Nutrition and exercise programs may improve surgery outcomes and shorten hospital stays

Hospital patients adhering to structured exercise and nutrition support before undergoing surgery can reduce their overall complications and shorten their hospital stay, according to findings from a new scientific review. 

Post-surgery complications after surgery, such as infections and wound-healing issues, can prolong hospital stays, increase health care costs, and delay or prevent patients from returning to work and to their daily lives. Prehabilitation programs are designed to help patients optimize their health before surgery, promoting faster, better recovery.

“Prehabilitation,” the term ascribed to care provided before surgery, is emerging in medical care, the researchers highlight. These programs can include exercise, nutrition, psychological support, and education to help patients prepare for surgery and recover more quickly.

“These findings support the value of prehabilitation programs in optimizing health for patients, especially those who are at high risk of facing complications or who may benefit from extra support before undergoing surgery,” says senior author Justine Lee, M.D., Ph.D., professor and associate chief in the Division of Plastic and Reconstructive Surgery at University of California, Los Angeles (UCLA) David Geffen School of Medicine, US.

Extensive review of data

Researchers from the UCLA reviewed 23 randomized controlled trials involving more than 2,100 patients who participated in prehabilitation programs, which were designed around exercise and nutrition optimization.

Nutrition-centered programs were most effective at shortening hospital stays.Approximately 78% (18 studies) involved exercise interventions, while 22% (five studies) used nutrition-based approaches.

They assessed how prehabilitation programs affected patients’ hospital length of stay, complications within 12 weeks after surgery, and other outcomes such as quality of life and mental health.

Across all reviewed studies, these prehabilitation programs reduced postoperative complications by almost half (48%) and shortened hospital stays by 11%.

Effective nutrition programs

In the review published in the Journal of the American College of Surgeons, nutrition-centered programs were more effective at shortening hospital stays. Notably, they reduced time spent in the hospital by about 14% compared with standard care. The programs typically lasted from five to 14 days and often included specialized nutritional supplements designed to support the immune system and recovery.

Meanwhile, exercise programs were linked to better overall well-being and daily functioning. However, they did not significantly reduce pain or improve emotional health after surgery. They also lowered the risk of complications the most, as patients who participated in exercise-based programs had a 55% lower chance of complications compared with standard care.

“Both nutritional and exercise-based prehabilitation programs can improve recovery after surgery, but each may offer different benefits,” says Catherine Cascavita from UCLA, first author of the study.

“More research is needed to determine which type of program works best for individual patients and their specific surgery.”

Research limitations and future directions

The authors note that differences in prehabilitation protocols across the studies may limit some of the findings. The review also excluded programs not explicitly labeled as prehabilitation.

Moreover, the type of surgery may have influenced whether exercise or nutrition-based programs were more effective, Dr. Cascavita adds.

Although this review covered various surgeries, exercise-based programs were most often used in orthopedic cases, whereas nutrition-based programs were primarily used in gastrointestinal and cardiac surgeries.

Future research will focus on making prehabilitation programs more widely available, standardizing protocols, and reducing barriers such as cost and insurance coverage. The research team is currently developing specialized prehabilitation programs for patients undergoing craniofacial reconstruction.

“We are just beginning to understand how we can improve surgical outcomes before a patient has surgery,” says Lee.

Medical nutrition is increasingly spotlighted in research, propelling the “Food is Medicine” movement in healthcare. The Rockefeller Foundation recently forecasted that programs in this field will significantly boost the US economy, creating over US$45 billion in economic activity and generating jobs.

Last month, the Food Is Medicine Coalition and Harvard Law School released a “first-of-its-kind” national framework designed to inform hospital professionals how to introduce medically tailored meals into the US healthcare system.