Nutrition and the surgical patient: triumphs and challenges.

The understanding of the role of nutrition in the surgical patient has lead to major developments in the nutritional support of patients undergoing surgery. Reductions in morbidity by ensuring that patients receive optimal nutritional support can be achieved. Furthermore, the use of nutrients to modify immune, inflammatory and metabolic processes also offers new possibilities for reducing morbidity following major surgery. However, we are only at an embryonic stage in our understanding of how nutrients and nutrition affect the genome and this knowledge offers exciting possibilities in the future for modulating many key intracellular processes, particularly in the patient with cancer.