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Yildirim Keskin A, Şentürk S, Teke ZB. Ramadan as religious ritual: Experiences of Muslim people with Type 2 Diabetes in Türkiye regarding Ramadan. Diabetes Res Clin Pract 2024; 215:111802. [PMID: 39094742 DOI: 10.1016/j.diabres.2024.111802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/24/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
This study aims to determine the experiences of Muslim people with Type 2 Diabetes Mellitus (DM) about Ramadan in Türkiye. This phenomenological study was conducted with 30 Muslim people with Type 2 DM. The data were collected by holding in-depth individual interviews with a semi-structured interview form and analyzed using Colaizzi's seven-stage analysis and the MAXQDA-20 program. As a result, three main themes with 12 categories were determined as follows: (i) "the month of Ramadan and the meaning of fasting", (ii) "the effects of fasting", and (iii) "coping with difficulties". The participants stated that the month of Ramadan is one of the pillars of Islam and that it includes worshiping, finding peace, completing oneself in the religious sense, purifying oneself from sins, resting physically and spiritually, and appreciating the meaning of hunger, thirst, and blessings. However, some people reported that there was social pressure when they did not fast. Health professionals should provide people with DM with regular and safe training specific to Ramadan, establish support groups, and cooperate with religious officials (imams) to meet their religious demands.
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Affiliation(s)
- Alev Yildirim Keskin
- Associate Professor, Department of Nursing, Akşehir Kadir Yallagöz Health School, Selçuk University, Akşehir-Konya, Turkiye.
| | - Sibel Şentürk
- Associate Professor, Department of Nursing, Bucak Health School, Burdur Mehmet Akif Ersoy University, Bucak-Burdur, Turkiye.
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Emara MH, Soliman H, Said EM, Elbatae H, Elazab M, Elhefnawy S, Zaher TI, Abdel-Razik A, Elnadry M. Intermittent fasting and the liver: Focus on the Ramadan model. World J Hepatol 2024; 16:1070-1083. [PMID: 39221099 PMCID: PMC11362902 DOI: 10.4254/wjh.v16.i8.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/24/2024] [Accepted: 07/09/2024] [Indexed: 08/21/2024] Open
Abstract
Intermittent fasting (IF) is an intervention that involves not only dietary modifications but also behavioral changes with the main core being a period of fasting alternating with a period of controlled feeding. The duration of fasting differs from one regimen to another. Ramadan fasting (RF) is a religious fasting for Muslims, it lasts for only one month every one lunar year. In this model of fasting, observers abstain from food and water for a period that extends from dawn to sunset. The period of daily fasting is variable (12-18 hours) as Ramadan rotates in all seasons of the year. Consequently, longer duration of daily fasting is observed during the summer. In fact, RF is a peculiar type of IF. It is a dry IF as no water is allowed during the fasting hours, also there are no calorie restrictions during feeding hours, and the mealtime is exclusively nighttime. These three variables of the RF model are believed to have a variable impact on different liver diseases. RF was evaluated by different observational and interventional studies among patients with non-alcoholic fatty liver disease and it was associated with improvements in anthropometric measures, metabolic profile, and liver biochemistry regardless of the calorie restriction among lean and obese patients. The situation is rather different for patients with liver cirrhosis. RF was associated with adverse events among patients with liver cirrhosis irrespective of the underlying etiology of cirrhosis. Cirrhotic patients developed new ascites, ascites were increased, had higher serum bilirubin levels after Ramadan, and frequently developed hepatic encephalopathy and acute upper gastrointestinal bleeding. These complications were higher among patients with Child class B and C cirrhosis, and some fatalities occurred due to fasting. Liver transplant recipients as a special group of patients, are vulnerable to dehydration, fluctuation in blood immunosuppressive levels, likelihood of deterioration and hence observing RF without special precautions could represent a real danger for them. Patients with Gilbert syndrome can safely observe RF despite the minor elevations in serum bilirubin reported during the early days of fasting.
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Affiliation(s)
- Mohamed H Emara
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafr-Elshikh 33516, Egypt
- Department of Medicine, Alyousif Hospital, Alkhobar 34622, Saudi Arabia.
| | - Hanan Soliman
- Department of Tropical Medicine and Infectious Diseases, Tanta University, Tanta 31512, Egypt
| | - Ebada M Said
- Department of Hepatology, Gastroenterology and Infectious Diseases, Benha University, Benha 13511, Egypt
| | - Hassan Elbatae
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafr-Elshikh 33516, Egypt
| | - Mostafa Elazab
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafr-Elshikh 33516, Egypt
| | - Shady Elhefnawy
- Department of Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafr-Elshikh 33516, Egypt
| | - Tarik I Zaher
- Department of Tropical Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Ahmed Abdel-Razik
- Department of Tropical Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Elnadry
- Department of Hepato-Gastroenterology and Infectious Diseases, Al-Azhar University, Cairo 11651, Egypt
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Ozcan M, Abdellatif M, Javaheri A, Sedej S. Risks and Benefits of Intermittent Fasting for the Aging Cardiovascular System. Can J Cardiol 2024; 40:1445-1457. [PMID: 38354947 DOI: 10.1016/j.cjca.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/08/2024] [Accepted: 02/08/2024] [Indexed: 02/16/2024] Open
Abstract
Population aging and the associated increase in cardiovascular disease rates pose serious threats to global public health. Different forms of fasting have become an increasingly attractive strategy to directly address aging and potentially limit or delay the onset of cardiovascular diseases. A growing number of experimental studies and clinical trials indicate that the amount and timing of food intake as well as the daily time window during which food is consumed, are crucial determinants of cardiovascular health. Indeed, intermittent fasting counteracts the molecular hallmarks of cardiovascular aging and promotes different aspects of cardiometabolic health, including blood pressure and glycemic control, as well as body weight reduction. In this report, we summarize current evidence from randomized clinical trials of intermittent fasting on body weight and composition as well as cardiovascular and metabolic risk factors. Moreover, we critically discuss the preventive and therapeutic potential of intermittent fasting, but also possible detrimental effects in the context of cardiovascular aging and related disease. We delve into the physiological mechanisms through which intermittent fasting might improve cardiovascular health, and raise important factors to consider in the design of clinical trials on the efficacy of intermittent fasting to reduce major adverse cardiovascular events among aged individuals at high risk of cardiovascular disease. We conclude that despite growing evidence and interest among the lay and scientific communities in the cardiovascular health-improving effects of intermittent fasting, further research efforts and appropriate caution are warranted before broadly implementing intermittent fasting regimens, especially in elderly persons.
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Affiliation(s)
- Mualla Ozcan
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Mahmoud Abdellatif
- Department of Cardiology, Medical University of Graz, Graz, Austria; BioTechMed Graz, Graz, Austria
| | - Ali Javaheri
- Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA; John J. Cochran Veterans Affairs Medical Center, St. Louis, Missouri, USA
| | - Simon Sedej
- Department of Cardiology, Medical University of Graz, Graz, Austria; BioTechMed Graz, Graz, Austria; Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia.
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Ahmed M, Ahmed MH. Ramadan Fasting in Individuals with Metabolic Dysfunction-Associated Steatotic Liver Disease, Liver Transplant, and Bariatric Surgery: A Narrative Review. J Clin Med 2024; 13:3893. [PMID: 38999457 PMCID: PMC11242100 DOI: 10.3390/jcm13133893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
Metabolic dysfunction-associated steatotic liver disease is a growing worldwide pandemic. A limited number of studies have investigated the potential effect of Ramadan fasting on metabolic dysfunction-associated steatotic liver disease (MASLD). There is no single medication for the treatment of MASLD. There is a growing interest in dietary intervention as potential treatment for metabolic diseases including MASLD. The aim of this study was to discuss the epidemiology, pathogenesis, and risk factors of MASLD and the potential effects of Ramadan fasting on MASLD, liver transplant, and bariatric surgery. We searched PubMed and SCOPUS databases using different search terms. The literature search was based on research studies published in English from the year 2000 to the 2024. Thirty-two studies were included in this review. Ramadan fasting reduced body weight and improved lipid profile, anthropometric indices, fasting plasma glucose, plasma insulin, and inflammatory cytokines. Ramadan fasting improved risk factors of nonalcoholic fatty liver disease and might improve MASLD through weight reduction. However, further studies are needed to assess the safety and effectiveness of Ramadan fasting in liver transplant recipients and bariatric surgery.
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Affiliation(s)
- Musaab Ahmed
- College of Medicine, Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes MK6 5LD, UK
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes MK6 5LD, UK
- Honorary Senior Lecturer of the Faculty of Medicine and Health Sciences, University of Buckingham, Buckingham MK18 1EG, UK
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Ma RX. A detective story of intermittent fasting effect on immunity. Immunology 2024. [PMID: 38922825 DOI: 10.1111/imm.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Intermittent fasting (IF) refers to periodic fasting routines, that caloric intake is minimized not by meal portion size reduction but by intermittently eliminating ingestion of one or several consecutive meals. IF can instigate comprehensive and multifaceted alterations in energy metabolism, these metabolic channels may aboundingly function as primordial mechanisms that interface with the immune system, instigating intricate immune transformations. This review delivers a comprehensive understanding of IF, paying particular attention to its influence on the immune system, thus seeking to bridge these two research domains. We explore how IF effects lipid metabolism, hormonal levels, circadian rhythm, autophagy, oxidative stress, gut microbiota, and intestinal barrier integrity, and conjecture about the mechanisms orchestrating the intersect between these factors and the immune system. Moreover, the review includes research findings on the implications of IF on the immune system and patients burdened with autoimmune diseases.
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Affiliation(s)
- Ru-Xue Ma
- School of Medical, Qinghai University, Xining, China
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Elhessy HM, Berika M, Salem YG, El-Desoky MM, Eldesoqui M, Mostafa N, Habotta OA, Lashine NH. Therapeutic effects of intermittent fasting on high-fat, high-fructose diet; involvement of jejunal aquaporin 1, 3, and 7. Heliyon 2024; 10:e28436. [PMID: 38560252 PMCID: PMC10979098 DOI: 10.1016/j.heliyon.2024.e28436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Background Aquaporins (AQPs) are transmembrane channel proteins. Aquaporin 1 (AQP1), Aquaporin 3 (AQP3), and Aquaporin 7 (AQP7) are expressed in the jejunum. The purpose of this study was to ascertain how a high-fat high-fructose diet (HFFD) and intermittent fasting (IF) affect AQP1, AQP3, and AQP7 expression in the rat jejunum. Methods Sixteen adult male rats were divided into control rats (n = 4) fed on a basal diet and water ad libitum for 12 weeks; IF control rats (n = 4) followed the IF protocol, HFFD-fed rats (n = 8) fed HFFD for eight weeks, and rats were randomized into two groups: HFFD only or HFFD and IF protocol from the beginning of the 9th week until the end of the experiment. The lipid profile values were assessed after 12 weeks. Jejunal oxidative markers (malondialdehyde and reduced glutathione) and AQP1, AQP3, and AQP7 mRNA expression were measured. Jejunal sections were used for morphometric analysis of villus length and crypt depth. Immunohistochemical evaluation of AQP1, AQP3, and AQP7 expression was also performed. Results IF ameliorates HFFD-induced lipid profile, oxidative stress, and jejunal morphometric changes. The results of both mRNA expression using PCR and immunohistochemistry showed a significant increase in AQP1, AQP3, and AQP7 expression in HFFD, whereas IF caused a decline in this expression. Conclusion These findings suggest that IF can reduce inflammation, and oxidative stress and restore jejunal morphology caused by HFFD.
