Participants With ACL Injury Have Poor Diet Quality And Lower Energy Intake After Reconstruction Surgery.

Abstract

PURPOSE: High-quality diet and sufficient energy support optimal recovery following orthopedic injury. Our goal is to determine participants’ energy intake and diet quality before and after anterior cruciate ligament (ACL) reconstruction. METHODS: Thirty-six participants (mean ± SD; age, 21.5 ± 5.9; BMI, 25.1 ± 4.0; 53% female) who sustained an ACL tear volunteered for a physical therapy rehabilitation study. Concurrent with the parent trial, 3-day diet records were collected before and after ACL reconstruction. Participants recorded food and drink intake for two weekdays and one weekend day. A registered dietitian educated participants about keeping food records and estimating portion sizes. The dietitian prompted participants to complete records on assigned days and checked diet logs throughout the recording period for completeness. Energy consumption was analyzed through Nutrition Data System for Research (NDSR), and diet quality was measured using Healthy Eating Index 2015 (HEI-2015). Paired t-tests were used to compare pre-and post-surgery average energy intake (kcal), weight (kg), and protein (g/kg). One-sample tests were used to compare HEI-2015 to population averages for children and adults using NHANES 2015-2016 data. RESULTS: Average energy consumption decreased from pre-surgery to post-surgery (1797.3 ± 588.9 vs. 1587.8 ± 604.9, respectively; p = 0.029). Comparisons pre- and post-surgery for weight (74.9 kg ±18.0 vs. 74.5 ± 18.5), kcal/kg (24.8 ± 7.5 vs 22.3 ± 8.8), and protein g/kg (0.99 ± 0.35 vs. 0.97 ± 0.44) did not show differences. HEI-2015 was significantly lower in teenagers pre- and post-surgery compared to the US average of 53 for Americans age 2-19 (42.4 ± 8.5; p < .001; 42.7 ± 9.8; p < .001). Adult participants’ HEI was significantly lower than the US average of 59 only after ACL reconstruction (53.2 ± 13.3; p = 0.073; 50.5 ± 13.2; p = 0.011). Children had significantly lower HEI-2015 than adults before reconstruction (42.4 ± 8.5 vs 53.2 ± 13.3; p = 0.007) but not after (42.7 ± 9.8 vs 50.5 ± 13.2; p = 0.057). CONCLUSION: On average, energy intake decreases following ACL surgery in young participants. Future research should address links between diet quality, reduced energy intake and recovery following ACL surgery.