[Preventive Nutritional Medicine in Anesthesiology - Strategies for Reducing Postoperative Morbidity]

Perioperative nutrition has emerged as a key component of modern preventive medicine, with growing evidence that nutritional status substantially influences surgical outcomes. This article reviews the role of nutritional medicine within anesthesiology and perioperative care, focusing on modifiable risk factors that affect resilience to surgical stress and postoperative recovery. Particular attention is given to malnutrition in all its forms - including undernutrition, overweight and obesity - as well as sarcopenia, sarcopenic obesity, frailty, anemia and nutrition-related non-communicable diseases, all of which are associated with increased perioperative morbidity and mortality. Additionally, this paper presents a clinical case report of a patient presenting with sarcopenic obesity and an unintended weight loss of 12 kg over two months prior to surgery. We outline the implementation of a tailored perioperative nutritional intervention.Current concepts such as prehabilitation and Enhanced Recovery After Surgery (ERAS) emphasize early screening, structured nutritional assessment, and targeted interventions before surgery. Multimodal prehabilitation programs combining exercise, nutritional support, and risk factor modification can improve functional capacity and reduce postoperative complications. The article also discusses the pathophysiology of the postoperative stress response, highlighting how surgical trauma induces inflammatory, endocrine, and metabolic changes that contribute to catabolism, insulin resistance, and loss of muscle mass. Understanding these mechanisms is essential for tailoring perioperative nutritional strategies.The article concludes that nutritional management should be considered a core interdisciplinary element of perioperative medicine. Early identification and treatment of nutrition-related risks, integrated within anesthesiology-led perioperative pathways, may enhance patient resilience, reduce complications, shorten hospital stays, and improve overall surgical outcomes.