Encompass Healthcare and Wound Medicine

Assessing Nutritional Needs During Healing

The body has special nutritional needs when it’s healing.

Proper nutrition is a mantra at Encompass HealthCare & Wound Medicine, Michigan

Proper nutrition is a mantra at Encompass HealthCare & Wound Medicine, Michigan

What are the nutritional needs in a non healing or infection healing state? Your body needs more of everything in a healing situation. In particular, it needs more protein. In fact, your body needs up to three or more times times the recommended daily allowance for protein in order to heal. Only with that kind of increased intake can the body carry on normal body functions while allocating extra proteins, calories and energies to wound healing.

To determine a patient’s nutritional status, we use the results from blood tests and/or an indirect calorimeter.

An indirect calorimetry test helps determine a patient's nutritional needs at Encompass HealthCare.

An indirect calorimetry test helps determine a patient’s nutritional needs at Encompass HealthCare.

One of the blood tests looks for levels of albumin and globulin. Albumin and globulin are proteins made in the liver and released into the blood. They are useful for evaluating overall health and nutrition status. Globulin fights disease. Albumin makes up about 2/3 of the total protein in the body and keeps water inside blood vessels.

An indirect calorimeter is a machine we have in-house used to detect a person’s basal metabolism and thus how many calories are needed in order to maintain or gain weight. In many instances, our patients need to gain weight, but in the form of muscle in order to aid in wound healing.It can also measure how many calories your body burns after eating.

The test involves measuring the amount of oxygen a subject breathes in, and the amount of carbon dioxide (CO2) breathed out.  From these gas exchange data, the number of calories burned per minute is determined.

Getting the extra nutrition to heal wounds can be challenging because:

  1. A patient can look well-nourished and still be deficient in the nutrients needed for wound healing including zinc and the vitamins A & C.
  2. The amount of additional protein needed is quite substantial. But in some cases, the patient does not have the capacity to take in the extra protein and calories due to an underlying condition(s). That’s when feeding tubes become an important treatment modality since they can provide nutrition throughout the day and night.
  3. It matters where the extra calories come from. For example, fats are calorie dense but your body needs proteins and carbohydrates over extra fats to speed healing.

PROTEIN: THE BASIS FOR ALL HEALING.

It all begins with protein intake since your body uses proteins to build new tissues, carry away dead tissue and deliver nutrients to wound sites. Here is some important information about proteins:

    • It can take up to three times the normal amount of protein intake to heal a wound. So if you’re normally supposed to take in 56 grams of protein each day to carry out normal activities, you need up to 160 grams or more each day during the healing process.
    • Great sources of protein include …
    • Seafood: Seafood is an excellent source of protein because it’s usually low in fat. Fish such as salmon is a little higher in fat, but it is the heart-healthy kind: omega-3 fatty acids.
    • White-Meat Poultry: Stick to the white meat of poultry for excellent, lean protein. Dark meat is a little higher in fat. The skin is loaded with saturated fat, so remove skin before cooking.
    • Milk, Cheese, and Yogurt: Not only are dairy foods — like milk, cheese, and yogurt — excellent sources of protein but they also contain valuable calcium, and many are fortified with vitamin D. Choose skim or low fat dairy to keep bones and teeth strong and prevent osteoporosis.
    • Eggs: Eggs are one of the least expensive forms of protein.
    • Beans: One-half cup of beans contains as much protein as an ounce of broiled steak. Plus, these nutritious nuggets are loaded with fiber to keep you feeling full for hours.
    • Pork Tenderloin: This great and versatile white meat is 31% leaner than it was 20 years ago.
    • Soy: Fifty grams of soy protein daily can help lower cholesterol about 3%. Eating soy protein instead of sources of protein higher in fat — along with a healthy diet — can be heart healthy.
    • Beans and legumes are an excellent source of protein and carbohydrates--Encompass HealthCare & Wound Medicine, Michigan

      Beans and legumes are an excellent source of protein and carbohydrates–Encompass HealthCare & Wound Medicine, Michigan

      Lean Beef: Lean beef has only one more gram of saturated fat than a skinless chicken breast. Lean beef is also an excellent source of zinc, iron, and vitamin B12.

    • Great protein sources--Encompass HealthCare & Wound Medicine, Michigan

      Great protein sources–Encompass HealthCare & Wound Medicine, Michigan

      Protein on the Go: Grab a meal replacement drink, cereal bar, or energy bar. Just check the label to be sure the product contains at least six grams of protein and is low in sugar and fat.

    • Protein at Breakfast: Research shows that including a source of protein like an egg or Greek yogurt at breakfast along with a high fiber grain like whole-wheat toast can help you feel full longer and eat less throughout the day.
Read expert Dr. Bruce Ruben’s article on Why Protein is Important for Healing Wounds.
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