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Affiliation(s)
- Heba M. Elhessy
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
- Department of Anatomy and Embryology, Faculty of Medicine, New Mansoura University, Mansoura, Egypt
| | - Mohamed Berika
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
- Department of Rehabilitation Science, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Yassmin G. Salem
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Manal M. El-Desoky
- Department of Chemistry, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Mamdouh Eldesoqui
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Diriyah, 13713, Riyadh, Saudi Arabia
| | - Nora Mostafa
- Department of Chemistry, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Ola A. Habotta
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Nermeen H. Lashine
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
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Al lami Z, Kurtca M, Atique MU, Opekun AR, Siam MS, Jalal PK, Najafi B, Devaraj S, Mindikoglu AL. Dawn-to-dusk dry fasting decreases circulating inflammatory cytokines in subjects with increased body mass index. Metabol Open 2024; 21:100274. [PMID: 38455231 PMCID: PMC10918425 DOI: 10.1016/j.metop.2024.100274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/04/2024] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Background The circadian rhythm involves numerous metabolic processes, including sleep/awakening, body temperature regulation, hormone secretion, hepatic function, cellular plasticity, and cytokine release (inflammation), that appear to have a dynamic relationship with all the processes above. Studies have linked various cytokines to the chronic state of low-grade inflammation and oxidative stress in obesity. Dawn-to-dusk dry fasting (DDDF) could alleviate the adverse effects of obesity by decreasing inflammation. This study examined the effects of DDDF on circulating inflammatory cytokines in subjects with increased body mass index (BMI). Methods The current observational prospective study included adult subjects with a BMI equal to or greater than 25 kg/m2 who practiced the annual religious 30-day DDDF. Individuals with significant underlying medical conditions were excluded to limit confounding factors. All subjects were evaluated within two weeks before 30-day DDDF, within the fourth week of 30-day DDDF, and within two weeks after 30-day DDDF. Multiple cytokines and clinical health indicators were measured at each evaluation. Results Thirteen subjects (10 men and three women) with a mean age of 32.9 years (SD = 9.7 years) and a mean BMI of 32 kg/m2 (SD = 4.6 kg/m2) were included. An overall associated decrease in the levels of multiple cytokines with DDDF was observed. A significant decrease in the mean interleukin 1 beta level was observed within the fourth week of 30-day DDDF (P = 0.045), which persisted even after the fasting period (P = 0.024). There was also a significant decrease in the mean levels of interleukin 15 (IL-15) (P = 0.014), interleukin 1 receptor antagonist (P = 0.041), macrophage-derived chemokine (MDC) (P = 0.013), and monokine induced by interferon gamma/chemokine (C-X-C motif) ligand 9 (P = 0.027) within the fourth week of 30-day DDDF and in the mean levels of fibroblast growth factor 2 (P = 0.010), interleukin 12 p40 subunit (P = 0.038), interleukin 22 (P = 0.025) and tumor necrosis factor alpha (P = 0.046) within two weeks after 30-DDDF. In terms of anthropometric parameters, there was a decrease in mean body weight (P = 0.032), BMI (P = 0.028), and hip circumference (P = 0.007) within the fourth week of 30-day DDDF and a decrease in mean weight (P = 0.026), BMI (P = 0.033) and hip circumference (P = 0.016) within two weeks after 30-day DDDF compared with the levels measured within two weeks before 30-day DDDF. Although there was no significant correlation between changes in weight and changes in circulating inflammatory cytokines, there was a significant positive correlation between changes in waist circumference and changes in specific inflammatory cytokines (e.g., IL-15, MDC, platelet-derived growth factor, soluble CD40L, vascular endothelial growth factor A) within the fourth week of 30-day DDDF and/or two weeks after 30-day DDDF. A significant decrease in mean average resting heart rate within the fourth week of 30-day DDDF was also observed (P = 0.023), and changes between average resting heart rate and changes in interleukin-8 levels within the fourth week of 30-day DDDF compared with baseline levels were positively correlated (r = 0.57, P = 0.042). Conclusion DDDF appears to be a unique and potent treatment to reduce low-grade chronic inflammation caused by obesity and visceral adiposity. Further studies with more extended follow-up periods are warranted to investigate the long-term anti-inflammatory benefits of DDDF in individuals with increased BMI.
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Affiliation(s)
- Zahraa Al lami
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - Miray Kurtca
- Clinical Chemistry and Point of Care Technology, Texas Children's Hospital and Health Centers, Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Moin Uddin Atique
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Antone R. Opekun
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
- Department of Pediatrics, Division of Gastroenterology, Nutrition and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - Mohamad S. Siam
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
| | - Prasun K. Jalal
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, Houston, TX, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Sridevi Devaraj
- Clinical Chemistry and Point of Care Technology, Texas Children's Hospital and Health Centers, Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA
| | - Ayse L. Mindikoglu
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, Houston, TX, USA
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Mirrazavi ZS, Behrouz V. Various types of fasting diet and possible benefits in nonalcoholic fatty liver: Mechanism of actions and literature update. Clin Nutr 2024; 43:519-533. [PMID: 38219703 DOI: 10.1016/j.clnu.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/28/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the major causes of chronic liver injury, affecting around one-fourth of the general population across the world. Several important pathophysiological mechanisms underlying NAFLD include oxidative stress, inflammation, liver fibrosis, and apoptosis. Currently, therapeutic approaches are not ideal for managing NAFLD, thus new approaches and treatments are still needed. Over the last two decades, various fasting protocols have been explored to reduce body weight and improve metabolic disorders. In this review, we provide updated literature that supports fasting regimens for subjects with NAFLD and describes underlying mechanisms of action. We suggest that fasting regimens may modulate NAFLD via several mechanisms, including changes in gut microbiota, hepatic arginase, hepatic autophagy, inflammatory responses, liver functional enzymes and hepatic steatosis, fibroblast growth factors signaling, white adipose tissue browning, adipokines, circadian rhythms, lipid profiles, and body composition.
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Affiliation(s)
| | - Vahideh Behrouz
- Department of Nutrition, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
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Mackieh R, Al-Bakkar N, Kfoury M, Okdeh N, Pietra H, Roufayel R, Legros C, Fajloun Z, Sabatier JM. Unlocking the Benefits of Fasting: A Review of its Impact on Various Biological Systems and Human Health. Curr Med Chem 2024; 31:1781-1803. [PMID: 38018193 DOI: 10.2174/0109298673275492231121062033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/26/2023] [Accepted: 10/17/2023] [Indexed: 11/30/2023]
Abstract
Fasting has gained significant attention in recent years for its potential health benefits in various body systems. This review aims to comprehensively examine the effects of fasting on human health, specifically focusing on its impact on different body's physiological systems. The cardiovascular system plays a vital role in maintaining overall health, and fasting has shown promising effects in improving cardiovascular health markers such as blood pressure, cholesterol levels, and triglyceride levels. Additionally, fasting has been suggested to enhance insulin sensitivity, promote weight loss, and improve metabolic health, thus offering potential benefits to individuals with diabetes and metabolic disorders. Furthermore, fasting can boost immune function, reduce inflammation, enhance autophagy, and support the body's defense against infections, cancer, and autoimmune diseases. Fasting has also demonstrated a positive effect on the brain and nervous system. It has been associated with neuroprotective properties, improving cognitive function, and reducing the risk of neurodegenerative diseases, besides the ability of increasing the lifespan. Hence, understanding the potential advantages of fasting can provide valuable insights for individuals and healthcare professionals alike in promoting health and wellbeing. The data presented here may have significant implications for the development of therapeutic approaches and interventions using fasting as a potential preventive and therapeutic strategy.
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Affiliation(s)
- Rawan Mackieh
- Department of Biology, Faculty of Sciences, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
| | - Nadia Al-Bakkar
- Faculty of Health Sciences, College of Life Sciences, Beirut Arab University, Beirut Campus, P.O. Box 11 50 20, Riad El Solh, Beirut 11072809, Lebanon
| | - Milena Kfoury
- Department of Biology, Faculty of Sciences, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
| | - Nathalie Okdeh
- Department of Biology, Faculty of Sciences, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
| | - Hervé Pietra
- Association Esprit Jeûne & Fasting Spirit, 226, Chemin du Pélican, Toulon 83000, France
| | - Rabih Roufayel
- College of Engineering and Technology, American University of the Middle East, Hadiya, Kuwait
| | - Christian Legros
- Univ Angers, INSERM, CNRS, MITOVASC, Team 2 CarMe, SFR ICAT, Angers 49000, France
| | - Ziad Fajloun
- Department of Biology, Faculty of Sciences, Lebanese University, Campus Michel Slayman Ras Maska, Tripoli 1352, Lebanon
- Laboratory of Applied Biotechnology (LBA3B), Azm Center for Research in Biotechnology and its Applications, EDST, Lebanese University, Tripoli 1300, Lebanon
| | - Jean-Marc Sabatier
- Aix-- Marseille Université, CNRS, INP, Inst Neurophysiopathol, Marseille 13385, France
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Abdelrahim DN, El Herrag SE, Khaled MB, Radwan H, Naja F, Alkurd R, Khan MAB, Zeb F, AbuShihab KH, Mahrous L, Obaideen K, Kalam F, Granata Iv F, Madkour M, Faris ME. Changes in energy and macronutrient intakes during Ramadan fasting: a systematic review, meta-analysis, and meta-regression. Nutr Rev 2023:nuad141. [PMID: 37986623 DOI: 10.1093/nutrit/nuad141] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
CONTEXT Ramadan fasting (RF) is associated with various physiological and metabolic changes among fasting Muslims. However, it remains unclear whether these effects are attributable to changes in meal timing or changes in dietary energy and macronutrient intakes. Furthermore, the literature on the associations between RF, meal timing, and energy and macronutrient intakes is inconclusive. OBJECTIVES This systematic review aimed to estimate the effect sizes of RF on energy and macronutrient intakes (carbohydrates, protein, fats, dietary fiber, and water) and determine the effect of different moderators on the examined outcomes. DATA SOURCES The Cochrane, CINAHL, EMBASE, EBSCOhost, Google Scholar, PubMed/MEDLINE, ProQuest Medical, Scopus, ScienceDirect, and Web of Science databases were searched from inception to January 31, 2022. DATA EXTRACTION The studies that assessed energy, carbohydrate, protein, fat, fiber, and water intakes pre- and post-fasting were extracted. DATA ANALYSIS Of the 4776 identified studies, 85 relevant studies (n = 4594 participants aged 9-85 y) were selected. The effect sizes for the studied variables were as follows: energy (number of studies [K] = 80, n = 3343 participants; mean difference [MD]: -142.45; 95% confidence interval [CI]: -215.19, -69.71), carbohydrates (K = 75, n = 3111; MD: -23.90; 95% CI: -36.42, -11.38), protein (K = 74, n = 3108; MD: -4.21; 95% CI: -7.34, -1.07), fats (K = 73, n = 3058; MD: -2.03; 95% CI: -5.73, 1.67), fiber (K = 16, n = 1198; MD: 0.47; 95% CI: -1.44, 2.39), and water (K = 17, n = 772; MD: -350.80; 95% CI: -618.09, 83.50). Subgroup analyses showed age significantly moderated the 6 dietary outcomes, and physical activity significantly moderated water intake. There were significant reductions in energy, carbohydrate, and protein intakes during RF. CONCLUSIONS The change in meal timing rather than quantitative dietary intake may explain various physiological and health effects associated with RF.
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Affiliation(s)
- Dana N Abdelrahim
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Salah Eddine El Herrag
- Laboratoire de Nutrition, Pathologie, Agro-biotechnologie & Santé (Lab-NuPABS), Djillali Liabes University, Sidi Bel Abbes, Algeria
- Department of Biology, Faculty of Life and Natural Science, Djillali Liabes University of Sidi Bel Abbes, Sidi Bel Abbes, Algeria
| | - Meghit Boumediene Khaled
- Laboratoire de Nutrition, Pathologie, Agro-biotechnologie & Santé (Lab-NuPABS), Djillali Liabes University, Sidi Bel Abbes, Algeria
- Department of Biology, Faculty of Life and Natural Science, Djillali Liabes University of Sidi Bel Abbes, Sidi Bel Abbes, Algeria
| | - Hadia Radwan
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Refat Alkurd
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, Petra University, Amman, Jordan
| | - Moien A B Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Falak Zeb
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Katia H AbuShihab
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Lana Mahrous
- Department of Health Sciences/Track of Clinical Nutrition, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Khaled Obaideen
- Sustainable Energy and Power Systems Research Centre, RISE, University of Sharjah, Sharjah, United Arab Emirates
| | - Faiza Kalam
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Frank Granata Iv
- Department of Medical Education, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA
| | - Mohamed Madkour
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Mishra A, Sobha D, Patel D, Suresh PS. Intermittent fasting in health and disease. Arch Physiol Biochem 2023:1-13. [PMID: 37828854 DOI: 10.1080/13813455.2023.2268301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/29/2023] [Indexed: 10/14/2023]
Abstract
CONTEXT Intermittent fasting, a new-age dietary concept derived from an age-old tradition, involves repetitive cycles of fasting/calorie restriction and eating. OBJECTIVE We aim to take a deep dive into the biological responses to intermittent fasting, delineate the disease-modifying and cognitive effects of intermittent fasting, and also shed light on the possible side effects. METHODS Numerous in vitro and in vivo studies were reviewed, followed by an in-depth analysis, and compilation of their implications in health and disease. RESULTS Intermittent fasting improves the body's stress tolerance, which is further amplified with exercise. It impacts various pathological conditions like cancer, obesity, diabetes, cardiovascular disease, and neurodegenerative diseases. CONCLUSION During dietary restriction, the human body experiences a metabolic switch due to the depletion of liver glycogen, which promotes a shift towards utilising fatty acids and ketones in the system, thereby significantly impacting adiposity, ageing and the immune response to various diseases.
