Jayshil J Patel, Zheng-Yii Lee, Christian Stoppe, Daren K Heyland (2023-09-16). Correspondence] EFFORT Protein trial: questions remain — Authors' reply. thelancet.com We thank G Jan Zijlstra for his interest in our study, the EFFORT Protein trial.1 He suggests our trial was conducted in a heterogeneous group of critically ill patients and the study is absent of individualised protein prescriptions. Previous to the EFFORT trial, signals from observational data suggested a higher protein dose, compared with lower, was associated with better outcomes in critically ill patients with high nutritional risk.2 In addition, the wide range of protein recommendations by clinical practice guidelines and the substantial variability in protein delivery, as shown by our international nutriti…