ArticleThe Journal of clinical endocrinology and metabolism2026
A Very-low-energy Fast Involves Increased Adipose Inflammatory Gene Expression: A 6-day Feeding Trial (FASTOMICS-6).
Article in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02671279 (Effect of 6 Days Low Calorie Diet Before Bariatric Surgery), which is not on this map. Cited by 2 papers.
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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.
Effect of 6 Days Low Calorie Diet Before Bariatric Surgery
Who cites it
2 citing papers in PubMed.
- Marked Changes in One-Carbon Metabolism on a Low-Carbohydrate High-Fat Diet: A Randomized Controlled Trial (CARBFUNC).The Journal of nutrition · 2026Trial
- A Very-low-energy Fast Involves Increased Adipose Inflammatory Gene Expression: A 6-day Feeding Trial (FASTOMICS-6).The Journal of clinical endocrinology and metabolism · 2026Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundFasting and ketogenic diets may have health benefits, but we lack a deeper understanding of tissue mechanisms and associated metabolome changes, particularly in humans.
objectiveDetermine changes in subcutaneous adipose tissue (SAT) gene expression, plasma metabolomics, and circulating serum markers after a 6-day very-low-energy fast.
methods13 patients with obesity (mean body mass index = 41.6) underwent a week-long in-hospital feeding study (600 kcal/day). Body composition was assessed by bioimpedance. Blood and SAT were collected on days 1 and 7 for metabolomics (gas chromatography coupled with tandem mass spectrometry) and transcriptomics (RNA-sequencing). Biological pathways were inferred from affected gene sets (gene set enrichment analysis) and gene networks that correlated with plasma metabolites.
resultsRelative mean change (95% CI) in fat mass and fat-free mass was -2.07% (-2.93 to -1.20) and -4.42% (-5.53 to -3.28), respectively. Marked significant changes (relative mean change [95% CI]) were observed in total ketone bodies (acetoacetate + β-hydroxybutyrate) (+615% [366-999]), fasting insulin (-41.2% [-53.1 to -26.4]) and homeostatic model assessment for insulin resistance (-31.8% [-41.4 to -20.6]), as well as α-hydroxybutyrate (+103% [69.9-142]) and the advanced glycation end-products carboxyethyl-lysine (-46.0% [-53.6 to -37.2]) and carboxymethyl-lysine (-50.9% [-59.8 to -40.1]). Gene set enrichment analysis indicated upregulated inflammatory responses, and downregulated oxidative phosphorylation, adipogenesis, fatty acid metabolism, and mTORC1 signaling (P < .01) in SAT.
conclusionAfter 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. CLINICAL TRIAL REGISTRY NUMBER: NCT02671279 (https://clinicaltrials.gov/study/NCT02671279).
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