Nutrition: The Role of Diet in Musculoskeletal Healing
Proper nutrition is essential for musculoskeletal recovery. Excessive intake of fats or refined sugars, low-calorie diets, and deficiencies in protein, minerals, or vitamins—particularly vitamin D—can impair the healing of muscles, tendons, ligaments, and bones.
1 Low Calorie, Protein, and Mineral Intake: Effects on Tissue Repair
Insufficient calorie intake limits cellular repair, delays collagen synthesis, and increases the risk of muscle atrophy, especially during periods of immobilization or reduced activity [Giraldo-Vallejo et al., 2023; Smith-Ryan et al., 2020; Tipton, 2015; Papadopoulou, 2023].
Tendons and Ligaments
Dietary proteins are broken down into amino acids, essential for collagen synthesis and matrix remodeling in tendons and ligaments. Low protein intake reduces protein synthesis and slows tissue regeneration. Mineral deficiencies further compromise collagen matrix mineralization, weakening connective tissue and increasing reinjury risk [Curtis, 2016; DePhillipo et al., 2018; Roberts & Drissi, 2020; Fischer et al., 2017; Gouissem et al., 2025].
Bone Healing
Insufficient protein and minerals delay callus formation and bone remodeling. Low protein reduces IGF-1 production, critical for osteoblast function, while deficiencies in calcium, vitamin D, manganese, and zinc impair bone mineralization and collagen matrix formation, slowing fracture repair [Fischer et al., 2017; Zaman & Ullah, 2025; Cheng et al., 2020; Kwun et al., 2010; Bourrin et al., 2000; Taskozhina et al., 2024; Cholewińska et al., 2025].
During immobilization, absence of mechanical loading further suppresses osteoblast activity. Low calorie intake and energy deficiency amplify these effects, reducing bone formation and increasing resorption [Rantakokko et al., 1999; Gaudio et al., 2009; Murphy et al., 2021; Liu et al., 2024].
Adequate protein intake during injury recovery exceeds baseline requirements, emphasizing the importance of nutrition in rehabilitation [Tipton, 2015; Rocha-Rodrigues et al., 2024].
2. Impact of Refined Sugar and Saturated Fats on Healing
High intake of refined sugars and saturated fats promotes chronic low-grade inflammation, negatively affecting tissue repair [Elli et al., 2021; Satokari, 2020; Ma et al., 2022].
Excessive sugar alters gut microbiota, increasing pro-inflammatory bacteria while reducing anti-inflammatory species. This can increase gut permeability, allowing inflammatory by-products into circulation, sustaining systemic inflammation and delaying tissue healing [Satokari, 2020; Ma et al., 2022; Shen et al., 2025; Jones et al., 2021].
Saturated fats activate innate immune pathways, triggering inflammation even without infection, which can further impair musculoskeletal repair [Li et al., 2020; Ruiz-Núñez et al., 2016; Christ et al., 2019; Elli et al., 2021; Zhao et al., 2024].
3. Bone Health and Fracture Risk
Post-injury, poor nutrition exacerbates bone loss, increasing the risk of secondary fractures, particularly in individuals with osteoporosis. Calcium and vitamin D are essential for new bone formation, mineralization, and reducing bone resorption. Deficiencies compromise bone density and skeletal integrity during recovery [Fischer et al., 2017; Rizzoli et al., 2021; Bonjour et al., 1996; Geusens et al., 2019].
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