Perioperative supplementation with a fruit and vegetable juice powder concentrate and postsurgical morbidity: a double-blind, randomised, placebo controlled clinical trial

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Colleges, School and Institutes


Background & Aims: Surgical trauma leads to an inflammatory response that causes surgical morbidity. Reduced antioxidant micronutrient (AM)a levels and/or excessive levels of Reactive Oxygen Species (ROS)b have previously been linked to delayed wound healing and presence of chronic wounds. We aimed to evaluate the effect of pre-operative supplementation with encapsulated fruit and vegetable juice powder concentrate (JuicePlus+®) on postoperative morbidity and Quality of Life (QoL)c. Methods: We conducted a randomised, double-blind, placebo-controlled two-arm parallel clinical trial evaluating postoperative morbidity following lower third molar surgery. Patients aged between 18 and 65 years were randomised to take verum or placebo for 10 weeks prior to surgery and during the first postoperative week. The primary endpoint was the between-group difference in QoL over the first postoperative week, with secondary endpoints being related to other measures of postoperative morbidity (pain and trismus). Results: One-hundred and eighty-three out of 238 randomised patients received surgery (Intention-To-Treat population). Postoperative QoL tended to be higher in the active compared to the placebo group (p=0.059). Furthermore, reduction in mouth opening 2 days after surgery was 3.1 mm smaller (p=0.042), the mean pain score over the postoperative week was 9.4 mm lower (p=0.007) and patients were less likely to experience moderate to severe pain on postoperative day 2 (RR 0.58, p=0.030), comparing verum to placebo groups. Conclusion: Pre-operative supplementation with a fruit and vegetable supplement rich in AM may improve postoperative QoL and reduce surgical morbidity and post-operative complications after surgery.
Registered under Identifier no. NCT01145820


Original languageEnglish
Pages (from-to)1448-1455
JournalClinical Nutrition
Issue number5
Early online date10 Aug 2017
Publication statusPublished - 1 Oct 2018


  • Third molar surgery, Wound healing, Pain, Antioxidant micronutrients, Reactive oxygen species, Oxidative stress