• Posted January 24, 2025

Eating Right, Exercising Before Surgery Improves Outcomes

Patients can improve their odds for a successful surgery by actively preparing for the procedure through diet and exercise, a tactic called “prehabilitation,” a new evidence review shows.

Surgical patients who prehabbed had fewer complications and shorter hospital stays, also recovered better and had a higher quality of life, researchers reported Jan. 22 in The BMJ.

“If you are going to be having surgery, it is always a good idea to ask about prehabilitation,” said lead researcher Dr. Daniel McIsaac, an anesthesiologist and senior scientist at The Ottawa Hospital and clinical research chair in perioperative innovation at the University of Ottawa in Canada.

“If you are willing and able to regularly increase your activity levels and protein intake for a few weeks before surgery, you are likely to experience a noticeably shorter recovery time after surgery,” he added in a news release.

The term “prehabilitation” dates to World War II and the British Army's efforts to improve the general health and fitness of military recruits, researchers said in background notes.

The medical community later adopted the term, making prehabilitation a major area of research for the past three decades, researchers said.

“We know that people who are more physically fit tend to recover faster from surgery and suffer fewer complications,” McIsaac said. “While many patients, with encouragement from their doctors, want to improve their fitness before surgery, patients often aren’t sure where or how to start.”

For the review, researchers pooled data on 186 prehabilitation clinical trials involving more than 15,500 patients total.

Exercise was associated with a 50% reduced risk of complications, and a healthy diet with a 38% reduced risk.

Combining diet, exercise and social support reduced complication risk by 36%, researchers found.

Exercise and social support cut patients’ hospital stay by more than two days, while combining exercise and diet cut hospital stays by more than a day.

However, researchers noted that many of these trials were conducted in single hospitals. It’s not clear how well the results will translate to other hospitals or outside of tightly controlled research settings.

“Prehabilitation is very promising, but we still don’t know how best to implement it across hospitals and health systems,” McIsaac said. “We’re pretty sure that if patients can do the work of prehabilitation, they are likely to benefit. The big question is how do we deliver prehabilitation that works for all surgical patients at a system-level?”

Two large ongoing clinical trials are intended to provide more evidence regarding the effectiveness of prehabilitation. Results from one trial at The Ottawa Hospital are expected to be published in March, researchers said.

“It is very empowering to know that there’s something you can do to prepare for surgery that will help your recovery. Patients are hungry for this,” Gurlie Kidd, a patient consultant at The Ottawa Hospital, concluded in a news release. “I hope that one day, prehab will be the standard of care before all major surgeries.”

More information

The American College of Surgeons has more on prehabilitation.

SOURCE: The BMJ, news release, Jan. 22, 2025