Peter Attia

So you can't actually put feeding tubes in them.

So you use a central line, you put an intravenous catheter into one of the major central veins in their body.

And you give them all of their nutrition through that conduit, which is called parenteral nutrition.

And with total parenteral nutrition, you are chemically crafting the exact composition of what they consume, exactly how much glucose, exactly how much fat, what type of fat, how much protein, what type of protein, what micronutrients, et cetera, et cetera.

And again, I don't remember the exact study, but it showed that there was no benefit to a higher protein diet.

And this was counterintuitive.

Now that I'm remembering it, I believe the study sought to ask the question, wouldn't patients in the intensive care unit benefit from a higher protein diet?

Because they're very catabolic.

The body is incredibly catabolic in that setting.

And so I think the surprising outcome of that study was that the patients on the higher dose of protein did know better.

If my memory serves me correctly, they didn't do worse.

Am I remembering that correctly?

Right.

And in that patient population, death, mortality is the most important outcome.

There are other things, days in the ICU, days on the ventilator, those things all matter tremendously.

But you're looking at such a sick population that's on the precipice of death, that when you look at ACM or all-cause mortality, you're going to get some interesting and valuable insights.

Yeah, I think another type of inquiry that can be misinterpreted, but there's a great analogy for it, is around the dose response curve for muscle protein synthesis as protein dose increases.

There was a study

that was referenced that looked at, as you went from 0.8 to 1 to 1.2 to 1.4 to 1.6 grams of protein per kilogram of body weight, what did the rate of muscle protein synthesis do?

In other words, where did you start to achieve the plateau and beyond which you were not going to get more?