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Affiliation(s)
- Anubhav Mishra
- School of Biotechnology, National Institute of Technology, Calicut, Calicut, India
| | - Devika Sobha
- School of Biotechnology, National Institute of Technology, Calicut, Calicut, India
| | - Dimple Patel
- School of Biotechnology, National Institute of Technology, Calicut, Calicut, India
| | - Padmanaban S Suresh
- School of Biotechnology, National Institute of Technology, Calicut, Calicut, India
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Alinezhad‐Namaghi M, Eslami S, Nematy M, Rezvani R, Khoshnasab A, Bonakdaran S, Philippou E, Norouzy A. Association of time-restricted feeding, arterial age, and arterial stiffness in adults with metabolic syndrome. Health Sci Rep 2023; 6:e1385. [PMID: 37408869 PMCID: PMC10318230 DOI: 10.1002/hsr2.1385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/16/2023] [Accepted: 06/18/2023] [Indexed: 07/07/2023] Open
Abstract
Background Time-restricted feeding (TRF) is a kind of intermittent fasting defined as eating and drinking only during a certain number of hours in a day. It has been suggested that intermittent fasting may improve cardiovascular risk factors. This study evaluated the association of TRF and arterial stiffness, using pulse wave velocity (PWV), pulse wave analysis, and arterial age in metabolic syndrome participants. Methods A cohort study was carried out among metabolic syndrome adults who were followed over the Ramadan fasting period (used as a model of TRF since food was only allowed for about 8 h/day). The subjects were divided into Ramadan fasting and Ramadan nonfasting groups. The aortic PWV and central aortic pressure waveform were measured. Central systolic pressure, central pulse pressure, and indices of arterial compliance, such as augmentation pressure and augmentation index (AIx), were determined from waveform analysis. Results Ninety-five adults (31.57% female, age: 45.46 ± 9.10 years) with metabolic syndrome (based on the International Diabetes Federation definition) participated in this study. Ramadan fasting and Ramadan nonfasting groups were including 80 and 15 individuals respectively. A significant reduction was seen in PWV (0.29 m/s), central systolic pressure (4.03 mmHg), central pulse pressure (2.43 mmHg), central augmentation pressure (1.88 mmHg), and central AIx (2.47) in the Ramadan fasting group (p = 0.014, p < 0.001, p = 0.001, p = 0.003, and p = 0.036 respectively). There were no significant changes in these indices among the Ramadan nonfasting group. Conclusions This study suggested that TRF reduces arterial age and improves arterial stiffness among people with metabolic syndrome. This might be considered a beneficial nutrition strategy for extending healthspan (and perhaps longevity).
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Affiliation(s)
- Maryam Alinezhad‐Namaghi
- International UNESCO Center for Health‐Related Basic Sciences and Human NutritionMashhad University of Medical SciencesMashhadIran
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Saeid Eslami
- Pharmaceutical Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mohsen Nematy
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Reza Rezvani
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Adeleh Khoshnasab
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Shokoofeh Bonakdaran
- Metabolic Syndrome Research CenterMashhad University of Medical SciencesMashhadIran
| | - Elena Philippou
- Department of Life and Health Sciences, School of Sciences and EngineeringUniversity of NicosiaCyprus
- Department of Nutritional SciencesKing's CollegeLondonUK
| | - Abdolreza Norouzy
- Nutrition Department, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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AlZunaidy NA, Al-Khalifa AS, Alhussain MH, Mohammed MA, Alfheeaid HA, Althwab SA, Faris ME. The Effect of Ramadan Intermittent Fasting on Food Intake, Anthropometric Indices, and Metabolic Markers among Premenopausal and Postmenopausal Women: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1191. [PMID: 37512003 PMCID: PMC10385901 DOI: 10.3390/medicina59071191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/23/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023]
Abstract
Background and objectives: Ramadan intermittent fasting (RIF) is a monthlong practice in which Muslims fast during the whole day from sunrise to sunset. During this month, fasting people change their dietary behavior and alter their eating hours from day to night. The objective of the current study was to examine the effect of RIF on dietary consumption, anthropometric indices, and metabolic markers in healthy premenopausal (PRE-M) and postmenopausal (POST-M) Saudi women. Materials and Methods: The study included 62 women (31 PRE-M, 21-42 years, and 31 POST-M, 43-68 years). A structured questionnaire was used to collect socioeconomic data. Physical activity, anthropometric, dietary, and biochemical assessments were assessed before and at the end of the third week of Ramadan. Results: Socioeconomic data varied among participants. For both groups, observing RIF was associated with significantly (at either p ≤ 0.01 or p ≤ 0.05) lower intake of calories, macronutrients, minerals (excluding Na), and vitamins than before RIF. For the PRE-M group, the percentage of overweight participants decreased significantly (p ≤ 0.01) during Ramadan, while the percentage of obese participants remained unchanged. In contrast, for the POST-M group, the percentage of overweight participants increased significantly (p ≤ 0.05) during Ramadan, but dropped at the end of Ramadan. Following RIF, waist-to-hip ratio, body fat, and fat mass (FM) decreased in both groups. High-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), triglycerides (TG), and blood pressure (SBP, DBP) were generally maintained at acceptable normal levels in most participants before and at the end of RIF. However, low-density lipoprotein cholesterol (LDL-C) at the end of RIF was significantly lower than before, particularly in POST-M women. Age, occupation, and monthly income were the most important predictors for the changes in nutritional status and body fat upon RIF. Conclusions: observing RIF by PRE-M and POST-M Saudi women was associated with significant improvements in variable health indicators, with a few exceptions, and may help lower risk factors for chronic diseases, particularly among POST-M women. However, further studies with a larger sample size are required to determine and confirm the exact effect of RIF on these groups.
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Affiliation(s)
- Nada A AlZunaidy
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Abdulrahman S Al-Khalifa
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Maha H Alhussain
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Mohammed A Mohammed
- Department of Food Science and Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Hani A Alfheeaid
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia
| | - Sami A Althwab
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
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Samaan E, Eldeeb AA, Ibrahim AB, Erman M, Sabry AA, Mahmoud MA. Effect of Ramadan fasting on chronic inflammation markers and gut bacterial endotoxins among Egyptian hemodialysis patients. Ther Apher Dial 2023. [PMID: 37028928 DOI: 10.1111/1744-9987.13988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/19/2023] [Accepted: 03/25/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is associated with a state of chronic inflammation. This study aimed to investigate effects of Ramadan fasting on the markers of chronic inflammation and gut bacterial endotoxin levels in maintenance hemodialysis. METHOD A prospective self-controlled observational study included 45 patients. Serum levels of High Sensitive CRP (hsCRP), indoxyl sulfate, and trimethylamine-n-levels were measured within a week before and a week after Ramadan fasting. RESULTS Twenty-seven patients have fasted more than 15 days (29 ± 2.2 days). The levels of high sensitive C-reactive protein (hsCRP) (median of 62 mg/L vs. 91 mg/L), trimethylamine-n-oxide (TMAO) (median of 4.5 μmoL/L vs. 17 μmoL/L), platelet-to-lymphocyte ratio (PLR) (mean of 98.9 mg/L vs. 111.8 mg/L) and neutrophil-to-lymphocyte ratio (NLR) (median of 1.56 vs. 1.59) were significantly lower after Ramadan fasting with p < 0.001, p < 0.001, p < 0.001, and p = 0.04, respectively. CONCLUSION A beneficial effect of Ramadan fasting on levels of bacterial endotoxins and markers of chronic inflammation in hemodialysis patients was observed.
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Affiliation(s)
- Emad Samaan
- Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed A Eldeeb
- Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed B Ibrahim
- Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mohammed Erman
- Clinical Pathology Department, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Alaa A Sabry
- Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Mostafa A Mahmoud
- Mansoura Nephrology and Dialysis Unit, Mansoura Faculty of Medicine, Mansoura, Egypt
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Tibi S, Ahmed S, Nizam Y, Aldoghmi M, Moosa A, Bourenane K, Yakub M, Mohsin H. Implications of Ramadan Fasting in the Setting of Gastrointestinal Disorders. Cureus 2023; 15:e36972. [PMID: 37139278 PMCID: PMC10151003 DOI: 10.7759/cureus.36972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 04/03/2023] Open
Abstract
Intermittent fasting is an increasingly popular dieting technique with many well-studied benefits, such as permitting weight loss in obese patients, lowering low-density lipoprotein cholesterol (LDL-C) levels and triglyceride levels, and optimizing circadian rhythms. A special type of intermittent fasting occurs during Ramadan, when Muslims worldwide fast daily from dawn to sunset for a month. Ramadan fasting has demonstrated several health benefits, including improving the gut microbiome, modifying gut hormone levels, and lowering proinflammatory markers such as cytokines and blood lipids. Although fasting has many health benefits, fasting during Ramadan may aggravate chronic medical conditions. We aim to review the literature devoted to Ramadan fasting and its effects on Muslim patients with gastrointestinal (GI) disorders, such as Inflammatory bowel disease (IBD), peptic ulcer disease (PUD), upper GI bleeding (UGIB), gastroesophageal reflux disease (GERD), and liver conditions. We will discuss recommendations for diet and medication compliance during Ramadan in the recommended pre-Ramadan counseling sessions. In this study, we used PubMed to research journals using the key terms "Ramadan," "intermittent fasting," and "gastrointestinal diseases." The current literature studying the impact of Ramadan on gastrointestinal disorders shows that patients with IBD have a minimal risk of disease exacerbation, although older men with ulcerative colitis (UC) were more prone to exacerbation during fasting. Patients with duodenal ulcers were at a higher risk of hemorrhage after Ramadan fasting. Although with mixed results, studies show patients with liver disease demonstrated improvements in liver enzymes, cholesterol, and bilirubin after Ramadan. Physicians should offer pre-Ramadan counseling to educate patients on the risks of fasting and encourage shared decision-making. To facilitate more definitive discussions between the physician and a Muslim patient, clinicians should seek a deeper understanding of how Ramadan fasting affects certain health conditions and offer accommodations, such as diet and medication adjustments.
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Al-Jafar R, Wahyuni NS, Belhaj K, Ersi MH, Boroghani Z, Alreshidi A, Alkhalaf Z, Elliott P, Tsilidis KK, Dehghan A. The impact of Ramadan intermittent fasting on anthropometric measurements and body composition: Evidence from LORANS study and a meta-analysis. Front Nutr 2023; 10:1082217. [PMID: 36733380 PMCID: PMC9886683 DOI: 10.3389/fnut.2023.1082217] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Background Although the effect of Ramadan intermittent fasting (RIF) on anthropometry and body composition has been questioned, none of the previous studies tried to explain the reported changes in these parameters. Also, systematic reviews that investigated the topic were limited to healthy individuals or a specific disease group. Methods The London Ramadan Study (LORANS) is an observational study on health effects of RIF. We measured weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), basal metabolic rate (BMR), fat percentage (FP), free-fat mass (FFM), extremities predicted muscle mass, total body water (TBW), trunk FM, trunk FFM and trunk predicted muscle mass before and immediately after Ramadan. Using mixed-effects regression models, we investigated the effect of RIF with adjustment for potential confounders. We also conducted a meta-analysis of the results of LORANS with other studies that investigated the effect of RIF on anthropometry and body composition. The review protocol is registered with PROSPERO registry (CRD42020186532). Results We recruited 146 participants (Mean ± SD age = 43.3 ± 15 years). Immediately after Ramadan, compared with before Ramadan, the mean difference was-1.6 kg (P<0.01) in weight,-1.95cm (P<0.01) in WC,-2.86cm (P <0.01) in HC, -0.60 kg/m2 (P < 0.01) in BMI and -1.24 kg (P < 0.01) in FM. In the systematic review and meta-analysis, after screening 2,150 titles and abstracts, 66 studies comprising 7,611 participants were included. In the general population, RIF was followed by a reduction of 1.12 Kg in body weight (-1.89- -0.36, I2 = 0), 0.74 kg/m2 reduction in BMI (-0.96- -0.53, I2 = 0), 1.54cm reduction in WC (-2.37- -0.71, I2 = 0) and 1.76cm reduction in HC (-2.69- -0.83, I2 = 0). The effect of fasting on anthropometric and body composition parameters starts to manifest in the second week of Ramadan and starts to diminish 3 weeks after Ramadan. Conclusion RIF is associated with a reduction in body weight, BMI, WC, HC, FM, FP and TBW. Most of these reductions are partially attributed to reduced FM and TBW. The reductions in these parameters appear to reverse after Ramadan.
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Affiliation(s)
- Rami Al-Jafar
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Data Services, Lean Business Services, Riyadh, Saudi Arabia
| | - Nisa Sri Wahyuni
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Karim Belhaj
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Mohammad Hamed Ersi
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Boroghani
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Clinical Research Development of Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amer Alreshidi
- Pharmaceutical Care Department, Hail General Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia
| | - Zahra Alkhalaf
- Dammam Medical Complex, Medical and Clinical Affairs, Dammam, Saudi Arabia
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Dementia Research Institute at Imperial College London, London, United Kingdom
- National Institute for Health Research Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Dementia Research Institute at Imperial College London, London, United Kingdom
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
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17
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Kord-Varkaneh H, Salehi-Sahlabadi A, Tinsley GM, Santos HO, Hekmatdoost A. Effects of time-restricted feeding (16/8) combined with a low-sugar diet on the management of non-alcoholic fatty liver disease: A randomized controlled trial. Nutrition 2023; 105:111847. [PMID: 36257081 DOI: 10.1016/j.nut.2022.111847] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/23/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES Emerging studies have employed time-restricted feeding (TRF) and a low-sugar diet alone in the management of non-alcoholic fatty liver disease (NAFLD), but their combination has not been tested. The aim of this study was to investigate the effects of TRF combined with a low-sugar diet on NAFLD parameters, cardiometabolic and inflammatory biomarkers, and body composition in patients with NAFLD. METHODS A 12-wk randomized controlled trial was performed to compare the effects of TRF (16 h fasting/8 h feeding daily [16/8]) plus a low-sugar diet versus a control diet based on traditional meal distribution in patients with NAFLD. Changes in body composition, anthropometric indices, and liver and cardiometabolic markers were investigated. RESULTS TRF 16/8 with a low-sugar diet reduced body fat (26.7 ± 5.4 to 24.2 ± 4.9 kg), body weight (83.8 ± 12.7 to 80.5 ± 12.1 kg), waist circumference (104.59 ± 10.47 to 101.91 ± 7.42 cm), and body mass index (29.1 ± 2.6 to 28 ± 2.7 kg/m2), as well as circulating levels of fasting blood glucose and liver (alanine aminotransferase, 34 ± 13.9 to 21.2 ± 5.4 U/L; aspartate aminotransferase, 26.3 ± 6.2 to 20.50 ± 4 U/L; γ-glutamyl transpeptidase, 33 ± 15 to 23.2 ± 11.1 U/L; fibrosis score, 6.3 ± 1 to 5.2 ± 1.2 kPa; and controlled attenuation parameter, 322.9 ± 34.9 to 270.9 ± 36.2 dB/m), lipids (triacylglycerols, 201.5 ± 35.3 to 133.3 ± 48.7 mg/dL; total cholesterol, 190 ± 36.6 to 157.8 ± 33.6 mg/dL; and low-density lipoprotein cholesterol, 104.6 ± 27.3 to 84 ± 26.3 mg/dL), and inflammatory markers (high-sensitivity C-reactive protein, 3.1 ± 1.1 to 2 ± 0.9 mg/L; and cytokeratin-18, 1.35 ± 0.03 to 1.16 ± 0.03 ng/mL). These results were statistically significant (P < 0.05) compared with the control group. CONCLUSIONS TRF plus a low-sugar diet can reduce adiposity and improve liver, lipid, and inflammatory markers in patients with NAFLD.
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Affiliation(s)
- Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ammar Salehi-Sahlabadi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Ardahanlı İ, Özkan Hİ, Özel F, Gurbanov R, Teker HT, Ceylani T. Infrared spectrochemical findings on intermittent fasting-associated gross molecular modifications in rat myocardium. Biophys Chem 2022; 289:106873. [PMID: 35964448 DOI: 10.1016/j.bpc.2022.106873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 11/19/2022]
Abstract
Cardiovascular diseases are among the primary life-threatening conditions affecting human society. Intermittent fasting is shown to be functional in the prevention of cardiovascular diseases, however, the information on fasting-associated modifications in myocardial biomolecules is limited. This study aimed to determine the impact of 18-h intermittent fasting administered for five weeks on 12 months-old rats using supervised linear discriminant analysis and support vector machine algorithms constructed on spectrochemical data obtained from myocardial tissues. These algorithms revealed gross biomolecular modifications, while quantitative analyses demonstrated higher amounts of saturated lipids (19%), triglycerides (11%), and lipids (56%), in addition to enhancement in membrane dynamics (18%). The concentrations of nucleic acids and glucose are increased by 52%, while the glycogen content is diminished by 61%. The protein carbonylation/oxidation is reduced by 38%, whereas a 35% increase in protein content was measured. Phosphorylated proteins have been calculated to be at higher concentrations in the 13-62% range. The study findings demonstrated significant molecular changes in the myocardium of rats subjected to intermittent fasting.
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Affiliation(s)
- İsa Ardahanlı
- Department of Cardiology, Faculty of Medicine, Bilecik Şeyh Edebali University Bilecik, Turkey
| | - Halil İbrahim Özkan
- Department of Biochemistry, Faculty of Medicine, Atatürk University Erzurum, Turkey
| | - Faik Özel
- Department of Internal Medicine, Faculty of Medicine, Bilecik Şeyh Edebali University Bilecik, Turkey
| | - Rafig Gurbanov
- Department of Bioengineering, Faculty of Engineering, Bilecik Şeyh Edebali University Bilecik, Turkey; Central Research Laboratory, Bilecik Şeyh Edebali University Bilecik, Turkey
| | | | - Taha Ceylani
- Department of Food Quality Control and Analysis, Muş Alparslan University Muş, Turkey.
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19
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Obaideen K, Abu Shihab KH, Madkour MI, Faris ME. Seven decades of Ramadan intermittent fasting research: Bibliometrics analysis, global trends, and future directions. Diabetes Metab Syndr 2022; 16:102566. [PMID: 35872466 DOI: 10.1016/j.dsx.2022.102566] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/28/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND AIMS There is a large body of research focused on various aspects related to Ramadan intermittent fasting (RIF) and human health and disease. This study aimed to quantify the bibliometric data of RIF medical research over the past seven decades and explore these variables qualitatively via text mining analysis. METHODS We used the Scopus search engine to identify published articles related to RIF from inception to December 31, 2021. All types of research articles were included. Scientometric and bibliometric measures were determined using Excel, Biblioshiny, and VOSviewer. This study proposed a bibliometric and text mining method to qualitatively and quantitatively recognize the RIF research trend. RESULTS The Scopus search returned 1915 relevant articles. Most citations pertained to publications from the last two decades, and most publications were original research articles. These publications had received around 27,000 citations, and the 20 most prolific publishing journals had an average h-index of 112.25. More than one-third of all medical publications were in open-access journals. There was a 13-fold increase in medical research on RIF over the past few decades. We identified the 10 most prolific publishing countries, institutes, journals, and authors. We also identified five scientific hotspots of RIF scientific literature, which were: diabetes, metabolic health, public health, physiology, and maternity. CONCLUSION This is the first comprehensive bibliometric analysis of medical research related to RIF. The research gaps identified will shape future research directions and foster collaborative research activities toward enhanced medical nutrition research revolving around RIF.
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Affiliation(s)
- Khaled Obaideen
- Sustainable Energy & Power Systems Research Centre, RISE, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates
| | - Katia H Abu Shihab
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed I Madkour
- Department of Medical Laboratory Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates.
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Alotaibi N, Aldriweesh MA, Alhasson MA, Albdah BA, Aldbas AA, Alluhidan WA, Alsaif SA, Almutairi FM, Alskaini MA, Al Khathaami AM. Clinical characteristics and outcomes of ischemic stroke patients during Ramadan vs. non-Ramadan months: Is there a difference? Front Neurol 2022; 13:925764. [PMID: 35937074 PMCID: PMC9353707 DOI: 10.3389/fneur.2022.925764] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To study the clinical characteristics and outcomes of patients experiencing an ischemic stroke during Ramadan vs. non-Ramadan months in a tertiary academic center in an Islamic country. Methods We retrospectively reviewed all patients with ischemic stroke (IS) in Ramadan and non-Ramadan months for four consecutive years (February 2016–June 2019). All demographics, vascular risk factors, laboratory results, modified Rankin Scale (mRS) at admission and discharge, National Institute Stroke Scale (NIHSS), and in-hospital complication data were collected for all patients. Results One thousand and 58 patients were included (non-Ramadan, n = 960; during Ramadan, n = 98). The mean age during Ramadan was 59 ± 13 years. Most non-Ramadan IS patients during Ramadan were male (68.5%; 57.1%, respectively). There was no statistical difference in vascular risk factors and medical history between the two groups. However, Ramadan patients had higher median NIHSS scores at discharge (p = 0.0045). In addition, more ICU admissions were noted among Ramadan patients (p = 0.009). In the gender-specific analysis for Ramadan patients, we found a statistically significant difference in smoking and urinary tract infection (p = 0.006, p = 0.005, respectively). Conclusion Based on our results, there was no difference, in general, between patients with IS during Ramadan and non-Ramadan months. However, IS patients had higher NIHSS scores at discharge and more ICU admissions during Ramadan. Last, we suggest future studies with larger sample sizes, longer duration, and including all types of strokes.
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Affiliation(s)
- Naser Alotaibi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed A. Aldriweesh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Muath A. Alhasson
- Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Bayan A. Albdah
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Abdulaziz A. Aldbas
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Waleed A. Alluhidan
- College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | | | - Faisal M. Almutairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mohammed A. Alskaini
- Department of Neurology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ali M. Al Khathaami
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Division of Neurology, Department of Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
- *Correspondence: Ali M. Al Khathaami ;
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Dehghanbanadaki H, Aazami H, Hosseinkhani S, Razi F, Bandarian F, Larijani B. Bibliometric overview of Ramadan fasting studies during 2010-2021. Diabetes Metab Syndr 2022; 16:102531. [PMID: 35717895 DOI: 10.1016/j.dsx.2022.102531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS To quantify the bibliometric parameters of Ramadan fasting literature from 2010 to 2021. MATERIALS AND METHODS Scopus was searched for all articles related to Ramadan fasting or Islamic fasting from the beginning of 2010 to the end of 2021. Only original articles and reviews were included and their bibliometric and scientometric parameters were determined using Excel, Graph Pad Prism, VOSviewer, and Sci2 tool software. RESULTS Finally 1276 articles, including 1109 original articles and 167 reviews, were included. These articles had 14263 citations and an H-index of 48. Based on the number of publications, top institute, top journal, top country, and top authors were University of Sfax (n = 48 articles), Diabetes Research and Clinical Practice (n = 69), the United States (n = 144), and Chtourou H & Hassanein M (n = 38), respectively. Also, Diabetes Research and Clinical Practice had a strong bibliographic coupling with other journals. The recent bursting words were adrenal insufficiency and COVID-19. The most co-occurred topics were the effect of Ramadan fasting on diabetic patients, pregnant women, and glycemic state and body composition of diabetic patients. CONCLUSION This study provided a comprehensive bibliometric overview of Ramadan fasting literature from 2010 to 2021. The temporal change in the number of publications and other analyses on the literature of 2019, 2020 and 2021 showed that substantial increasing publications with new emerging subjects had become of interest to many researchers during the last three years.
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Affiliation(s)
- Hojat Dehghanbanadaki
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Aazami
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Scientometrics Department, FarIdea Company, Tehran, Iran
| | - Shaghayegh Hosseinkhani
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Razi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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22
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Impact of Ramadan intermittent fasting on metabolic and inflammatory profiles in type 2 diabetic patients. J Diabetes Metab Disord 2022; 21:751-758. [PMID: 35673477 PMCID: PMC9167369 DOI: 10.1007/s40200-022-01046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
Purpose The aim of this study was to assess the impact of Ramadan intermittent fasting on metabolic and inflammatory profiles in type 2 diabetic patients (T2D). Methods It was a prospective study including 55 T2D patients treated with oral hypoglycemic drugs, who intended to observe Ramadan fasting in 2019. All participants underwent a questionnaire, a physical examination, laboratory investigations, and a cardiovascular risk assessment using the Framingham score before Ramadan (T0), immediately after Ramadan (T1), and two months after Ramadan (T2). Results The mean age of participants was 54.5 ± 10.1 years. The number of fasted days was 29.3 ± 2.3 days. The mean total daily calorie intake decreased significantly by 19% during Ramadan (p < 10-3). A significant decrease in weight (79.8 ± 12.9 vs 78.4 ± 13.3 kg, p = 0.003), body mass index (29.8 ± 5.4 vs 29.2 ± 5.4 kg/m2, p = 0.004), waist circumference (98.2 ± 9.6 vs 96.3 ± 10.2 cm, p = 0.015), fat body mass (24.3 ± 9.4 vs 23.5 ± 9.7 kg, p = 0.043) was observed at T1. The weight loss was significantly correlated with the number of fasting days (r = 0.348, p = 0.009) and was maintained at T2. Serum fructosamine increased at T1 (303.6 ± 46 vs 333.49 ± 59.49 µmol/L, p < 10-3) and returned to its baseline levels at T2. A significant decrease in insulin (9.7 ± 5.5 vs 7.98 ± 5.05 mIU/L, p = 0.043), fibrinogen (3.7 ± 0.8 vs 3.4 ± 0.6 g/L, p = 0.003), and hs-CRP (4.8 ± 5.7 vs 3.7 ± 4.5 mg/L, p = 0.058) levels was observed at T1. Homocysteine level was significantly higher after Ramadan (12.2 ± 6.2 vs 13.5 ± 6.4 µmol/L, p = 0.001). However, no significant changes were found in blood pressure, fasting blood glucose, HOMA-IR, uric acid, lipids, and white blood cells count. The mean Framingham score decreased insignificantly after Ramadan. Conclusions Ramadan fasting in T2D patients seems to have a favorable impact on anthropometric parameters and inflammatory profile. However, it may cause a transient worsening of glycemic control.
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Craggs-Dino L, El Chaar M, Husain FA, Rogers AM, Lima AG, Sadegh M, Bashiti J, Chapmon K. American Society for Metabolic and Bariatric Surgery Review on Fasting for Religious Purposes after Surgery. Surg Obes Relat Dis 2022; 18:861-871. [DOI: 10.1016/j.soard.2022.04.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/28/2022]
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Kammoun N, Hidouri S, Ghram A, Ammar A, Masmoudi L, Driss T, Knechtle B, Weiss K, Hammouda O, Chlif M. Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males. Am J Mens Health 2022; 16:15579883221103418. [PMID: 35723054 PMCID: PMC9344188 DOI: 10.1177/15579883221103418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effect of a walking football (WF) program during Ramadan fasting (RF) on heart rate variability (HRV) indices, body composition, and physical fitness in middle-aged males. Thirty-one healthy sedentary men were randomized to WF (n = 18) and control (n = 13) groups. Both groups participated in RF. The WF group were involved in a training program (small-sided games) of three sessions a week during RF. The time and frequency domains of HRV, body composition, handgrip, lumbar strength, Modified Agility Test (MAT), and 6-minute walk test (6MWT) were measured before Ramadan (BR), during Ramadan (DR), and after Ramadan (AR). We reported that RF has significantly altered some parameters of HRV DR; the mean HR decreased while the mean RR, LF, and HF increased. WF had a significant effect on HRV and mean HR DR compared with BR and AR decreased while mean RR, HF and LF increased. DR, body mass decreased in both groups, while body mass index (BMI) decreased and lean mass increased only in WF group. Lower body mass and BMI levels were reported AR only in WF group. Physical capacity improved AR, compared with BR, only in the WF group with longer distance in 6MWT, shorter time(s) in MAT, and higher lumbar strength levels. We conclude that RF increases parasympathetic system activity. WF practice during RF is safe and might improve body composition, physical fitness, autonomic cardiac function, and physical fitness in middle-aged males.
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Affiliation(s)
- Noureddine Kammoun
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sami Hidouri
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Amine Ghram
- Healthy Living for Pandemic Event Protection (Hl-Pivot) Network, Chicago, IL, USA.,Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Achraf Ammar
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France.,Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Liwa Masmoudi
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarak Driss
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Omar Hammouda
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.,Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mehdi Chlif
- EA 3300 "APS and Motor Patterns: Adaptations-Rehabilitation," Sport Science Department, Picardie Jules Verne University, Amiens, France.,Tunisian Research Laboratory Sports Performance Optimization, National Center of Medicine and Science in Sports (NCMSS), Tunis, Tunisia
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Gad AI, Abdel-Ghani HA, Barakat AAEA. Effect of Ramadan fasting on hepatic steatosis as quantified by controlled attenuation parameter (CAP): a prospective observational study. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00187-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Although Ramadan fasting has a beneficial effect on health, the role of Ramadan fasting on patients with non-alcoholic fatty liver disease (NAFLD), as quantified by the controlled attenuation parameter (CAP), is not determined yet. So, this study aimed to determine the effect of Ramadan fasting on patients with NAFLD by assessing the controlled attenuation parameter (CAP) and biochemical parameters of the fatty liver.
Patients and methods
A prospective observational study was conducted on 40 NAFLD patients, who were diagnosed by ultrasonography and quantified with controlled attenuation parameter (CAP) in transient elastography (FibroScan) and fasted the month of Ramadan. Transient elastography for CAP and liver stiffness measurement (LSM) were performed. Fibrosis 4 score (FIB4) and NAFLD fibrosis score (NFS) were also calculated.
Results
There is a statistically significant change in body mass index, fasting blood glucose, HbA1c, triglycerides, LDL cholesterol, HDL cholesterol, total cholesterol, serum albumin, total protein, AST, ALT, and alkaline phosphatase after Ramadan fasting. There were significant clinical improvements after Ramadan fasting in FIB-4 (1.31 ± 0.26 and 1.24 ± 0.25 respectively, p < 0.001), CAP (318.52 ± 34.59 and 294.0 ± 20.34, respectively, p < 0. 001), and LSM (6.95 ± 1.62 and 6.59 ± 1.49, respectively, p < 0. 001).
Conclusion
Our study demonstrates that Ramadan fasting could improve liver steatosis in patients with NAFLD proved with a significant reduction in the CAP and LSM.
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Zairi I, Bejar MA, Ben Mrad I, Mzoughi K, Kraiem S. Effects of Ramadan fasting on blood pressure in hypertensive patients. LA TUNISIE MEDICALE 2022; 99:727-733. [PMID: 35261004 PMCID: PMC8796675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION During Ramadan, repeated cycles of fasting might contribute to changes in blood pressure among hypertensive patients. Studies on the effects of fasting on the blood pressure of hypertensive patients are scarce and have provided inconclusive results. AIM To examine the effect of fasting on ambulatory blood pressure and heart rate in treated hypertensive subjects. METHODS The study prospectively recruited 60 hypertensive patients between April and June 2019, followed up at the cardiology department of Habib Thameur Hospital of Tunis. A 24-hour pressure monitoring was carried out during two periods: prior to Ramadan and during the last ten days of Ramadan. We compared the average values of 24 hour, awake and asleep systolic and diastolic blood pressure and 24 hour, awake and asleep heart rate. RESULTS We studied 40 women and 20 men; mean age was 58.4 years. 33% of the patients were diabetics, 42% dyslipidemics, 15% had coronaropathy. 45% of the patients were on monotherapy, 37% on dual therapy and 18% on a triple antihypertensive therapy. During Ramadan, 74% of the patients were taking the treatment once daily, 3% twice daily, and 23% three times per day. Average 24hour ambulatory blood pressure in the whole group was 129±17/74±10 mmHg before Ramadan and 128±17/73±9 mmHg during Ramadan (p>0.05). Daytime and nighttime mean values of systolic and diastolic blood pressure as well as mean values of heart rate were not different between both periods regardless of age, gender, medical history and lifestyle. CONCLUSIONS In this study, there were no significant changes in systolic and diastolic blood pressures as well as heart rate during the 2 periods.
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AlAbdan NA, Almohammed OA, Altukhaim MS, Farooqui MA, Abdalla MI, Al Otaibi HQ, Alshuraym NR, Alghusun SN, Alotaibi LH, Alsayyari AA. Fasting during Ramadan and acute kidney injury (AKI): a retrospective, propensity matched cohort study. BMC Nephrol 2022; 23:54. [PMID: 35125093 PMCID: PMC8819932 DOI: 10.1186/s12882-022-02674-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background During the month of Ramadan, Muslims abstain from daytime consumption of fluids and foods, although some high-risk individuals are exempt. Because fasting's effects on the risk of acute kidney injury (AKI) have not been established, this study assesses the relationship between fasting and risk of AKI and identifies patients at high risk. Methods A single-center, retrospective, propensity-score matched, cohort study was conducted with data collected from adult patients admitted to the emergency room during Ramadan and the following month over two consecutive years (2016 and 2017). AKI was diagnosed based on the 2012 definition from the Kidney Disease: Improving Global Outcomes clinical practice guideline. Multivariable logistic regression analyses were used to examine the correlation and measure the effect of fasting on the incidence of AKI, and assess the effect of different variables on the incidence of AKI between the matching cohorts. Results A total of 1199 patients were included; after matching, each cohort had 499 patients. In the fasting cohort, the incidence of AKI and the risk of developing AKI were significantly lower (adjusted odds ratio (AOR) 0.65;95% confidence interval (CI) 0.44–0.98). The most indicative risk factors for AKI were hypertension (AOR 2.17; 95% CI 1.48–3.18), history of AKI (AOR 5.05; 95% CI 3.46–7.39), and liver cirrhosis (AOR 3.01; 95% CI 1.04–8.70). Patients with these factors or most other comorbidities in the fasting cohort had a lower risk of AKI as compared with their nonfasting counterparts. Conclusion The data show a strong reduction in the risk of developing AKI as a benefit of fasting, particularly in patients with comorbid conditions. Therefore, most patients with comorbid conditions are not harmed from fasting during Ramadan. However, larger prospective studies are needed to investigate the benefit of fasting in reducing the risk of developing AKI.
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Hammami R, Bahloul A, Charfeddine S, Gargouri R, Ellouze T, Abid L, Triki F, Kammoun S, Mrad IB, Amor HIH. [Maladies cardiaques et Ramadan : revue de la littérature]. Ann Cardiol Angeiol (Paris) 2022; 71:166-172. [PMID: 35039144 DOI: 10.1016/j.ancard.2021.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 09/07/2021] [Indexed: 12/23/2022]
Abstract
We review the literature on the safety of fasting in cardiac patients. We examined the changes of blood pressure among hypertensive patients and the incidence of cardiac events during Ramadan in patients with coronary disease and heart failure. We also assess the modifications of INR levels in cardiac patients who take oral anticoagulant. We found that Ramadan fasting is safe in stable cardiac patients, even under several drugs. Fasting does not affect blood pressure. There is no difference in regards to cardiac event incidence between Ramadan and the non-fasting-months. The level of INR is slightly higher when fasting, it is thus recommended to monitor patients with high bleeding risk during Ramadan.
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Affiliation(s)
- Rania Hammami
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Amine Bahloul
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Selma Charfeddine
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Rania Gargouri
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Tarek Ellouze
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Leila Abid
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Faten Triki
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
| | - Samir Kammoun
- Cardiology department, Hedi Chaker Hospital, Research Unit RU17ES37, Sfax Faculty of Medecine, Sfax, Tunisia.
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Is Ramadan fasting associated with low scores of Healthy Eating Index? NUTR HOSP 2022; 39:1058-1063. [DOI: 10.20960/nh.04042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Religiously Conditioned Health Behaviors within Selected Religious Traditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010454. [PMID: 35010714 PMCID: PMC8744965 DOI: 10.3390/ijerph19010454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/27/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022]
Abstract
Background: Health is a value of paramount importance for human existence. It has a special place in every religious system, both on the doctrinal and practical levels. Most religions view health as a priority value to be cared for, and require followers of individual religious groups to take care of their physical and mental health, and to maintain a balance between body and spirit. The aim of the study was to verify whether the level of religious commitment significantly influences health behaviors and whether in selected religions the faithful have a different approach to health behaviors. Methods: This cross-sectional study was conducted on a group of 296 people—118 Seventh-day Adventists (SDA), 134 Catholics, and 14 Jews living in southern Poland, and 31 Muslims living in southern and north-eastern Poland. The following research tools were used as part of the diagnostic survey method: a questionnaire survey designed by us; the International Physical Activity Questionnaire (IPAQ); the Inventory of Health Behaviours (IHB); the Perceived Stress Scale (PSS 10) and anthropometric measurements, physical examination, laboratory tests. Results: Only 75% of Catholics who participated in the study declared a high level of religious commitment. On the other hand, all (100%) of SDA, Jews, and Muslim respondents declared their religious commitment at a high level. SDA were characterized by the most desirable health behaviors on the IHB (high and average levels), especially eating habits. They did not consume alcohol, did not smoke cigarettes. The physical activity of most ADS was high and moderate. Most of the SDA subjects were characterized by an average and low level of stress intensity. The most common correct scores for homocysteine, triglycerides, and CRP were SDA, cholesterol by Jews, glucose by Muslims, and HDL by Catholics. The most common negative results were: homocysteine, glucose and triglycerides among Jews, cholesterol and CRP among Catholics, HDL among Muslims. Optimal blood pressure was most common among Catholics, and hypertension was most often diagnosed among Jews. Most often, Muslims had the correct body weight, and at the same time it was the group of respondents most often diagnosed with obesity. In contrast, underweight was observed only among Catholics. The SDA subjects were most often overweight. Conclusions: The results suggest that public health professionals and nurses should develop culturally specific educational interventions, especially among Catholics.
