Assessment of diet quality after operative fixation of acute fractures

Abstract

Summary: Background: Nutrition supplementation has potential to improve clinical outcomes of musculoskeletal trauma. An improved understanding of common nutrition deficiencies present during the healing phase after trauma is needed to choose the appropriate composition of nutrition supplementation. Our objective is to document dietary deficiencies after operative fixation of acute fractures in young adults. Methods: A prospective observational study enrolled young adults (age 18–55 years) indicated for operative fixation of a pelvic or extremity fracture. Postoperative dietary intake was measured using the Automated Self-Administered 24-h dietary recall (ASA24®). Inadequate dietary intake was determined using Dietary Reference Intake (DRI) values and the Healthy Eating Index 2015 (HEI-2015) score. Results: Thirty-two subjects completed 122 ASA24® surveys in the 4 weeks after operative fixation. Dietary intake overall was severely inadequate in the early post-operative period; 81% did not meet calorie needs and protein intake was inadequate in 41%. All subjects did not meet DRIs for fiber, vitamin E, or potassium. More than 50% did not meet DRI for magnesium, zinc, folate, vitamins C, A, K, or D. The mean HEI-2015 score was 44.0 (±11.4 SD) across all time points. Conclusions: In a population of previously healthy, young adults indicated for operative fracture fixation, dietary quality was poor even compared to the average for the US population (44.0 vs 58.7 HEI-2015). This data provides targets for future clinical investigations of nutrition interventions to improve outcomes in young adults with significant musculoskeletal trauma.

Keywords

• Nutrition assessment
• Malnutrition
• Orthopedic trauma
• Postoperative
• Wound healing