nine teaspoons per day.

The next big thing to think about when focusing on weight loss is high-volume, low-calorie foods. What those are going to be are vegetables. Most vegetables are full of water and fiber and starch. They help fill you up longer, take up more space in your stomach. That is one reason why 50% of your plate should come from vegetables. If you aren’t used to doing this, if you’re not used to vegetables being a main course on your plate, it’s going to take some time, practice, and adjustment. Do you not like vegetables? What’s not to like? They’re colorful, you can cook them in a variety of different ways, flavor them with healthy seasonings and fats. They’re low-calorie, high-volume. If you are not used to eating them often, it will take learning, practice, and finding out how to cook them and what flavors to add to make them part of your daily routine.

We have more information about food, nutrition, and diet than ever before. It’s accessible everywhere. There’s tons of misinformation, correct information, and what your neighbor did. Yet we still struggle with weight. We still struggle to achieve that healthy body image and a weight that feels good for us. What gets in the way of losing that weight and maintaining a healthy weight? It’s not lack of information. It’s loss of motivation in the face of food triggers, nostalgia, and things we had eaten as a kid that may not be so good for us now. Lack of self-acceptance, starting where we are, and just going from there. Mindset, like fear of failure, perfection, or self-sabotaging ourselves because we are afraid we’re not going to be successful at weight loss. And then there’s just life, stress, and fatigue. All these things get in the way of eating in a way that aligns with how we want to feel and what we want to accomplish.

Here are a few strategies to adopt as you begin to modify what and how you eat. Number one, accept progress over perfection. That means striving for a healthy way of eating, a balanced plate, 70 to 80%, preferably 80%, of the time you’re eating each week. The other 20 to 30% just cut yourself some slack for being human. Number two, identify your why. When motivation is gone, and motivation does not last, remember what you’re after. Like the ability to take walks in nature, play with your kids, participate in athletics, and do these things with energy, strength, and without pain. Number three, identify fears and patterns around food by pausing before you eat something and asking yourself, why am I eating this? Am I eating this to nourish, build, repair, or am I eating it for pleasure? Am I eating it for community? Am I eating it just for the flavor? All the reasons are okay. It’s just about identifying why you’re eating it and paying attention to it. Number four, make balanced eating routine by not skipping meals and nourishing your body instead of starving and depriving it. When we deprive ourselves, it just makes us want things more.

These are just a few of the things aside from what to eat that we go over in our orthon nutrition class each week. The orthopedic department at Tahoe Forest offers a nutrition lunch hour. Are you interested in learning more about what you eat, why you eat, how you eat, and adopting new behaviors and routines? You can join me every Wednesday for a complimentary class at Tahoe Forest Center for Health hosted on Zoom, 11:30 to 12:30. You can register by calling the Tahoe Forest Center for Health.