April 2022

Healing Wounds from the Inside-Out Using Nutrition

Jean LaMantia, RD

Jean LaMantia, RD is a registered dietitian and co-author of “The Complete Lymphedema Management and Nutrition Guide.” She has a virtual private practice and specializes in cancer, lymphedema and lipedema. She also runs the online Lymphedema Nutrition School. Find out more about Jean and read her blog at jeanlamantia.com.

Healing a wound requires a great deal of care and know-how. Ideally, you should be working with a wound care specialist, whom can advise the best wound care regime, and a registered dietitian that can help assess and advise you on the best nutrition for wound healing.

It’s critical to recognize the important role nutrition plays in wound healing with special attention needed for protein, energy, fluid, arginine, zinc and antioxidants. Even if you are overweight or obese, you could still have malnutrition or sarcopenia (loss of muscle mass), which will impair healing. (Munoz, 2020).

Protein is considered the single most important nutrient when it comes to wound healing. The guidelines from the European Pressure Ulcer Advisory Panel are 1.25-1.5 grams of protein per kilogram body weight (1.25-1.5g/kg). This is the same as 0.57g/lb – 0.7 g/lb.

For example, if you weigh 200 lbs (91 kg), you need 114-140 grams per day. It will take a concentrated effort to receive this much protein in your diet. Ideally, you want to spread that protein out and not have it all in one meal. The recommended amount per meal protein target is 0.4-0.6 g/kg (0.2-0.28 g/lb) (Moore, 2014).

Here is an example of how to eat 120+ grams of protein per day:

Breakfast
Grams of Protein
1 Whole grain English Muffin
7
2 eggs
14
8 oz milk (or soy* beverage)
8
½ scoop whey protein powder
12
Subtotal: 41 grams
Morning Snack
1 high protein drink**
16
Lunch
1 slice sprouted grain bread
5
½ can tuna (170 g/6oz)
13
1 tbsp mayonnaise
0
8 oz milk (or soy beverage)
8
Subtotal: 26 grams
Afternoon Snack
1 slice sprouted grain bread
5
1 tbsp almond butter
3
1 tsp hemp hearts
1
Subtotal: 9 grams
Dinner
4 oz salmon (cooked weight)
28
2/3 cup cooked quinoa
8
2/3 cup green peas
5
Subtotal: 41 grams
Day total: 133 grams

*Note: only a soy beverage has the same amount of protein as cow’s milk. All the other plant “milks” are much lower, some with only 1 gram per 8 oz serving. Read your labels!
** Commercially available protein drinks are convenient, but you can also make your own at home and achieve the same amount of protein.

As you can see – it takes a lot of protein rich foods to reach a target of 120+ grams per day. If you are not reading labels and tracking your protein intake, chances are you are not getting enough…and that could be slowing down your wound healing. I recommend the following steps:

  1. Calculate your protein needs based on your body weight.
  2. Analyze your current protein intake by reading labels and/or using an app.
  3. Increase protein as required to meet your target.
  4. See a registered dietitian if you need help with some creative ways to help you increase your protein.
  5. Track your wound healing and protein to see the difference it is making for you.

In addition, be sure you are getting enough vitamin C by eating citrus fruits, bell peppers, strawberries or tomatoes everyday. If you have diabetes, then keeping your blood sugars within the target range will also help with wound healing.

Proper wound dressings can only do so much. Your body needs the proper building blocks to be able to heal a wound.

References:
Munoz N, Posthauer ME, Cereda E, Schols JMGA, Haesler E. The Role of Nutrition for Pressure Injury Prevention and Healing: The 2019 International Clinical Practice Guideline Recommendations. Adv Skin Wound Care. 2020 Mar;33(3):123-136. doi: 10.1097/01.ASW.0000653144.90739.ad. PMID: 32058438.

Moore DR, Churchward-Venne TA, Witard O, Breen L, Burd NA, Tipton KD, Phillips SM. Protein ingestion to stimulate myofibrillar protein synthesis requires greater relative protein intakes in healthy older versus younger men. J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):57-62. doi: 10.1093/gerona/glu103. Epub 2014 Jul 23. PMID: 25056502.


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