Traditionally, the focus on exercise and nutrition has been reserved for after surgery as a way to recover from the operation. New research from UCLA shows that what is done before a surgery in terms of exercise and nutrition is even more important when it comes to improving outcomes and reducing recovery time.

The concept is called prehabilitation and it's growing in popularity among doctors as a way to reduce complications and shorten the hospital stays of their patients.

Researchers looked at 23 randomized controlled trials with more than 2,100 patients. The focus was on participants who went through prehabilitation programs designed to improve physical health through exercise and nutrition optimization.

The scientists looked at how prehabilitation affected complications and the length of hospital stays within 12 weeks after surgery. They also looked at things such as quality of life and mental health. A majority of the studies (78 percent) focused on exercise interventions, while the remainder used nutrition as the basis for pre-surgery intervention.

Both exercise and nutrition programs improved outcomes. Postoperative complications were reduced by nearly half (48 percent) and hospital stays were shortened by 11 percent.

Despite a large disparity in terms of the length of pre-surgery exercise, two weeks to six months, and the fact some was conducted under clinical supervision and some was self-supervised, the chance of developing complications from the surgery was cut by 55 percent.

Nutrition-based interventions cut hospital stays by about 14 percent. These programs were typically one to two weeks prior to surgery and were focused on specialized nutritional supplementation geared toward immune system support.

"Both nutritional and exercise-based prehabilitation programs can improve recovery after surgery, but each may offer different benefits," said Catherine T. Cascavita, MD, first author of the study. "More research is needed to determine which type of program works best for individual patients and their specific surgery."

The prehabilitation programs in the studies were typically exercise-based for orthopedic cases and nutrition was the intervention when the surgery involved gastrointestinal or cardiac issues.

"These findings support the value of prehabilitation programs in optimizing health for patients, especially those who are at high risk of facing complications or who may benefit from extra support before undergoing surgery," said senior author Justine C. Lee, MD, Ph.D. "We are just beginning to understand how we can improve surgical outcomes before a patient has surgery."

Click here to read more in the Journal of the American College of Surgeons.