An often overlooked part of surgery is the nutrition factor. Eating correctly will help your body recover faster and fuel it for the increased metabolic demand. This series we have Kylie Gearhart MS, RD-AP, CDN, CNSC to give expert advice on some common supplements for orthopedic patients and what to watch out for when shopping for supplements!

Miss Part 1 on what to eat before surgery? Check it out here!

Part 2 on what to after surgery can be seen here!

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Common Supplements and Supplement Overview

Patients are often seeking herbal/nutritional supplements to optimize their nutritional

status and healing, however internet searches mixed with exceptional brand marketing

strategies can lead to misinformation. The job of a registered dietitian is quite often myth busting the results of those internet searches by applying evidence based research applied with the overall patient clinical picture in order to provide appropriate patient-centered advice.

This post will serve as a guide to frequently inquired about herbal and nutritional supplements by orthopedic patients.

Turmeric: This popular spice has been used for centuries, not just to flavor or color food, but for anti-inflammatory effects of the phytochemical curcumin. Research has shown that on top of curcumin’s anti-inflammatory properties, evidence exists for cholesterol-lowering, antidiabetic, antioxidant, and anticancer properties. Specific to orthopedic patients, curcumin has been shown in studies to reduce arthritis pain and swelling. There is currently no recommended dosage, however studies have suggested 1 to 3 grams of dried, powdered turmeric root per day is needed to achieve benefits. Add to coffee, tea, rice, lentils, vegetables, soups, stews, or dressings and consume with high fat foods such as olive oil, avocado, fish, and seeds to optimize absorption.

Red Algae: For thousands of years, different forms of algae have been used to help lower blood glucose levels, detoxify heavy metals, and improve gastrointestinal health. Research shows red algae may increase blood circulation, control hypertension, act as an antioxidant, regulate glucose levels, lower LDL or “bad” cholesterol, and improve the immune system. In its natural form, red algae is a sea vegetable which is rich in protein, fiber, and vitamins. If you are a sushi-lover, chances are you consume red algae in the nori sheets which are typically used to roll sushi. Red algae comes in a supplement form for those looking to achieve glucose control, lower cholesterol, or improve their immune system, however use caution with dosage as there is a risk of iodine toxicity side effects and drug/nutrient interaction, especially with blood-thinning medications due to the high vitamin K content. Consult with a doctor before beginning supplementation.

Green Tea: Green tea has been studied for decades and is strongly associated with metabolism and fat burning properties. Green tea contains catechins which are flavanoids (also found in red wine) and provide strong antioxidant activity, therefore exhibiting protection against many chronic diseases including cardiovascular disease, cancer, type 2 diabetes, and neurodegenerative disease. However, research shows that usually three to four 8-oz cups of green tea per day are needed to achieve the beneficial effects on weight loss, metabolic syndrome and type 2 diabetes, which is why some people opt for a dietary supplement form of green tea extract. Beware that excess consumption of green tea extract has been linked to liver toxicity and should only be given under direction and supervision of a physician. Green tea has beneficial effects and is healthier than many other beverages, but the capsulated form would not be something I would personally recommend as it is not worth the risk of liver injury.

Picking the Right Supplements

As a general rule of thumb, avoid products with over the top marketing and over-zealous benefit claims, ie. boasting maximized energy, rapid healing, high-performance brain power, elevated mood, ultimate relaxation, etc. These claims are likely not backed by research and more-so subjective statements used by marketers and social media experts to grasp consumers’ attention (and money). However, if patients tried a product and felt it was effective (and not just placebo effect), and their physician/dietitian feel the product is safe for consumption – by all means, continue consuming the product. It is also important to keep in mind any drug/nutrient interactions and to consult with a licensed practitioner before relying on any nutritional supplement for desired health outcomes, especially if anticipating a surgery as some dietary supplements impact the viscosity of blood. Another concept to consider is that purchasing costly functional beverages doesn’t seem to be necessary when many food sources contain the same nutrients or functional ingredients.

Food should always come first!

References:

1. Shehzad A, Rehman G, Lee YS. Curcumin in inflammatory diseases. Biofactors. 2013;39(1):69-77.
2. Shishodia S, Sethi G, Aggarwal BB. Curcumin: getting back to the roots. Ann N Y Acad Sci. 2005;1056:206-217.
3. Aggarwal BB, Harikumar KB. Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases. Int J Biochem Cell Biol. 2009;41(1):40-59.
4. Menon VP, Sudheer AR. Antioxidant and anti-inflammatory properties of curcumin. Adv Exp Med Biol. 2007;595:105-125.
5. Turmeric. University of Maryland Medical Center website. Last reviewed May 4, 2011. Accessed April 23, 2014.
6. Frenkel M, Abrams DI, Ladas EJ, et al. Integrating dietary supplements into cancer care. Integr Cancer Ther. 2013;12(5):369-384.
7. Seon-Heui Cha, et al. Screening of Extracts From Red Algae in jeju for Potentials Marine Angiotension-1 Converting Enzyme (ACE) Inhibitory Acitvity. Algae. 2006:21(3): 343-348.
8. Dennett, C. Green Tea Catechins. Today’s Dietitian. 2019: 21(8): 18.
9. Yang CS, Wang H, Sheridan ZP. Studies on prevention of obesity, metabolic syndrome, diabetes, cardiovascular diseases and cancer by tea. J Food Drug Anal. 2018;26(1):1-13.

Kylie Gearhart MS, RD-AP, CDN, CNSC is a registered dietitian nutritionist based in New York City.

Associate Dietitian – New York Nutrition Group (accepting most insurance coverage and available for in person or virtual nutrition consultations): https://www.nynutritiongroup.com/

Contact Kylie for a nutrition evaluation: kyliegearhart@gmail.com

Follow Kylie on social media @kylie.nutrition

Check out her personal website: https://kylierd.com/