Nutritional Orthopedics and Space Nutrition as Two Sides of the Same Coin: A Scoping Review

Abstract

Since the Moon landing, nutritional research has been charged with the task of guaranteeing human health in space. In addition, nutrition applied to Orthopedics has developed in recent years, driven by the need to improve the efficiency of the treatment path by enhancing the recovery after surgery. As a result, nutritional sciences have specialized into two distinct fields of research: Nutritional Orthopedics and Space Nutrition. The former primarily deals with the nutritional requirements of old patients in hospitals, whereas the latter focuses on the varied food challenges of space travelers heading to deep space. Although they may seem disconnected, they both investigate similar nutritional issues. This scoping review shows what these two disciplines have in common, highlighting the mutual features between (1) pre-operative vs. pre-launch nutritional programs, (2) hospital-based vs. space station nutritional issues, and (3) post-discharge vs. deep space nutritional resilience. PubMed and Google Scholar were used to collect documents published from 1950 to 2020, from which 44 references were selected on Nutritional Orthopedics and 44 on Space Nutrition. Both the orthopedic patient and the astronaut were found to suffer from food insecurity, malnutrition, musculoskeletal involution, flavor/pleasure issues, fluid shifts, metabolic stresses, and isolation/confinement. Both fields of research aid the planning of demand-driven food systems and advanced nutritional approaches, like tailored diets with nutrients of interest (e.g., vitamin D and calcium). The nutritional features of orthopedic patients on Earth and of astronauts in space are undeniably related. Consequently, it is important to initiate close collaborations between orthopedic nutritionists and space experts, with the musculoskeletal-related dedications playing as common fuel.

Perioperative Anesthesia and Acute Smell Alterations in Spine Surgery: A “Sniffing Impairment” Influencing Refeeding?

“…Importantly, these sensory neurons play a fundamental role in driving eating behaviors, and subjects with sniffing impairment can decide to alter their diet to compensate for the loss ( 6 ). In fact, the smelling of palatable food aromas promotes appetite, liking, and food intake ( 7 , 8 ), especially in restrained eaters ( 9 ). Fasting patients undergoing surgery refrain from eating from the day before, making early oral food after surgery one of the cornerstones of the perioperative nutritional support program in spine surgery ( 10 , 11 ).…”

Long-Term Space Nutrition: A Scoping Review

“…An optimized diet [ 105 , 106 ] helps to mitigate bone loss with little risk of side effects by providing adequate amounts of calcium, vitamin D, and vitamin K in the space diet [ 107 ]. Many parallels have been found between nutritional orthopedics and space nutrition because of the similar challenges faced by an aging orthopedic patient on Earth and an astronaut experiencing the degenerative effects of long-duration space missions [ 108 ]. A daily balance of fiber, liquids, and bioactive substances, such as coffee, is necessary to prevent hip fracture when transitioning from a low-gravity field to hyper-gravity while landing on a planet.…”

Risks and Countermeasures for the Musculoskeletal systems in the Extreme Environment of Aviators and Astronauts

“…Other necessities in diet include to protect bone health are increased calcium and vitamin D intake [50]. On land, these are highly used to prevent osteoporosis.…”