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Patient Education - Nutrition for wound healing: What if I have other health conditions?

Patient Education - Nutrition for wound healing: What if I have other health conditions?

Patient Education - Nutrition for wound healing: What if I have other health conditions?

What should I do if I have diabetes mellitus, kidney disease, high blood pressure, food allergies, and other conditions that affect what I eat? 

If you have other health conditions that affect what you can or cannot eat, follow the recommendations provided by your clinician and/or registered dietitian. Below you can find generalized nutrition guidance on common conditions such as diabetes mellitus, kidney disease, high blood pressure, obesity, and food allergies.


Diabetes mellitus

High blood sugar levels interfere with wound healing. Nutrition is essential in the management of diabetic ulcers. Nutritional goals include achieving and maintaining a healthy weight and adequate levels of sugar/fat in your blood. To do that [1][2]:

  • Keep track of how much carbohydrate you eat. For instance, you can count how many carbohydrates you eat per meal.
  • If you take insulin, your insulin doses need to be coordinated with the amount of carbohydrate you eat in each meal. Follow your clinician’s recommendations.
  • For good health, get your carbohydrates from high-fiber foods (such as vegetables, fruits, whole grains, legumes) instead of processed foods with added fats, sugars, or sodium.
  • Consume foods rich in micronutrients (such as vitamins A, D, E, and C, minerals, and trace elements of iron, zinc, and magnesium) 

Kidney disease

Kidney disease can delay wound healing. A kidney that is not working properly can fail to properly filter the blood, causing the body to accumulate substances that are normally eliminated through urine. As a result, patients with kidney disease often need to limit the amount of protein and certain nutrients in their diet. However, for a wound to heal, the body needs more protein and vitamins. Thus, patients with kidney disease and wounds need to have a nutritional plan that considers both conditions. General recommendations include[3][4]:

  • Protein:
    • For kidney disease in the initial stages (stages 1 and 2): your clinician may suggest increased amounts of protein to help your wound heal (1.25-1.5 grams of protein per kilogram of body weight per day)
    • For kidney disease in later stages (stages 3-5): your clinician may restrict protein to preserve your kidney (protein intake may be decreased to 0.6 to 0.75 grams of protein per kilogram of body weight per day). If you are on dialysis, your clinician may increase the amount of protein in your diet, to help your wounds heal faster. 
  • Sodium: too much sodium can increase blood pressure. Avoid high-sodium foods such as salt, bacon, ham, corned beef, pepperoni, sausage, pizza, etc. 
  • Potassium: limit the amount of potassium in your diet to avoid potassium buildup in your body. Foods to be avoided include bananas, oranges, milk, prunes, etc. 
  • Phosphorus: you may need to avoid phosphorus-rich foods such as milk, beans, nuts, etc
  • Vitamins and minerals: oral supplementation is often needed

High blood pressure

High blood pressure can delay wound healing. Problems in your arteries can decrease the amount of blood and nutrients delivered to your wound. It is important to have healthy habits and take medication to get or keep your blood pressure normal, as recommended by your healthcare professional. General suggestions include: 

  • Choose high-fiber foods and minimize processed foods. 
  • Eat less fatty foods. That is, choose foods rich in a type of fat called “omega 3 and 6” and cut down on saturated and trans fats.
  • Avoid substances that increase blood pressure, such as nicotine, alcohol, caffeine, salt, etc.
  • Keep your blood pressure controlled by taking your blood pressure medications as recommended by your healthcare provider.

Obesity

Obesity can delay wound healing by decreasing the amount of blood and nutrients delivered to your wound.[5] Along with exercise, adequate nutrition is one of the most critical pillars in achieving and maintaining a healthy weight. Your healthcare provider may suggest that you: 

  • Choose nutrient-dense and high-fiber foods and minimize processed foods.
  • Eat more proteins and decrease the number of carbohydrates and fats. Maximize protein intake while minimizing calories.

Food allergies

Avoid food that can induce allergic reactions.

  • Find a safe alternative food with similar nutritional value or consider oral supplementation.
  • Follow the recommendations of your healthcare provider if a food allergen is accidentally ingested.

How do I put what I have learned into action? 

Glad you asked! Click on the topics below to jump-start good eating habits that will help you heal your wounds faster (topics coming soon!)

  • Patient Education - Nutrition for Wound Healing: Understanding the Basics
  • Nutrition for wound healing in action - Step 1: Map out your meals
  • Nutrition for wound healing in action - Step 2: Leverage supplements
  • Nutrition for wound healing in action - Step 3: Shop smartly
  • Nutrition for wound healing in action - Step 4: What if I don’t cook?

When to contact your healthcare provider

In general, if there is little to no improvement in the condition of your wound/pressure ulcer, it is a good time to reach out to your healthcare provider. Proper nutrition can pave the way to a clean and healthy wound, as well as improve your overall health and well-being. 

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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

REFERENCES

  1. Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P, Yancy WS Jr et al. Nutrition therapy recommendations for the management of adults with diabetes. Diabetes care. 2014;volume 37 Suppl 1():S120-43.
  2. Vas PRJ, Edmonds ME, Papanas N et al. Nutritional Supplementation for Diabetic Foot Ulcers: The Big Challenge. The international journal of lower extremity wounds. 2017;volume 16(4):226-229.
  3. Collins N. Nutrition 411: Nutrition for the Patient with Chronic Kidney Disease and Wounds Wound Management & Prevention [Internet]. 2011;volume 57(9):.
  4. Maroz N. Impact of Renal Failure on Wounds Healing. The journal of the American College of Clinical Wound Specialists. 2018;volume 8(1-3):12-13.
  5. Avishai E, Yeghiazaryan K, Golubnitschaja O et al. Impaired wound healing: facts and hypotheses for multi-professional considerations in predictive, preventive and personalised medicine. The EPMA journal. 2017;volume 8(1):23-33.
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