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According to a new study, the last few meals before
surgery might make a difference in recovery after
surgery. Fat tissue is one of the most dominant
components that make up the body, and fat tissue is
always traumatized during major surgery.
Researchers at Brigham and Women's Hospital (BWH)
found that this direct trauma greatly impacts the
chemical balance of fat tissue-chemicals that are
known to communicate with nearby and distant organs.
In the study, mice that consumed a typical Western,
high-fat diet showed an exaggerated imbalanced
response. Importantly, restricting food intake to a
lower-fat diet just a few weeks before surgery
reduced the imbalance back toward a more normal
response.
The study is published in the April 2013 issue of
Surgery.
Senior study author C. Keith Ozaki, MD, Director of
BWH Vascular Surgery Research, and colleagues
measured how fat responds to surgery and whether
restricting calorie intake before surgery changed
how the fat tissue responded to typical trauma that
usually occurs during an operation.
"Surgeons have learned that generally minimizing
trauma accelerates patient recovery from surgery,"
noted Ozaki. "While we do this well for specific
organs such as the heart, blood vessels, liver, and
so forth, we historically have paid little attention
to the fat that we cut through to expose these
organs.
Our findings challenge us all to learn more about
how fat responds to trauma, what factors impact this
response, and how fat's response is linked to the
outcome of individual patients."
Researchers fed one group of mice a high-fat diet (containing
60 percent calories from fat), while a control group
was given a more normal diet (containing 10 percent
calories from fat).
Three weeks before surgery, researchers switched
some of the high-fat diet mice to the normal diet.
During surgery, the researchers performed procedures
that would occur during a typical operation and
observed that such surgical trauma rapidly affected
the fat tissues located both near and away from the
trauma site. This resulted in increased inflammation
and decreased specialized fat hormone synthesis,
especially in the young adult mice and those that
had a simulated wound infection.
However, reducing food intake before surgery tended
to reverse these activities for all mice age groups,
even in the setting of the simulated infection.
The results suggest that while fat is a very
dominant tissue in the human body, its ability to
rapidly change might be leveraged to lessen
complications in humans during stressful situations
such as surgery.
In an accompanying review article composed with key
collaborator James Mitchell, PhD, assistant
professor of Genetics and Complex Diseases, Harvard
School of Public Health, the researchers suggest
that restricting diet in humans before surgery
provides a unique opportunity to test whether this
method will decrease the incidence and severity of
surgical complications brought on by over-exuberant
inflammation and other stressors.
Simply cutting out certain dietary elements (without
malnutrition) may be a feasible, inexpensive and
effective way of protecting the body against stress
from an operation. In the review article, the
researchers specifically point to further studying
this method in patients undergoing vascular surgery,
a population that faces increased risks of surgical
complications such as wound-healing problems, heart
attack and stroke.
The study was supported by the National Heart, Lung,
and Blood Institute of the National Institutes of
Health; American Heart Association; Ellison Medical
Foundation; and Glenn Foundation.
The research team included partners from the Center
for Cancer Computational Biology at the Dana-Farber
Cancer Institute, and the Department of Genetics and
Complex Diseases at the Harvard School of Public
Health.
For more information
http://www.journals.elsevier.com/surgery/
(MDN)
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