Devour

Recovery Time

Discover how nutritional status affects injury recovery time

By Sarah Nielsen

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Table of Contents

Introduction................................................................................. 3

Market Driver............................................................................... 4

Problem....................................................................................... 5

Historical Approach..................................................................... 6

Generic Solution.......................................................................... 7

Specific Solution.......................................................................... 8

Call to Action............................................................................... 11

Works Cited................................................................................. 13

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Introduction

The goal of all injured patients is to heal quickly and com-

pletely. Severe injuries can prevent people from working or

participating in the activities they love. Right now, most

patients think all they can do is sit around and wait for their

body to heal itself. They want to get back to their lifestyle

but are often restricted by long injury recovery times. Are there ways to speed up the healing

process so people can get back to their lives? Many factors contribute to injury recovery time

including infection, wound hypoxia and poor nutritional status. Some of the factors are uncon-

trollable but others can be easily affected. Doctors and nurses try their best to keep the

wound site clean and speed the healing process as much as possible. Yet, medical personnel

have a short amount of time with each patient and are too busy to address every detail of

healing. Therefore, patient’s who want to heal quickly and get back to their normal lives need

to be proactive with their own healing. What controllable factors can patients change to

decrease their own recovery time?

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Injuries...

Frequent, Frustrating and Financially Stressful

“In 2000, an estimated 31 million people, one in every 10 people in the United States, were treated for nonfatal injuries in hospital emergency departments,” according to the Center for Disease Control and Prevention.

Injuries are pain-

ful, aggravating and

not uncommon. A

wound can be a tre-

mendous burden on a family. It can prevent

someone from preparing meals, taking care

of children or even getting out of bed. Inju-

ries can also create financial stress. Accord

ing to Santa Clara University, “the average

cost of a one-day stay in a hospital has

risen to over $500.” Most wound victims

must also take off multiple days of work. In

order to save money and avoid probable

debt, it is crucial that people heal as quickly

as possible. Wounds can also prevent

people from participating in activities they

enjoy like running, playing soccer or hiking.

For an athlete, an injury has dire conse-

quences. A long recovery can result in sig-

nificant atrophy of the muscles and force an

athlete to forfeit the season. Older popula-

tions are at an even higher risk for injury

than the general population. As you age,

muscle mass and bone density decrease

resulting in an increased

risk of falling. Older

populations are also

more prone to skin

breakdown. Injuries are frequent, frustrating

and financially stressful.

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Lack of Knowledge

The inconvenience injuries create in people’s lives make

people want to speed up their recovery time as mush as

possible. Nurses and doctors do their best the keep the

wound site clean and prescribe medication to prevent infec-

tion. Yet, there are many other factors that medical person-

nel often overlook due to lack of time with each individual patient. If more emphasis was put

on these impediments to healing, a patient’s recovery time could be significantly decreased. If

doctors and nurses don’t have time to discuss all the factors influencing healing, it would be

beneficial for patients to educate themselves. In general, the average person is not know-

ledgeable about the working of the human body. The body’s healing process in particular is

relatively complicated and it would be unreasonable to expect anyone who has not studied

medicine to understand it. Yet, many of the factors influencing healing are simple and can be

easily manipulated by anyone. People can do much more to influence their body’s healing

than sit around and wait to recover. “The three largest factors that

prevent fast healing are poor nutritional status, infection and im-

paired organ function” (Shephard, 55). Other impediments to heal-

ing include wound hypoxia, presence of debris, use of anti-

inflammatory medications and metabolic complications. Lack of

knowledge about these factors leaves people with long, painful

recoveries.

