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- Title
Is Overnight Fasting before Surgery Too Much or Not Enough? How Basic Aging Research Can Guide Preoperative Nutritional Recommendations to Improve Surgical Outcomes: A Mini-Review.
- Authors
Longchamp, alban; Harputlugil, Eylul; Corpataux, Jean-Marc; Ozaki, C. Keith; Mitchell, James R.
- Abstract
Dietary restriction (DR) is best known for extending lifespan in experimental model organisms, but also increases resistance to a variety of clinically relevant stressors, including those associated with surgery. Extended periods of DR, lasting months to years, are required for optimal longevity benefits in rodents, but short-term dietary preconditioning (less than 1 week) remarkably protects from acute injury. Here, we discuss recent advances in our understanding of the mechanistic basis of short-term DR and fasting in the context of surgical stress resistance, including upstream amino acid sensing by the GCN2 and mTORC1 pathways, and downstream effector mechanisms including increased insulin-dependent prosurvival signaling and elevated endogenous hydrogen sulfide production. We also review the current trend in preoperative nutrition away from preoperative fasting and towards carbohydrate loading. Finally, we discuss the rationale for the nonmutually exclusive use of brief DR or pharmacological DR mimetics to precondition against the stress and potential complications of surgery.
- Subjects
PREPROCEDURAL fasting; SURGICAL complications; ENDOGENOUS hydrogen sulfide; PROTEIN metabolism; AGING; ANIMALS; DIET therapy; FASTING; CARBOHYDRATE content of food; HYDROGEN sulfide; INSULIN; MEDICAL research; NUTRITIONAL requirements; PHOSPHOTRANSFERASES; PREOPERATIVE care; PHYSIOLOGICAL stress; TRANSFERASES
- Publication
Gerontology, 2017, Vol 63, Issue 3, p228
- ISSN
0304-324X
- Publication type
journal article
- DOI
10.1159/000453109