How pro-inflammatory diets influence perioperative outcomes

Recent evidence shows that pro-inflammatory diets-high in saturated fats, added sugars, and ultra processed foods-have been linked to elevated levels of cytokines like interleukin-6 (IL-6) and tumor necrosis factor (TNF), showing a marked increase in systemic inflammation, disrupted immune function and altered anesthetic drug metabolism. These effects have been linked to prolonged recovery, impaired wound healing, and increased complication rates. Additionally, a pro-inflammatory diet changes the gut microbiome, impacting pain perception, opioid sensitivity and stress response by the gut-brain axis. On the contrary, an anti-inflammatory diet reduces inflammatory markers and is associated with a shorter hospital stay. This review synthesizes data from randomized controlled trials (RCT), meta-analyses, and mechanistic studies from 2000-2025, emphasizing literature on omega-3 fatty acids, specialized pro-resolving mediators (SPMs), and short-chain fatty acids (SCFAs). Targeted interventions such as education on nutrition and dietary assessment risk could enhance surgical recovery. Perioperative interventions discussed include pre/probiotic supplementation, omega-3 fatty acid administration, and also dietary counseling as part of Enhanced Recovery After Surgery (ERAS) pathways.