By Mary Ellen Posthauer RDN, CD, LD, FAND
The role of protein in wound healing has been documented in many studies with the focus on offering high calorie, high protein supplements in addition to diet. Protein is responsible for cell multiplication, repair, and synthesis of enzymes involved in wound healing. Protein supplies the binding material of skin, cartilage, and muscle. In wound cases, research supports offering protein above the traditional 0.8 grams/kilogram of body weight recommended for the healthy adult.
The challenge for clinicians is to offer clients sources of protein with a high biological value that still contain all of the essential amino acids in amounts adequate for healing. Meat, fish, poultry, eggs, and milk are considered "complete protein" based on their amino acid profiles. Eggs are a highly valued protein source because they are an easily digestible complete protein. Protein foods from animal sources are the most expensive portion of any diet, and adding high protein supplements to the plan of care for the individual with wounds impacts the budget.
Currently, every health care entity is faced with budget reductions, and is asked to produce positive outcomes with fewer resources. Food should be the first priority when developing the nutrition component of the wound care plan. Healthcare professionals working in clinics or home-care should request that a dietitian counsel the individual on simple ways to incorporate more protein into their diet. The dietitian or health care provider should interview the individual and/or caregiver to determine:
- What are the clients’ favorite protein foods?
- Do they have any problems chewing or swallowing?
- Do they have any food allergies, such as nuts, fish, or eggs?
- Do they drink milk, or are they lactose intolerant?
- Does their budget allow them to purchase meat, fish, poultry, etc.?
- Are they able to purchase and prepare protein foods?
- What is their traditional meal pattern (i.e. two meals a day or three)?
- Are their any cultural or religious preferences that should be considered?
Menu variety is key when incorporating more protein in the diet for clients with wounds. Taste fatigue is frequently the reason clients refuse to consume the traditional oral supplements when the same product is offered regularly during the day. Some simple ways to increase protein include: adding skim milk powder to meat casseroles, scrambled eggs, gravies, mashed potatoes; using milk instead of water for creamed soups, hot cereals, or instant cocoa; adding grated cheese to salads, potatoes, pasta, or vegetables; adding eggs to casseroles or ground meat; offering yogurt (some brands provide 15-19 grams of protein per serving), pudding, ice cream, or peanut butter at meals or as a snack.
There are commercial products, both powders and liquids, that provide protein in a compact form without increasing the volume of protein-rich foods that needs be consumed. The powdered protein supplements can be mixed into food, such as cereals, potatoes, etc. Several liquid protein supplements provide 15 or more grams of protein in an ounce. As with any nutritional recommendation, the client must consume the food or supplement to achieve the benefit of the protein.
About The Author
Mary Ellen Posthauer RDN, CD, LD, FAND is an award winning dietitian, consultant for MEP Healthcare Dietary Services, published author, and member of the Purdue University Hall of Fame, Department of Foods and Nutrition, having held positions on numerous boards and panels including the National Pressure Ulcer Panel and the American Dietetic Association’s Unintentional Weight Loss work group.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.