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Historical Approach

In America, people have been interested in the factors influencing healing for centuries. The

Native Americans focused on restoring health by balancing

the mind, body and spirit. Any areas of weakness within the

body’s systems were addressed to restore complete har-

mony. The Native Americans found that factors that might

seem unrelated to healing, like spirituality or nutrition, could

severely affect injury recovery. The Europeans brought with

them very different medical strategies. They practiced

aggressive healing techniques and often overlooked all the

factors influencing healing. The 19th century Popular Health

Movement in America was a reaction against the European doctors. The movement empha-

sized the healing powers of water, fresh air, healthy food and exercise. The medical system of

Naturopathy was developed around this same time. The Ency-

clopedia of Natural Medicine describes Naturopathy as “a sys-

tem of medicine that focuses on prevention and use of non-

toxic natural therapies like proper diet and nutrition, exercise,

nutritional supplements, herbology and lifestyle modification

and counseling.” Naturopathy is still practiced today and

focuses on supporting the body’s own healing abilities and empowering individuals to make

lifestyle changes necessary for the best possible health. As Naturopathy suggests, there are

many factors that people can influence to support their body’s healing abilities.

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The largest, controllable variable affecting wound

healing is nutritional status of the individual.

“Wound healing sets off a complex chain of

events that involve increased cellular activity and

an intensified metabolic demand for nutrients.

Patients who do not have enough nutrients to

meet this increased demand are at risk for delay-

ing healing, infection, longer hospital stays and

even death” (Hogan, 27). Injured patients need

to make sure they are not deficient in any of the

nutrients, vitamins or minerals used in healing.

For the average person, a balanced diet should

be enough to provide adequate amounts of

these vitamins. Unfortunately, most Americans

do not eat what dieti-

tians would consider

a healthy, balanced

diet. The Center for

Nutrition Policy and

Promotion compiled their Healthy Eating Index

for 2000 and found that only ten percent of the

U.S. population had a good diet. Along with poor

diets, studies found that the nutrients in foods

have declined. The soil is not as nutrient-dense

as it used to be and the processing of foods de-

grades the nutrients that do exist. So not only

are Americans eating fewer healthy foods, but

those we do eat contain fewer nutrients than

they once did. The American Medical Association

noted that some individuals, such as the elderly,

vegans, women of childbearing age, and those

at risk for cardiovascular disease, are at higher

risk of vitamin deficiencies. This shows that most

uninjured Americans are at risk for deficiencies.

Once an injury occurs, the problem worsens.

The body requires even more nutrients and vi-

tamins than normal for the healing process. Dur-

ing this time, people should only be eating

nutrient-filled foods that will benefit healing. Yet,

this is often not the case. When people are hurt,

they usually turn to comfort foods to make them-

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Nutritional Status

selves feel better. These foods are frequently

high in fat and sugar and do not contain the nec-

essary vitamins and minerals for healing. On top

of all this, in the “U.S. approximately 40% of

hospitalized patients suffer from malnutrition”

(Hogan 26). One study found that nurses overes-

timate patient’s dietary intake by 20%. Deficien-

cies are not uncommon which is why the pur-

pose of this report is to explain how they can be

dealt with in order to ensure a speedy recovery.

Vitamin and mineral deficiencies often go unnoticed because they rarely affect an uninjured

person’s daily life. Unless the deficiency is severe, the symptoms are usually mild and can

include irritability, rough skin, and poor appetite. When it comes to wound healing though, de-

ficiencies can have a profound affect. Considering the limitations of a lengthy recovery and

the simplicity of the solution, one would think more attention would be paid to nutrition.

Choosing to eat a healthy diet full of the right fruits and vegetables can cure a deficiency. The

specific nutrients, vitamins and mineral that influence recovery time are the amino acid

arginine, vitamin A, vitamin C and zinc.

Reduce recovery time

through nutrition

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Recommendations The specific vitamins, minerals and nutrients that directly influence injury recovery time and the body’s healing process are vitamin A, vitamin C, arginine and zinc.

Vitamin A

Vitamin A is necessary for the inflammatory phase of wound healing. It

also promotes collagen secretion and strengthens scar tissue. A defi-

ciency leads to altered collagen synthesis, limited cross-linking of fibers

and diminished maintenance of epithelial tissue. In order to prevent a

vitamin A deficiency, one should consume carrots, green leafy vegetables,

sweet potatoes and cheese. The RDA recommendation for vitamin A is

700 µg/day for women and 900 µg/day for men. If an injured patient does

not consume this amount, impaired healing could occur.

