title: Preservation of autophagy should not direct nutritional therapy.
abstract: OBJECTIVE
  Recent reports in the literature have proposed that forced mandatory feeding should be avoided in the first week of critical illness to preserve autophagy, in order to maximize responses to oxidative stress, preserve organ function, and improve outcomes.
  
  
  RESULTS
  Autophagy is a well recognized physiologic process that serves a housekeeping role for the cell to eliminate large protein aggregates and as a survival mechanism in starvation for generating energy (ATP) and promoting protein synthesis to maintain cell structure. In the critical care setting, autophagy may have important roles in modulating immune function, fighting infection, and preventing organ failure. The effect of feeding on autophagy is complex, poorly understood, and difficult to predict.
  
  
  CONCLUSIONS
  The argument to withhold feeding to preserve autophagy is poorly substantiated and should not interfere with the delivery of early enteral nutrition to the critically ill patient in that first week following admission to the ICU.
authors: aDepartment of Medicine, University of Louisville School of Medicine, Louisville, Kentucky, USA bDepartments of Nutrition and Dietetics, Internal medicine, and Intensive Care Medicine, Vu University Medical Center and Department of Nutrition and Dietetics, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands.
authors: Stephen A
authors: SA
authors: McClave
authors: Peter J M
authors: PJ
authors: Weijs
mesh_terms: D001343:Autophagy / Q000276:immunology / Q000502:physiology*; D000075202:Contraindications; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000628:therapy*; D004734:Energy Metabolism / Q000502:physiology; D004750:Enteral Nutrition; D006801:Humans; D058570:TOR Serine-Threonine Kinases / Q000502:physiology; D013997:Time Factors
chemical_list: C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases