Medically reviewed by Dr. Patrick Denard, orthopaedic surgeon, on October 8, 2026

Short answer: No food guarantees faster healing, but going into surgery well fed is the part you control. In the 2 to 4 weeks before planned surgery, aim for at least 1.2 g of protein per kg of body weight a day (about 96 g for a 176 lb adult), use a protein shake only to fill gaps, ask to be screened for poor nutrition, get blood sugar into range if you have diabetes, and let your surgeon set stop dates for supplements. Fasting rules come from your anesthesia team, not the internet.

This is our hub for the weeks before surgery: what the guidelines say, where the evidence is thin, how to turn it into meals, and what to expect from the week before surgery to 6 weeks after. For the last 24 hours, see what to eat the night before surgery and our carb loading drink guide. Procedure pages are listed near the end.

Disclosure: Thrive Protocol makes surgical nutrition products, and this is Thrive Protocol's own site. We describe our own kit near the end of this page, separately from the research.

Why the weeks before surgery matter

Surgery is a planned stress. For a few days afterward most people eat less, move less and lose some muscle, and the body draws on whatever reserves it walked in with. The European Society for Clinical Nutrition and Metabolism (ESPEN) lists the key steps of good surgical nutrition as screening for risk early, avoiding long fasts, controlling blood sugar and getting people eating and moving again quickly after the operation [1, 2].

The weeks before surgery are the only part of that list you fully control. You can't change the operation. You can change what you bring to it.

Step 1: Ask whether you should be screened for poor nutrition

Poor nutrition doesn't always show on the scale, so a short screen helps. The American Society for Enhanced Recovery and Perioperative Quality Initiative (ASER/POQI) built a quick check called the Perioperative Nutrition Screen. It flags you as being at nutrition risk if any of these apply [3]:

  • BMI under 18.5, or under 20 if you are over 65
  • Weight loss you didn't plan for in recent months
  • Eating less than half of your normal diet in the past week
  • A blood albumin level under 3.0 g/dL

If you are flagged, the consensus advice is high-protein oral nutrition supplements for at least 7 days before major surgery, with at least 18 g of protein per serving, two to three times a day [3]. ESPEN goes further for people at severe nutritional risk, such as those who have lost 10 to 15% of their body weight in six months. For them, nutrition therapy should come before major surgery even if the date has to move, and seven to 14 days may be appropriate [2]. Your surgical team makes that call.

Step 2: Hit a daily protein target

ESPEN estimates protein needs around surgery at about 1.5 g per kg of ideal body weight a day [1]. ASER/POQI notes that stressed patients are generally advised to get at least 1.2 to 2.0 g per kg a day [3]. Here is the arithmetic for one example person:

  • Body weight: 176 lb, which is 80 kg (176 divided by 2.2)
  • At 1.2 g/kg: 80 x 1.2 = 96 g of protein a day
  • At 1.5 g/kg: 80 x 1.5 = 120 g of protein a day
  • Split over three meals and one snack: roughly 25 to 35 g at each meal plus a 20 to 25 g snack

Spreading protein across the day matters more than one big dinner. ASER/POQI suggests about 25 to 35 g at every meal as a reasonable pattern [3]. If you have kidney disease or have been told to limit protein, check your number with your doctor first.

Two small trials in knee replacement are often cited in this space. In one, 28 older adults took 20 g of essential amino acids twice a day from 1 week before to 2 weeks after surgery. At 2 weeks the placebo group had lost about 14% of thigh muscle volume compared with about 3% in the amino acid group [4]. In a second trial of 60 patients, 9 g a day over the same window was linked to less thigh muscle loss and a quicker return to daily activities [5]. Both were small, used amino acid formulas rather than food, and studied only knee replacement. They suggest the week before surgery is a sensible time to start, not that any product will match those results.

Step 3: Immunonutrition, and where the evidence runs out

"Immunonutrition" means drinks enriched with arginine, omega-3 fats and nucleotides, a common pitch in pre-op supplement marketing.