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Tucker JM, Siegel R, Murray PJ, Han JC, Boyer K, Reed N, Allenby T, Novick M. Acceptability of Time-Limited Eating in Pediatric Weight Management. Front Endocrinol (Lausanne) 2022; 13:811489. [PMID: 35527997 PMCID: PMC9068968 DOI: 10.3389/fendo.2022.811489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/15/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Adherence to dietary interventions is a significant barrier in the treatment of childhood obesity. Time-limited eating (TLE) is a simple dietary approach that limits food intake to a given number of consecutive hours per day, but parental and youth acceptability of TLE in youth with obesity is unknown. This study explored the feasibility of utilizing TLE among parents and youth attending pediatric weight management (PWM). METHODS Members of COMPASS (Childhood Obesity Multi-Program Analysis and Study System) developed a survey to assess the acceptability of TLE in families attending PWM, which included patient characteristics, current diet and sleep schedules, and interests in trying TLE. The survey was administered electronically via REDCap or manually to parents of patients between the ages of 8-17 years old and to patients 11-17 years old attending one of five PWM practices in the COMPASS network. RESULTS Patients (n=213) were 13.0 ± 2.5 years old, 58% female, 52% White, 22% Black, 17% Hispanic/Latino, and 47% reported a diagnosed psychological disorder. On average, parents reported their child's daily eating spanned 12.5 ± 1.9 hours (7:35am - 8:05pm) and included 5.6 ± 1.6 eating bouts (meals + snacks). Most parents reported being likely to try TLE ≤12 hours/d (TLE12: 66%), which was similar to the likelihood of following a nutrient-balanced diet (59%). Likelihood was lower for TLE ≤10 hours/d (TLE10: 39%) or ≤8 hours/d (TLE8: 26%) (p<0.001 for both). Interest in TLE was not consistently related to patient age, sex, or ethnicity, but was lower in patients with a psychiatric diagnosis vs. no diagnosis (TLE8: 19% vs. 32%; p=0.034). Patients of parents who reported being likely to try TLE, compared to those unlikely to try TLE, had shorter eating windows (p<0.001) and ate fewer snacks (p=0.006). CONCLUSIONS Two-thirds of parents with children attending PWM programs report interest in TLE ≤12 hours/d regardless of demographic characteristics, but interest wanes when limiting eating to ≤10 or ≤8 hours per day. Time-limited eating appears to be a feasible option in PWM settings provided treatment options are individualized based on the interests and barriers of patients and their families.
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Affiliation(s)
- Jared M. Tucker
- Healthy Weight Center, Helen DeVos Children's Hospital, Grand Rapids, MI, United States
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Grand Rapids, MI, United States
- *Correspondence: Jared M. Tucker,
| | - Robert Siegel
- Center for Better Health and Nutrition, Cincinnati Children's Hospital, Cincinnati, OH, United States
| | - Pamela J. Murray
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, United States
- Adolescent and Young Adult Medicine, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard University Medical School, Boston, MA, United States
| | - Joan C. Han
- Department of Pediatrics, Le Bonheur Children’s Hospital and University of Tennessee Health Science Center, Memphis, TN, United States
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Katherine Boyer
- Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Grand Rapids, MI, United States
| | - Nichole Reed
- Department of Pediatrics, Le Bonheur Children’s Hospital and University of Tennessee Health Science Center, Memphis, TN, United States
| | - Taylor Allenby
- Department of General Surgery, University of Colorado School of Medicine, Aurora, CO, United States
| | - Marsha Novick
- Pennsylvania State Medical Center, Harrisburg, PA, United States
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Bhatti SI, Mindikoglu AL. The impact of dawn to sunset fasting on immune system and its clinical significance in Covid-19 pandemic. Metabol Open 2021; 13:100162. [PMID: 34977523 PMCID: PMC8713419 DOI: 10.1016/j.metop.2021.100162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 02/06/2023] Open
Abstract
Dawn to sunset fasting, a type of intermittent fasting commonly practiced in the month of Ramadan, requires fasting from dawn to sunset without food or liquid intake. Dawn and dusk are two transition time zones of the day that play a critical role in the human circadian rhythm. Practicing dawn to sunset fasting requires the alignment of mealtimes and wake-sleep times with the human biological dawn and dusk. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impairs immune cell responses at multiple levels and leads to severe Coronavirus Disease 2019 (COVID-19). It generates high levels of pro-inflammatory cytokines and chemokines, also known as a cytokine storm, leads to mitochondrial dysfunction and generation of excessive amounts of mitochondrial reactive oxygen species, downregulates autophagy to escape detection for unchecked replication, and alters gut microbiome composition. Severe cases of COVID-19 have been associated with several comorbidities that impair immune responses (e.g., obesity, diabetes, malignancy) and blood laboratory abnormalities (e.g., elevated procalcitonin, C-reactive protein, interleukin-6 (IL-6), leukocytosis, lymphopenia). Several studies of dawn to sunset fasting showed anti-inflammatory effect by suppressing several pro-inflammatory cytokines, reducing oxidative stress, inducing a proteome response associated with increased autophagy, remodeling the gut microbiome, and improving the components of metabolic syndrome (e.g., obesity, blood glucose levels, blood pressure, lipids). In conclusion, dawn to sunset fasting has the potential to optimize the immune system function against SARS-CoV-2 during the COVID-19 pandemic as it suppresses chronic inflammation and oxidative stress, improves metabolic profile, and remodels the gut microbiome. This review presents scientific literature related to the effects of dawn to sunset fasting on the immune system. Studies are needed to assess and confirm the potential benefits of dawn to sunset fasting against SARS-CoV-2.
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Affiliation(s)
- Sundus I Bhatti
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, Houston, TX, USA
| | - Ayse L Mindikoglu
- Margaret M. and Albert B. Alkek Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation, Baylor College of Medicine, Houston, TX, USA
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Angoorani P, Ejtahed HS, Hasani-Ranjbar S, Siadat SD, Soroush AR, Larijani B. Gut microbiota modulation as a possible mediating mechanism for fasting-induced alleviation of metabolic complications: a systematic review. Nutr Metab (Lond) 2021; 18:105. [PMID: 34906176 PMCID: PMC8670288 DOI: 10.1186/s12986-021-00635-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/30/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Intermittent fasting has been reported to have positive effects on obesity, diabetes, cardiovascular diseases, hypertension, and several neurodegenerative diseases through different mechanisms such as alteration in the gut microbiota. This systematic review was conducted with the aim of providing an overview of the existing animal and human literature regarding the gut microbiota alterations in various fasting regimens. METHOD A systematic literature search was conducted on PubMed, Scopus and Web of Science databases up to May 2021 to find all relevant studies examining the gut microbiota alteration during the fasting. Original researches on animal models or human patients were included in this study. RESULTS The search fulfilled 3072 documents from which 31 studies (20 animal and 11 human studies) were included. Upon fasting, abundance of several beneficial bacteria including Lactobacillus and Bifidobacterium shifted significantly. Moreover, some taxa, including Odoribacter which negatively associated with blood pressure bloomed during fasting. Ramadan fasting, as a kind of intermittent fasting, improves health parameters through positive changes in gut microbiota including upregulation of A. muciniphila, B. fragilis, Bacteroides and butyric acid-producing Lachnospiraceae. CONCLUSION The findings suggest that different fasting regimens including alternate-day fasting, calorie- and time-restricted fasting programs and Ramadan fasting could promote health maybe through the modulation of gut microbiome. However, further studies are needed to explore properly the connection between gut microbiota and meal frequency and timing.
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Affiliation(s)
- Pooneh Angoorani
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411413137, Tehran, Iran.
| | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Microbiology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Ahmad Reza Soroush
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, North Kargar Ave, 1411413137, Tehran, Iran
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Apergi K, Karatzi K, Reppas K, Mavrogianni C, Shadid S, P FB, De Miguel-Etayo P, Bazdarska Y, Radó S, Rurik I, Wikström K, Tankova T, Gardon G, Iotova V, Manios Y, Makrilakis K. Association between daily number of eating occasions with fasting glucose and insulin sensitivity in adults from families at high risk for type 2 diabetes in Europe: the Feel4Diabetes Study. Nutrition 2021; 95:111566. [PMID: 35051881 DOI: 10.1016/j.nut.2021.111566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/02/2021] [Accepted: 11/28/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to examine the association between the number of times one eats daily (termed eating occasions [EO]) with indices of glycemic control and insulin resistance (IR) in a large sample of adults from families at high risk for type 2 diabetes mellitus (T2DM) from six European countries. The study also considered sex and socioeconomic status (SES). METHODS Standardized questionnaires and procedures were used to assess sociodemographic characteristics, dietary intake, sedentary behavior, and anthropometric and biochemical indices. Univariate analysis of variance was used to investigate associations of daily EOs with fasting glucose (FG), fasting insulin (FI), and IR. RESULTS In 1552 adults (41.6 ± 7.2 y), three to four daily EOs rather than less than three were inversely associated with FG (β = -2.598; 95% confidence interval [CI], -4.521 to -0.675), independent of age, body mass index (BMI), dietary quality, and sedentary time. In women, three to four EOs per day were also associated with FG (β = -3.071; 95% CI to -5.573 to -0.570) independently of the mentioned confounders. In high SES participants, having more than four EOs per day had an inverse association with FI (β = -1.348; 95% CI to -2.583 to -0.114). No such associations were observed in men or in low SES participants. CONCLUSION In adults at high risk for T2DM, and especially in women, having three to four daily EOs was inversely associated with FG, whereas in high SES participants, more than four EOs was associated with FI. Future studies should further elucidate the underlying mechanisms and offer insight into the optimum number of daily EOs for the prevention of T2DM especially in men and in adults with low SES where the number of daily EOs was not found to be significantly related to glycemic indices.
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Affiliation(s)
- Kyriaki Apergi
- National and Kapodistrian, University of Athens Medical School, 11527 Athens, Greece.
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, Greece
| | - Kyriakos Reppas
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Christina Mavrogianni
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece
| | - Samiah Shadid
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium
| | - Flores-Barrantes P
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza 50009, Spain; Centro de Investigación Biomédica em Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN). Instituto de Salud Carlos III, Madrid 28020, Spain; Instituto Agroalimentario de Aragón (IA2), 50009 Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
| | - Pilar De Miguel-Etayo
- Growth, Exercise, Nutrition and Development (GENUD) Research Group, Instituto Agroalimentario de Aragón (IA2), Universidad de Zaragoza, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza 50009, Spain; Centro de Investigación Biomédica em Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN). Instituto de Salud Carlos III, Madrid 28020, Spain
| | - Yuliya Bazdarska
- Department of Pediatrics, Medical University of Varna, Varna, Bulgaria
| | - Sándorné Radó
- University of Debrecen, Faculty of Health, Doctoral School of Health Science, 4032 Debrecen, Hungary
| | - Imre Rurik
- Department of Family and Occupational Medicine, Faculty of Medicine, University of Debrecen, Hungary
| | - Katja Wikström
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
| | | | - Greet Gardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium
| | - Violeta Iotova
- Clinical Center of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 17671 Athens, Greece; Institute of Agri-food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece (Agro-Health)
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Thackrey E, Chen J, Martino CR, Preda V. The effects of diet on weight and metabolic outcomes in patients with double diabetes: A systematic review. Nutrition 2021; 94:111536. [PMID: 34936947 DOI: 10.1016/j.nut.2021.111536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/29/2021] [Accepted: 11/01/2021] [Indexed: 11/15/2022]
Abstract
With the global rise in obesity and the metabolic syndrome, double diabetes is increasingly prevalent in patients with type 1 diabetes. This review investigated the effects of diet on weight management and metabolic outcomes in patients with double diabetes. MEDLINE, CENTRAL, EMBASE, PsycINFO, CINAHL, ERIC, and Web of Science databases were searched through September 2020. Population- or individual-level dietary interventions, and observational studies investigating dietary patterns in adults with type 1 diabetes and overweight or obesity, were eligible for inclusion. The quality of studies was assessed. Four eligible studies were included in this review, comprising two randomized controlled trials, one pretest-posttest study, and one cross-sectional study. Study populations included between 10 and 1040 participants. Dietary interventions included the Mediterranean diet, low-fat diet, intermittent fasting, continuous energy restriction, and a combination of fasting and a standardized low-calorie diabetic diet (LCD). Significant weight loss was observed within groups for low-fat diet, Mediterranean diet, fasting, LCD with fasting, intermittent fasting, or continuous energy restriction, but there were no between-group differences. Weight maintenance was only achieved in interventions where fasting or intermittent fasting were present. Dietary interventions in published data failed to demonstrate effects on metabolic syndrome. Larger sample, high-quality trials conducted over longer periods are urgently required to determine the efficacy of diet for weight management and improving metabolic outcomes in individuals with double diabetes. This would provide much needed evidence-based guidance for dietary interventions, which are well known to be the cornerstone of clinical care.
