By MEND Founder, Eziah Syed
Dual purpose roles in clinical nutrition
I started MEND after experiencing a stress fracture in my foot that was slow to heal. As an active person dedicated to maintaining a healthy lifestyle, I was desperate to return to normal life so I began to contemplate whether consuming certain nutrients during my recovery would have accelerated my healing. It was at that point, I became obsessed with understanding nutrition for healing and determining which specific nutrients should be consumed and in what frequency to accelerate the healing of bone, tissue and ultimately orthopedic injury?
Since that time, I’ve learned the critical role nutrition plays in healing. And specifically, the value of targeted nutrition vs. general nutrition interventions during recovery from injury, surgery or trauma.
Nutrition is incredibly important to the hospital patient, and medicine is beginning to recognize that more needs to be done
We now know from research – being conducted by MEND and other leading institutions – that an undernourished or malnourished patient will not heal as effectively as a well-nourished patient. During trauma the body’s nutritional needs significantly increase:
- The body enters a higher metabolic state and requires more energy
- Trauma and lack of use leads to muscle atrophy, which prolongs recovery
- The immune system may be weakened due to stress and shock
- Risk of wound infection is increased
- Persistent inflammation delays return of function
- Trauma and physiological stress lead to increased fatigue
- If bone is involved, the body may need more of certain nutrients, such as calcium and vitamin D, to repair
There is also evidence that better nutrition leads to better healing and less readmissions.
Readmissions lead to high costs for patients and the healthcare system. In a value-based care system where healthcare providers have greater responsibility for patient outcomes, nutrition has quantifiable implications for hospitals and professional practices, and there are billions of dollars at risk.
MDs who may have previously been skeptical are now clearly seeing the value of nutrition as the clinical evidence continues to mount. We are seeing this at the most senior level in hospitals where the chiefs of departments are currently implementing MEND because they have come to realize the import of nutrition. Many have openly acknowledged that “there is a buzz around nutrition” and “there is a gap in medicine and we are behind in this area.”
To date, nutritional interventions have focused mostly on a general approach with “complete nutrition”
The general approach to date by the larger pharmas and food companies has been to create products to improve the general nutrition status of the patient by increasing their calories, carbohydrates, protein and adding vitamins and minerals. A system wide view on “complete nutrition” – a meal in a bottle if you will, to help the undernourished patients meet their basic nutritional requirements.
There is indeed an important role for general nutrition for patients who are simply undernourished. And furthermore, since trauma significantly raises the body’s nutritional needs, all patients are in need of additional nutritional support to address this gap during injury/surgery recovery.
Unfortunately, many products on the market are still filled with ingredients that may not be the most helpful to those in need of better nutrition; water, corn syrup and sugar being the first three ingredients in one popular brand.
During trauma, the general approach may not be sufficient, creating a role for more targeted nutrition therapies
While general nutrition is important, we have discovered through research that targeted nutrition can play a very important role in addressing specific outcomes and complications. Analogous to pharmaceutical drugs used to target specific outcomes, targeted natural compounds can improve outcomes in a safe and clinically significant manner.
For example, in orthopedic trauma, ACL and joint replacement populations, patients can lose considerable muscle due to surgical shock and atrophy from disuse and this can significantly impact their recovery time while also leading to complications. Muscle atrophy and weakness (MAW) can persist for years, compromising the patients quality of life and adding to healthcare costs.
There is no evidence to show that the general nutrition products used in hospitals today can reduce MAW and enhance functional outcomes.
Another example is the military, sports or traffic accident populations; where head trauma can lead to damage to the central nervous system (CNS), neurodegenerative conditions, and lifelong problems. General nutrition, while it may be necessary for the patient’s overall health status, has no evidence to show that it will help with CNS damage. It simply isn’t designed for this purpose.
At MEND we are dedicated to addressing this challenge, identifying specific targeted nutritional therapies designed to achieve specific outcomes.
For example, we have shown through multiple randomized trials published in the most prestigious journals that muscle atrophy can indeed be reduced and functional recovery enhanced in orthopedic populations through the use of a specific formulation of essential amino acids during the acute period of recovery.
Our formulation proliferates muscle cells, preserves muscle volume and strength, improves recovery and also has shown to reduce post-operative inflammation. This is a major win for orthopedic populations where muscle atrophy and weakness is a common and thorny problem (e.g. joint replacement, ACL reconstruction, rotator cuff, trauma, etc.).
We are also working with the US Department of Defense and other high risk populations (e.g. sports and fall accidents) to look at traumatic brain injury and concussions and advance studies to show that a specific formulation of nutrients can reduce CNS damage and also be neuroreparative. Based on all the science to date, we believe that our targeted patent pending TBI formulation will show clinically significant results and will be a big win in the TBI space.
Adding targeted nutrition to a patient’s protocol can further improve outcomes.
Hospitals and private practices can add to their multimodal toolkit of patient care with this powerful combination of general nutrition and targeted nutrition designed to enhance healing and outcomes. There is enormous value to be unlocked through this approach both for the patient and for care providers.
Back to my original motivation for starting MEND. It is now clear to me that I could have enhanced my stress fracture healing and been back to normal living weeks faster than was the case. Two to three weeks of additional immobility is very significant emotionally, psychologically and perhaps financially. We are excited to be leading advancements in this emerging field of medical nutrition. We believe, as the science if supporting, clinical nutrition will become a core pillar of medicine and how we care for patients both pre and post trauma.