title: Is Overnight Fasting before Surgery Too Much or Not Enough? How Basic Aging Research Can Guide Preoperative Nutritional Recommendations to Improve Surgical Outcomes: A Mini-Review.
abstract: Dietary restriction (DR) is best known for extending lifespan in experimental model organisms, but also increases resistance to a variety of clinically relevant stressors, including those associated with surgery. Extended periods of DR, lasting months to years, are required for optimal longevity benefits in rodents, but short-term dietary preconditioning (less than 1 week) remarkably protects from acute injury. Here, we discuss recent advances in our understanding of the mechanistic basis of short-term DR and fasting in the context of surgical stress resistance, including upstream amino acid sensing by the GCN2 and mTORC1 pathways, and downstream effector mechanisms including increased insulin-dependent prosurvival signaling and elevated endogenous hydrogen sulfide production. We also review the current trend in preoperative nutrition away from preoperative fasting and towards carbohydrate loading. Finally, we discuss the rationale for the nonmutually exclusive use of brief DR or pharmacological DR mimetics to precondition against the stress and potential complications of surgery.
authors.affiliation: Department of Genetics and Complex Diseases, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Alban
authors.initials: A
authors.lastname: Longchamp
authors.forename: Eylul
authors.initials: E
authors.lastname: Harputlugil
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Corpataux
authors.forename: C Keith
authors.initials: CK
authors.lastname: Ozaki
authors.forename: James R
authors.initials: JR
authors.lastname: Mitchell
mesh_terms: D055372:AMP-Activated Protein Kinases / Q000378:metabolism; D000375:Aging / Q000502:physiology; D000818:Animals; D031204:Caloric Restriction / Q000009:adverse effects / Q000379:methods; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D005215:Fasting / Q000009:adverse effects; D006801:Humans; D006862:Hydrogen Sulfide / Q000378:metabolism; D007328:Insulin / Q000378:metabolism; D000076222:Mechanistic Target of Rapamycin Complex 1; D046912:Multiprotein Complexes / Q000378:metabolism; D009747:Nutritional Physiological Phenomena; D011300:Preoperative Care / Q000009:adverse effects / Q000379:methods*; D017346:Protein Serine-Threonine Kinases / Q000378:metabolism; D056564:Sirtuin 1 / Q000378:metabolism; D013312:Stress, Physiological; D058570:TOR Serine-Threonine Kinases / Q000378:metabolism; D057170:Translational Research, Biomedical
chemical_list: D004040:Dietary Carbohydrates; D007328:Insulin; D046912:Multiprotein Complexes; D000076222:Mechanistic Target of Rapamycin Complex 1; D017346:Protein Serine-Threonine Kinases; D058570:TOR Serine-Threonine Kinases; D055372:AMP-Activated Protein Kinases; D056564:Sirtuin 1; D006862:Hydrogen Sulfide