The effects of dietary macronutrient balance on cutaneous wound healing

Jonathan Hew1, Craig P. Mooney1, Julian K. Smyth1, Cassandra Chong1, Samantha Solon-Biet2, Stephen J. Simpson2, Zhe Li3, Peter Maitz3 and Yiwei Wang3

1Burns research Group, ANZAC Research Institute, The University of Sydney, NSW, 2173, cmoo8245@uni.sydney.edu.au,  jhew2010@gmail.com, cchong89@yahoo.com
2Nutritional ecology, Charles Perkins Centre, The University of Sydney, NSW, 2006, biet@sydney.edu.au, simpson@sydney.edu.au
3Burns Unit, Concord Repatriation General Hospital, Concord, NSW, 2173, zhe.li@sswahs.nsw.gov.au, maitz@sydney.edu.au, yiweiwang@anzac.edu.au

Rational

Diets high in both protein and energy content have been clinically proven to effectively enhance the wound healing process post severe burn injury (Hall et al., 2012). However, the optimum macronutrient composition for burn and cutaneous wound healing and the mechanisms by which nutrition influences the healing process remains unclear (Abdullahi and Jeschke, 2014).

Objective

This preliminary study investigates how the macronutrient P:C:F (protein: carbohydrate: fat) composition of diets modulates key elements in cutaneous wound healing.

Methods and Results

Male C57BL6 mice (n = 180) were fed control chow ad libitum for eight weeks. At eight weeks, two individual 1x1cm dorsal wounds was surgically created. After wounding mice were fed one of 12 experimental diets selected to cover a wide range of the macronutrional spectrum for four weeks. Wound healing rate was measured and skin/organ biopsy collected on day 3,5,7,10,14, 21 and 28. Results were analysed using a novel method “Nutritional Geometry” which is capable of assessing both the individual and interactive effect of macronutrients (Simpson et al., 2015). We found that the optimum diet for cutaneous wound healing is a low protein, high carbohydrate diet with 50% wounds healed by 4 days compared to the poorest diet (high fat, high protein), with 9 days required to reach 50% healing. We also found that carbohydrate is the dominant macronutrient expediting early wound healing (day 1-7) whilst the later stage of wound healing process is dependent on protein intake ( day 7-21).

Conclusions

We present the first ever-systematic investigation, exploring the interaction between macronutrients and cutaneous wound healing in a mammal, showing that specific macronutrient consumption influences wound healing. In future this process will be repeated in a severe burn  wound model associated with hypermetabolism

Key Words

Nutrition, wound healing, mouse model

References

Abdullahi, A. & Jeschke, M.G. 2014. Nutrition and Anabolic Pharmacotherapies in the Care of Burn Patients. Nutr Clin Pract.
Hall, K.L. Shahrokhi, S. & Jeschke, M. G. 2012. Enteral nutrition support in burn care: a review of current recommendations as instituted in the Ross Tilley Burn Centre. Nutrients, 4, 1554-65.
Simpson, S.J., Le Couteur, D.G. & Raubenheimer, D. 2015. Putting the balance back in diet. Cell, 161, 18-23.

Biography

A 2015 graduate of the medical program at the Sydney University. I began a PhD with the Burns Research Group during my second year of my medical degree. Since this time i have complete both scientific and medical work in pursuit of my interest in burns and surgery.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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