Ramadan and Cardiology




All the medical articles from all the journals on Ramadan! Enjoy this compilation. [more]

Eur J Clin Nutr. 2006 Jul;60(7):877-81. Epub 2006 Feb 8.

Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia.

Dewanti LWatanabe CSulistiawatiOhtsuka R.

Department of Human Ecology, University of Tokyo, Tokyo, Japan. lindaperisdiono@yahoo.com

Abstract

OBJECTIVE: To examine the effect of Ramadan fasting on basic hematological parameters, in addition to the effects on body weight and blood pressure of fasters and nonfasters. DESIGN, SETTING, AND SUBJECTS: One hundred male outdoor workers at a vehicle terminal in a city in East Java were recruited for this study. Anthropometric measurements and blood sampling were conducted on two separate occasions, just before the start of Ramadan and in the third week of the month of Ramadan (October-November 2004). The degree of subjective compliance with Ramadan fasting (complete, partial, or none) was evaluated using a questionnaire. RESULTS: The mean body mass index (BMI) of the fasting group was, as expected, significantly lower at the second sampling period, and the decrease in BMI correlated significantly with decreased blood pressure in this group. The blood pressure was also reduced in the partial fasting and nonfasting groups, which was an unexpected result. While red blood cell production was suppressed, as evidenced by lower levels of hemoglobin, red blood cell (RBC), and packed cell volume (PCV) at the second sampling, the subjects were normocytic and normochromic, based on normal mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) levels. CONCLUSIONS: These results indicate that, regardless of fasting status, blood pressure is lower and RBC production is suppressed in subjects during the Ramadan period. These findings should be taken into account when evaluating the effects of Ramadan on the general population. To avoid the adverse effects of anemia, increased intake of iron-rich foodstuffs is recommended during the Ramadan month, regardless of fasting practice.

PMID: 16489329 [PubMed – indexed for MEDLINE]

J Egypt Public Health Assoc. 2004;79(5-6):461-83.

Ramadan fasting: relation to atherogenic risk among obese Muslims.

Saleh SAEl-Kemery TAFarrag KABadawy MRSarkis NNSoliman FSMangoud H.

Unit of Medical Nutrition Therapy, Damanhour Medical National Institute.

Abstract

Increased platelet aggregation as well as changes in coagulation factors have an important effect on the occurrence of atherogenicity and cardiovascular diseases. Fasting in general has been used in medicine for medical purposes when other measures fail. Since Ramadan fasting is different from total fasting, the present work was conducted to study the effect of Ramadan fasting on lipid pattern, some blood coagulation parameters, blood pressure and body mass index (BMI)–as atherosclerotic risk factors–in one hundred and three apparently healthy obese volunteers (15 men and 88 women) aged 15-52 years. The study comprised an initial visit for assessment V1 (before Ramadan) and three other follow up visits: V2 (at the end of Ramadan), V3 (4 weeks after Ramadan) and V4 (8 weeks after Ramadan), Targets were subjected to an interview questionnaire, complete physical and clinical examination, anthropometric measurements, dietary profile, and laboratory assay of complete blood picture (CBC), fasting serum glucose level (FSG), serum lipid pattern: total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL-c) and low density lipoprotein (LDL-c), lipoprotein a Lp (a), apolipoprotein A1 (APA), and apolipoprotein B (APB) levels; bleeding (BT) and clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and plasma factor VII activity. Statistical analysis was performed using Chi squared, Fisher exact, Student t test, paired t test and Pearson’s correlation coefficient. Statistical significance was defined at P < 0.05. The study showed that by the end of Ramadan fasting, there was a significant improvement in the mean levels of hemoglobin (Hb), TC, TG, HDL-c, LDL-c, TC/HDL, LDL/HDL, Lp (a), APA, APB, PT and systolic (SBP) and diastolic blood pressure (DBP) that persisted for four weeks after fasting (P < 0.05). Ramadan fasting has not adversely affected leucocytic count or coagulation parameters (P > 0.05). There was also a significant association between dietary intake, SBP, DBP, weight, BMI, percent body fat and waist, fibrinogen and factor VII activity and TC, TG, HDL-c, LDL-c, LDL/HDL, Lp (a) and APB (P < 0.05). The model of Ramadan fasting could be followed as a behavior modification program to control or prevent atherogenicity because of its positive impact on the lipid pattern, blood count and coagulation parameters.

