Dr Jonathan Hew1, Roxanne J Parungao1, Dr Criag P Mooney1, Dr Julian K Smyth1, Dr Samantha Solon-Biet2, Caroline Nicholls3, Dr Cassandra Chong1, Professor Stephen J Simpson2, Dr Zhe Li1, Professor Peter Maitz1, Dr Yiwei Wang1
1The Anzac Research Institute, Concord, Australia, 2Nutritional Ecology , Camperdown, Australia, 3Burns unit, Concord, Australia
Rational: High-protein, high-energy diets are used to support the healing process for burn wounds and donor sites while minimising the loss of lean body mass after injury. However, the optimal macronutrient, protein:carbohydrate:fat (P:C:F) composition and the mechanisms by which nutrition influences the healing process remains unclear. This study investigates how macronutrients enhance cutaneous wound healing and alter the systemic response to injury.
Methods and Results: Two individual 1x1cm dorsal wounds were surgically created on male C57BL6 mice (n=180). After wounding mice were fed one of 12 diets varying in P:C:F. Results confirmed wounding induced a systemic stress response with weight loss, increased energy expenditure, reduced adipose and lean body mass (LBM). Surprisingly, while a high-protein diet minimized loss of LBM it was associated with delayed wound healing. Unexpectedly, we found a low-protein, high-carbohydrate diet optimised cutaneous wound repair with a subsequent small loss of LBM. This finding is in opposition to the current assumption that increased protein intake is required for protein synthesis during wound healing processes and supports a novel idea that mobilisation of protein reservoirs in lean body mass may be beneficial for wound healing.
Conclusions: We present the first ever systematic investigation, exploring the interaction between macronutrients and cutaneous wound healing in a mammal, showing that low protein diets are optimal for cutaneous wound healing. In future, this process will be repeated in a severe burn wound model.
An aspiring burns surgeon who has been completing a PhD in nutrition and wound healing the past 5 years at the ANZAC Institute, Sydney.