ArticleCritical care (London, England)2020
Towards a fasting-mimicking diet for critically ill patients: the pilot randomized crossover ICU-FM-1 study.
Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation de l'efficacité du Support Nutritionnel entéral Intermittent Sur la défaillance d'Organes de Patients de réanimation Sous Ventilation assistée ENteral NUTrition - Continue Intermittent
The Effect of Intermittent Feeding on Circadian Rhythm in Critical Illness
Who cites it
23 citing papers in PubMed, 49 citations in OpenAlex.
- Does Intermittent Nutrition Enterally Normalise hormonal and metabolic responses to feeding in critically ill adults? The DINE-normal proof-of-concept study.Clinical nutrition (Edinburgh, Scotland) · 2025Trial
- The metabolic effects of intermittent versus continuous feeding in critically ill patients.Scientific reports · 2023Trial
- Impact of tight glucose control on circulating 3-hydroxybutyrate in critically ill patients.Critical care (London, England) · 2021Trial
- Individualising blood glucose control in ICU patients: evidence and practical implementations.Critical care (London, England) · 2026Review
- Improving the Outcome of Brain-Injured Patients by Non-Continuous Feeding to Prevent Dysbiosis.Nutrients · 2026Review
- Diabetes Management Strategies in Intensive Care Settings.The Medical clinics of North America · 2026Review
- Feeding the injured brain: nutrients, dose, timing, and monitoring.Intensive care medicine · 2026Review
- The impact of lipid-rich nutrition on ketogenesis and muscle weakness in sepsis.Intensive care medicine experimental · 2026Article
- Functional and muscle recovery after critical illness: current and future nutritional, physical and metabolic strategies.Annals of intensive care · 2026Review
- Article
- Personalized Nutrition Strategies for Patients in the Intensive Care Unit: A Narrative Review on the Future of Critical Care Nutrition.Nutrients · 2025Review
- Impact of Fasting Mimicking Diet (FMD) on cardiovascular risk factors: a systematic review and meta-analysis of randomized control trials.Diabetology & metabolic syndrome · 2025Review
- On how to feed critically ill children in intensive care: A slowly shifting paradigm.Clinical nutrition (Edinburgh, Scotland) · 2025Review
- Chrononutrition in Critical Illness.Nutrition reviews · 2025Review
- Circadian rhythms, metabolism, and nutrition support in critically ill adult patients: a narrative review.Current opinion in clinical nutrition and metabolic care · 2025Review
- Advances in Intermittent Fasting Applications for Critically Ill Patients.International journal of general medicine · 2025Review
- Fasting in critical illness: the role of ketonuria - a retrospective observational study.Journal of anesthesia, analgesia and critical care · 2024Article
- Nutrition in the intensive care unit: from the acute phase to beyond.Intensive care medicine · 2024Review
- Article
- Personalized nutrition therapy in critical care: 10 expert recommendations.Critical care (London, England) · 2023Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn two recent randomized controlled trials, withholding parenteral nutrition early in critical illness improved outcome as compared to early up-to-calculated-target nutrition, which may be explained by beneficial effects of fasting. Outside critical care, fasting-mimicking diets were found to maintain fasting-induced benefits while avoiding prolonged starvation. It is unclear whether critically ill patients can develop a fasting response after a short-term nutrient interruption. In this randomized crossover pilot study, we investigated whether 12-h nutrient interruption initiates a metabolic fasting response in prolonged critically ill patients. As a secondary objective, we studied the feasibility of monitoring autophagy in blood samples.
methodsIn a single-center study in 70 prolonged critically ill patients, 12-h up-to-calculated-target feeding was alternated with 12-h fasting on day 8 ± 1 in ICU, in random order. Blood samples were obtained at the start of the study, at the crossover point, and at the end of the 24-h study period. Primary endpoints were a fasting-induced increase in serum bilirubin and decrease in insulin requirements to maintain normoglycemia. Secondary outcomes included serum insulin-like growth factor I (IGF-I), serum urea, plasma beta-hydroxybutyrate (BOH), and mRNA and protein markers of autophagy in whole blood and isolated white blood cells. To obtain a healthy reference, mRNA and protein markers of autophagy were assessed in whole blood and isolated white blood cells of 23 matched healthy subjects in fed and fasted conditions. Data were analyzed using repeated-measures ANOVA, Fisher's exact test, or Mann-Whitney U test, as appropriate.
resultsA 12-h nutrient interruption significantly increased serum bilirubin and BOH and decreased insulin requirements and serum IGF-I (all p ≤ 0.001). Urea was not affected. BOH was already increased from 4 h fasting onwards. Autophagic markers in blood samples were largely unaffected by fasting in patients and healthy subjects.
conclusionsA 12-h nutrient interruption initiated a metabolic fasting response in prolonged critically ill patients, which opens perspectives for the development of a fasting-mimicking diet. Blood samples may not be a good readout of autophagy at the tissue level.
trial registrationISRCTN, ISRCTN98404761. Registered 3 May 2017.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.