Muscle loss in the immediate post-workout period is associated with a lack of dietary protein and energy.

In this group of patients lost 9.16 ± 2.0% of the quadriceps muscle (measured as Lateral Stains remote area with ultrasound [9]) at 5 days after surgery [9], the daily energy consumption was 536.6 ± 527.8 kcal throughout the 4 days of operation, and 490.0 ± 470.7, 505.0 ± 251.8, 541.0 ± 488.1, 610.5 ± 900.5 kcal with respect to 100.5 kcal (POD 4 kcal). Despite the increase in the number of days, there was no significant difference in strength between days. Daily protein intake was 15.6 ± 16.4 g throughout the 4 post-operative days, and 13.9 ± 14.1, 14.9 ± 10.2, 15.0 ± 15.6, 18.5 ± 25.6 g on POD 1 to 4 respectively (fig. No significant difference in protein intake between days. This was equivalent to mean daily energy over POD1 to 4 being only 25.3 ± 24.9% of the ESPEN recommendation, decreasing to 12.8 ± 2.6% in patients with ileus. The daily protein intake was only 12.3 ± 12.9% of ESPEN recommendations, and only 5.7 ± 0.9% for those with ileus. In general, it is only one patient consumed the recommended intake (on POD4). No patients achieved more than 50% of the recommended protein intake on POD1 to 3, with only one patient achieving this (78%) on POD4 .

Figure 1: Food intake in postoperative patients.

Daily energy intake (A) and daily protein intake (B) in patients days 1–4 after surgery (black data points). For daily energy intake, ESPEN representative data are calculated using the average weight of patients enrolled in this study (84.7 kg) and the minimum recommended energy intake (25 kcal/kg/d) [8]. For daily protein intake, ESPEN representative scores are calculated using the average weight of the patients enrolled in this study (84.7 kg) and protein intake (1.5 g/kg/d) [8]. Data are presented as mean ± SEM.

Collectively for all patients, the percentage of energy consumed as protein was 11.65 ± 2.0 on POD1, 12.26 ± 4.9 on POD2, 11.12 ± 4.9 on POD3, and 11.9 ± 3.9% on POD4, which is indicative of dietary less protein throughout this period. Interestingly, compared to the daily increase in energy throughout the post-operation period, the percentage of energy used as protein did not increase.

Patients showed a clear preference for processed foods (eg, soup, jelly, ice cream), and these made up 73% of food choices on POD1, 84% on POD2, 55% on POD3, and 48% on POD4. Overall, 66% of food choices across POD1 to 4 were easy.

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