PMID: 17265611 [PubMed – indexed for MEDLINE]

 

Am J Clin Nutr. 1988 Nov;48(5):1197-210.

Body weight loss and changes in blood lipid levels in normal men on hypocaloric diets during Ramadan fasting.

Hallak MH, Nomani MZ.

Division of Family Resources, West Virginia University, Morgantown 26506-6124.

Abstract

An investigation was conducted to study the changes in body weight and blood lipids during Ramadan fasting in men on hypocaloric diets. Sixteen healthy male college students were fed a high-carbohydrate diet for the first 2 wk (means 1696 kcal/d), followed by another 2 wk of high-fat diet (means 1834 kcal/d). Fasting blood samples were taken on days 0 (base line), 14, and 28 and were analyzed for triglycerides (TGs) and cholesterol. By the end of Ramadan, body weight, blood TGs, and high-density lipoprotein cholesterol (HDL-chol) had decreased significantly (p less than 0.05), low-density lipoprotein cholesterol (LDL-chol) had increased, and total cholesterol had not changed compared with base-line values. The variance in blood lipid levels was explained by weight change through linear and curvilinear regression models. The findings contribute to a better understanding of the contrasting results reported by various investigators and they may be useful in regulating blood lipid levels through Ramadan fasting.

PMID: 3189206 [PubMed – indexed for MEDLINE]

Eur J Clin Nutr. 2000 Jun;54(6):508-13.

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait.

Akanji AO, Mojiminiyi OA, Abdella N.

Department of Pathology, Kuwait University Faculty of Medicine, Safat. abayomi@hsc.kuniv.edu.kw

Abstract

BACKGROUND: In patients with metabolic and nutritional disorders such as diabetes and hyperlipidaemia, where strict compliance to advice on timing and composition of food intake is important, the prolonged daylight fasting during the month of Ramadan could produce undesirable biochemical consequences. AIM: The study aimed to compare pre- and post-Ramadan lipid and lipoprotein profiles in stable Kuwaiti hyperlipidaemic subjects attending a Lipid Clinic. SUBJECTS AND METHODS: The study population comprised 64 adult Kuwaitis (33 M, 31 F) who had been attending a Lipid Clinic for at least 12 months and were considered stable, without any acute systemic illness. At each clinic visit, the following parameters were measured: weight, total cholesterol (TC), triglycerides (TG), HDL, LDL, apo A-1, apo B, glucose and uric acid. These biochemical parameters were measured by routine automated analyzer techniques. The pre-Ramadan values comprised the means of two measurements taken at about 3 month and 1 month before commencement of Ramadan. Post-Ramadan values were obtained within 1 month of the end of the Ramadan fast. The parameters so obtained were compared in the whole group, and then according to gender, glycaemic status and modality of treatment (diet alone or with a fibrate or statin). RESULTS AND DISCUSSION: In the nondiabetic subjects, apo A-1 and apo A-1/apo B and apo A-1/HDL ratios were increased post-Ramadan (P<0.001). Weight did not change and the other lipid parameters-TC, TG, LDL, apo B-did not worsen. These observations, more consistent in the men than in the women, and in subjects treated with a fibrate or a statin rather than on diet alone, indicate a favorable coronary heart disease (CHD) risk profile. In the diabetic patients, these changes in the apo A-1 level and its ratio to HDL and apo B were also present, but TC and apo B levels increased, the latter significantly (P<0.05). These divergent effects in diabetic patients could variably influence CHD risk liability. Serum uric acid levels were also simultaneously reduced post-Ramadan in the non-diabetic subjects and those on statin treatment. CONCLUSION: When pre- and post-Ramadan lipid and lipoprotein profiles were compared in stable hyperlipidaemic subjects attending a Lipid Clinic in Kuwait, the most consistent changes post-Ramadan were increased levels of apo A-1 and apo A-1/apo B and apo A-1/HDL ratios and reduced uric acid levels. Body weight remained essentially unchanged and the other lipoprotein and lipid parameters were not worsened. These results suggest that Ramadan fasting in hyperlipidaemic subjects might favorably influence CHD risk.

