Loss of muscle mass in the immediate post-operative period is associated with inadequate dietary protein and energy intake

Despite the implementation of 'Enhanced Recovery After Surgery' (ERAS) protocols, major abdominal surgery is still associated with significant and detrimental losses of muscle mass and function in the post-operative period. Although ERAS protocols advocate both early mobility and dietary intake, dietary composition in the immediate post-operative period is poorly characterised, despite muscle losses being greatest in this period. Herein, we show in 15 patients (66 +/- 6 y, 12:3 M:F) who lost similar to 10% m. vastus lateralis muscle mass in the 5 days after open colorectal resective surgery, mean energy intake was only similar to 25% of the minimum ESPEN recommendation of 25 kcal/kg/d and daily dietary protein intake was only similar to 12% of the ESPEN recommended guidelines of 1.5 g/kg/d. Given the known importance of nutrition for muscle mass maintenance, innovative dietary interventions are needed in the immediate post-operative period, accounting for specific patient dietary preference to maximise compliance (e.g., soft-textured foods).

Automated summary

Despite the implementation of ERAS protocols, major abdominal surgery still leads to significant muscle mass and function loss in the post-operative period. Dietary intake in this period is poorly characterised, with energy and protein intake falling far below the recommended guidelines. Innovative dietary interventions, taking patient dietary preference into account, are needed to address this issue.