The study will include patients who require elective major abdominal surgery for cancerous or non-cancerous conditions. The goal of the research is to assess the benefit of a prehabilitation program before surgery that includes nutrition, exercise, smoking cessation, and optimization of chronic disease. A group of 10 patients will take part in a prehabilitation program. These patients will be compared to 20 patients who received standard of care.

The study will include patients who require elective major abdominal surgery. The study will compare patients who received standard of care to patients who received a prehabilitation program before surgery.

The prehabilitation program will take place for 4-6 weeks before your surgery and will include:

• Review of frailty risk analysis calculator score obtained in the frailty study (#2212-74)
• Review of lab results including complete blood count, creatinine, albumin, and prealbumin
• Review of chronic conditions
• An office visit or telehealth visit to review instructions on nutrition, exercise, smoking cessation, and optimization of chronic disease.
• Drinking Surgery Immunonutrition shake twice daily for 5 days before surgery.
• Educational information and video instruction
• Weekly phone calls to motivate, ensure adherence, and assess progress.
• Measurements of hand grip strength and body weight

Inclusion Criteria:

• Subjects over age 60 who require elective major abdominal surgery

Exclusion Criteria:

• pregnant women

Subjects over age 60 who require elective major abdominal surgery