1
|
Guilfoyle MM. Ramadan fasting in the third trimester of pregnancy and postpartum colostrum cortisol concentrations in Morocco. Am J Hum Biol 2024; 36:e24071. [PMID: 38497094 DOI: 10.1002/ajhb.24071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 03/19/2024] Open
Abstract
Breast milk cortisol concentration varies among and within lactating women, but the causes and consequences of variation are not yet fully understood. This study investigated whether maternal fasting from food and water for over 16 h per day during the third trimester of pregnancy was associated with increased concentrations of cortisol in colostrum during the month of Ramadan in a Moroccan sample. Participants were women who gave birth at the public maternity hospital in Rabat, Morocco throughout the month of and month following Ramadan. Participants completed interviews (N = 92), underwent anthropometric assessment (N = 73), and colostrum samples (N = 63) were collected approximately 48-72 h postpartum. Cortisol analysis was completed on a subset of colostrum samples (N = 43). Women were categorized as fasting every day of Ramadan before giving birth (N = 52/92, 57%), fasting some days (N = 29/92, 32%), and not fasting (N = 11/92, 11%). For women who fasted, average fasting duration was 19.5 days (range: 1-29 days), and average time between the last day of fasting and birth was 8.8 days (range: 0-43 days). The number of days of fasting was positively associated with cortisol concentrations in colostrum (p < .009) in a multivariate analysis controlling for maternal anthropometry, hypertension and/or diabetes, and reasons for opting out of fasting. Each day of fasting was associated with a 4.05% increase in colostrum cortisol. Results are consistent with the hypothesis that maternal fasting during the third trimester of pregnancy increases breast milk cortisol and thus alters the hormonal milieu to which the infant is exposed.
Collapse
|
2
|
Chen YE, Loy SL, Chen LW. Chrononutrition during Pregnancy and Its Association with Maternal and Offspring Outcomes: A Systematic Review and Meta-Analysis of Ramadan and Non-Ramadan Studies. Nutrients 2023; 15:nu15030756. [PMID: 36771469 PMCID: PMC9921927 DOI: 10.3390/nu15030756] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/19/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Much evidence suggests that food intakes and eating patterns are major determinants of the phase of peripheral circadian clocks, and desynchronization between them is thought to contribute to the development of metabolic disorders. However, much remains to be understood about how different dimensions of chrononutrition during pregnancy affect pregnant women's and their offspring's health outcomes. Therefore, we systematically reviewed and integrated all emerging evidence on chrononutrition during pregnancy (including meal skipping, meal frequency, night eating, and (Ramadan) fasting) and their relationships with maternal and offspring outcomes. The results suggest that meal skipping and night eating during pregnancy were generally associated with adverse pregnancy and birth outcomes, whereas no strong conclusion could be reached for meal frequency. In our meta-analysis, Ramadan fasting did not seem to be related with birth weight or gestational age at birth, but evidence for other mother-offspring outcomes was inconsistent. To further elucidate the effect of chrononutrition factors on maternal and offspring health outcomes, larger and well-conducted prospective cohort and interventional studies are needed. In addition, information on covariates such as physical activity, sleep, diet quality and quantity, fasting days, fasting period per day, and trimester exposure should also be collected and considered during analysis.
