Jonathan J Hew1, Roxanne J Parungao1, Craig P Mooney1, Julian K Smyth1, Sarah Kim2, Kevin H-Y Tsai3, Huaikai Shi1, Cassandra Chong1, Renee C F Chan4, Beba Attia4, Caroline Nicholls5, Zhe Li1,5, Samantha M Solon-Biet6,7, David G Le Couteur6, Stephen J Simpson7, Marc G Jeschke8, Peter K Maitz1,5, Yiwei Wang1,9. 1. Burns Research and Reconstructive Surgery, ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, Australia 2139. 2. Bone Biology Group, ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, Australia 2139. 3. Adrenal Steroids Laboratory, ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, Australia 2139. 4. Electron Microscopy Unit, Anatomical Pathology, Concord Hospital, Sydney, Australia 2139. 5. Burns Unit, Concord Repatriation General Hospital, Concord, Australia 2139. 6. Ageing and Alzheimer Institute and ANZAC Research Institute, Concord Hospital, University of Sydney, Sydney, Australia 2139. 7. Charles Perkins Centre and School of Life and Environmental Sciences, University of Sydney, Australia 2006. 8. Sunnybrook Research Institute, Toronto, Ontario, Canada, M4N 3M5. 9. School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, PR China 210023.
Abstract
BACKGROUND: Wound healing processes are influenced by macronutrient intake (protein, carbohydrate and fat). The most favourable diet for cutaneous wound healing is not known, although high-protein diets are currently favoured clinically. This experimental study investigates the optimal macronutrient balance for cutaneous wound healing using a mouse model and the Geometric Framework, a nutrient modelling method, capable of analyzing the individual and interactive effects of a wide spectrum of macronutrient intake. METHODS: Two adjacent and identical full-thickness skin excisions (1 cm2) were surgically created on the dorsal area of male C57BL/6 mice. Mice were then allocated to one of 12 high-energy diets that varied in protein, carbohydrate and fat content. In select diets, wound healing processes, cytokine expression, energy expenditure, body composition, muscle and fat reserves were assessed. RESULTS: Using the Geometric Framework, we show that a low-protein intake, coupled with a balanced intake of carbohydrate and fat is optimal for wound healing. Mice fed a low-protein diet progressed quickly through wound healing stages with favourable wound inflammatory cytokine expression and significantly accelerated collagen production. These local processes were associated with an increased early systemic inflammatory response and a higher overall energy expenditure, related to metabolic changes occurring in key macronutrient reserves in lean body mass and fat depots. CONCLUSIONS: The results suggest that a low-protein diet may have a greater potential to accelerate wound healing than the current clinically used high-protein diets.
BACKGROUND: Wound healing processes are influenced by macronutrient intake (protein, carbohydrate and fat). The most favourable diet for cutaneous wound healing is not known, although high-protein diets are currently favoured clinically. This experimental study investigates the optimal macronutrient balance for cutaneous wound healing using a mouse model and the Geometric Framework, a nutrient modelling method, capable of analyzing the individual and interactive effects of a wide spectrum of macronutrient intake. METHODS: Two adjacent and identical full-thickness skin excisions (1 cm2) were surgically created on the dorsal area of male C57BL/6 mice. Mice were then allocated to one of 12 high-energy diets that varied in protein, carbohydrate and fat content. In select diets, wound healing processes, cytokine expression, energy expenditure, body composition, muscle and fat reserves were assessed. RESULTS: Using the Geometric Framework, we show that a low-protein intake, coupled with a balanced intake of carbohydrate and fat is optimal for wound healing. Mice fed a low-protein diet progressed quickly through wound healing stages with favourable wound inflammatory cytokine expression and significantly accelerated collagen production. These local processes were associated with an increased early systemic inflammatory response and a higher overall energy expenditure, related to metabolic changes occurring in key macronutrient reserves in lean body mass and fat depots. CONCLUSIONS: The results suggest that a low-protein diet may have a greater potential to accelerate wound healing than the current clinically used high-protein diets.
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