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Abstract Tumor metabolic reprogramming is a highly complex process that enables tumor survival in the presence of limited nutrients, involving multiple signaling pathways, non-coding RNAs (ncRNAs), and transcription factors

(PMC) A separate metabolism-focused paper reviewing human trial history makes a similar point: early signals of weight loss were not consistently reproduced in later studies, particularly when intensive diet/exercise protocols were included

In humans, its not associated with immunodeficiency and only minor abnormalities in immune functions have been reported [27]