Most of the trials were in major abdominal and cancer surgery. A 2017 analysis pooled 83 trials with 7,116 patients having major abdominal surgery. Across all trials, the immunonutrition groups had fewer infectious complications and shorter hospital stays. But those effects disappeared when only trials at low risk of bias were counted, and trials not funded by industry found no benefit for overall complications [6].

ESPEN's current position reflects that. It recommends these formulas around surgery for malnourished patients having major cancer surgery, and it says there is no clear evidence that they beat standard supplements when used before surgery alone [2]. For a healthy adult having a knee, hip or shoulder operation, the evidence base is much thinner. Ask your surgeon before buying a specialized drink.

Step 4: Carb loading before surgery and the clear-fluid rules

The old "nothing after midnight" rule is no longer the standard for most healthy adults having planned surgery. ESPEN and the ERAS Society both say clear fluids can usually be taken until 2 hours before anesthesia and solid food until 6 hours before [2, 7]. The American Society of Anesthesiologists (ASA) 2023 update says healthy adults can drink carbohydrate-containing clear liquids until 2 hours before elective procedures [8].

Read the fine print, though. The ASA's "healthy adults" excludes people with diabetes, obesity, significant reflux, gastroparesis, prior gastric surgery, opioid use and several other conditions [8]. The ASA also found insufficient evidence to recommend protein-containing clear liquids over other clear liquids in that 2-hour window [8]. A milk-based protein shake is not a clear liquid.

What does a pre surgery nutrition drink actually do? ESPEN recommends a carbohydrate drink the night before and about 2 hours before surgery to reduce discomfort, including anxiety [2]. A Cochrane review of 27 trials found it was linked to a hospital stay about 0.3 days shorter than fasting or placebo, rated very low-quality evidence. There was no change in complication rates, and no difference in stay when compared only with a placebo drink [9].

For hip and knee replacement specifically, the ERAS Society says carbohydrate loading may improve well-being and metabolism, but it has not been shown to speed discharge or reduce complications, so it is not recommended as an essential routine step [7]. In plain terms: it may help you feel better going in, and it's optional. Our post on carb loading before surgery covers the individual trials, and the carb loading drink guide compares pre-op drinks and timing.

Step 5: Get blood sugar into range

If you have diabetes, glucose control is one of the most useful things to work on in the weeks before surgery. The American Diabetes Association recommends a pre-surgery A1C below 8% within the 3 months before elective surgery, and blood glucose kept between 100 and 180 mg/dL before, during and after the operation [10]. It also says surgery should not be postponed on A1C alone. Ask your doctor about medication timing, and see our post on glucose control after surgery.

If you take a GLP-1 medicine such as semaglutide or tirzepatide, tell your surgeon, anesthesiologist and prescriber early. A 2024 multi-society guidance says the decision to continue or hold it should be shared between those teams, and some patients may be asked to follow a liquid diet for at least 24 hours before surgery [11].

Step 6: Supplements to pause before surgery

Always follow your surgeon's and anesthesia team's instructions on fasting and supplements. They override anything on this page.

  • The ASA warns that garlic, ginkgo, ginseng and vitamin E can increase bleeding, and that kava, St. John's wort and valerian can change how anesthesia works [12].
  • The ASA notes your anesthesiologist may ask you to stop supplements at least two weeks before your procedure [12]. Stop dates differ by product and by surgeon, so ask for yours in writing.
  • Bring every bottle, protein powders included, to your pre-op visit. Thrive kits contain omega-3s and curcumin, so name them too. The FAQ below covers whether to stop them.