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Affiliation(s)
- Eleanor Thackrey
- The University of Sydney, Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Juliana Chen
- The University of Sydney, Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia; Healthy Weight Clinic, MQ Health, Macquarie University Hospital, Australia; Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Chantelle-Rose Martino
- The University of Sydney, Charles Perkins Centre, Discipline of Nutrition and Dietetics, School of Life and Environmental Sciences, Camperdown, New South Wales, Australia
| | - Veronica Preda
- Healthy Weight Clinic, MQ Health, Macquarie University Hospital, Australia; Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia
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Hammoud S, Kurdi M, van den Bemt BJF. Impact of Fasting on Cardiovascular Outcomes in Patients With Hypertension. J Cardiovasc Pharmacol 2021; 78:481-495. [PMID: 34225340 DOI: 10.1097/fjc.0000000000001097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT Fasting has been frequently practiced for religious or medical purposes worldwide. However, limited literature assesses the impact of different fasting patterns on the physiologic and cardiac-related parameters in patients with hypertension. This review aims to examine the effect of fasting on cardiovascular outcomes in hypertensive patients. Medline, Embase, and Cochrane library were systematically screened until March 2021 for observational prospective cohorts investigating the effect of fasting on cardiovascular outcomes. Articles were assessed by searching for hypertension and fasting, both as Medical Subject Headings (MeSH) terms and text words. The review included studies assessing Ramadan, intermittent, and water-only fasting. Water-only fasting reduces body weight, blood pressure, and lipolytic activity of fasting hypertensive patients without affecting average heart rate. Ramadan fasting enhances lipid profile, although it shows conflicting results for body weight, blood pressure, and heart rate variability. Considering the limited studies in this field, further research should be conducted to support the clinical impact of fasting on the cardiovascular health of patients with hypertension.
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Affiliation(s)
- Sabah Hammoud
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mazen Kurdi
- Laboratory of Experimental and Clinical Pharmacology, Faculty of Sciences, Section 1, Lebanese University, Rafic Hariri Educational Campus, Hadat, Lebanon
| | - Bart J F van den Bemt
- Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; and
- Department of Pharmacy, University Medical Center Maastricht, Maastricht, the Netherlands
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Effects of long-term fasting and confinement on the cardiovascular activity. Med Biol Eng Comput 2021; 59:1901-1915. [PMID: 34370188 DOI: 10.1007/s11517-021-02380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 05/08/2021] [Indexed: 10/20/2022]
Abstract
Fasting has been demonstrated to improve health and slow aging in human and other species; however, its impact on the human body in the confined environment is still unclear. This work studies the effects of long-term fasting and confined environment on the cardiovascular activities of human via a 10-day fasting experiment with two groups of subjects being in confined (6 subjects) and unconfined (7 subjects) environments respectively and undergoing the same four-stage fasting/feeding process. It is found that the confinement has significant influences on the autonomic regulation to the heart rate during the fasting process by altering the activity of the parasympathetic nervous system, which is manifested by the significant higher pNN50, rMSSD, and Ln-HF of heart rate variability (HRV) (p < 0.05) and slower heart rate (p < 0.01) in the confined group than that in the unconfined group. Furthermore, the long-term fasting induces a series of changes in both groups, including reduced level of serum sodium (p < 0.01), increased the serum calcium (p < 0.05), prolonged QTc intervals (p < 0.05), and reduced systolic blood pressures (p < 0.05). These effects are potentially negative to human health and therefore need to be treated with caution. Study of the effects of fasting and confinement on the cardiovascular activities.
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Mohamed H, Abbas AM, Huneif MA, Alqahtani SM, Ahmed AM, Babker AMA, Elagab EAM, Haris PI. Influence of Ramadan Fasting on Hemoglobin A1C, Lipid Profile, and Body Mass Index among Type 2 Diabetic Patients in Najran City, Saudi Arabia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Saudi Arabia is known to have one of the highest prevalence of diabetes in the world. The impact of Ramadan fasting on the health of type 2 diabetic patients is an important issue that has not been adequately investigated.
AIM: The current study was aimed at assessing the impact of Ramadan fasting on hemoglobin A1C (HbA1c), lipid profile, blood pressure, and body mass index (BMI) in adult Saudis with Type 2 diabetes residing in Najran city.
METHODS: This is a descriptive cross-sectional study which enrolled 289 patients who chose to fast during the month of Ramadan and were attending the outpatient clinics of Najran University Hospital. Fasting blood samples were taken 1 month before and 1 month after Ramadan to determine glycated hemoglobin and fasting lipid profile (low-density lipoprotein [LDL], high-density lipoprotein [HDL], triglyceride [TG], and total cholesterol [TC]) and BMI was also calculated. Information regarding demographics and physical activity was obtained through a questionnaire.
RESULTS: As many as 176 (60.9%) of the participants reported to be physically inactive during Ramadan. There was a statistically significant (p < 0.05) decrease in the mean percentage of HbA1c when comparing before Ramadan (9.85 ± 2.37%) with after Ramadan (7.65 ± 1.70%). Furthermore, statistically significant difference (p < 0.05) was detected in the mean concentrations of LDL before (3.39 ± 1.06 mmol/L) and after (2.40 ± 0.83 mmol/L) Ramadan. The mean concentration of TC (before = 5.98 ± 2.00 mmol/L; after = 4.05 ± 1.18 mmol/L) and TG (before = 2.97 ± 1.95 mmol/L; after = 2.65 ± 1.65 mmol/L) also reduced after Ramadan. The mean concentrations of HDL (before = 1.78 ± 0.74 mmol/L; after= 2.23 ± 0.23 mmol/L) increased after Ramadan. The mean BMI of the study participants (before = 28.30 ± 6.27; after = 27.43 ± 5.92) decreased slightly after Ramadan. The systolic blood pressure (SBP) (before= 128.10 ± 6.32; after, 123.09 ± 5.71) and diastolic blood pressure (DBP) (before = 81.21 ± 8.51; after = 79.83 ± 7.21) showed a slight reduction after Ramadan.
CONCLUSIONS: Type 2 diabetic patients who performed Ramadan fasting displayed a lowering of HbA1c, LDL, TC, and TG, and increased HDL, but had small positive effects on body weight, BMI, as well as SBP and DBP. More studies are needed with a larger population in the future to assess the potential of Ramadan fasting as a therapeutic strategy for managing Type 2 diabetes.
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Alper AT, Akboğa MK, Özcan KS, Tengiz İ, Türk UÖ, Yıldız M, Yılmaz MB, Kayıkçıoğlu M, Gazi E, Yıldırır A. Recommendations for Ramadan fasting to patients with cardiovascular diseases; Turkish Society of Cardiology consensus report. Anatol J Cardiol 2021; 25:284-293. [PMID: 33960303 DOI: 10.5152/anatoljcardiol.2021.206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ahmet Taha Alper
- Department of Cardiology, University of Health and Sciences, Siyami Ersek Training and Research Hospital; İstanbul-Turkey
| | - Mehmet Kadri Akboğa
- Department of Cardiology, Faculty of Medicine, Gazi University; Ankara-Turkey
| | - Kazım Serhan Özcan
- Department of Cardiology, University of Health and Sciences, Siyami Ersek Training and Research Hospital; İstanbul-Turkey
| | - İstemihan Tengiz
- Department of Cardiology, Medical Park İzmir Hospital; İzmir-Turkey
| | - Uğur Önsel Türk
- Department of Cardiology, Medical Park İzmir Hospital; İzmir-Turkey
| | - Mustafa Yıldız
- Department of Cardiology, Institute of Cardiology, İstanbul University-Cerrahpaşa; İstanbul-Turkey
| | - Mehmet Birhan Yılmaz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University; İzmir-Turkey
| | - Meral Kayıkçıoğlu
- Department of Cardiology, Faculty of Medicine, Ege University; İzmir-Turkey
| | - Emine Gazi
- Department of Cardiology, Faculty of Medicine, Çanakkale Onsekiz Mart University; Çanakkale-Turkey
| | - Aylin Yıldırır
- Department of Cardiology, Faculty of Medicine, Başkent University; Ankara-Turkey
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Emara MH, Soliman HH, Elnadry M, Mohamed Said E, Abd-Elsalam S, Elbatae HE, Zaher TI, Ezzeldin S Bazeed S, Abdel-Razik A, Youssef Mohamed S, Elfert A. Ramadan fasting and liver diseases: A review with practice advices and recommendations. Liver Int 2021; 41:436-448. [PMID: 33369880 DOI: 10.1111/liv.14775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 02/05/2023]
Abstract
Ramadan fasting is obligatory for Muslim healthy adults. However, there are many exemptions from fasting; including patients, whose diseases will be aggravated by fasting. Muslim patients with different liver diseases are frequently seen in the clinics discussing their intent to fast this month with their treating physicians. To answer our patients' inquiries about the expected benefits and/or risks of fasting and delivering them the best care, we carried out this review and we draw advices and recommendations based on the available evidence. A web-based search, combining multiple keywords representing different liver diseases with Ramadan fasting had been carried out. To answer the research question: Do adult Muslim patients with different liver diseases who fast the month of Ramadan have had a deleterious effect on their health in comparison to those who did not fast? Relevant publications were retrieved. No randomized controlled trials were focusing on Ramadan fasting and liver diseases in the filtered databases, eg Cochrane library. Consequently, non-filtered databases, eg PubMed, Google Scholar and Egyptian Knowledge Bank searched and full-text high-quality research articles were carefully analysed to draw recommendations. Other relevant publications with low quality of evidence like case studies and short communications were also reviewed to address practice advices. Although Ramadan fasting was found beneficial for patients with NAFLD, it was found deleterious to patients with Child B and C cirrhosis and patients with peptic ulcer. Patients with chronic hepatitis, Child A cirrhosis and those with non-complicated liver transplant can fast with prefasting assessment and strict follow up.