PMID: 10878654 [PubMed – indexed for MEDLINE]

Ann Nutr Metab. 2004;48(4):296-303. Epub 2004 Sep 24.

Physiological and chronobiological changes during Ramadan intermittent fasting.

Roky R, Houti I, Moussamih S, Qotbi S, Aadil N.

Department of Pharmacology, Faculty of Medicine, Casablanca, Morocco. rroky2001@yahoo.fr

Abstract

BACKGROUND AND AIMS: During the month of Ramadan, Moslems refrain from drinking and eating between sunrise and sunset. This review aimed to analyze the effects of Ramadan fasting on physiological and behavioral variables in healthy subjects. METHODS: Articles included in this paper were taken from Medline, three international congresses on health and Ramadan, and in several cases from local journals. RESULTS: Ramadan fasting did not dramatically affect the metabolism of lipids, carbohydrates and proteins, or the daily mean of hormonal serum levels. An increase in serum urea and uric acid was frequently reported and this could be attributed to dehydration during this month. Some changes, such as the increase of HDL and apoprotein A1, and the decrease in LDL, could be beneficial for the cardiovascular system. However, the chronobiological studies have shown that Ramadan fasting affects the circadian distribution of body temperature, cortisol, melatonin and glycemia. The amplitude of most of these rhythms decreased and the acrophase shifted. Nocturnal sleep, daytime alertness and psychomotor performance were decreased. CONCLUSION: The major changes during Ramadan fasting are chronobiological and behavioral. They could be responsible for the high incidence of road traffic accidents and the reduction of working hours during the month of Ramadan. Copyright (c) 2004 S. Karger AG, Basel.

PMID: 15452402 [PubMed – indexed for MEDLINE]

Ann Endocrinol (Paris). 2006 Mar;67(1):54-9.

Ramadan fasting in type 2 diabetes mellitus

[Article in French]

Bouguerra R, Jabrane J, Maâtki C, Ben Salem L, Hamzaoui J, El Kadhi A, Ben Rayana C, Ben Slama C.

Service d’Endocrinologie, Métabolisme et Nutrition, Institut national de Nutrition, 11, rue Djebel Lakhdar – Bab Saadoun 1007 Tunis, Tunisie. radhia.bouguerra@rns.tn

Abstract

This study was designed to assess the effects of fasting during Ramadan on weight, blood pressure, metabolic control and plasma lipoproteins in diabetic patients. This study was conducted in December 2000 (Ramadan 1421) when the length of fasting was 12 hours a day. It included 38 type 2 diabetic patients (20 males and 18 females). Mean patient age was 51.410.5 years and mean body mass index (BMI) 28.94.7kg/m2. Three patients were treated with diet and 35 with oral hypoglycemic agents. Clinical and biochemical parameters were evaluated during three periods: three weeks before Ramadan (T0), at the fourth week of Ramadan (T1) and three weeks after the end of Ramadan (T2). During the month of Ramadan, a decrease in weight (0.52kg) and no change in blood pressure were observed. No metabolic complication occurred in our patients. A significant effect of Ramadan fasting was observed on glycemic control and lipoprotein levels. In patients whose fructosamine level before Ramadan was higher than 340micromol/l, plasma fasting glucose and serum fructosamine increased during Ramadan (p<0.003) and returned to initial levels at the end of Ramadan T2; in these patients also, a decrease of HDL-cholesterol (p<0.01) associated with an increase of LDL-cholesterol (p<0.003) were observed at T1 and disappeared at T2. But, in patients whose fructosamine level at T0 was lower than 340micromol/l, no effect on glycemic control and no significant effect on serum lipoprotein levels were found during Ramadan month. Ramadan fasting in type 2 diabetic patients seems to cause slight effects on glycemia and lipoprotein levels when previous metabolic control is quite good; but fasting induces more deterioration when previous control is poor.

