• Stephen A McClave and Peter J M Weijs.
• 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.
• Curr Opin Clin Nutr Metab Care. 2015 Mar 1; 18 (2): 155-61.

Purpose Of ReviewRecent 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.Recent FindingsAutophagy 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.SummaryThe 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.

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