Protein for Healing
Q My best friend Emily is 22 and she lost her right leg below the knee in a car accident this past feb.14th. She is a vegetarian, (nearly vegan), and the doctors are telling her that she needs to eat animal proteins, (especially eggs), in order to heal faster. She is really trying to get her life back in order, and will do whatever it takes to get strong enough to relearn how to walk and use a prosthetic, but she would like to do so while remaining on a more natural and healthy diet. Her doctors are extremely skeptical about it. Could someone there please give us some advice on the very best things she can eat in order to facilitate her healing? We would appreciate it so much. She will be out of the hospital in the next week or so.
A It is a perfectly normal response for healthcare professionals who are not vegetarians or vegans to push animal proteins when a major surgery or wound healing event occurs. Protein needs increase dramatically during these times. However, a vegan diet can take care of these increases. Just like folks that ingest animal products, during surgery you have to take a little more care on what it is you are eating.
I usually promote beans and grains for the average veghead. However, with Emily, I would like her to focus on soy products and quinoa. These are very high in protein. There is a scale to measure the amount of protein in foods called, Protein Digestibility Corrected Amino Acid Score (PDCAAS) . The PDCAAS looks at the amino acid content and digestibility to give individual foods a score. The highest value is 1.0 with 0 as the lowest. Here is a table with some PDCAAS values
As you can see soy is higher than beef in this scale of protein sources. There is adequate amounts of protein in plant foods. As opposed to what I usually say, in my most annoying voice, about ?get over the protein thing?, in this case I would be tracking the protein intake.
How much protein?
The usual schmoe-nose walking down the street needs about 0.8 grams of protein per kilogram. I?m 5?5? and weigh 125 pounds. I need about 45 grams per day. That includes the days I am working out.
Surgical patients need more protein because they are healing wounds. Their needs are 1.5-2.0 grams per kilogram. So, that would put me up to 85 grams. That is a lot of protein. Here?s an idea of how to get it:
scramble [3oz], soy milk [8oz]
|15 + 8||23|
[2 Tbls], rye bread 
|12 + 3||15|
beans [1C], whole wheat tortilla , rice cheese [1 slice], hemp milk
|14 + 3 + 4 +4||25|
[.5C], spicy pumpkin seeds [2 Tbls]
|4.5 + 5||9.5|
Pasta [1C], cannelini beans [.5C]
|20 + 7.5||27.5|
There are a million ways to make this work. I left out the fruits and vegetables that would accompany the foods listed above. There will be added proteins from the fruits and vegetables, although in much lower amounts. I would include omega-3 sources. Good sources for omega-3s are walnuts, pumpkin seeds and flax meal, not flax seeds.
Another nutrient essential in healing is zinc. Vegetarians/vegans are notorious for not getting enough. Zinc assists the immune system, skin health, growth hormones and appetite just to name a few. The recommended daily allowance for zinc is around 8mg for adult women.
Here is a website with a small table of zinc sources: http://www.vegsoc.org/info/zinc.html.
I put out this topic on the listserv of Vegetarian Nutrition Practice Group of the American Dietetic Association.* Responses to that jogged my memory about other nutrients for major trauma healing.
Vitamin C – Vitamin C is necessary for tissue health. That leg and any other healing area Emily may be nursing could use a boost. Looking at my pretend menu, adding 10 cups of salad and greens with a couple of fresh fruits would bring in the needed vitamin C. A word of caution, vitamin C is very susceptible to heat and light. So, I?m stressing having raw veggies and fruits to make sure you get all the vitamin C you can from your foods. Remember, I?m a dietitian. We think food does just about everything you need. I mean, you can run a car on old frying oil. However, I will come down off my pedestal to say that if Emily?s primary care practitioner offers vitamin C or zinc supplements I would take them.
The last piece of information from the merry band of nutrition gurus was about the use of Arginine. I looked up a couple of studies to find support for the use of arginine, an amino acid, with collagen and tissue growth as well as increasing T cells. It appears that these studies used 30mg of arginine aspartate to achieve increases in wound healing.
Once the initial wound healing is done, Emily may still need an elevated protein amount, I am guessing around 1gram per kilogram, until she is done with physical therapy.
My heart goes out to Emily and her changed life. She has many issues to deal with, but she can keep her food choices and keep her health.
*Thanks to Dina Aronson, MS, RD; Cathy Hains, RD; Diane Ferchak, RD, LDN