ICU-FM: design and validation of a fasting mimicking diet for the critically ill: Extending the borders of autophagy-activation and monitoring and broadening the beneficial application of nutrition restriction in acute illness.

Short term fasting may be beneficial in health and disease. We avoided complications and improved muscle force in the intensive care unit (ICU) by withholding intravenous nutrition for one week in a RCT. These unexpected results may be explained by nutrient restriction improving cellular integrity and function through activation of autophagy; cells digesting their own dysfunctional components. We aim to broaden these beneficial effects beyond the first ICU-week (ICU-FM) and outside the ICU (EFECTS). We will design a novel fasting-mimicking-diet in ICU (ICU-FM), based on cyclic feeding interruptions aimed at activating autophagy while avoiding prolonged starvation. Applied after the first ICU week, ICU-FM should ultimately lead to better functional outcome in ICU-survivors. In the 3-armed EFECTS-trial we will evaluate at the surgical ward, in patients recovering from oesophageal resection, the impact of early nutrient restriction on autophagy activation, functional recovery, oncological and vital outcome as compared to current practice early intravenous or enteral nutrition.

Keywords:autophagy-activation

Disciplines:Laboratory medicine, Palliative care and end-of-life care, Regenerative medicine, Other basic sciences, Other health sciences, Nursing, Other paramedical sciences, Other translational sciences, Other medical and health sciences