Wound healing involves three main stages: inflammation, proliferation and remodeling. It involves different cell types, soluble mediators and proteins. Nutrition influences wound healing, in that, those with nutritional deficiencies or certain disorders, such as diabetes, can experience impaired wound healing.
Carbohydrates provide the main source of energy for wound healing. A lack of calories from carbohydrates results in the use of protein as an energy source. The American Dietetic Association recommends that 45 to 65 percent of diabetics daily calorie intake should be through carbohydrates, spread throughout the day, to maintain blood sugar level and allow normal wound healing.
A diet reduced in protein can inhibit wound healing. Dietary proteins are broken down into amino acids and peptides that are needed to repair tissue, such as collagen. Breslow demonstrated in a study in 1993 and published in the "Journal of the American Geriatrics Society," a high-protein diet improved healing of chronic wounds, such as pressure sores. The amount of protein required depends on the age of the patient, size of the wound and underlying factors such as stress or infection.
A number of vitamins facilitate wound healing. In 2009, a study published in the "Brazilian Journal of Biology," showed that in an animal model, wounds treated with a cream containing ascorbic acid improved healing. Ascorbic acid, otherwise known as vitamin C, is involved in the manufacture of collagen. Other vitamins, such as vitamins A and E, are also shown to improve wound healing, though supplementation should be taken with caution and only under the care and supervision of a physician.
Fat in the diet is also used as an energy source. Fatty acids are also important in both cell signaling and in the cell membrane. In 2010, Dr. Park and colleagues from Kyung Hee University published "Mediators of Inflammation," which showed that in an animal model, supplementation with linoleic acid, an essential fatty acid, accelerated wound healing by improving inflammation.
Wound healing requires minerals. Enzymes involved in the remodeling phase of wound healing require zinc, and collagen synthesis also requires zinc. Iron is also involved in collagen synthesis, and lack of iron can result in a poor wound healing. Zinc and iron are both required for the enzymes needed for the synthesis of collagen.
- American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2004;27(suppl 1):S5--S10.
- "Journal of the American Geriatrics Society"; The Importance of Dietary Protein in Healing Pressure Ulcers;
- "Brazilian Journal of Biology"; Ascorbic Acid for the Healing of Skin Wounds in Rats; Lima CC, et al.; November 2009
- "Mediators of Inflamation;" Effect of Dietary Conjugated Linoleic Acid Supplementation on Early Inflammatory Responses During Cutaneous Wound Healing; Park NY, et al.; August 2010