PMID: 16596059 [PubMed – indexed for MEDLINE]

Saudi Med J. 2006 Jan;27(1):23-6.

Ramadan fasting induces modifications of certain serum components in obese women with type 2 diabetes.

Khaled BM, Bendahmane M, Belbraouet S.

Department of Biology, Faculty of Sciences, Djillali Liabes University, Sidi-Bel-Abbes, Algeria.

Abstract

OBJECTIVE: To examine the effect of fasting during Ramadan on certain serum components such as fasting serum glucose (FSG), glycated hemoglobin (HbA1c), total cholesterol (TC), triglycerides (TGs), high density lipoproteins (HDL-C), and low density lipoproteins (LDL-C) parameters in obese women patients with type 2 diabetes. METHODS: We conducted the study in Petit-Vichy Diabetology Center, Sidi-Bel-Abbes, Algeria from October 2003 to March 2004, on 60 obese outpatient women (BMI = 35.41 +/- 3.64 kg/m2), aged 51 +/- 10 years, who had diabetes for 5 +/- 2.5 years. The patients followed no specific diet, on medications, and presenting no degenerative complications. We carried out the study over 3 periods: before (pre-fasting), during (fasting), and after Ramadan month (post-fasting). RESULTS: Comparing Ramadan (fasting period) with non-Ramadan days (pre- and post-fasting periods), we observed significant decreases in FSG (16.72%, p<0.001), in HbA1c (11.3%, p<0.005), and in HDL-C (26.81%, p<0.001) rates, while TC (13.85%, p<0.001), TGs (16.9%, p<0.003), and the LDL-C (22.39%, p<0.0001) levels increased significantly. CONCLUSION: These findings show a beneficial effect of fasting during Ramadan on glucose homeostasis, however, we observed an unbalanced profile on lipids.

PMID: 16432588 [PubMed – indexed for MEDLINE]

Saudi Med J. 2004 Dec;25(12):1858-63.

Metabolic alterations as a result of Ramadan fasting in non-insulin-dependent diabetes mellitus patients in relation to food intake.

Khatib FA, Shafagoj YA.

Department of Physiology and Biochemistry, Faculty of Medicine, University of Jordan, Amman, Jordan.

Abstract

OBJECTIVE: Diabetes is known to be associated with alterations in metabolic parameters. The aim of this study is to investigate whether Ramadan fasting can affect these metabolic parameters in non-insulin dependent diabetes mellitus (NIDDM) patients. METHODS: This study was conducted in the outpatient Clinic of Jordan University Hospital, Amman, Jordan in February of 1415 Hijra year (1995 Gregorian). Forty-four NIDDM male patients volunteered for this study. Patients fasted the month of Ramadan and few metabolic parameters were recorded. Body weight, fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) and high density lipoprotein-cholesterol (HDL-C) were measured, before, at mid- and at the end- of Ramadan. Detailed energy intakes were also recorded. RESULTS: Patients mean age were 52+/-9 years (range 35-75). Patients showed a statistically significant reduction in their body weight, FBS, HbA1c, and TG levels by the end of Ramadan (1.57 kg, 31 mg/dl, 0.85%, and 35 mg/dl). Other parameters such as TC, LDL-C, HDL-C were not affected by Ramadan fasting. The total daily energy intake remained unchanged including the qualitative components of nutrients. CONCLUSION: Muslim NIDDM patients showed a trend towards better glycemic control following Ramadan fasting. However, the pre-Ramadan existed dyslipidemia was sustained or even worsened following Ramadan fasting.

