A Very-low-energy Fast Involves Increased Adipose Inflammatory Gene Expression: A 6-day Feeding Trial (FASTOMICS-6)
Authors' conclusion
After a 6-day very-low-energy fast, adipose inflammatory gene expression increased concomitant with decreased plasma advanced glycation end-products and improved insulin sensitivity. These data suggest a role for inflammatory and autophagy-associated pathways in the metabolic adaptation to a ketogenic very-low-energy fast.
Study context
- Population
- Patients with obesity (mean BMI = 41.6)
- Participants
- 13 patients
- Comparison
- Day 7 vs day 1 of a very-low-energy fast
- Very-low-energy fastn = 13
- Outcome
- Changes in SAT gene expression, plasma metabolomics and serum markers
- Follow-up
- Days 1 to 7
Methodological detailsin-hospital, 6-day very-low-energy fast (600 kcal/day)
- In-hospital
- 6-day very-low-energy fast (600 kcal/day)
Main finding
As reported in the abstract
- Relative mean change in fat mass
- −2.07% (95% CI −2.93 to −1.20)
- Relative mean change in fat-free mass
- −4.42% (95% CI −5.53 to −3.28)
- Total ketone bodies, relative mean change
- +615% (95% CI 366-999)
- Fasting insulin, relative mean change
- −41.2% (95% CI −53.1 to −26.4)
- HOMA-IR, relative mean change
- −31.8% (95% CI −41.4 to −20.6)
- α-hydroxybutyrate, relative mean change
- +103% (95% CI 69.9-142)
- Carboxyethyl-lysine, relative mean change
- −46.0% (95% CI −53.6 to −37.2)
- Carboxymethyl-lysine, relative mean change
- −50.9% (95% CI −59.8 to −40.1)
- Subcutaneous adipose tissue (SAT) gene set enrichment: upregulated inflammatory responses; downregulated oxidative phosphorylation, adipogenesis, fatty acid metabolism and mTORC1 signaling
- P < .01
Original publication
A Very-low-energy Fast Involves Increased Adipose Inflammatory Gene Expression: A 6-day Feeding Trial (FASTOMICS-6). J Clin Endocrinol Metab. Published 28 October 2025. doi:10.
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