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Wound Healing and Nutrition

May 15, 2009 Written by JP       [Font too small?]

At some point in of our lives, we’ll all be wounded in one way or another. It could be something minor, like a sprained ankle or something as serious as spinal cord injury. Even the after effects of elective surgery should be considered in any thorough discussion about wound recovery. But there is an aspect of healing that is rarely discussed in modern medicine – the role that one’s mental state and nutrition play in physical recovery.

Wound Healing Phases

A new study conducted at Massachusetts General Hospital’s Institute for Mind Body Medicine provides powerful evidence that the recovery environment can play a crucial role in the ability to heal wounds.

The experiment was conducted on young rats who were in the process of healing from a burn injury. They were split up into three distinct groups: a) one group of rats was kept in individual, isolated cages; b) the second group was placed in isolated cages, but were also given pieces of cotton from which they could build bedding; and c) the final group was placed in shared cages with other recovering rats.

After four weeks, 92% of the rats in the shared cages had healed from their injury. Only 12% of the isolated rats recovered well. But the most surprising finding was the the isolated rats who were given the nesting material (cotton squares) exhibited a recovery-rate of 64%.

The researchers theorized that the reason for the enhanced healing in the isolated “nesting” rats was due to an increase in oxytocin production. Oxytocin is a hormone that is associated with affection and bonding. In order to test that hypothesis, they conducted another trial in which oxytocin was administered to a group of rats. The results closely approximated the healing course that was shown in the rats who built nests out of cotton.

Further testing demonstrated a reduction in hyperactive behavior in the isolated, nesting rats. When their brains were analyzed, a change in genetic expression was found in the hippocampus region. This is an area that plays a major role in managing the effects of stress. This is of utmost importance because increased stress has been implicated in cases of poor wound recovery.

Dr. Gregory Fricchione, the lead author of this pioneering research, concluded that, “giving these animals a behavioral intervention changed not only their behavior, but also their physical health, raising important mind-body questions that requires further investigation in humans as well as animal models.” (1)

Optimal nutrition can also play a role in recovery from physical trauma. In recent years, many reports have been published that highlight the potential of various micro and macro nutrients in assisting the body and mind during a healing crisis. Here are a few examples:

  • Vitamin C: In February 2008, a study was published in the Archives of Orthopaedic and Trauma Surgery which established that high-dose Vitamin C could increase blood flow and improve tissue repair (via collagen synthesis) in a rat model of Achilles tendon injury. In September 2008, a review suggested the regular use of high-dose Vitamin C supplementation to combat deficiencies in intensive care units. (2,3)
  • Choline: Choline is one of the lesser known B-vitamins. It plays a role in the formation of a chemical messenger in the brain called acetylcholine, which is vital for proper cognitive functioning. It also appears to provide some protection against “neurological impairment” that results from traumatic brain injuries. A study presented in the Journal of Neurotrauma found that rats with brain injuries demonstrated improved memory and test performance if they were given choline before and after the traumatic event. A specific form of choline known as citricoline is also suggested as a possible post stroke agent in the Fall 2008 issue of Reviews in Neurological Diseases. The authors note is ability to afford neuroprotection and neurorepair in experimental studies. (4,5)
  • Probiotics: Post-operative infections are major obstacles in the healing process. They often prolong hospital stays and increase the need for additional prescription medications. The use of friendly bacteria may help reduce the likelihood of such common infections. A March 2009 scientific review concluded that, “The use of probiotics/synbiotics may reduce postoperative infections after abdominal surgery. This is a promising infection-preventive measure that may decrease morbidity, length of antibiotic therapy, duration of hospital stay, and pressure for emergence of antimicrobial resistance.” Other investigations tend to agree with this preliminary assessment. In addition to the oral application of probiotics, some strains are even being used topically to aid skin healing. (6,7,8)
Whey Protein Bioavailability
  • Whey Protein and Lactoferrin: Many injuries increase the body’s need for dietary protein. In such instances, it’s important to utilize the most bio-available forms of protein from food and supplementary sources. Whey concentrate and isolate is a milk derived protein source that appears to be particularly well suited for physical recovery needs. Modern research indicates that whey increases antioxidant activity in the body, combats fatigue and inflammation, hastens healing, improves stamina and may even discourage related infections due to its immune enhancing effects and the natural antibiotic properties of one of its components (lactoferrin). (9,10,11,12,13)
  • Zinc: In September 2008, there were two separate studies published in the journal Biological Trace Element Research that point to the importance of adequate zinc status during the healing of burns. A lack of zinc resulted in higher blood sugar levels and insulin-resistance, increased oxidative damage and impaired wound healing. (14,15)

