Over the past few years, there has been a lot of research done on people who do “intermittent” fasting, specifically Ramadan. They are asking a lot of questions, namely how does Ramadan affect your blood pressure, glucose, cholesterol, and other cardiovascular risk factors. Luckily, we have answers and a lot of studies to back up claims we were making a few years ago.
Before going into the research and studies, it’s important to note that Ramadan is not about fasting and gorging. People who gorge at night have worst outcomes. This has also bee studied and we will discuss those studies as well. Here are some abbreviations that I may use throughout this article.
TC = Total Cholesterol
HDL = Good Cholesterol
LDL = Bad Cholesterol
TGs = Triglycerides (extra sugars in your bloodstream)
BMI = Body Mass Index (how much you weigh for your height, the lower the better, up to 25 is normal)
The most comprehensive study, looked at 103 healthy, obese volunteers (88 were women) and evaluated their blood pressure, lipid panel, and other cardiovascular risk factors. The ages ranged from 15 to 52 years of age. They evaluated the patients before Ramadan, at the end of Ramadan, 4 weeks after Ramadan, and 8 weeks after the end of Ramadan. The patients were subjected to an interview questionnaire, complete physical and clinical examination, anthropometric measurements (height, weight, body fat), dietary profile, and laboratory assay of complete blood count (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. They measured a lot of things and wanted to know what happened.
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). They concluded that, “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 parameter.”
So in the above study, everything got better. Blood pressure, fasting sugars, cholesterol profiles, your clotting cascade, as well as many other factors. Further, this lasted well after Ramadan. This is good news for people worried that fasting would derail their cardiovascular health. It turns out that it improves everything we could measure.
In Indonesia, they did a similar study on 100 outdoor workers and found that whether they fasted fully, partially, or not at all, they all lost weight and lowered their blood pressure. I think it’s probably because even the ones who didn’t fast, pretended to fast with their friends, and still lost weight. We’ve known for a long time that weight loss lowers blood pressure.
At the Toor Institute in Israel, they looked at 22 healthy subjects before and after Ramadan, and compared them to 16 similar individuals who did not fast. They looked at changes in their cholesterol profile. They found that at the end of week 4 (the end of Ramadan), the group that fasted had 23% increase in their HDL (good cholesterol), but no change in total cholesterol, triglycerides, LDL (bad cholesterol), or BMI (body mass index). They concluded that “gorging” was a good pharmacological way to increase HDL. I find this odd that they didn’t report it as “intermittent” fasting raised HDL, as all of the other studies have reported that fasting is what seems to be raising HDL.