Your pre-op nutrition timeline: 4 weeks out to the morning of surgery

When What's happening What to focus on
4 weeks out Pre-op visit, labs, medication review Ask about nutrition screening, A1C and anemia. Stop smoking now: ERAS advises 4 weeks or more before hip and knee replacement [7]. Cut back on alcohol.
3 to 2 weeks out Prehab, home setup Build the protein habit: 25 to 35 g per meal. Get supplement stop dates in writing. Stock the freezer.
The last 1 to 2 weeks Final countdown Keep meals regular and protein steady. Paused supplements stay paused. Confirm your fasting instructions.
Day before Normal day of eating Eat breakfast and lunch as usual. Light, early dinner. See what to eat the night before surgery.
Night before Fasting window begins A clear carbohydrate drink only if your team approves it. Stop food at the exact time you were given.
Morning of Surgery Clear liquids only until your stop time, if allowed. Approved medicines with a sip of water.

What happens after you start: 1 week before to 6 weeks after surgery

Here is what the countdown looks like once you begin, using the Surgical Protocol Kit as the example, and what the research on this page does and does not tell you. No trial has tested a Thrive product, so read the right-hand column as context, not as a promised result.

When What you do What to expect
About 1 week before surgery Start OptiFuel: one packet a day between meals, mixed with 12 to 16 oz of water, milk or non-dairy milk. Keep eating your normal meals. One extra shake a day, not a new diet. At 25 g, one packet covers about a quarter of a 96 g daily target (25 divided by 96 is about 26%), so food still does most of the work. In the knee replacement trials above, amino acids were started 1 week before surgery [4, 5].
Night before Light, early dinner. Stop food at the exact time you were given. If your anesthesia team approves, take 2 OptiCharge packets at bedtime, each in 12 to 16 oz of water, never milk. ESPEN recommends a carbohydrate drink the night before and about 2 hours before surgery to reduce discomfort, including anxiety [2]. OptiCharge is used only the night before. It may help you feel better going in, but it is optional and has not been shown to reduce complications [7, 9]. With type 1 diabetes, do not use it without your physician's OK.
Morning of surgery Clear liquids only until your stop time, if allowed. Approved medicines with a sip of water. No OptiFuel this morning. A milk-based shake is not a clear liquid, and the ASA found too little evidence to favor protein drinks in the last 2 hours [8]. Bring your supplement list to check-in.
First days after surgery Restart OptiFuel once your team says you can eat and drink normally. It is thin enough to drink through a straw on days when a full meal feels like too much. Most people eat less, move less and lose some muscle for a few days. In the 28-person knee trial, the placebo group had lost about 14% of thigh muscle volume at 2 weeks, compared with about 3% in the amino acid group [4]. That was a different formula at a different dose, so treat it as a reason to keep protein up, not as a forecast.
Weeks 2 to 6 Keep 25 to 35 g of protein at each meal plus one packet a day as rehab picks up. A 4-week kit started 1 week before surgery runs out about 3 weeks after it (28 packets minus 7 days before surgery = 21 days). In the 60-patient knee trial, amino acids taken from 1 week before to 2 weeks after surgery were linked to less thigh muscle loss and a quicker return to daily activities [5]. If you have diabetes, keep glucose in the range your doctor set.
After 6 weeks Longer rehab is what the 3-month and 6-month supplies are for. Ask your surgeon whether your protein target should change. The trials on this page measured muscle in the first weeks after surgery, so they cannot tell you what happens months later. Your surgeon and therapist guide the rest.

What it looks like day to day. One shaker, one packet, once a day between meals. Most of your protein still comes from food, so the shake is there for the days when appetite drops or cooking feels like too much. Our quick OptiFuel recipes show a few ways to mix it.

For what changes after a specific operation, see the supplement guides for knee replacement, hip replacement and rotator cuff repair (other procedures are listed below), or start with our guide to what to eat after surgery.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

A sample pre-op day (about 100 g of protein)

  • Breakfast: 2 eggs plus 1 cup of cottage cheese, toast, berries (about 35 g)
  • Lunch: 3 oz grilled chicken over rice with cooked vegetables (about 25 g)
  • Snack: Greek yogurt or a protein shake (about 20 to 25 g)
  • Dinner: 4 oz salmon, potatoes, green beans (about 25 g)

Food first. A shake fills gaps on busy days. If you're short on time, our guide to preparing for orthopedic surgery and home prep checklist cover the non-food side.

