Recovering from a critical illness (such as cancer, stroke or heart attack) or a serious operation can be a slow, difficult process. It can be hard to adjust to the body’s limitations, and it may be frustrating being unable to return to normal straight away, but you must give your body time to repair and rebuild itself.
Building up the body’s strength and natural defences is an important part of rehabilitation after a critical illness or surgery. Nutritional support is key to contributing to and aiding recovery - providing the body with essential vitamins and minerals needed to build strength, boost immune function, help with weight management, and restore overall health and well-being.
However, nutrition for recovery must be done in a controlled, measured way. Dietary changes need to be introduced gradually to prevent putting too much stress on the body as it readjusts after serious illness or surgery. A nutritionist will be able to devise a specific rehabilitation diet plan in order to effectively increase the body’s strength and return it to full health.
Readjusting after critical illness or surgery
Ill health affects people in different ways, but being unwell for some time can be quite traumatic for the body. Speed of recovery will depend greatly on the type of illness you have had, how long you have been ill for, how your weight has been affected, and other factors individual to you.
The same applies if you have recently undergone major surgery. The impact on your body will depend on the type of surgery, as well the nature and severity of the physical and emotional changes that may have occurred. While some people may experience quite significant change to their physical and emotional health following a critical illness or major surgery, others will experience very little.
Understanding the changes that can happen to your body will offer insight into the importance of nutrition in contributing to and aiding rehabilitation. Below we explore in more depth common physical and emotional changes that can occur following an illness or operation.
In some cases, an illness or surgery can result in weight-loss. This can be caused by a number of things, including inactivity, a loss of appetite or a change in sense of taste or smell. Foods previously enjoyed may taste unpleasant or bland, while some people may not have been able to eat while in hospital due to complications.
Nutrition for recovery is often tailored to help patients gain weight. This is because being underweight means the body will lack the strength and nutrition it needs to get back to normal. Being underweight can also lead to a weakened immune system - making the body more vulnerable to colds and viruses.
Muscle weakness and mobility problems
Often weight-loss associated with illness is a loss of muscle density. This can leave the body very weak and joints can be stiff, leading to mobility problems. Rehabilitation will typically involve physiotherapy and the introduction of an exercise programme to help patients improve their strength and stamina over time. Nutritional support plays a vital role in boosting this recovery process. A tailored diet plan will ensure a sufficient calorie input to boost energy levels and aid muscle growth.
Critical illness and surgery can be disruptive emotionally as well as physically. Fluctuating moods - feeling fine one minute then really down the next - are not uncommon, and some patients report feeling depressed. The slow recovery process can be incredibly frustrating; so all these feelings are perfectly understandable and normal. Research suggests there is a strong link between nutrition and mental health, therefore a nutrition recovery programme that is tailored to consider mental well-being as well as physical well-being is just as important.
A good rehabilitation programme will involve many different avenues of care to help restore a patient to good health and make independent living a possibility. Typically a detailed health check (also known as a comprehensive clinical assessment) will be undertaken to identify your individual rehabilitation needs and what forms of structural support you require. Your healthcare team will then discuss the goals of your rehabilitation programme which will be reviewed at regular stages to check your progress.
A rehabilitation programme typically includes:
- Measures to prevent physical or physiological problems that can be easily avoided (i.e. preventing stiffness in the muscles and joints and helping to ease pain and discomfort).
- A review of your previous and current medicines.
- Measures to maintain or improve your health via the level of nutrients in your body. This is where nutrition for recovery comes into the equation.
Nutrition for recovery
Nutrition for recovery is one of the lesser-known components of a rehabilitation programme, but it is essential nonetheless. Diet has a significant impact on the body's health, and eating correctly will ensure a patient has the necessary nutrients needed to recover as well as go on to lead a healthy lifestyle.
If you have undergone major surgery or are recovering from a critical illness, and require nutritional support, you will first undergo an assessment to identify what nutrients are necessary for your healing and recovery. Your nutrition needs will depend on a variety of factors, including your height, weight, physical activity, any present medical complications and medications you are taking - all of which will be factored in to an individual nutritional programme. A nutritionist will be in charge of this part of your rehabilitation and will support you through the entire process.
Below we explore in more depth some of the ways nutritional support can help with recovery from illness or surgery:
If you have lost weight as a result of your illness or operation, your nutritionist will be focused on helping you gain weight gradually by recommending foods that provide slow energy release and help build muscle rather than fat. You may need to take supplements and a nutritionist can show you other ways of including extra nutrients - for instance in smoothies or juices. This will help to ensure you are getting as many calories and nutrients as possible.