Collapse
Affiliation(s)
- Yu-En Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
| | - See Ling Loy
- Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore 229899, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Ling-Wei Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
- Master of Public Health Program, College of Public Health, National Taiwan University, No. 17 Xu-Zhou Road, Taipei 10055, Taiwan
- Correspondence:
| |
Collapse
|
3
|
Kumar S, Diamond T. Ramadan Fasting and Maternal and Fetal Outcomes in Pregnant Women with Diabetes Mellitus: Literature Review. Front Endocrinol (Lausanne) 2022; 13:900153. [PMID: 35813638 PMCID: PMC9263982 DOI: 10.3389/fendo.2022.900153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
There is an emerging Muslim and diabetic population in the United States and other Western countries and majority of pregnant women and patients with diabetes mellitus choose to fast during Ramadan. Fasting during Ramadan in pregnant women with diabetes may represent a 'perfect storm' of metabolic disturbances including hyperglycemia, hypoglycemia and ketosis. Recent continuous and flash glucose monitoring data suggests increased glycemic variability (fasting hypo- and post-Iftar hyperglycemia) in non-pregnant patients with diabetes during Ramadan. Only five small-scale studies, predominantly focused on women with gestational diabetes mellitus in Muslim-majority nations have explored maternal glycemic outcomes during Ramadan which is associated with lower mean blood glucose levels and higher frequency of fasting hypoglycemia. Data is limited however on important clinical outcomes such as symptomatic and serious hypoglycemia requiring hospitalization. Results have been conflicting regarding maternal Ramadan fasting and association with fetal outcomes in women without diabetes. Only one recently published study reported on perinatal outcomes in pregnant women with gestational diabetes which found no effect of Ramadan exposure on mean birthweight or macrosomia frequency but lower neonatal hypoglycemia prevalence, however a significant limitation was lack of documentation of maternal fasting status. At this stage, due to paucity of data, the current medical recommendation is against Ramadan fasting for pregnant Muslim women with diabetes. Large-scale population-based studies are warranted regarding maternal and fetal outcomes in pregnant fasting women with diabetes and such studies should characterize maternal fasting status and have meaningful and consistent clinical outcomes. High-quality data derived from these studies can assist clinicians in providing more evidence-based advice to safely navigate both mother and fetus through a potentially challenging pregnancy.
Collapse
|
4
|
Ramadan Fasting during Pregnancy and Health Outcomes in Offspring: A Systematic Review. Nutrients 2021; 13:nu13103450. [PMID: 34684451 PMCID: PMC8540108 DOI: 10.3390/nu13103450] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/16/2021] [Accepted: 09/26/2021] [Indexed: 11/18/2022] Open
Abstract
Ramadan is one of the five pillars of Islam, during which fasting is obligatory for all healthy individuals. Although pregnant women are exempt from this Islamic law, the majority nevertheless choose to fast. This review aims to identify the effects of Ramadan fasting on the offspring of Muslim mothers, particularly on fetal growth, birth indices, cognitive effects and long-term effects. A systematic literature search was conducted until March 2020 in Web of Science, Pubmed, Cochrane Library, Embase and Google Scholar. Studies were evaluated based on a pre-defined quality score ranging from 0 (low quality) to 10 (high quality), and 43 articles were included. The study quality ranged from 2 to 9 with a mean quality score of 5.4. Only 3 studies had a high quality score (>7), of which one found a lower birth weight among fasting women. Few medium quality studies found a significant negative effect on fetal growth or birth indices. The quality of articles that investigated cognitive and long-term effects was poor. The association between Ramadan fasting and health outcomes of offspring is not supported by strong evidence. To further elucidate the effects of Ramadan fasting, larger prospective and retrospective studies with novel designs are needed.
