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Fasting and exercise independently alter metabolic and immunological processes; their combination could provide insights into immunometabolic interactions. Using a randomized crossover design, 15 healthy adults (six females, nine males, 26.5\u2009\u00b1\u20094.3\u2009years) fasted for 60\u2009h with and without the addition of a 3\u2009h cycling bout (65%\u201380% VO<jats:sub>2<\/jats:sub> peak). Fasting alone (FAST) and with exercise (FEX) reduced plasma glucose, insulin, respiratory exchange ratio, and increased \u03b2\u2010hydroxybutyrate (BHB; all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). FEX elicited more rapid changes in glucose and BHB and higher BHB concentrations at 60\u2009h (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Both conditions decreased circulating TNF\u2010\u237a concentrations and increased IL\u201010 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), although the increase in IL\u201010 appeared to be driven by the FEX condition (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). IL\u20106 concentrations tended to increase in both conditions (<jats:italic>p<\/jats:italic>\u2009=\u20090.1). Total white blood cell count remained unchanged after 60\u2009h in both conditions, with only modest changes in some leukocyte subpopulations. Collectively, the observed changes in circulating cytokine concentrations support an overall anti\u2010inflammatory effect of prolonged fasting, while the maintenance of leukocyte concentrations suggests immune function is not compromised. Despite greater metabolic strain, the addition of prolonged exercise did not appear to augment changes in systemic cytokines and leukocytes.<\/jats:p>","DOI":"10.14814\/phy2.70294","type":"journal-article","created":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T02:56:05Z","timestamp":1743044165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Changes in plasma cytokines following a 60\u2010h fast are not influenced by the addition of exercise despite elevated ketones in healthy young adults"],"prefix":"10.14814","volume":"13","author":[{"given":"Tori","family":"Bouck","sequence":"first","affiliation":[{"name":"School of Health and Exercise Sciences, The University of British Columbia Okanagan  Kelowna British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Monteleone","sequence":"additional","affiliation":[{"name":"School of Health and Exercise Sciences, 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