The weeks leading up to orthopedic surgery are one of the most overlooked windows in the entire recovery process. Patients often focus on the procedure itself — the surgeon, the technique, the hospital — but the nutritional state of the body on the day of surgery has a measurable effect on how quickly tissues heal, how much muscle is preserved, and how strong the final outcome becomes. For athletes, active adults, and anyone preparing for a rotator cuff repair, ACL reconstruction, or shoulder replacement, nutrition is not a background detail. It is a clinical variable that can be optimized.
Dr. Reza Jazayeri, MD has authored and coauthored publications on orthopedic nutrition, including a 2024 JAAOS review of amino acid supplementation, a 2025 Instructional Course Lectures publication on nutritional intervention, and a 2026 JAAOS review of nutritional optimization in spine surgery.
September 2026 Research Update
The new spine-surgery review emphasizes early nutritional assessment and the limits of isolated laboratory markers. Albumin and prealbumin can reflect inflammation, so they should be interpreted alongside clinical history, intake, weight change, and function. The article reviews existing studies; its findings do not establish identical benefits for shoulder or knee procedures, or for a particular commercial supplement.
For practical questions, evidence limitations, and the publication’s financial disclosure, see our nutrition before and after surgery guide.
Why Nutrition Is a Surgical Variable
Surgery of any kind places the body under significant metabolic stress. Tissue repair requires energy, protein, and a steady supply of micronutrients at the cellular level. When nutritional reserves are low — something that is surprisingly common even in healthy, active patients — the body struggles to meet those demands. The result can be slower wound healing, prolonged inflammation, increased muscle loss, and a longer return-to-activity timeline.
The issue is particularly pronounced in orthopedic surgery, where both bone and soft tissue must remodel over weeks to months. Inadequate protein intake after a procedure can lead to measurable muscle atrophy around the repaired joint, which in turn delays rehabilitation progress and extends the window before a patient can safely return to sport.
The Role of Amino Acids in Muscle Preservation
Amino acids are the building blocks of protein, and certain essential amino acids — particularly leucine — act as direct signals that stimulate muscle protein synthesis. After surgery, when patients are less active and under metabolic stress, the body tends to break muscle down faster than it builds it. Supplementation has been studied as a way to limit postoperative muscle loss, but results depend on the patient population and regimen. It should be considered in the context of usual intake and clinical needs.
In his published work, Dr. Jazayeri outlines the clinical rationale for increasing protein and essential amino acid intake both before and after orthopedic procedures. The goal is to shift the body’s internal balance toward anabolism — the state in which tissue is actively rebuilt rather than lost.
Key Nutritional Priorities Before Surgery
There is no single supplement that guarantees a better outcome, but several nutritional priorities have strong supporting evidence and are worth discussing with a surgeon well before the date of surgery.
- Protein Intake: Ask your care team to assess your usual intake and set an individualized target for recovery.
- Essential Amino Acids: Leucine-rich sources such as whey protein or targeted amino acid supplements help stimulate muscle protein synthesis.
- Vitamin D Status: Discuss whether testing or treatment is appropriate for your procedure and medical history.
- Vitamin C and Zinc: Both play documented roles in collagen formation and wound healing.
- Blood Sugar Control: Stable glycemic control reduces surgical-site complications and supports a cleaner recovery.
- Hydration and Electrolyte Balance: Adequate hydration in the days leading up to surgery supports circulation and tissue delivery of nutrients.
A Practical Pre-Surgical Nutritional Plan
A realistic nutritional plan does not require a complete lifestyle overhaul. Raise nutrition questions at the initial surgical consultation so there is time for assessment and, when indicated, treatment and reassessment. The timeline depends on individual needs.
- Ask your surgeon whether a nutritional assessment or registered dietitian referral is appropriate. Laboratory testing should follow clinical indications.
- Discuss how meals and protein-containing foods can help meet the target recommended by your care team.
- Use a protein or amino acid supplement only if appropriate for your needs after discussing it with your care team.
- Correct any identified micronutrient deficiencies under medical guidance, especially vitamin D.
- Avoid crash dieting or aggressive weight loss in the weeks before surgery, which can deplete nutritional reserves.
- Continue targeted nutrition into the post-operative phase, when tissue demands are highest.
“Patients spend months choosing the right surgeon and the right procedure, and then show up to surgery nutritionally unprepared. The data is clear: how we eat in the weeks before and after surgery changes how we heal.”
— Dr. Reza Jazayeri, M.D.
Optimize Your Recovery with Dr. Jazayeri in Beverly Hills
Patients can discuss prehabilitation and nutritional needs as part of surgical preparation. Whether preparing for a shoulder, knee, or elbow procedure, or exploring ways to optimize long-term joint health, patients can request a consultation to discuss how nutrition fits into the larger recovery plan. Contact the office to discuss an individualized preparation and recovery plan.
References
Ng MK, Mastrokostas LE, Mastrokostas PG, Razi A, Monas A, Bou Monsef J, Razi AE, Jazayeri R. Nutritional Optimization in Spine Surgery: A Review of Its Implications for Postoperative Recovery and Outcomes. J Am Acad Orthop Surg. 2026;34(18):e2603-e2612. doi:10.5435/JAAOS-D-25-00757.
Related publications: Willey et al., 2025; Jazayeri et al., 2024, with published corrections in July and December 2024.
Updated September 21, 2026, to incorporate the 2026 spine-surgery review. Educational information does not replace your care team’s instructions, including medication, supplement, and fasting guidance.
Medically reviewed by Reza Jazayeri, M.D. on
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