SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Prolonged Fasting: Scoping Review with ☸️SAIMSARA.

Gastrointestinal & Metabolic Health

Gastrointestinal & Metabolic Health

Issue 9, Volume 1, 2026

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DOI: 10.62487/saimsara93074bf6

Editorial note
• Last update: 2026-05-25 13:13:31
What is this paper about
Prolonged fasting is not a simple wellness shortcut: this evidence map shows it as a powerful metabolic stressor that can shift fuel use, inflammation, glucose control, gut biology, and endocrine signaling — but also expose serious risks in diabetes, pregnancy, surgery, frailty, and inherited metabolic disease. The full evidence map separates where fasting looks adaptive, therapeutic, diagnostic, or harmful, helping readers move beyond fasting hype toward phenotype-matched, supervised, and clinically realistic use.
Additional notes
Due to strong reader interest in this topic, this paper was rebuilt using the latest enhanced SAIMSARA version. The updated evidence map now includes more references, deeper original-study topic synthesis, and broader clinical safety mapping — available at the same price. Enjoy the expanded read.
Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.
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Video summary generated from this ☸️SAIMSARA evidence map. Full reference-linked paper and evidence JSON are available after purchase.


Abstract: To synthesize the original-study evidence on prolonged fasting, emphasizing recurrent biological mechanisms, clinical outcomes, safety signals, implementation issues, and research directions relevant to human health and translational physiology. The review uses 335 references and builds its evidence map from 1406 original studies with 378780 total participants/sample observations (topic-deduplicated ΣN). Across the mapped evidence, prolonged fasting emerges as a potent, context-dependent metabolic stressor rather than a uniformly beneficial or harmful intervention, with its clinical meaning shaped by indication, duration, supervision, and host vulnerability. Recurrent signals indicate a coordinated shift toward lipid oxidation, ketogenesis, and gluconeogenesis—illustrated by systemic proteomic remodeling of more than 1,000 proteins after a 7-day water-only fast and gluconeogenesis supplying roughly 90% of glucose production after 40 hours—alongside consistent harms from unnecessary perioperative fasting and decompensation risk in diabetes, pregnancy, and inherited metabolic disease. This duality suggests that supervised, phenotype-matched fasting protocols, rather than blanket prescriptions or prolonged perioperative nil-by-mouth practices, best reflect current evidence. Future research should prioritize standardized fasting phenotypes paired with risk-stratified safety monitoring to clarify who benefits, who is harmed, and under what refeeding conditions.

Keywords: Prolonged fasting; Water-only fasting; Metabolic adaptation; Ketogenesis; Insulin resistance; Lipid oxidation; Gut microbiota; Systemic proteomics; IGF-1 signaling; Oxidative stress

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Reference Index (335)

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