Collapse
|
5
|
Alkhalefah A, Dunn WB, Allwood JW, Parry KL, Houghton FD, Ashton N, Glazier JD. Maternal intermittent fasting during pregnancy induces fetal growth restriction and down-regulated placental system A amino acid transport in the rat. Clin Sci (Lond) 2021; 135:1445-1466. [PMID: 34008846 DOI: 10.1042/cs20210137] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/11/2021] [Accepted: 05/19/2021] [Indexed: 11/17/2022]
Abstract
During Ramadan, many pregnant Muslim women fast between dawn and sunset. Although the impacts of prolonged maternal intermittent fasting (IF) on fetal growth and placental function are under-researched, reported effects include reduced placental weight and birth weight. In the present study, pregnant Wistar rats were used to model repeated cycles of IF on fetal development and placental function and to examine sex-specific effects. In the IF group, food was withdrawn daily from 17:00 to 09:00 over 21 days of gestation, while the control group received food ad libitum. Both groups had free water access. IF dams consumed less food, had significantly reduced weight compared with controls, with reduced plasma glucose and amino acids. Both fetal sexes were significantly lighter in the IF group with reduced fetal plasma amino acids. Placental weights and morphology were unchanged. The profile of placental metabolites was altered in the IF group with sex-specific responses evident. Transplacental flux of 14C-methylaminoisobutyric acid (14C-MeAIB), a system A amino acid transporter substrate, was significantly reduced in both fetal sexes in the IF group. Sodium-dependent 14C-MeAIB uptake into isolated placental plasma membrane vesicles was unchanged. The gene expression of system A transporter Slc38a1, Slc38a2 and Slc38a4 was up-regulated in IF male placentas only. No changes were observed in placental SNAT1 and SNAT2 protein expression. Maternal IF results in detrimental impacts on maternal physiology and fetal development with changes in the placental and fetal metabolite profiles. Reduced placental system A transporter activity may be responsible for fetal growth restriction in both sexes.
Collapse
Affiliation(s)
- Alaa Alkhalefah
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, St. Mary's Hospital, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9WL, U.K
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9NT, U.K
| | - Warwick B Dunn
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, U.K
| | - James W Allwood
- School of Biosciences, University of Birmingham, Birmingham B15 2TT, U.K
| | - Kate L Parry
- Centre for Human Development, Stem Cells and Regeneration, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, U.K
| | - Franchesca D Houghton
- Centre for Human Development, Stem Cells and Regeneration, School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, U.K
| | - Nick Ashton
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9NT, U.K
| | - Jocelyn D Glazier
- Division of Evolution and Genomic Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PT, U.K
| |
Collapse
|
6
|
Safari K, Piro TJ, Ahmad HM. Perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy. BMC Pregnancy Childbirth 2019; 19:128. [PMID: 30987614 PMCID: PMC6466666 DOI: 10.1186/s12884-019-2275-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 03/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background There are controversies over the effects of Ramadan fasting on pregnancy outcomes, and women’s perspectives of fasting are diverse. This study aimed to assess the perspectives and pregnancy outcomes of maternal Ramadan fasting in the second trimester of pregnancy. Methods A case-control study was conducted at Hawler Maternity Teaching Hospital of Erbil, Iraq from October 2017 to January 2018. Out of 301 participating women, 155 fasted during the second trimester of their current pregnancy, while the remaining 146 did not. Mothers were asked concerning their fasting behaviors and perception of fasting during pregnancy. The main outcomes of this study were gestational diabetes, preterm labour, preeclampsia, low birth weight, Apgar score, height, weight, and head circumference of the newborn. Results About 80% of the women in the fasting group fasted for 21–29 days during Ramadan, out of whom 38.7% completed fasting for the entire Ramadan period. The results revealed that the decision to fast during pregnancy was negatively associated with the mother’s educational level and occupation. Weight gain during pregnancy in the fasting women was approximately 0.4 kg less than those who did not fast. The incidence of gestational diabetes was 2.6% in the fasting women, while it was 8.3% in the non-fasting mothers (P = 0.02). Regression analysis showed that women who did not fast during the second trimester of pregnancy were 1.51 times more likely to develop gestational diabetes [odd ratio (OR) 1.51; 95% confidence intervals (CI) 0.06, 0.74, P = 0.01]. It was also found that among the women in the fasting categories, those who fasted for 21–29 days during pregnancy had a lower risk of gestational diabetes compared to the other groups. More than half of the mothers in the fasting group (60%) perceived that fasting during pregnancy was compulsory for healthy and non-healthy women, comparing with those who did not fast. Conclusion It was found that fasting during the second trimester of the pregnancy decreased the risk of gestational diabetes and excessive weight gain during pregnancy. Most of Iraqi women did not fully recognize their right to be exempted from fasting during pregnancy by the Islamic law. Electronic supplementary material The online version of this article (10.1186/s12884-019-2275-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Kolsoom Safari
- Department of Midwifery, College of Nursing, Hawler Medical University, Erbil, Iraq.