PMID: 15711655 [PubMed – indexed for MEDLINE]

Ann Nutr Metab. 2007;51(1):88-95. Epub 2007 Mar 19.

Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting.

Aksungar FB, Topkaya AE, Akyildiz M.

Department of Biochemistry, Maltepe University, School of Medicine, Istanbul, Turkey. fehimebenli@gmail.com <fehimebenli@gmail.com>

Abstract

BACKGROUND: It is well known that nutritional habits, sleeping patterns and meal frequency have profound effects on maintaining human health. Ramadan is a religious month for Islam, during which Muslims do not eat and drink during the daylight hours. The duration of restricted food and beverage intake is approximately 12 h/day for 1 month, which makes Ramadan a model of prolonged intermittent fasting. METHODS: In order to evaluate the effects of long-lasting modifications of food intake on inflammatory markers and biochemical parameters 40 healthy volunteers of normal weight [20 females aged between 20 and 38 years, 20 males aged between 23 and 39 years, body mass index (BMI) <25 kg/m(2)] who fasted during Ramadan and another 28 healthy age- and BMI-matched volunteers (14 males, 14 females) who did not fast participated in the study. Venous blood samples were taken 1 week before Ramadan, during the last week of Ramadan and 3 weeks after Ramadan. Serum interleukin-6 (IL-6), C-reactive protein (CRP), homocysteine, vitamin B(12), folate, total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels were measured. RESULTS: No significant changes were observed in serum total cholesterol, triglycerides and LDL levels. TC/HDL ratio (HDL risk factor) was decreased during and after Ramadan in both genders in the fasting group while there were no changes in the nonfasting group. IL-6 (p < 0.001), CRP (p < 0.001) and homocysteine (p < 0.01) levels were significantly low during Ramadan in the fasting subjects of both genders when compared to basal values (1 week before Ramadan). CONCLUSION: Our results demonstrate that prolonged intermittent fasting in a model like Ramadan has some positive effects on the inflammatory status of the body and on the risk factors for cardiovascular diseases such as homocysteine, CRP and TC/HDL ratio. Copyright 2007 S. Karger AG, Basel.

PMID: 17374948 [PubMed – indexed for MEDLINE]

Am J Clin Nutr. 1993 May;57(5):640-2.

Marked increase in plasma high-density-lipoprotein cholesterol after prolonged fasting during Ramadan.

Maislos M, Khamaysi N, Assali A, Abou-Rabiah Y, Zvili I, Shany S.

Department of Medicine, Tour Institute, Soroka Medical Center, Ben-Gurion University Faculty of Health Sciences, Beer Sheva, Israel.

Abstract

We evaluated the effect of the Ramadan fasting on plasma lipids and lipoproteins in normal individuals. Twenty-four healthy subjects were studied before the end of the Ramadan month (Ram) and for 1 mo thereafter. Plasma total cholesterol (TC), triglycerides, low-density-lipoprotein cholesterol (LDL-C), and very-low-density-lipoprotein cholesterol (VLDL-C) did not change. High-density-lipoprotein cholesterol (HDL-C) was 30% higher (P < 0.005) at the end of Ram; apolipoprotein A-I also increased (P < 0.0001). Both the ratios of TC to HDL-C and LDL-C to HDL-C (P < 0.001) decreased at Ram. There was a striking nonpharmacologic improvement in plasma HDL-C and ratios of TC to HDL-C and LDL-C to HDL-C, which were most probably induced by eating one large evening meal a day. Further studies to determine the mechanism of this observation are underway.

PMID: 8480679 [PubMed – indexed for MEDLINE]

Ann Nutr Metab. 1997;41(4):242-9.

Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol.

Adlouni A, Ghalim N, Benslimane A, Lecerf JM, Saile R.

Département de Biologie, Faculté des Sciences Ben M’sik, Casablanca, Morocco.