Vitamin CVitamin C is a water-soluble vitamin so the body cannot store it. During the

healing process, it is responsible for collagen synthesis. When deficient,

the wound tensile strength is decreased related to a poorly laid collagen

framework. A lack of vitamin C also limits the cellular immune response Vitamin C is found in foods like citrus fruits, broccoli, peppers,

strawberries and green leafy vegetables. The daily recommendation for

vitamin C is 90 mg for men and 75 mg for women.

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Arginine“In healthy people, arginine is a nonessential amino acid-that is, the body

can synthesis enough for normal requirements. During episodes of increase

metabolic demand or wound repair, the requirement for arginine increases

beyond the body’s ability to meet demand and it becomes an essential

amino acid that must be supplied through dietary sources” (Casey, 55).

Arginine has been shown to affect healing in several ways. It is required for

normal vascular and immune functions. Without proper amount of arginine,

macrophages (the clean-up crew) cannot function properly and collagen

synthesis is impaired. Arginine can be found in nuts, flax seed, soybeans,

tofu and chocolate syrup.

Zinc

Zinc, a trace mineral, supports collagen development, cell division and pro-

tein synthesis. “Deficiencies can affect a wound’s susceptibility to various

pathogens and impair overall wound integrity by lowering rates of fibroblast

proliferation, collagen synthesis and epithelialization” (Nutritional Status, 5).

A deficiency can be solved by eating foods such as meat, fish, poultry, nuts,

asparagus and spinach. The recommended zinc consumption for women is

8mg/day and 11mg/day for men.

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The problem of deficiencies is serious and can lead to poor injury recovery but the solu-

tion is simple. Every year millions of American are injured and prevented from getting back to

their daily activities due to long, painful recoveries. Nutrition

is one of the keys to cutting down these recovery times. But

who is responsible for discussing nutrition with injured pa-

tients? Doctors do not have the time or often the knowledge

to provide nutritional information for each of their patients.

For this reason, it is important for doctors to work in coop-

eration with members of a multidisciplinary team. A doctor

treating a wound victim can direct nutritional resources to

those patients who need further assistance. Dietitians

should work with doctors and physical therapists to make

sure patients are eating the right foods to support healing.

It is important to identify any possible deficiencies early to prevent poor wound healing. A

nutritional assessment should be given to each wound victim to determine the patient’s cur-

rent nutritional status and provide a baseline on which to evaluate possible recommendations.

A basic nutritional assessment could be included with a patient’s pre-appointment paperwork.

If this assessment shows a possible risk for vitamin or mineral deficiencies, then further inves-

tigation by a dietician would be necessary. Some injuries are not severe enough to require

medical attention. In those cases, people must address their nutritional needs and take a pro-

active approach to their healing. There are many nutritional assessment tools available to the

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Take action: Make a difference in your own recovery time

general public online. The United States Department of Agriculture’s Center for Nutrition Pol-

icy and Promotion provides many easy-to-use tools that will tell an individual the amount of

each vitamin and mineral they consume. Americans need to start taking nutrition more seri-

ously and realize all the profound affects it can have on health. Wound healing is just one of

the many body processes that is influenced by nutrition. Next time an injury occurs, remember

you can devour your recovery time by making informed decisions about what you eat.

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! ! ! ! ! ! Works Cited

Casey, Georgina. “Nutritional Support Wound Healing.” Nursing Standard 17.23

(2003): 55.

Hogan, SL. “How to Help Wounds Heal.” RN 67.8 (2004): 26-32.

“Nutritional Status and Wound Healing.” Nutritional Research Newsletter 27.9

(2008): 5.

Shepherd, Alison A. “Nutrition for Optimum Wound Healing.” Nursing Standard

18.6 (2003): 55

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