| | - Tiran Jamil Piro
- Department of Midwifery, College of Nursing, Hawler Medical University, Erbil, Iraq
| | - Hamdia Mirkhan Ahmad
- Department of Basic Science, College of Basic Science, Hawler Medical University, Erbil, Iraq
| |
Collapse
|
7
|
Masood SN, Saeed S, Lakho N, Masood Y, Ahmedani MY, Shera AS. Pre-Ramadan health seeking behavior, fasting trends, eating pattern and sleep cycle in pregnant women at a tertiary care institution of Pakistan. Pak J Med Sci 2018; 34:1326-1331. [PMID: 30559779 PMCID: PMC6290227 DOI: 10.12669/pjms.346.15883] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To observe the pre-Ramadan health seeking behavior, fasting trends, eating pattern and, sleep cycle in pregnant women. Methods: It is a cross-sectional observational study, from July to September 2017, conducted at Tertiary Care Hospital in Karachi. The tool used for data collection was interviewer based closed ended questionnaire, 279 pregnant women who fasted during Ramadan were included in the study. Results: One to ten days of fasting was observed by 85.7% (198) of women. About 72.4% (202) never consulted any doctor for pre-Ramadan advice regarding fasting in pregnancy. Pregnant women 81.7% (228) believed that fasting would not cause any harm to their unborn child, while 42.7% (119) of family members feared about the health of mother and unborn child. Seventy four percent (208) of respondents had a reduced sleep cycle of about 3-4 hours. The food items consumed at Sehri and Iftar were rich in carbohydrates and fats. Conclusions: Pre-Ramadan medical consultation regarding safety of fasting during pregnancy should be structured and customized for women and their families. Gaps in knowledge identified in this study may help healthcare professionals to address these issues.
Collapse
Affiliation(s)
- Shabeen Naz Masood
- Prof. Shabeen Naz Masood, MBBS, MCPS, FICS, FCPS, PhD, DCPS (HCSM). Department of Obstetrics & Gynecology, ISRA University, Karachi, Pakistan
| | - Saira Saeed
- Dr. Saira Saeed, MBBS, FCPS. Department of Obstetrics & Gynecology, ISRA University, Karachi, Pakistan
| | - Nusrat Lakho
- Dr. Nusrat Lakho, MBBS, FCPS. Department of Obstetrics & Gynecology, ISRA University, Karachi, Pakistan
| | - Yasir Masood
- Dr. Yasir Masood, M.D. International Centre for Clinical Research Pakistan, (ICCRP), Karachi, Pakistan
| | - Muhammad Yakoob Ahmedani
- Prof. M. Yakoob Ahmedani, FCPS. Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - A Samad Shera
- Prof. A. Samad Shera, FRCP. Diabetic Association of Pakistan, WHO Collaborating Centre, Karachi-Pakistan
| |
Collapse
|
8
|
Lindeboom M, van Ewijk R. Babies of the War: The Effect of War Exposure Early in Life on Mortality Throughout Life. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2015; 61:167-186. [PMID: 26266971 DOI: 10.1080/19485565.2015.1047489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
There is increasing evidence that circumstances very early in our lives, and particularly during pregnancy, can affect our health for the remainder of life. Studies that have looked at this relationship have often used extreme situations, such as famines that occurred during wartime. Here we investigate whether less extreme situations during World War II also affected later-life mortality for cohorts born in Belgium, France, The Netherlands, and Norway. We argue that these occupied countries experienced a considerable deterioration in daily life situations and show that this resulted in strongly increased mortality rates and lower probabilities of survival until age 55 among civilian populations who had been prenatally exposed to wartime circumstances. However, this mortality effect among the prenatally exposed is entirely concentrated in the first years of life, particularly infanthood. Once we condition on having survived the first years of life, those who had been prenatally exposed do not have higher mortality rates. This suggests that "culling" is important and that effects found in earlier studies may have been biased downward substantially.
