Everyone always worries about recovery, and what to eat after surgery. But your recovery starts long before your general anaesthetic, and here's why.

Surgery puts stress on your body- it is trauma, not entirely unlike an injury. It's just performed in a controlled environment. And stress triggers inflammation and uses up vital nutrients which can impact your recovery. Therefore the state of your health prior to surgery can impact your recovery as much as the steps you take after surgery to nourish yourself.

I like to think about it this way: when an athlete comes to me to prepare for an event, we all see it as common sense. A race or a competition is a big event that calls on your body's resources. So I work hard with that athlete to build them up, optimise their food intake for their body so that they can approach every training session strong, and recovery quickly afterwards. So why do we wait until after surgery to worry about what we eat?

Let's for a moment take out some of the obvious complicating factors like emergency surgery or patients with complicated chronic conditions because they, where possible, do receive dietary advice.

Standard surgical guidelines from your doctor or the hospital include an overnight or a morning fast. I'm going to stress here that it is essential that you follow the instructions given to you by your surgical team- there is good reason behind this protocol relating to gastric emptying, or how quickly your stomach processes your food. Not following this advice could result in a life threatening situation should you vomit while under anaesthetic. But that doesn't mean there isn't a down side to this.

Fasting prior to surgery means that patients are often dehydrated and their bodies then begin to tip into a metabolically stressed state. This means that you are drawing on your body's stores of nutrients for repair and recovery, when you are trying to heal. In the case of a bigger surgery, this is not ideal. If you do a quick search in Pubmed you'll find no shortage of articles talking about carb loading before surgery for this reason. And whilst it is becoming more widely accepted that patient information pre surgery may need to change, we aren't quite there yet. As a consequence there are doctors working on new guidelines and products that can safely be used before surgery to refuel and rehydrate patients. A friend of mine who is an anethetist is currently working on one such product, called Dex, to address this.

I'm not suggesting that you attempt to change the world before going under the knife, rather there are a few things that you can do in the days leading up to your surgery that may help:

• Hydrate: This is a really easy one. Make an effort to drink about 2L every day in the lead up to surgery. Don't go guzzling it all at once or for the most part, you will lose it in urine.
• Don't skip meals. We all do it from time to time for one reason or another. Even if you never do it again, prioritise you and your food for a few days. Give your body plenty of nutrients so you can hit the ground running long before your surgeon's scalpel even touches you.
• Eat carbs. Not just any carbs, but good quality carbs like wholemeal breads and wholegrains with every meal for a couple of days. Think of it as a low key carb load and aim for 1-2 pieces of bread or 1/2 to 1 cup of carbs with every meal in the days leading up to your surgery, and especially with your last meal prior to surgery. This serves two purposes. Firstly, when you have carbs stored in your muscles as glycogen, they store water with them so it will help you with hydration. Secondly, your body will have plenty of energy onboard to hopefully prevent some of the symptoms of fasting as well as a good energy supply until you get the all clear to eat again

I plan to do all of the above in preparation for my surgery on Friday - I may have had a small oops on my bike last week, resulting in a nasty fracture. I'm also eating moderate serves of lean protein and lots and lots of fresh fruit and veg.