Abstract

We demonstrated for the first time in a Moroccan population that fasting during Ramadan, the ninth lunar month of the Muslims’ year, affected lipid and lipoprotein metabolism in a group of 32 healthy adult male volunteers. This investigation was conducted to study the changes in serum total cholesterol, triglycerides, cholesterol in high-density lipoprotein (HDL) and low-density lipoprotein (LDL), glucose, and body weight during Ramadan. The results showed a significant decrease (7.9%, p < 0.001) in serum total cholesterol concentration during Ramadan as compared with the prefasting period. Also, we obtained a significant decrease of serum triglyceride concentration (30%, p < 0.001) during Ramadan fasting as compared to the period before Ramadan. The reduction of both serum triglycerides and total cholesterol was maintained 1 month after Ramadan. By the end of Ramadan, serum HDL cholesterol had markedly increased (14.3%, p < 0.001) and remained elevated 1 month after Ramadan in contrast to LDL cholesterol which showed a significant decrease (11.7%, p < 0.0001) also maintained 1 month after Ramadan. Mean body weight declined by 2.6% (p < 0.01) on day 29 of Ramadan, whereas during Ramadan, the diet pattern used by our subjects showed an increase of total energy intake due to carbohydrates (+ 1.4% of total energy), proteins (+ 0.4% of total energy) but not fat (-0.7% of total energy) compared to a usual diet used throughout the rest of the year. Moreover, the fat diet is high in monounsaturated (p < 0.05) and polyunsaturated fatty acid in contrast to saturated fatty acid which significantly (p < 0.05) decreased during Ramadan. These findings suggest that feeding behavior that occurs during Ramadan beneficially affects plasma lipids and lipoproteins.

PMID: 9363296 [PubMed – indexed for MEDLINE]

Eur J Clin Nutr. 1998 Feb;52(2):127-30.

Gorging and plasma HDL-cholesterol–the Ramadan model.

Maislos M, Abou-Rabiah Y, Zuili I, Iordash S, Shany S.

Department of Medicine, Toor Institute, Israel.

Abstract

OBJECTIVES: To evaluate the effect of a single evening meal (gorging) on plasma lipids and lipoproteins in normal individuals observing the Ramadan Fast. During the Ramadan month, Muslims refrain from food and liquids during the day and eat a large meal after sundown. DESIGN: Sequential measurement of plasma lipids and lipoproteins in Muslims observing the Ramadan Fast and non-fasting individuals. SETTING: The study was conducted in the Bedouin town of Rahat, in the northern Negev area of Israel. SUBJECTS: Twenty-two healthy subjects who fasted during Ramadan and 16 non-fasting laboratory workers, were studied before Ramadan, at week 1, 2 and 4 of the Ramadan month, and again four weeks after the end of Ramadan. RESULTS: Plasma high-density lipoprotein cholesterol (HDL) rose significantly (P < 0.001) at the week 4 measurement, returning to basal levels 4 weeks after the end of Ramadan. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), very-low density lipoprotein cholesterol (VLDL), and lipoprotein (a) [Lp(a)] did not change significantly. CONCLUSIONS: Plasma HDL increased by 23% after four weeks of gorging. The dietary change did not affect the composition of other lipoproteins, such as LDL, VLDL or Lp(a), other plasma biochemical parameters, or BMI. Prolonged gorging, well tolerated by all individuals, is a very effective non-pharmacological method to increase plasma HDL-cholesterol.

PMID: 9505158 [PubMed – indexed for MEDLINE]

Ann Nutr Metab. 2005 Mar-Apr;49(2):77-82. Epub 2005 Mar 29.

Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels.

Aksungar FB, Eren A, Ure S, Teskin O, Ates G.

