Diet Impacts Adipose Tissue Response to Surgical Trauma

A new study suggests that restricting food intake to a lower-fat diet for a few weeks before surgery may protect the body against stress.

Researchers at Brigham and Women's Hospital (BWH; Boston, MA, USA) subjected mice to two types of diet. One group of mice was fed a typical Western high-fat diet (containing 60% calories from fat), while the second (control) group was given a more normal diet (containing 10% calories from fat). Three weeks before surgery, the researchers switched some of the high-fat diet mice to the normal diet. Both local and distant adipose tissue phenotypic responses were measured by gene expression of inflammatory, tissue remodeling, growth, and metabolic markers.

The researchers found that surgical trauma had a profound effect on adipose tissue phenotype at the site of trauma. Milder but significant distal effects on nontraumatized adipose tissue were also observed. Diet-induced obesity exacerbated the inflammatory aspects of the response, while preoperative diet reduction tended to reverse these changes. Age and lipopolysaccharide (LPS)-simulated bacterial contamination also impacted the adipose tissue response to trauma, with young adult animals and LPS treatment exacerbating the proinflammatory response. The study was published in the April 2013 issue of Surgery.

“Surgeons have learned that generally minimizing trauma accelerates patient recovery from surgery. While we do this well for specific organs such as the heart, blood vessels, liver, and so forth, we historically have paid little attention to the fat that we cut through to expose these organs,” said lead author Charles Keith Ozaki, MD, director of BWH vascular surgery research. “Our findings challenge us all to learn more about how fat responds to trauma, what factors impact this response, and how fat's response is linked to the outcome of individual patients.”

Dietary interventions that lend protection against stress in animal models impact both quality and quantity of adipose tissue, which holds high surgical relevance because of its anatomic location and large tissue volume. The researchers therefore suggest that fat’s its ability to rapidly change might be leveraged to lessen complications in humans during stressful situations such as surgery by reducing the imbalance back toward a more normal response.

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