When to call your care team before surgery

  • You've lost weight without trying, or you've eaten less than half your usual meals for a week [3].
  • Your blood sugar readings are running outside the range your doctor gave you.
  • You started, stopped or changed a GLP-1 medicine, blood thinner or diabetes medicine.
  • You've been vomiting or can't keep fluids down in the days before surgery.
  • Your written fasting instructions conflict with what you were told, or you aren't sure a drink is allowed.

Where Thrive fits

Here is what the kit covers, and what it does not, so you can see where it fits next to food.

Need around surgery In the Surgical Protocol Kit?
Daily protein Yes. OptiFuel, 25 g of whey protein per packet, one a day
Leucine Yes. 3 g per OptiFuel packet
A carbohydrate drink for the night before Yes. 2 OptiCharge packets, each with 46 g of carbohydrate (maltodextrin) plus electrolytes
Vitamins C, D3 and B vitamins Yes, in OptiFuel
Omega-3 fish oil and turmeric Yes, in low amounts in OptiFuel
Creatine and arginine No. These are only in the separate Recovery and Strength Mix
Zinc No. No Thrive product contains zinc
Meals No. OptiFuel is not a meal replacement

Surgical Protocol Kit (for surgery that is still ahead). It works alongside your care team's plan, not instead of it.

  • OptiFuel, once a day. Each packet has 25 g of whey protein and 3 g of leucine, plus glutamine, collagen, omega-3 fish oil, MAXICUMA turmeric extract and vitamins including C, D3 and B vitamins. Mix one packet with 12 to 16 oz of water, milk or non-dairy milk, and take it between meals, not as a meal replacement. 28 packets come in each monthly supply.
  • OptiCharge, the night before. A complex carbohydrate and electrolyte drink (maltodextrin plus sodium, potassium, magnesium and calcium salts). The product directions are 2 packets just before bed the night before surgery, each mixed with 12 to 16 oz of water, never milk. Use it only if your anesthesia team approves it within your fasting plan. If you have type 1 diabetes, do not use it without your physician's OK.
  • Timing. Start the kit 1 week before surgery. If your date is sooner than that, start as soon as you can and choose expedited shipping.
  • Fish oil and turmeric. OptiFuel contains both in low amounts. The evidence does not show that these amounts cause bleeding, so there is no need to stop it before surgery. Your surgeon's instructions still come first.
  • Recovery and Strength Mix. Ideally, everyone on the Surgical Protocol Kit also takes the Recovery and Strength Mix daily. It is the only Thrive product with creatine. If you have kidney disease, check it with your doctor first.

4-week supply $299.99, 3-month $499.99, 6-month $669.99. See the Surgical Protocol Kit. Already had surgery? The Recovery Protocol Kit is OptiFuel without the night-before drink. Thrive kits are HSA/FSA eligible: you can pay with your HSA or FSA card at checkout or submit the receipt for reimbursement. Only want the night-before drink? OptiCharge is also sold on its own as the Endurance Pack.

Comparing options? Our Surgical Protocol Kit review sets it against other pre-op products and lists who it is not for, and our roundup of the best supplements for surgery recovery covers the wider evidence.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Free guide: Want the checklist version? Get the free Surgery Recovery Guide.

Pre-surgery nutrition by procedure

Each procedure changes the details: what you'll be able to do with your hands, how long you'll be off your feet, which tissue is healing. Start with your operation.

Knee and hip

Shoulder, spine and limbs

General, heart, cancer and other surgery

Browse everything in Nutrition by Procedure.

Frequently asked questions

How far ahead should I start pre-surgery nutrition?

Two to four weeks gives you time to get screened, adjust medicines and build a protein habit. ASER/POQI suggests at least 7 days of high-protein supplements for people at nutrition risk [3], and ESPEN says seven to 14 days may be appropriate for those at severe risk [2]. If your date is close, start anyway and ask your team what matters most.