Department of Biochemistry, School of Medicine, Maltepe University, Istanbul, Turkey. fehimebenli@hotmail.com

Abstract

BACKGROUND: During Ramadan, Muslims fast during the daylight hours for a month. The duration of restricted food and beverage intake is approximately 12 h/day which makes Ramadan a unique model of intermittent fasting. Many physiological and psychological changes are observed during Ramadan that are probably due to the changes in eating and sleeping patterns. METHODS: Serum total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), prothrombin time, activated partial thromboplastin time (aPTT), plasma fibrinogen, D-dimer and homocysteine levels were measured in 24 healthy fasting volunteers (12 females, 12 males) aged 21-35 years. Venous blood samples were taken 1 week before Ramadan, on the 21st day of Ramadan and 20 days after Ramadan. RESULTS: No significant changes were observed on serum total cholesterol, triglycerides and LDL levels. HDL levels were significantly elevated during Ramadan (p < 0.001) and 20 days after Ramadan (p < 0.05). Prothrombin time, aPTT, fibrinogen and D-dimer levels were in the physiologic limits in all samples but D-dimer levels were significantly low at the end of Ramadan in comparison to pre- and post-fasting levels (p < 0.001). Homocysteine levels, being still in reference ranges, were low during Ramadan (p < 0.05) and reached the pre-fasting levels after Ramadan. CONCLUSION: Our results demonstrate that intermittent fasting led to some beneficial changes in serum HDL and plasma homocysteine levels, and the coagulation status. These changes may be due to omitting at least one meal when the body was particularly metabolically active and possibly had a low blood viscosity level at the same time. We conclude that intermittent fasting may have beneficial effects on hemostatic risk markers for cardiovascular diseases. Copyright (c) 2005 S. Karger AG, Basel.

PMID: 15802901 [PubMed – indexed for MEDLINE]

Tunis Med. 2006 Oct;84(10):647-50.

Food intake and high density lipoprotein cholesterol levels changes during ramadan fasting in healthy young subjects.

Lamine F, Bouguerra R, Jabrane J, Marrakchi Z, Ben Rayana MC, Ben Slama C, Gaigi S.

Service d’Endocrinologie, Métabolisme et Nutrition, Hôpital de Jour Institut National de Nutrition Tunis.

Abstract

During the holy month of Ramadan, it is obligatory for all adult healthy Muslims to abstain from food, drink and smoking each day from dawn to sunset. The aims of our study were to evaluate the effects of Ramadan fasting on plasma lipids, lipoproteins and the change of food consumption in healthy subjects. Thirty young healthy and normal weighted adults (9 males and 21 females) were evaluated during three periods: 3 weeks before Ramadan (T0); the 4th week of Ramadan (T1) and 3 weeks after the end of Ramadan (T2). Main Clinical and biological parameters investigated were: body weight, blood glucose, plasma triglycerides (TG), plasma total cholesterol (TC), high density lipoprotein cholesterol (HDL-c) and. low density lipoprotein cholesterol (LDL-c) Body weight, and blood glucose were unchanged. There was a significant increase of the mean daily caloric intake, the lipids intake particularly mono-unsaturated and poly-unsaturated fatty acids (p < 0.001) and cholesterol intake (p < 0.001) during Ramadan with a decrease of the meal frequency. There was also a significant increase of plasma total cholesterol and HDL-cholesterol. The most striking finding was a significant increase in the HDL-Cholesterol during Ramadan +20% (p < 0.02). This increase was lost after Ramadan. Fasting Ramadan affects beneficially serum lipoprotein metabolism in young adult healthy subjects with an increase of HDL-cholesterol.

PMID: 17193859 [PubMed – indexed for MEDLINE]

J Egypt Public Health Assoc. 2004;79(5-6):461-83.

Ramadan fasting: relation to atherogenic risk among obese Muslims.

Saleh SA, El-Kemery TA, Farrag KA, Badawy MR, Sarkis NN, Soliman FS, Mangoud H.

Unit of Medical Nutrition Therapy, Damanhour Medical National Institute.