If you’re recovering from any type of wound, please inquire with your preferred health professional about what you can do to support your healing process. Consider all of the possible alternatives. If diet and supplementation isn’t an option, then consider a mind-body technique such as aroma or color therapy, guided imagery, hyperbaric oxygen treatment, hypnosis, massage or meditation. The important thing is that you be proactive about it. Be a part of your recovery process and you’ll likely heal faster and more completely.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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Posted in Alternative Therapies, Nutrition, Nutritional Supplements

10 Comments & Updates to “Wound Healing and Nutrition”

  1. Iggy Dalrymple Says:

    De Art Ayers’ blog, “Cooling Inflamation”, discusses the
    topical use of castor oil and anti–inflammatory diet.
    http://tinyurl.com/CoolingInflammation

  2. JP Says:

    Thanks for the link, Iggy.

    Be well!

    JP

  3. Glenn Fernandes Says:

    Thanks for the useful article. Nice research done. I agree that whey increases antioxidant activity in the body. Whey is very much useful.

  4. JP Says:

    You’re welcome, Glenn.

    Thank you for your kind comments.

    Be well!

    JP

  5. sawsan Says:

    Thanks for the useful article.

  6. Ronnie Rodriguez Says:

    Curious I have incorporated stress management, integrating with family and friends, eliminating “dead horses” out of peoples lifestyles during clients training with me.

    Far reach from your work- but I have seen that “feeling good” runs deeper than just working out with me.

    High fives, partial hugs, hand shakes, “atta boys or girls”, etc seem to encourage acknowledgement, purpose, etc- if I could ever put together a study I will email you a copy. Prioritizing one self versus martyring one self can significantly change the outcome or path. For example my knee is damaged from an MVA vs pedestrian accident- but my work excites me so much I focus on getting the day done to change people’s lives. Is the pain gone? no. Is the injury still there? yes. Choosing to redirect energies has played an important role to me and my clients.

    I believe that “feeling good” runs deeper than the physical part and it can ease or minimize those physical ailments or refocus the clients thus making management of those problems easier.

    Good luck sir.

  7. JP Says:

    Thank you, Ronnie.

    Excellent observations and wisdom that can be adopted by anyone who reads it! Well said.

    Be well!

    JP

  8. JP Says:

    Update 05/27/15:

    http://www.ncbi.nlm.nih.gov/pubmed/25948437

    Glob J Health Sci. 2014 Oct 29;7(3):40015.

    The topical effect of grape seed extract 2% cream on surgery wound healing.

    BACKGROUND: Reducing the wound healing time is crucial in wound as it lowers the chance of infection and decreases complications and cost. Grape seed extract has the ability to release endothelial growth factor and its topical application results in contraction and closure of the skin wound. Furthermore, it possesses antioxidant and antibacterial properties. In several studies it has been proved effective in animals. Therefore, due to low side effects and recognition of herbal medicine, we decided to evaluate the effect of grape seed extract 2% herbal cream on human skin lesions.

    MATERIALS: This study is a double blind clinical trial conducted on two groups of treatment and placebo. Surgery was performed on skin lesions such as skin tags and moles which were found on the neck, trunk and limbs (except for face). After enrollment and obtaining informed consent from participants, they were randomized into two groups of treatment and placebo. Excision of the lesions was done by surgical scissors. The lesions got restored by secondary intention method. After the first day of treatment, the patients were visited on the 3rd, 7th, 10th, 14th, and 21st day. Grape seed extract cream 2% was produced and coded by the Faculty of Pharmacy, Ahvaz University of Medical Sciences. In order to compare the two groups, T-test was used. For time assessing, analysis of variance with repeated measures was employed.

    RESULTS: The results showed complete repair of wounds averagely on day 8 for the treatment group and on day 14 for the placebo group, which was clearly significant in terms of statistical difference (p=0.00).