Collapse
|
9
|
Chen X. Fetus, fasting, and festival: the persistent effects of in utero social shocks. Int J Health Policy Manag 2014; 3:165-9. [PMID: 25279378 DOI: 10.15171/ijhpm.2014.92] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 09/23/2014] [Indexed: 11/09/2022] Open
Abstract
The Fetal Origins Hypothesis (FOH), put forward in the epidemiological literature and later flourished in the economics literature, suggests that the time in utero is a critical period for human development. However, much attention has been paid to the consequences of fetal exposures to more extreme natural shocks, while less is known about fetal exposures to milder but more commonly experienced social shocks. Using two examples of under-nutrition due to mild social shocks, i.e. Ramadan fasting and festival overspending, this paper summarizes our current knowledge, especially the contribution from economics, and key challenges in exploring fetal exposures to milder social shocks. I also discuss the salient added value of identifying milder versus more extreme fetal shocks. Finally, implications are drawn on individual decisions and public policy to improve children's well-being before they are born or even before their mothers realize that they are pregnant.
Collapse
Affiliation(s)
- Xi Chen
- Faculty of Arts and Sciences, Yale University, New Haven, CT, USA
| |
Collapse
|
10
|
Baynouna Al Ketbi LM, Niglekerke NJD, Zein Al Deen SM, Mirghani H. Diet restriction in Ramadan and the effect of fasting on glucose levels in pregnancy. BMC Res Notes 2014; 7:392. [PMID: 24962444 PMCID: PMC4088297 DOI: 10.1186/1756-0500-7-392] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 06/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal diet restriction might be associated with adverse maternal and perinatal outcomes due to metabolic changes. This study aimed to investigate the prevalence of changes in glucose levels due to Ramadan fasting in Emirati pregnant women. We conducted a cross-sectional observational study of 150 women from the United Arab Emirates, (76 during Ramadan and 74 after Ramadan), with uncomplicated pregnancies at a gestational age between 20 and 36 weeks. RESULTS The two groups of pregnant women had similar physiological parameters. Using the oral glucose tolerance test, the mean random blood glucose level after 1 hour of breaking the fast was significantly higher (p = 0.002) in the Ramadan fasting group than in the control group, and this was not affected by the number of fasting days. In 50% of patients after Ramadan and 70.5% during Ramadan, this value was more than 6.7 mmol/l, which is high and not an acceptable postprandial level in pregnancy. CONCLUSION Caregivers need to consider the 1-hour postprandial glucose level response after fasting in Muslim pregnant women. Research of an interventional design is required to determine remedial actions for this issue.
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW The most common method of antepartum fetal surveillance is the nonstress test (NST). Although it has satisfactory false-negative rates, dubious nonreactive results may challenge the physician. Any method or factor increasing the reactive NST results or shortening the time to attain a reactive test may be considerably useful. RECENT FINDINGS Most of the studies have found no effect of maternal glucose administration on fetal heart rate and fetal activity, specificity of NST, time to reactivity and percentage of reactive NST results when compared with the control group. Maternal intake of 70% cocoa or caffeine had stimulating action on the fetal reactivity, and this effect on the fetal heart rate was more marked with high concentrations of cocoa (80%). Studies on maternal positioning during NST had equivocal results. Fetal manipulation has no impact on the NST reactivity. Vibroacoustic and halogen light stimulation may be associated with a reduction in time to reactivity. SUMMARY These methods may increase the reactivity during a NST and may facilitate the antenatal fetal surveillance.