Abstract

Increased platelet aggregation as well as changes in coagulation factors have an important effect on the occurrence of atherogenicity and cardiovascular diseases. Fasting in general has been used in medicine for medical purposes when other measures fail. Since Ramadan fasting is different from total fasting, the present work was conducted to study the effect of Ramadan fasting on lipid pattern, some blood coagulation parameters, blood pressure and body mass index (BMI)–as atherosclerotic risk factors–in one hundred and three apparently healthy obese volunteers (15 men and 88 women) aged 15-52 years. The study comprised an initial visit for assessment V1 (before Ramadan) and three other follow up visits: V2 (at the end of Ramadan), V3 (4 weeks after Ramadan) and V4 (8 weeks after Ramadan), Targets were subjected to an interview questionnaire, complete physical and clinical examination, anthropometric measurements, dietary profile, and laboratory assay of complete blood picture (CBC), fasting serum glucose level (FSG), serum lipid pattern: total cholesterol (TC), triglycerides (TG), high density lipoproteins (HDL-c) and low density lipoprotein (LDL-c), lipoprotein a Lp (a), apolipoprotein A1 (APA), and apolipoprotein B (APB) levels; bleeding (BT) and clotting time (CT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and plasma factor VII activity. Statistical analysis was performed using Chi squared, Fisher exact, Student t test, paired t test and Pearson’s correlation coefficient. Statistical significance was defined at P < 0.05. The study showed that by the end of Ramadan fasting, there was a significant improvement in the mean levels of hemoglobin (Hb), TC, TG, HDL-c, LDL-c, TC/HDL, LDL/HDL, Lp (a), APA, APB, PT and systolic (SBP) and diastolic blood pressure (DBP) that persisted for four weeks after fasting (P < 0.05). Ramadan fasting has not adversely affected leucocytic count or coagulation parameters (P > 0.05). There was also a significant association between dietary intake, SBP, DBP, weight, BMI, percent body fat and waist, fibrinogen and factor VII activity and TC, TG, HDL-c, LDL-c, LDL/HDL, Lp (a) and APB (P < 0.05). The model of Ramadan fasting could be followed as a behavior modification program to control or prevent atherogenicity because of its positive impact on the lipid pattern, blood count and coagulation parameters.

PMID: 17265611 [PubMed – indexed for MEDLINE]

Ann Saudi Med. 2002 Sep-Nov;22(5-6):297-9.

Effects of Ramadan fasting on serum low-density and high-density lipoprotein-cholesterol concentrations.

Qujeq D, Bijani K, Kalavi K, Mohiti J, Aliakbarpour H.

Faculties of Medicine, Babol University of Medical Sciences, Babol, Iran. dqujeq@hotmail.com

Abstract

BACKGROUND: The aim of the study was to determine the status of low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) in human subjects during Ramadan fasting. Fasting during Ramadan (one month of food and water intake restricted only to night hours) is a religious obligation for Muslims. There are biochemical effects of changes in lifestyle during Ramadan. This report is a study of the effects of Ramadan fasting on the serum LDL-cholesterol and HDL-cholesterol concentrations. SUBJECTS AND METHODS: The study group consisted of 83 volunteers comprising 57 males (aged 21-55, mean 34.25+/-9.81 years) and 26 females (aged 20-58, mean 34.58+/-8.94 years). A regimen of one month of food and water intake restricted only to night hours was followed by the subjects. Subjects were evaluated one week before Ramadan fasting (pre-RF), two weeks after the start of Ramadan fasting (mid-RF), and at the fourth week of Ramadan fasting (end-RF). Serum specimens were obtained from subjects during daylight hours. Measurement of LDL-cholesterol and HDL-cholesterol were performed using a spectrophotometer. RESULTS: Our results showed statistically significant reduction of the LDL-cholesterol concentrations in midRamadan and end of Ramadan compared to concentration levels before Ramadan. Also, the results showed statistically significant elevation in the HDL-cholesterol concentrations in mid-Ramadan and end of Ramadan compared to levels before Ramadan. CONCLUSION: The findings suggest the potential usefulness of Ramadan fasting in the restriction of fat intake which is associated with further lowering of serum cholesterol. These findings should influence future studies on hyperlipidemia.