Alternatively, it could be that you have gained weight following a critical illness or major surgery - especially if you are experiencing mobility problems. If this is the case, your recovery diet plan will be tailored to include nutrient-rich foods that are low in fat and support blood sugar levels to lose weight effectively.
Loss of appetite can be an obstacle when it comes to recovery from illness or surgery. Getting back into the habit of eating regular meals can be difficult after a period of disruption or lack of food. If you were fed through a tube in your nose (nasogastric tube) while you were in hospital, it may take some time to get used to the taste and texture of food again.
To help improve your appetite, a nutritionist will devise a diet plan that includes small, frequent meals and snacks to help make eating a regular part of your daily routine. You will be encouraged to eat with others to help detract your focus from food and your nutritionist will advise you on how much water to drink during the day and whether or not to drink with your meals. Smoothies and juices may also be recommended as a great way of getting nutrients without being overwhelmed by solid foods.
Muscle repair and strengthening
If regular exercise forms a key part of your rehabilitation programme, your nutritionist will ensure your diet supports muscle growth and repair. All of the body's cells, tissues and organs are made from amino acids, which are the building blocks of foods high in protein. Therefore your diet plan will likely include plenty of protein-rich foods, such as lean meats, fish, natural yoghurt, nuts and seeds and eggs - depending on your individual nutritional needs. Tissue repair will also require plenty of iron, zinc and vitamin C, so your nutritionist will probably recommend including a variety of fruits and vegetables in your diet, including berries, leafy greens, beans and lentils.
Cancer and nutrition
If you are undergoing or have had cancer treatment, nutritional support is considered essential for maintaining energy levels, fighting infection and keeping body tissue healthy. The right nutrition can also help to reduce the side effects of aggressive forms of therapy, and it is believed some cancer treatments work better when patients are well nourished and have enough calories and protein in the diet. Well-nourished patients are also considered to have a better chance of recovery and quality of life. To find out more about cancer recovery and rehabilitation, please visit our cancer page.
Boosting the immune system
Major surgery and critical illness can affect immune function. If you have experienced weight-loss, and have had prolonged inactivity and are lacking in vital nutrients due to loss of appetite, your body's immune system is likely to be very weak. This puts you at risk of catching colds, viruses and other infections, which could seriously hinder the recovery process. Your nutritionist will make sure your nutrition recovery diet plan is tailored to include lots of antioxidant-rich foods to boost your immune system and reduce the risk of further illness. Fruit and vegetables are excellent sources of antioxidants, as well as beans, nuts and whole grains.
Whilst inflammation is a natural healing process in the body, it can lead to pain and fatigue. Providing the body with nutrients that help reduce inflammation and speed up recovery is therefore a key consideration. You will be encouraged to cut back on foods that are high in sugar, saturated fat, and hydrogenated fats (such as margarine), and minimise processed and low GI foods - all of which can trigger inflammation. Instead, your diet plan will include foods like oily fish (high in omega-3 fatty acids), berries, orange and yellow fruits, vegetables (particularly tomatoes, peppers, leafy greens and beetroot), as well as spices such as ginger and turmeric which have anti-inflammatory properties.
Coping after a critical illness or surgery
As aforementioned, recovery from illness or major surgery can be a frustrating and deeply emotional time, and while nutrition can provide valuable support in maintaining energy levels and boosting your physical health, looking after your mental health during this time may require more support. If you have undergone treatment for a particularly serious condition such as cancer or heart disease, you will probably be feeling extremely anxious and depressed. Your illness or surgery may have had quite an impact on your relationships, work and home life and your self-esteem may be very low.
If this is the case, you need to share your concerns with people closest to you and seek advice from the nurses, doctors, and therapists helping with your recovery. Speaking to your nutritionist can also help, as they can work on tailoring your nutrition for recovery diet to include foods that can help boost emotional well-being. A nutritionist can also provide valuable advice on looking after your mental health in the long-term by avoiding certain foods and drinks that can affect mood and interfere with certain medications, as well as advising on foods that can provide the brain with essential nutrients. To find out more about nutrition and emotional well-being, please visit our mental health page.
Content reviewed by registered nutritionist, Nicola Russell. All content displayed on Nutritionist Resource is provided for general information purposes only, and should not be treated as a substitute for advice given by your GP or any other healthcare professional.