Chew on this: 6/10

How diet affects wound healing

By Jayne Powers

Last fall, I described my harrowing experience of being ejected over the handle bars of my bike and sheering the bony tip of my elbow, the olecranon.

Thankfully, my trauma doctor repaired the fracture with a plate and eight screws, and I was on my way to recovery, a combination of physical therapy and a diet focused on speeding the rebuilding of my bones.

I conducted research on what to eat at betterbones.com (the Better Bones website is also a great resource if you’re at risk of or have been diagnosed with osteopenia or osteoporosis).

Like most accidents, the timing of my accident came at a particularly bad time. In a month, I had a winter rowing training program at Georgetown University, which meant that I’d be hopping on the ergometer, an indoor rowing machine, in about five weeks.

Up until then, I had been eating a high-quality diet, not something that I had started but something that has become a part of my lifestyle for many years.

That meant that my baseline for healing my bones was nutritionally sound, and I was able to jump back on the erg at the start of winter training in mid-December.

On May 29, my surgeon revisited my now-healed olecranon to take out the plate and screws, one of which had started to dislodge from the bone, which had inflamed my bursa. Yes, ouch!

Now, I have a 4-inch suture that runs along the underside of my elbow. And next week, I’m off to the U.S. Naval Academy for a week of crew camp.

I’ve healed very well, I believe, because of my diet. Wound healing is predicated on healthy eating from a variety of food groups that are strong in vitamins A and C and the mineral zinc. Adequate protein intake is also a factor.

To understand how nutrition plays a role in speeding wound healing, it is important to understand the phases of how your body heals itself. Inflammation, which is both a vice and virtue of life, occurs in the early stages of wound healing. In this case, inflammation is a good thing because it is a necessary part of the body’s response to injury and infection.

The two general phases of inflammation are attack and heal. Early on, inflammation calls on the immune system to protect the body from an injury to control infection. During the later stages, inflammation works to re-grow damaged tissue and start the wound healing process.

Adequate intake of foods rich in vitamin A is particularly important during the first two weeks, after which vitamin C assumes the stronger role. Zinc is important throughout the wound- healing process.

Vitamin A stimulates the inflammatory response and, in effect, jumpstarts the process of creating new collagen. This process is called collagen synthesis, which is necessary to develop new skin (and veins). According to the National Institutes of Health, low levels of vitamin A can lead to increased risk of wound infection and delayed healing.

Egg yolk, for example, is high in vitamin A. Most vitamin A found in foods is supplied by various carotenoids in plants, especially beta carotene. The leading sources of foods with vitamin A include organ meats and fish.

Leaner choices of vitamin A include yellow, orange and red fruits and vegetables, such as red bell peppers, sweet potatoes, carrots, spinach, Swiss chard and mangos. Rule of thumb: the darker the color of the vegetable or fruit, the more beta carotene it contains.

Vitamin C is necessary for collagen formation, proper immune function and as a tissue antioxidant. Another perk is that vitamin C helps the body better absorb iron, which works to supply the wound bed with oxygen and energy for more efficient cellular development.

I’m sure you’re aware that citrus fruits are a great source of vitamin C, but peppers and broccoli actually have more. To see what I mean, google “broccoli and oranges.”

You’ll get a side-by-side comparison of their nutritional values. You can use Google’s clever nutritional comparison tool to search for and compare any two types of food.

I’d also like to point out that the effect of vitamin E on surgical wounds is inconclusive, according to the National Institutes of Health.

As for zinc, this mineral is fundamental in the regulation of cell division, growth, wound healing and proper functioning of the immune system. Leading sources include oysters, beef chuck roast, Alaska king crab, broiled beef patties and fortified breakfast cereals. If you’re looking for leaner or vegetarian choices, consider baked beans, low-fat yogurt, cashews and chickpeas.

Two other important points: Consume enough calories (your body needs more during the early phases of wound healing) and ensure your protein intake is adequate, even though protein deficiency is uncommon in the American diet. Protein helps rebuild muscle tissue.

It’s also a good idea to consume fats as your wounds heal. Fats provide energy and spare protein for wound healing. It also aids in the absorption of vitamin A. Being deficient in essential fatty acids may adversely affect wound healing.

I’ve left out specifics on quantities because there are too many individual variables that would change the answer. Age, body weight, activity level, the severity and size of your wound or wounds and the stage in the healing process you’re in would affect your nutritional needs.

If you want to find an expert, please visit The Academy of Nutrition and Dietetics at eatright.org/find-an-expert.

Jayne Powers, MA, is a certified nutritionist and personal fitness trainer based in Washington, DC. Her column, Chew on This, speaks from the science of the current state of knowledge about all facets of nutrition. Find her online at masterscorefitness.com, or email your fitness questions to jayne@masterscorefitness.com

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Jayne Powers, MA, is a certified nutritionist and personal fitness trainer based in Washington, DC. Her column, Chew on This, speaks from the science of the current state of knowledge about all facets of nutrition. Find her online at masterscorefitness.com.

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