title: Variation in Protein Origin and Utilization: Research and Clinical Application.
abstract: Muscle health can be rapidly compromised in clinical environments. Modifiable strategies to preserve metabolic homeostasis in adult patient populations include physical activity and pharmacologic support; however, optimizing dietary practices, or more specifically protein intake, is a necessary prerequisite for any other treatment strategy to be fully effective. Simply increasing protein intake is a well-intentioned but often unfocused strategy to protect muscle health in an intensive care setting. Protein quality is a frequently overlooked factor with the potential to differentially influence health outcomes. Quality can be assessed by a variety of techniques, with digestible indispensable amino acid score being the current and most comprehensive technique endorsed by the Food and Agriculture Organization. In practical terms, animal-based proteins are consistently scored higher in quality compared with incomplete proteins, regardless of the assessment method. Consequently, choosing parenteral and/or enteral feeding options that contain high-quality proteins, rich in the branched-chain amino acid leucine, may help establish a dietary framework with the potential to support clinical practice and improve health outcomes in critically ill patients.
authors.affiliation: 1 Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, Texas, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Paddon-Jones
authors.affiliation: 2 Pediatrics Critical Care, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Coss-Bu
authors.affiliation: 3 Division of Pediatric Emergency Medicine, Emory School of Medicine, Atlanta, Georgia, USA.
authors.forename: Claudia R
authors.initials: CR
authors.lastname: Morris
authors.affiliation: 4 Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Phillips
authors.affiliation: 5 Department of Clinical Science, Karolinska University, Solna, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Wernerman
mesh_terms: D000597:Amino Acids, Branched-Chain; D000601:Amino Acids, Essential; D003422:Critical Care; D004044:Dietary Proteins; D004750:Enteral Nutrition; D006801:Humans; D010288:Parenteral Nutrition
chemical_list: D000597:Amino Acids, Branched-Chain; D000601:Amino Acids, Essential; D004044:Dietary Proteins
keywords: amino acids; critical care; intensive care units; muscle protein synthesis; nutrition; protein quality; skeletal muscle