Otherindependent cross-checkabstract checked I-SYS-107 standard review

Long water-only fasting triggers inflammation

Prolonged fasting promotes systemic inflammation and platelet activation in humans: A medically supervised, water-only fasting and refeeding study.

Overview

Commissati S et al.. Mol Metab 2025 · PMID 40268190 · DOI 10.1016/j.molmet.2025.102152

During about 10 days of water-only fasting, inflammation markers and blood clotting activity rose.

Does the study support the specific claim? No · Methodological quality: low

Study explained simply

What did the researchers want to find out?: Study protein changes during fasting.
How was the study done?: Supervised fasting study.
How many people, animals or samples were studied?: 20 volunteers + 1,422 cohort.
What was actually found?: Inflammation and clotting activation.
How large was the observed effect?: CRP 2.8 to 4.3 mg/L.
What do the results mean in everyday life?: Total fasting is a stress state, not perfect health.
What are the study's limitations?: Small; uncontrolled; COI.
What does it say about Elawady's specific claim?: Contradicts the claim.
Do the results apply to Germany and Europe?: Moderate.
What can explicitly not be concluded from this study?: Long-term harm.

Authors: Commissati S et al.
Journal: Mol Metab
Year: 2025
Identifier: PMID 40268190 DOI 10.1016/j.molmet.2025.102152
Verification: verified – PubMed efetch 2026-10-26 + Crossref
Retracted: no
Corrections: none
Extent checked: abstract only
Conflicts of interest and funding: One author founded a fasting facility; others employed by a diagnostics company (PubMed record)

Effects of prolonged fasting on the plasma proteome

Study design: Other – Medically supervised water-only fasting study with refeeding; plasma proteomics; retrospective cohort validation
Population: Middle-aged volunteers; validation cohort of 1,422 people undergoing modified fasting
Country: not stated in abstract (first author group and fasting facility per COI statement: USA)
Period: Published 2025
Sample size: 20 (water-only fast, mean 9.8 days); 1,422 (validation)
Inclusion and exclusion criteria: Volunteers

Results: Mean weight loss 7.7%; acute inflammatory response with elevated CRP, hepcidin, IL-8; increased platelet degranulation and complement/coagulation activation; CRP rose from 2.8 to 4.3 mg/L in the 1,422-person cohort.
Absolute risks: not applicable
Authors' conclusion: The acute inflammatory response may be adaptive but raises concerns about cardiometabolic effects.

Before-after comparison without control group.

Shows that total abstention from food triggers inflammation and coagulation activation - not a state of a body that 'does not get sick'.

Moderate.

Physiological evidence against 'zero inputs = infinite health'.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	low
Risk of bias	high
Precision of results	low
Directness	indirect
Reproducibility	unknown
Consistency with the overall evidence	consistent
Regional transferability	moderate
Adequacy of the interpretation (by the archive)	not applicable

Clinical significance.