Collapse
|
12
|
Esin S, Baser E, Cakir C, Ustun Tuncal GN, Kucukozkan T. Chocolate or orange juice for non-reactive non-stress test (NST) patterns: a randomized prospective controlled study. J Matern Fetal Neonatal Med 2013; 26:915-9. [DOI: 10.3109/14767058.2013.766698] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
13
|
van Ewijk R. Long-term health effects on the next generation of Ramadan fasting during pregnancy. JOURNAL OF HEALTH ECONOMICS 2011; 30:1246-1260. [PMID: 21930320 DOI: 10.1016/j.jhealeco.2011.07.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 07/15/2011] [Accepted: 07/26/2011] [Indexed: 05/31/2023]
Abstract
Each year, many pregnant Muslim women fast during Ramadan. Using Indonesian cross-sectional data and building upon work of Almond and Mazumder (2011), I show that people who were prenatally exposed to Ramadan fasting have a poorer general health than others. As predicted by medical theory, this effect is especially pronounced among older people, who also more often report symptoms indicative of coronary heart problems and type 2 diabetes. Among exposed Muslims the share of males is lower, which is most likely caused by death before birth. I show that these effects are unlikely the result of common health shocks correlated to the occurrence of Ramadan, or of fasting mainly occurring among women who would have had unhealthier children anyway.
Collapse
Affiliation(s)
- Reyn van Ewijk
- University of Mainz, VU University Amsterdam, Tinbergen Institute, Netspar.
| |
Collapse
|
14
|
Barger MK. Maternal nutrition and perinatal outcomes. J Midwifery Womens Health 2011; 55:502-11. [PMID: 20974412 DOI: 10.1016/j.jmwh.2010.02.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Revised: 02/17/2010] [Accepted: 02/18/2010] [Indexed: 12/01/2022]
Abstract
Diet and patterns of eating during pregnancy can affect perinatal outcomes through direct physiologic effects or by stressing the fetus in ways that permanently affect phenotype. Supplements are not a magic nutritional remedy, and evidence of profound benefit for most supplements remains inconclusive. However, research supports calcium supplements to decrease preeclampsia. Following a low glycemic, Mediterranean-type diet appears to improve ovulatory infertility, decrease preterm birth, and decrease the risk of gestational diabetes. Although women in the United States have adequate levels of most nutrients, subpopulations are low in vitamin D, folate, and iodine. Vitamin D has increasingly been shown to be important not only for bone health, but also for glucose regulation, immune function, and good uterine contractility in labor. To ensure adequate vitamin and micronutrient intake, especially of folate before conception, all reproductive age women should take a multivitamin daily. In pregnancy, health care providers need to assess women's diets, give them weight gain recommendations based on their body mass index measurement, and advise them to eat a Mediterranean diet rich in omega-3 fatty acids (ingested as low-mercury risk fatty fish or supplements), ingest adequate calcium, and achieve adequate vitamin D levels through sun exposure or supplements. Health care providers should continue to spend time on nutrition assessment and counseling.
Collapse
Affiliation(s)
- Mary K Barger
- Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, CA 94143-0606, USA.
| |
Collapse
|
15
|
Abstract
AIM To determine the effect maternal diet pattern on the uterine artery Doppler flow velocimetry. METHODS This is a cross-sectional observational study. The uterine artery Doppler flow velocimetry was measured between 20 and 24 weeks' gestation in healthy pregnant women observing Ramadan. For each fasting mother, a non-fasting healthy pregnant woman was recruited as a control. Maternal blood glucose level was measured. RESULTS A total of 106 pregnant women were studied. The mean hours since last oral intake were significantly longer, and the maternal glucose level was significantly lower in the study group than in the control group. The Mean (95% CI) of the uterine artery pulsatility index, resistance index, peak systolic velocity, end diastolic velocity and systolic/diastolic ratio was similar in both groups. CONCLUSION Maternal fasting is not associated with significant changes in the uterine artery Doppler flow velocimetry.
Collapse
Affiliation(s)
- Hisham M Mirghani
- Department Obstetrics & Gynecology, Faculty of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | | | | |
Collapse
|