A Guide to Dieting after Orthopedic Surgery

Writing Down Diet Plan

Improving your diet after surgery can enhance your recovery, while jumpstarting a long-term healthy lifestyle. With so many diets out there, how do you choose which one is right for you? Below are the pros and cons of some popular diets, along with some general post-surgical health tips to get you started:

Paleo diet:

  • What is a Paleo diet?
    • A diet that mimics the food availability of Paleolithic times, before food processing and industrial agriculture. Allowable foods can vary depending on what guide you use, but essentially include unprocessed meat (so no bacon or hot dogs), fish, fruits and vegetables.  No grains, legumes or beans, dairy, and definitely no refined carbohydrates.
  • What are the pros of a Paleo diet?
    • The diet may offer benefits in terms of weight loss, blood pressure control, and cholesterol levels. It may also improve blood sugar control if you have type 2 diabetes.  Paleo’s approach to eating more fruits, vegetables and lean meats while reducing refined carbohydrates/starches may also hold some anti-inflammatory properties.
  • What are the cons of a Paleo diet?
    • Paleo is a restrictive diet in its purest form, which may make it difficult to maintain long-term. Also, it may be difficult to get all required vitamins and minerals – especially if you are vegetarian or vegan.

Ketogenic diet

  • What is a ketogenic diet?
    • A high fat, moderate protein and extremely low carb diet (typically less than 20 grams of carbs daily). The goal is to eat so few carbohydrates that your body starts using fat as an energy source (ketosis).
  • What are the pros of a ketogenic diet?
    • The ketogenic diet has been used in children to treat epilepsy for nearly a century, and is being studied as a potential adjuvant treatment for patients with certain forms of cancer. If followed correctly, it can assist with weight loss and improve blood sugar control in type 2 diabetics.
  • What are the cons of a ketogenic diet?
    • This diet is extremely strict and therefore very difficult to adhere to, even in the short term. It’s not the type of diet that can be followed most of the time (so forget the occasional cheat day or that extra slice of cake); once the body is thrown out of ketosis, people don’t typically see the weight loss benefits.  Carbs have to be counted very diligently – and even the carbs in vegetables have to be limited.

Mediterranean diet

  • What is a Mediterranean diet?
    • A diet that is typical of what is seen in Mediterranean countries, including a high intake of fruits and vegetables, fish, olive oil and nuts, whole grains, and even a moderate amount of red wine. Unsaturated fat is allowed in the diet (found in olive oil and nuts), whereas saturated fat is limited (found in full-fat dairy and red meat, for example).
  • What are the pros of a Mediterranean diet?
    • The Mediterranean diet has been found to offer cardiovascular benefits and improvements in blood pressure. The diet can potentially help with weight loss if higher calorie foods (i.e. grains, oil, nuts, etc.) are eaten in moderation.  This type of diet can help control hunger throughout the day due to the increase of dietary fiber, protein and healthy fats along with the reduction of refined carbohydrates.
  • What are the cons of a Mediterranean diet?
    • While offering very significant health benefits, this diet may also be the easiest one to follow and to adhere to long-term.

Intermittent fasting:

  • What is intermittent fasting?
    • This diet involves restricting the timing of eating, rather than the quantity or quality of food. People limit themselves to eating within an 8-hour window (so from noon to 8pm, for example).  Another method is to drastically reduce caloric intake for 2 days per week, in general less than 800 calories, and then to eat more freely during the rest of the week.
  • What are the pros of intermittent fasting?
    • Intermittent fasting has been shown to be effective for weight loss and blood sugar control in type 2 diabetics.
  • What are the cons of intermittent fasting?
    • If the approach works for your lifestyle, it might be worth a trial of this type of diet, but for most people, it can be very difficult to time restrict or follow an extremely low-calorie day of eating.

General Post-surgery Health Tips:

  • The diet that will work the best for you is the one you can stick to. For this reason, fad diets, or diets that are very restrictive, tend to only work in the very short-term.  Many people gain back the weight they lose, and sometimes more.
  • Focus on the basics. Prioritize eating fresh fruits and vegetables, lean proteins, whole grains, and healthy fats while minimizing intake of refined carbohydrates, fried foods, processed foods and excess alcohol (>2 drinks/day).  Following this kind of plan (especially cutting down on refined carbohydrates) can also have anti-inflammatory benefits post-surgery.
  • Plan Ahead. If you will have limited mobility in the days or weeks following surgery, make life easier by planning ahead of time.  Consider cooking batches of food before surgery and freezing it for use later.  Stock up on healthy low-prep foods like pre-cut fruit/veggies, yogurt and low sodium frozen meals.  You can also research healthy take out options ahead of time, or consider signing up for a healthy meal delivery service for a few weeks after surgery.
  • Make it a group effort. Try to get your family involved.  Their support will be important for your success.  Your motivation can create the opportunity for the entire family to follow a healthier eating plan.
  • Stay Aim to drink enough fluids to keep your urine color straw-yellow or lighter.
  • Get some sleep. Aim for a good night’s sleep (at least 7 hours) most nights of the week to allow your body time to recover after surgery.  Getting in those hours of rest can also help with weight control.

Image - Dr. Caroline Andrew

Dr. Caroline Andrew is a medical weight management specialist at HSS. She is a board certified internal medicine physician and fellowship trained in obesity medicine. Using both dietary and behavioral interventions, along with medications for weight loss, she helps patients lose weight and maintain weight loss.

 

 

 

 

Jason Machowsky, HSS sports dietitian

Jason Machowsky is a board certified sports dietitian, registered clinical exercise physiologist, certified strength and conditioning specialist and wellness coach at the Tisch Sports Performance Center at Hospital for Special Surgery.



Tags: ,
The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.