Nutritional Support for Injuries

Energy necessity is an indispensable component of every nutrition plan and should be given special consideration during recovery. The majority of injured people decrease their total energy supply due to reduced physical activity. The procedure may seem apparent, however, it is important to note that during the recovery phase, energy demand increases, particularly when the injury is severe. If the restriction of energy balance is too great, recovery may be slowed by metabolic changes. Maintaining energy balance during injury is challenging. A negative energy balance can make healing more difficult and increase the risk of muscle loss. A positive can contribute to an increase in fat tissue. Regardless, an increase in energy necessity of 15–50% is recommended in injured individuals depending on the severity of the injury.

Inadequate protein intake can hinder wound healing and increase inflammation. It is important to note that muscle loss is associated with reduced myofibrillar protein synthesis, and treatment processes are heavily dependent on collagen and other protein syntheses. Providing adequate protein intake is of great importance, as limiting energy needs can also reduce protein supply. Less protein intake can have a negative impact on muscle metabolism, even if total protein consumption remains at recommended levels. This can be observed in individuals who consume a larger amount of protein. A drastic reduction in protein intake can lead to the development of a negative nitrogen balance. Additionally, during periods of inactivity, muscles become less anabolically sensitive, making it difficult to build and maintain muscle mass. Research suggests that daily protein requirements for injured individuals should be 1.6-2.5 g/kg body weight, which is the amount required to maintain muscle mass during immobilization. Protein portions should be carefully planned in a nutritional plan, and appropriate amounts of high-quality protein should be provided at regular intervals every 3-4 hours (20-40 g or 0.3-0.4 g/kg, 3 g leucine).

Substantiation exists for the increase in consumption of nutrients other than protein during periods of immobilization or decreased activity after an injury. Creatine is one such nutrient. The general application of creatine aims to enhance muscle mass gain during resistance training. Evidence regarding creatine use to prevent muscle mass loss during immobilization is inconclusive. On one hand, supplementation with creatine for 2 weeks by healthy individuals with an immobilized limb was not associated with a diminished muscle mass loss. On the other hand, during rehabilitation after physical activation, creatine supplementation results in augmented muscle gain and strength compared to a placebo. A recommended dosage is 10 grams daily for 2 weeks, followed by 5 grams daily for 4-6 weeks. Omega-3 fatty acids are frequently used by individuals in recovery due to their anti-inflammatory and immunomodulatory effects. They can be found in food products such as fatty oceanic fish, seafood, rapeseed oil, olive oil, and flax seeds; they are also available in dietary supplement form. Despite their health benefits, introducing omega-3 supplementation appears to be an ill-considered action. Administration of omega-3 fatty acids could be considered for individuals experiencing prolonged inflammation. However, research findings suggest that omega-3 fatty acids should not be introduced in acute inflammatory states due to impaired wound healing. Recommendations for omega-3 supplementation during immobilization should be treated with great caution.

Isoleucine, like leucine, is an exogenous amino acid and plays a significant role in the process of stimulating muscle mass synthesis. It is believed that supplementation with isoleucine during immobilization can help reduce the risk of muscle tissue loss and consequently strength loss. It is recommended to take 4 g of isoleucine in the evening.

Numerous dietary components and nutritional strategies are suggested for supporting the treatment of injuries and wounds. Caution is advised when introducing changes. It is recommended to avoid significant energy restriction and to create nutrition plans focused on rebuilding. Considering the introduction of increased protein (22,5 g protein/kg body weight per day) is advisable, with the protein amount remaining the same even with restricted energy intake. There is a clear correlation between many microelements and other nutrients (e.g., zinc, vitamin C, vitamin A, and others) and wound healing and body regeneration during the regeneration phase. The recommendations for microelement and vitamin intake are similar – avoiding deficiencies and providing adequate amounts of vitamins and minerals through diet is recommended.