What supplements or vitamins should I take before surgery?

For most people, enough protein from food comes first, with a protein supplement to fill gaps. Specialized immunonutrition drinks have the most support in malnourished patients having major cancer surgery [2, 6]. Anything else should be cleared with your surgeon, who will also tell you what to stop. Vitamins count too: the ASA lists vitamin E with garlic, ginkgo and ginseng as supplements that can increase bleeding [12].

Is carb loading before surgery safe?

For healthy adults, guidelines allow carbohydrate clear liquids until 2 hours before elective procedures [8], and no aspiration cases were reported in the Cochrane trials [9]. People with diabetes, reflux or obesity fall outside that "healthy adult" group, so ask first.

Can I have a protein shake the morning of surgery?

Usually not. Milk-based shakes are not clear liquids, and the ASA found too little evidence to favor protein-containing clear drinks in the last 2 hours [8]. Follow your written instructions.

Do I need to stop fish oil or turmeric before surgery?

Ask your surgeon, because stop dates differ by product and by surgeon, and your anesthesiologist may ask you to stop supplements at least two weeks before your procedure [12]. OptiFuel contains fish oil and turmeric in low amounts. The evidence does not show that these amounts cause bleeding, so there is no need to stop it before surgery. If you take a blood thinner, or your surgeon gives you a different instruction, follow your surgeon.

When should I start the Surgical Protocol Kit, and how long does it last?

Start OptiFuel 1 week before surgery, one packet a day between meals, and take the 2 OptiCharge packets at bedtime the night before if your anesthesia team approves. Each monthly supply has 28 packets, so a 4-week kit started 7 days before surgery lasts about 3 weeks after it (28 minus 7 = 21). If your date is less than a week away, start as soon as you can and choose expedited shipping.

References

  1. Weimann A, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36(3):623-650. PubMed 28385477
  2. Weimann A, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr. 2021;40(7):4745-4761. PubMed 34242915
  3. Wischmeyer PE, et al. ASER and POQI joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg. 2018;126(6):1883-1895. PubMed 29369092
  4. Dreyer HC, et al. Essential amino acid supplementation in patients following total knee arthroplasty. J Clin Invest. 2013;123(11):4654-4666. PubMed 24135139
  5. Ueyama H, et al. Perioperative essential amino acid supplementation suppresses rectus femoris muscle atrophy and accelerates early functional recovery following total knee arthroplasty. Bone Joint J. 2020;102-B(6 Supple A):10-18. PubMed 32475274
  6. Probst P, et al. Meta-analysis of immunonutrition in major abdominal surgery. Br J Surg. 2017;104(12):1594-1608. PubMed 28940219
  7. Wainwright TW, et al. Consensus statement for perioperative care in total hip replacement and total knee replacement surgery: ERAS Society recommendations. Acta Orthop. 2020;91(1):3-19. PubMed 31663402
  8. Joshi GP, et al. 2023 American Society of Anesthesiologists practice guidelines for preoperative fasting: carbohydrate-containing clear liquids with or without protein, chewing gum, and pediatric fasting duration. Anesthesiology. 2023;138(2):132-151. PubMed 36629465
  9. Smith MD, et al. Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev. 2014;(8):CD009161. PubMed 25121931
  10. American Diabetes Association Professional Practice Committee. 16. Diabetes care in the hospital: Standards of Care in Diabetes 2026. Diabetes Care. 2026;49(Suppl 1):S339-S355. PubMed 41358892
  11. Kindel TL, et al. Multi-society clinical practice guidance for the safe use of glucagon-like peptide-1 receptor agonists in the perioperative period. Surg Endosc. 2025;39(1):180-183. PubMed 39370500
  12. American Society of Anesthesiologists. Herbal and dietary supplements and anesthesia (patient handout). 2020. asahq.org