Preoperative Diet Therapy: The Right Choice of Components and Supplements Can Beneficially Impact Clinical Outcomes

Purpose of Review It is well established that malnutrition leads to worse outcomes in patients undergoing surgical procedures. To help prevent this, a litany of tools and scoring systems have been identified to identify both individuals and groups of patients who are at risk for malnutrition. The purpose of this review is to highlight the groups who are at the highest risk of malnutrition and to review the adjuncts to nutritional support in an effort to optimize post-operative outcomes. Recent Findings This review highlights the need to nutritionally optimize certain patient populations, including patients presenting with starvation-related malnutrition, geriatric patients, patients undergoing major surgery, and patients with sarcopenic obesity. In addition, we review the adjuncts to nutritional support, including preoperative carbohydrate loading, immune and metabolic modulation using arginine, fish oils, and RNA supplementation, and the use of pre and probiotics. Summary Patient nutrition remains a key preoperative intervenable area for quality improvement as a means to improve patient outcomes post-procedure. Not only have specific scoring systems been devised to quantify risk of complications in individuals, certain groups remain at high risk of malnutrition. Recognizing these groups preoperatively and providing nutritional adjuncts to improve patients’ nutritional status may help lead to improved patient outcomes.