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LETTER TO THE EDITOR
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Role of Adequate Nutrition during the Healing and Recovery Phase of Musculoskeletal Injury


 Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Date of Submission02-Mar-2020
Date of Decision14-Apr-2020
Date of Acceptance24-Jun-2020

Correspondence Address:
Chidiebere Emmanuel Okechukwu,
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome
Italy
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_74_20



How to cite this URL:
Okechukwu CE. Role of Adequate Nutrition during the Healing and Recovery Phase of Musculoskeletal Injury. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 Mar 5]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=309956



Dear Sir,

The two primary nutrition goals for injury recovery are to prevent inflammation after the physiological inflammatory response and to lessen muscle loss. Recovery from musculoskeletal injury takes place in two stages, the first stage is healing and recovery and it is illustrated by the wound-healing process after injury, this includes an inflammatory response followed by tissue remodeling, the second stage is returning to activity which includes increased usage and rehabilitation of the immobilized limb(s).[1] The body's ability to build new protein is affected during injury, the decrease in muscle use, and the body's decreased response to protein consumption results to muscle atrophy.[2]

Inadequate protein consumption increases inflammation, hinders wound healing, and encourage muscle loss through a decline in muscle protein synthesis (MPS) level.[3] To minimize muscle losses and increase recovery, patients daily protein intake should be kept high between 1.8 and 2.5 g protein/kg of bodyweight, in young people 20–25 g of protein in a meal has been shown to increase MPS, while older individuals aged 65 years and above may require about 35–40 g of protein per meal.[4] in order to maximize patients daily MPS rate, protein intake should be dispersed into several 20–40 g servings per day.[4]

A primary nutritional target for injury recovery is to reduce inflammation. However, Omega-3 fatty acids are anti-inflammatory, and its intake could sustain muscle strength and function, moreover Omega-3 fatty acid intake should be minimal for the initial 2–5 days after injury, in order to fasten wound healing, Omega-3 fatty acid intake should be increased to 4–6 g/day subsequently to sustain muscle activity after the primary inflammatory process.[5]

Micronutrients such as zinc, Vitamin C, Vitamin A, Vitamin D and antioxidant supplements plays vital roles in the healing process. Hence, it is advisable for patients to consume adequate quantities of these nutrients to accelerate the wound healing process. Moreover, alcohol impairs wound healing and increases muscle loss, therefore alcohol consumption should be avoided when recuperating from injury. An adequate nutrition care plan plays a vital role in the healing and recovery of a musculoskeletal injury; however, arguments exists regarding the optimal nutrition and supplements regimen. A comprehensive acceptable nutritional guideline for wound healing and recovery have not been established. To be able to achieve rapid healing and recovery from musculoskeletal injury, a team of clinicians comprising of a physician, clinical dietitian and nutritionist should regularly assess and adjust the nutrition care plan of patients corresponding to the advancement of healing, presence of any underlying medical condition, clinical status, and nutrition-evaluation parameters. Hence, this emphasizes the importance and role of individualizing the nutrition care plan according to each patient prognostic parameters and health status for optimal wound healing and recovery.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Close GL, Sale C, Baar K, Bermon S. Nutrition for the prevention and treatment of injuries in track and field athletes. Int J Sport Nutr Exerc Metab 2019;29:189-97.  Back to cited text no. 1
    
2.
Ebner N, Anker SD, von Haehling S. Recent developments in the field of cachexia, sarcopenia, and muscle wasting: Highlights from] the 12th Cachexia Conference. J Cachexia Sarcopenia Muscle 2020;11:274-85.  Back to cited text no. 2
    
3.
Berrazaga I, Micard V, Gueugneau M, Walrand S. The role of the anabolic properties of plant-versus animal-based protein sources in supporting muscle mass maintenance: A critical review. Nutrients 2019;11:1825.  Back to cited text no. 3
    
4.
Yang Y, Breen L, Burd NA, Hector AJ, Churchward-Venne TA, Josse AR, et al. Resistance exercise enhances myofibrillar protein synthesis with graded intakes of whey protein in older men. Br J Nutr 2012;108:1780-8.  Back to cited text no. 4
    
5.
Smith GI, Atherton P, Reeds DN, Mohammed BS, Rankin D, Rennie MJ, et al. Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: A randomized controlled trial. Am J Clin Nutr 2011;93:402-12.  Back to cited text no. 5
    




 

 
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