    CONCLUSION: Proanthocyanidins in grape seed extract trigger the release of vascular endothelial growth factor and its topical application causes wound contraction and closure. Curing skin lesions with grape seed extract caused proliferation areas with protected boundaries in epithelium, increased cell density and increased deposition of connective tissue at the wound site which in general improves cellular structure in wound. In addition, its anti-inflammatory and anti-microbial properties are effective in wound healing.

    Be well!

    JP

  9. JP Says:

    Update 06/06/15:

    http://www.jdmdonline.com/content/14/1/38

    J Diabetes Metab Disord. 2015 Apr 29;14:38.

    The effect of topical olive oil on the healing of foot ulcer in patients with type 2 diabetes: a double-blind randomized clinical trial study in Iran.

    BACKGROUND: Diabetic Foot Ulcer (DFU) is the most costly and devastating complication of diabetes mellitus which can lead to infection, gangrene, amputation, and even death if the necessary care is not provided. Nowadays, some herbal products have shown therapeutic effects on healing of DFU. So, this study aimed to assess the effects of topical olive oil on the healing of DFU.

    METHODS: This double-blind randomized clinical trial study was conducted in Diabetes Clinic of Ahvaz Golestan hospital, Iran, in 2014. Thirty-four patients with DFU of Wagner’s ulcer grade 1 or 2 were enrolled in this study. Patients who were randomly assigned to intervention group (n = 17) received topical olive oil in addition to routine cares, whereas patients in control group (n = 17) just received routine cares. Intervention was done once a day for 4 weeks in both groups, and in the end of each week; the ulcers were assessed and scored. Data was collected by demographic and clinical characteristics checklists as well as diabetic foot ulcer healing checklist, and was analyzed by SPSS version 19 software using descriptive (mean and standard deviation) and analytic (student’s sample t-test, chi-square and repeated-measures analysis of variance) statistics.

    RESULTS: At the end of 4(th) week, there was a significant differences between two groups regarding to 3 parameters of ulcer including degree (P = 0.03), color (P = 0.04) and surrounding tissues (P < 0.001) as well as total status of ulcer (P = 0.001), while related to ulcer drainages no significant difference was seen between the two groups (P = 0.072). At the end of the follow up, olive oil significantly decreased ulcer area (P = 0.01) and depth (P = 0.02) compared with control group. Complete ulcer healing in the intervention group was significantly greater than control group (73.3% vs. 13.3%, P = 0.003) at the end of follow up. Also, there were no adverse effects to report during the study in intervention group.

    CONCLUSIONS: Our results indicated that olive oil in combination with routine cares is more effective than routine cares alone, and is without any side effect. However, further studies are required in the future to confirm these results.

    Be well!

    JP

  10. JP Says:

    Updated 08/26/15:

    http://www.clinicalnutritionjournal.com/article/S0261-5614%2815%2900181-8/abstract

    Clin Nutr. 2015 Jul 17.

    Effects of combination of whey protein intake and rehabilitation on muscle strength and daily movements in patients with hip fracture in the early postoperative period.

    BACKGROUND & AIMS: Elderly patients can be at risk of protein catabolism and malnutrition in the early postoperative period. Whey protein includes most essential amino acids and stimulates the synthesis of muscle protein. The purpose of this study was to investigate the effect of resistance training in combination with whey protein intake in the early postoperative period.

    METHODS: We randomized patients to a whey protein group or a control group. The former group received 32.2 g of whey protein pre- and post-rehabilitation in the early postoperative period for two weeks. Outcomes were knee extension strength on either side by Biodex 4.0, and the ability of transfer, walking, toilet use and stair use by the Barthel Index (BI). We performed initial and final assessments in the second and tenth rehabilitation sessions.

    RESULTS: A total of 38 patients were recruited: 20 in the whey protein group and 18 in the control group. Participants in the whey protein group showed significantly greater improvement in knee extension strength in the operated limb compared with the control group (F = 6.11, P = 0.02). The non-operated limb also showed a similar tendency (F = 3.51, P = 0.07). The abilities of transfer, walking and toilet use showed greater improvements in the whey protein group than in the control group by BI (P < 0.05).

    CONCLUSION: The combination of whey protein intake and rehabilitation for two weeks in the early postoperative period has a beneficial effect on knee extension strength in both lower limbs and BI (transfer, walking and toilet use) scores in patients with hip fracture.

    Be well!

    JP

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