Scarlett McNally, an orthopedic surgeon and honorary clinical professor at Brighton and Sussex Medical School, put her knowledge of surgery preparation into practice three months ago, when she underwent a hip replacement.

Before surgery, she rode her electric bike every day for 45 minutes, ate sensibly, and slept well.

The result? She recovered amazingly well.

For many people, surgery brings a mix of anxiety and uncertainty. They often focus on the operation itself.

“Most patients are too scared to trust their body,” McNally said.

Yet what you do in the weeks leading up to an operation—physically and mentally—can make a big difference in how well and how quickly you recover.

Improve Surgery Outcomes

The time between diagnosis and surgery isn’t just waiting time—it’s an opportunity.

At the Centre for Perioperative Care, McNally and her team recommend preparation, also known as prehabilitation, before surgery. Prehabilitation includes seven steps: exercising, good nutrition, moderating alcohol consumption, quitting smoking, psychological preparation, practical planning, and optimizing other medical conditions.

Studies have shown that 86 percent of patients who undergo prehabilitation maintain or even improve their physical ability four weeks after surgery, compared with before they prepared for it.

“Prehabilitation transforms surgery from something that happens to patients into something they actively prepare for, dramatically improving outcomes across all measures​​​​​​​​​​​​,” Dr. Sunil Kumar, a board-certified lifestyle medicine physician, anesthesiologist, and author of “The Power of Preparation for Surgery,” told The Epoch Times.

International researchers conducting a randomized clinical trial published in JAMA Surgery assessed the effects of a structured four-week prehabilitation program in 251 patients before elective surgery for colon cancer. The patients participated in three one-hour high-intensity exercise sessions per week, alternating cycling intervals with strength exercises using weights, bands, or their own body weight.

Just as important was what they ate. A registered dietitian assisted each participant in achieving sufficient protein intake—approximately 1.5 grams per kilogram of body weight per day—with whey protein shakes taken after workouts and before bed, along with vitamin D and a multivitamin. The program also included breathing and relaxation exercises, as well as support for quitting smoking if needed.

The results? Complications were cut nearly in half.

“While surgical skill is crucial, preparation matters just as much,” Kumar said.

Preparation doesn’t always need to be long or complicated. While four to eight weeks is ideal, even shorter or home-based programs can bring real benefits, Kumar said.

Mental Preparation

The uncertainty and anticipation of surgery can cause feelings of anxiety, fear, and a sense of powerlessness, Kumar said.

There are practical ways to ease stress in the lead-up to surgery. Listening to calming music—whether classical pieces or the sounds of nature—can help you relax, while creative activities such as painting, playing an instrument, gardening, or cooking offer a welcome distraction from the worry of the procedure, he said.

You can also find counseling, support groups, or other interventions that help you feel more in control.

“Expressing your feelings through journaling or talking to a therapist can also help process difficult emotions, giving your mind a chance to work through anxiety in a healthy way,” Kumar said.

Nutrition Before Surgery

What you eat in the days and weeks leading up to surgery can be life-changing. Your diet could be just as important as the procedure itself. Good nutrition builds metabolic reserves, maintains muscle mass, and strengthens the immune system, all of which reduce the risk of complications and help you bounce back faster.

Up to half of patients going in for major surgery are malnourished. Poor nutritional status increases the risk of infections, impaired wound healing, and prolonged hospital stays.

Surgery puts a heavy strain on the body. It triggers inflammation, muscle breakdown, oxidative stress, and even insulin resistance, which makes it harder to control blood sugar. However, proper nutrition, including high-protein diets, helps buffer those effects.

“Protein is non-negotiable,” Theresa Gentile, a registered dietitian nutritionist, told The Epoch Times.

Protein redresses muscle loss, which is one of the most damaging effects of surgical stress. Stress hormones and inflammation drive protein breakdown, leaving the body weaker when it needs strength the most.

Certain amino acids, especially leucine, can activate pathways that protect and rebuild muscle. Whey protein is often used in pre-surgery programs because it’s rich in amino acids, quickly absorbed, and easy to digest. Maintaining a high protein intake also supports wound healing and immune function.

With that in mind, healthy fats from sources such as olive oil, avocados, seeds, and nuts can help reduce inflammation. Micronutrients from colorful vegetables and fruit will help support immunity and help repair damage, Mpho Tshukudu, a functional nutritionist, told The Epoch Times.

On the contrary, overeating processed foods—high in sugar, refined carbs, and unhealthy fats—can weaken the immune system and slow recovery.

For the night before surgery, Tshukudu recommended a small to medium meal that’s easy to digest, with moderate protein, low fat, and a slow-release carbohydrate. Examples include baked sweet potato with chicken and spinach, lentil, tomato, and olive soup, or a banana-nut smoothie with spinach or kale, yogurt, and cardamom. Staying well hydrated is equally important, she said.

In the days after surgery, she suggests shifting to light, nourishing meals, gradually increasing texture and variety as tolerated.

“Soups and smoothies are an easy way to get the nutrients you need,” Tshukudu said.

She suggested cooking soups in bulk before and after surgery so they’re ready when you don’t feel like preparing meals—some can even be enjoyed cold. If your appetite is poor, small meals or snacks every three to four hours can help you meet your nutritional needs without overwhelming your digestion.

“Even if appetite is poor, make sure not to undereat,” Gentile said.

Under-eating would cause the body to break down muscle for energy, as surgery places a higher energy demand on the body. Without enough fuel, the body can’t make new tissue efficiently, often leading to delayed wound closure, she said.

It has been shown that people who received nutritional support before surgery spent, on average, two fewer days in the hospital.

Exercise Before Surgery

The combination of nutrition and exercise makes the body more efficient in using energy and nutrients.

Exercise also builds the fitness needed to recover from the anesthetic, gives you the strength to get out of bed with less assistance, improves lung capacity to reduce the risk of chest infections, and reduces the need for painkillers, according to McNally.

Different types of exercise contribute in different ways. Aerobic activity improves oxygen use and delivery—both vital for tissue repair and recovery, while resistance training helps counteract the muscle breakdown and supports independence during rehabilitation.

During the buildup towards surgery, muscle should be preserved as much as possible, as muscle also acts as a store of protein and antibodies, and can further stabilize metabolism, she said.

McNally’s pre-surgery preparation paid off.

“I’ve done amazingly well—I got out of hospital rapidly and I’m back dancing. This really works!” she said.

Prehabilitation can also serve as a turning point for long-term health.

“Many people who adopt healthier routines before surgery keep them up afterwards, improving their overall health long beyond recovery,” McNally said.