Nutritional therapy is a critical aspect of perioperative management.  The surgical literature clearly shows that patients with optimized nutritional parameters have improved outcomes. Conversely, insufficient nutritional preparation is a recognized risk factor for post-surgical complications.  

Hypoalbuminemia is a modifiable risk factor associated with a statistically significant increased risk of wound infection, delayed healing, and readmission. During this period of acute physiologic stress and anabolic demand, patients require increased macronutrient and micronutrient support. Proper nutritional preparation is an essential, though under-appreciated, patient responsibility.  As a nutrient-focused surgical supplement, Nourish Rx taken daily is a proven and simple step to optimize nutrition and reduce the risk of adverse events. 

Studies find that a typical diet, while adequate for baseline function, is too often insufficient for surgical preparation.  The physiological stress of an operation increases the demand for acute phase protein synthesis, lymphocyte proliferation, and tissue repair. (Wischmeyer, 2018). Each Nourish Rx serving holds the recommended minimum daily protein intake of 20g. HMB (beta-hydroxy beta-methylbutarate), another component of Nourish Rx, serves to up-regulate protein synthesis pathways to increase muscle gain and functional strength in healthy older adults. (Wu). A large randomized study of 652 elderly hospitalized patients demonstrated that a high protein supplement including HMB reduced mortality by almost 50% relative to placebo. (Deutz, nourish study group 2016).

Protein supplementation has been shown to reduce the risk of surgical infection.  Arginine and other amino acids found in Nourish Rx provide potent immunonutrition support.  Cytokines are proteins and peptides secreted by white cells to regulate and coordinate the immune response.  Interleukins are specific glycoproteins that play an immunomodulatory role in T-cell activity.  In testing, lymphocytopenia with a count below 1500 is a direct marker of protein malnutrition. Several large studies correlate low protein levels with an increase in postoperative infection.

Strong bones improve recovery.  Older adults are especially at risk for osteopenia and osteoporosis.  Supplementation with Calcium and Vitamin D can enhance bone metabolism. Protein provides structural bone support and accounts for one third of bone mass and volume. Low levels of these can increase the risk of fragility and pathologic fractures. Nourish Rx contains both Calcium and Vitamin D to promote post-operative bone health.

Surgery and antibiotics are known to disrupt microbiome health. The normal gut flora regulates digestive health and bowel movements.  Nourish Rx contains Lactospore probiotics to repopulate healthy gut flora after antibiotic prophylaxis. Chicory root fiber is also added to minimize the impact of postoperative constipation. 

While the blend of nutrients was specifically chosen to optimize surgical recovery, certain supplements were deliberately omitted to minimize the risk of complications.  Although popular as cardiovascular supplements, omega 3 fatty acids and Vitamin E are associated with an increased bleeding risk and were therefore excluded.   Only natural sweeteners are used to create a pleasant vanilla flavor.  Excess sugars and carbohydrates were eliminated to minimize the risk of insulin sensitivity and excess weight gain.  Nourish Rx is nutrient rich but not heavy in calories.  After all, the goal of perioperative nutrition therapy is tissue repair and regeneration, not weight gain.

Among protein options, a pure whey isolate protein is especially bioavailable.  Unlike regular whey protein, the pure isolate in Nourish Rx is prepared to be nearly lactose free.  Without the lactose sugar component, it is well tolerated by those with lactose sensitivity or intolerance.

Tissue repair, wound healing, and muscle regeneration are necessary for a successful surgical outcome.  The American College of Surgeons and the American Association of Hip and Knee Surgeons both highlight the importance of additional protein-based supplementation.  Accordingly, a team of surgeons and nutritionists created Nourish Rx specifically to safely and effectively nourish the surgical patient. It is not intended for body building or as a sport supplement.