Systemic proteome adaptions to 7-day complete caloric restriction in humans

Maik Pietzner, Burulça Uluvar, Kristoffer J. Kolnes, Per Bendix Jeppesen, S. Victoria Frivold Frivold, Øyvind Skattebo, Egil I. Johansen, Bjørn S. Skålhegg, Jørgen F. P. Wojtaszewski, Anders J. Kolnes, Giles S. H. Yeo, Jørgen Jensen, Claudia Langenberg

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

Surviving long periods without food has shaped human evolution. In ancient and modern societies, prolonged fasting was/is practiced by billions of people globally for religious purposes, used to treat diseases such as epilepsy, and recently gained popularity as weight loss intervention, but we still have a very limited understanding of the systemic adaptions in humans to extreme caloric restriction of different durations. Here we show that a 7-day water-only fast leads to an average weight loss of 5.7 kg (±0.8 kg) among 12 volunteers (5 women, 7 men). We demonstrate nine distinct proteomic response profiles, with systemic changes evident only after 3 days of complete calorie restriction based on in-depth characterization of the temporal trajectories of ~3,000 plasma proteins measured before, daily during, and after fasting. The multi-organ response to complete caloric restriction shows distinct effects of fasting duration and weight loss and is remarkably conserved across volunteers with >1,000 significantly responding proteins. The fasting signature is strongly enriched for extracellular matrix proteins from various body sites, demonstrating profound non-metabolic adaptions, including extreme changes in the brain-specific extracellular matrix protein tenascin-R. Using proteogenomic approaches, we estimate the health consequences for 212 proteins that change during fasting across ~500 outcomes and identified putative beneficial (SWAP70 and rheumatoid arthritis or HYOU1 and heart disease), as well as adverse effects. Our results advance our understanding of prolonged fasting in humans beyond a merely energy-centric adaptions towards a systemic response that can inform targeted therapeutic modulation.

Original languageEnglish
JournalNature Metabolism
Volume6
Issue4
Pages (from-to)764-777
Number of pages14
ISSN2522-5812
DOIs
Publication statusPublished - Apr 2024

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