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Affiliation(s)
- Mohamed H Emara
- Faculty of Medicine, Department of Hepatology, Gastroenterology and infectious diseases, Kafrelsheikh University, Kafr El-Shikh, Egypt
| | - Hanan H Soliman
- Faculty of Medicine, Tropical medicine and infectious diseases Department, Tanta University, Tanta, Egypt
| | - Mohamed Elnadry
- Faculty of Medicine, Hepato-gastroenterology and infectious diseases Department, Al-Azhar University, Cairo, Egypt
| | - Ebada Mohamed Said
- Faculty of Medicine, Hepatology, Gastroenterology and Infectious Diseases Department, Benha University, Benha, Egypt
| | - Sherief Abd-Elsalam
- Faculty of Medicine, Tropical medicine and infectious diseases Department, Tanta University, Tanta, Egypt
| | - Hassan E Elbatae
- Faculty of Medicine, Department of Hepatology, Gastroenterology and infectious diseases, Kafrelsheikh University, Kafr El-Shikh, Egypt
| | - Tarik I Zaher
- Faculty of Medicine, Department of Tropical Medicine, Zagazig University, Zagazig, Egypt
| | - Shamardan Ezzeldin S Bazeed
- Faculty of Medicine, Tropical Medicine and Gastroenterology Department, South Valley University, Qena, Egypt
| | - Ahmed Abdel-Razik
- Faculty of Medicine, Department of Tropical Medicine, Mansoura University, Mansoura, Egypt
| | - Salem Youssef Mohamed
- Faculty of Medicine, Department of Internal Medicine, Zagazig University, Zagazig, Egypt
| | - Asem Elfert
- Faculty of Medicine, Tropical medicine and infectious diseases Department, Tanta University, Tanta, Egypt
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Ben Ahmed H, Allouche E, Bouzid K, Zrelli S, Hmaidi W, Molahedh Y, Ouechtati W, Bezdah L. Impact of Ramadan fasting on lipid profile and cardiovascular risk factors in patients with stable coronary artery disease. Ann Cardiol Angeiol (Paris) 2021; 71:36-40. [PMID: 33642044 DOI: 10.1016/j.ancard.2020.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/04/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The effects of Ramadan fasting (RF) on cardiometabolic risk factors in patients with stable ischemic heart disease are not well known. AIM The aim of this study was to evaluate the impact of RF on lipid profile and cardiovascular risk factors in patients with a stable coronary heart disease. METHODS A prospective observational study carried out in the Cardiology department of Charles Nicolle Hospital (Tunisia). Eighty-four patients with a stable ischemic heart disease who intended to fast were enrolled during May 2020. Detailed clinical and biochemical assessments were performed before and after the holy month. Parameters of glycemic control, lipid profile, ultrasensitive C-reactive protein concentration (us-CRP) and homocysteine were performed before- and after- Ramadan (BR and AR, respectively). RESULTS Eighty-four patients including 79 males and 5 females, with a mean age of 57±7 years completed the study. Levels of cholesterol, triglycerides, low-density lipoprotein-cholesterol and apoprotein A were significantly improved AR fasting in comparison with their BR values. There was a significant decrease in blood fasting glucose, insulin level, Homeostasis model assessment of insulin resistance index and in us-CRP level. CONCLUSION In patients with stable ischemic heart disease, RF may be accompanied by an improvement of lipid profile and glycemic parameters without increase in coronary events.
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Affiliation(s)
- Habib Ben Ahmed
- Service de Cardiologie, Hôpital Charles Nicolle, Tunis, Tunisie.
| | - Emna Allouche
- Service de Cardiologie, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Kahena Bouzid
- Service de Biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Sabrine Zrelli
- Service de Biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Wided Hmaidi
- Service de Biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie
| | - Yosra Molahedh
- Service de Biochimie clinique, Hôpital Charles Nicolle, Tunis, Tunisie
| | | | - Leila Bezdah
- Service de Cardiologie, Hôpital Charles Nicolle, Tunis, Tunisie
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Balasubramanian P, DelFavero J, Ungvari A, Papp M, Tarantini A, Price N, de Cabo R, Tarantini S. Time-restricted feeding (TRF) for prevention of age-related vascular cognitive impairment and dementia. Ageing Res Rev 2020; 64:101189. [PMID: 32998063 DOI: 10.1016/j.arr.2020.101189] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/04/2020] [Accepted: 09/21/2020] [Indexed: 12/13/2022]
Abstract
Aging is the most significant risk factor for vascular cognitive impairment (VCI), and the number of individuals affected by VCI is expected to exponentially increase in the upcoming decades. Yet, there are no current preventative or therapeutic treatments available against the development and progression of VCI. Therefore, there is a pressing need to better understand the pathophysiology underlying these conditions, for the development of novel tools and interventions to improve cerebrovascular health and delay the onset of VCI. There is strong epidemiological and experimental evidence that lifestyle factors, including nutrition and dietary habits, significantly affect cerebrovascular health and thereby influence the pathogenesis of VCI. Here, recent evidence is presented discussing the effects of lifestyle interventions against age-related diseases which in turn, inspired novel research aimed at investigating the possible beneficial effects of dietary interventions for the prevention of cognitive decline in older adults.
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Affiliation(s)
- Priya Balasubramanian
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging/Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jordan DelFavero
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging/Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anna Ungvari
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging/Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Magor Papp
- International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Amber Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging/Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary; Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Nathan Price
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Rafael de Cabo
- Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Stefano Tarantini
- Vascular Cognitive Impairment and Neurodegeneration Program, Reynolds Oklahoma Center on Aging/Center for Geroscience and Healthy Brain Aging, Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine/Department of Public Health, Semmelweis University, Budapest, Hungary; Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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Amin OA, Alaarag A. The safety of Ramadan Fasting following Percutaneous Coronary Intervention. BMC Cardiovasc Disord 2020; 20:489. [PMID: 33213367 PMCID: PMC7678075 DOI: 10.1186/s12872-020-01784-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This work aimed to assess the safety of Ramadan Fasting following the Percutaneous Coronary Intervention. METHODS In our two centers' Prospective Cohort Study, We included 303 patients who had successful Percutaneous Coronary Intervention before the first day of Ramadan. We advised the patients that recent Percutaneous Coronary Intervention could be a valid excuse for not fulfilling Ramadan Fasting. However, many patients intended to fast the following Ramadan, and we included them in the fasting Group I. We added the patients who decided not to fast the following Ramadan as a control Group II. We followed all the patients during Ramadan and for 6 months after Ramadan. RESULTS The demographic data of both groups and the complexity of the coronary anatomy showed no statistically significant difference. Group I (n = 153) showed a statistically significant difference in the incidence of Major Adverse Cardiac Events compared to Group II with a P value (0.005). The logistic multivariate regression analysis showed that the duration from index PCI till the start of RF, SYNTAX score > 22, and Complex procedure were independent predictors of Major Adverse Cardiac Events in the fasting Group I with {P = 0.001, OR (2.302), P = 0.026, OR (2.419), and P = 0.032 OR (1.952)}, respectively. Major Adverse Cardiac Events in Group I occurred mainly during Ramadan Fasting, with 19 patients having Major Adverse Cardiac Events during Ramadan and four patients during the remaining of the follow-up period. The Receiver Operating Characteristic curve analysis showed the decline of the incidence of Major Adverse Cardiac Events after 90 days from Percutaneous Coronary Intervention till the start of Ramadan Fasting with Sensitivity and specificity (90% and 65%), respectively. CONCLUSIONS We suggest that low-risk patients with a normal systolic function who underwent Percutaneous Coronary Intervention may safely fast Ramadan. At the same time, Ramadan Fasting during the first 3 months following the Percutaneous Coronary Intervention may not be safe.
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Affiliation(s)
- Osama A Amin
- Department of Cardiology, Beni Suef University, Beni Suef, Egypt.
| | - Ahmed Alaarag
- Department of Cardiology, Tanta University, Tanta, Egypt
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Elamari S, Elaziz S, Chadli A, Farouqi A. [Management of diabetes during Ramadan fasting: applications of international recommendations in clinical practice]. Pan Afr Med J 2020; 36:316. [PMID: 33193970 PMCID: PMC7603823 DOI: 10.11604/pamj.2020.36.316.7201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 06/19/2018] [Indexed: 11/24/2022] Open
Abstract
Le jeûne n’est pas sans risques chez les patients diabétiques. L’objectif de notre étude est d’évaluer l’impact du jeûne chez une cohorte de patients diabétiques ayant bénéficié d’une préparation au jeûne avec ajustement des traitements selon les recommandations de l’association américaine du diabète (ADA) en 2010. Il s’agit d’une étude prospective de cohorte menée en 2014, incluant des patients diabétiques désirants jeûneer au cours du mois de Ramadan consentant pour participer à l’étude. Nous avons exclu les patients considérés comme à très haut risque selon la classification de l’ADA. Les patients ont bénéficié d’une consultation avant le mois du Ramadan (J0) comprenant éducation et ajustement du traitement, suivi d’une consultation au cours du Ramadan (J7) puis à J30 et à J60. Notre étude a inclus 34 patients, dont 60% sont des femmes, d’âge moyen de 50,4 ans avec une ancienneté moyenne du diabète de 6,2 ans et un index de masse corporelle (IMC) moyen de 27,83 kg/m2. Les ajustements thérapeutiques réalisés (J0) étaient une diminution de la dose de sulfamides hypoglycémiants (SH) et la mise sous gliptine chez les patients à risque hypoglycémique, ainsi qu’une répartition de la dose de metformine. Au cours de la première semaine (J7), deux patients ont présenté une glycémie inférieure à 0,7g/l avant la rupture du jeûne, 38% de l’échantillon ont présenté une glycémie >2g/l après la rupture du jeûne. Nous avons noté des erreurs diététiques chez 15% des patients. L’ajustement à (J7) a consisté à adapter la dose du SH ou à ajouter une gliptine. Aucun patient n’a présenté d’hyperglycémie majeure, de cétose ou d’hypoglycémie grave. Une patiente a présenté une arythmie complète par fibrillation atriale (ACFA) sur cardiopathie ischémique méconnu avec arrêt du jeûne. Trois patients ont arrêté le jeûne entre J15 et J20 devant une asthénie intense sans déséquilibre glycémique. La moyenne d’HBA1C chez les patients après le jeûne était de 7,10 versus 6,8% avant le jeûne (p=0.42). Les facteurs significativement associés au déséquilibre glycémique après le jeûne avec des HBA1C > à 8% étaient principalement les taux d’HBA1C de départ (p=0.002), l’absence d’autosurveillance (p=0.01), et l’ancienneté du diabète (p=0.06). Une bonne évaluation du niveau de risque du patient, une éducation thérapeutique, une autosurveillance glycémique et un ajustement du traitement selon les recommandations internationales, permettent aux patients diabétiques musulmans de diminuer le risque lié au jeûne. Néanmoins une consultation au cours du Ramadan (J7) permet une correction des erreurs diététiques et un ajustement thérapeutique si cela est nécessaire.
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Affiliation(s)
- Saloua Elamari
- Service d'Endocrinologie du CHU Ibn Rochd, Casablanca, Maroc
| | - Siham Elaziz
- Service d'Endocrinologie du CHU Ibn Rochd, Casablanca, Maroc
| | - Asmaa Chadli
- Service d'Endocrinologie du CHU Ibn Rochd, Casablanca, Maroc
| | - Ahmed Farouqi
- Service d'Endocrinologie du CHU Ibn Rochd, Casablanca, Maroc
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Taetzsch A, Roberts SB, Bukhari A, Lichtenstein AH, Gilhooly CH, Martin E, Krauss AJ, Hatch-McChesney A, Das SK. Eating Timing: Associations with Dietary Intake and Metabolic Health. J Acad Nutr Diet 2020; 121:738-748. [PMID: 33187926 DOI: 10.1016/j.jand.2020.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 09/27/2020] [Accepted: 10/06/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Emerging research indicates that eating timing may influence dietary intake and metabolic health. However, studies to date have not examined the association of multiple measures of eating timing with both dietary intake and metabolic health in adults with overweight and obesity. OBJECTIVE To examine the association of multiple measures of eating timing with dietary intake (ie, dietary composition, diet quality, and eating frequency) and metabolic health (ie, body composition and cardiometabolic risk). DESIGN This is a cross-sectional analysis of baseline data from a weight loss and maintenance intervention collected from May 2015 to January 2018. PARTICIPANTS/SETTING Participants were women with overweight or obesity who were dependents of active duty and retired military personnel (N = 229; mean ± standard error, BMI = 34.7 ± 0.4 kg/m2, age = 40.9 ± 0.7 years). The study was conducted at military installations in Massachusetts, Connecticut, New York, Colorado, and Kentucky. MAIN OUTCOME MEASURES Eating timing variables examined included daily eating interval (time between first and last eating occasion), time-restricted eating (≤11 hours daily eating interval), early energy eaters (eating ≥60% of energy during the first half of time awake), and bedtime eaters (eating within 2 hours of bedtime). STATISTICAL ANALYSIS The main analysis was limited to those reporting plausible energy intake (64% of total sample [n = 146]). Linear, quantile, or logistic regression models were used to determine the association of eating timing with measures of dietary intake and metabolic health. RESULTS In individuals reporting plausible energy intake, each additional 1 hour in daily eating interval was associated with 53 kcal higher energy intake, higher glycemic load, eating frequency, and waist circumference (P < 0.05 for all). Significant associations were observed for: time-restricted eating and a lower energy intake, glycemic load, and eating frequency; early energy eating and higher carbohydrate intake; bedtime eating and a higher energy intake, glycemic load, and eating frequency. CONCLUSIONS These findings lend support for the mechanistic targeting of eating timing in behavioral interventions aimed at improving dietary intake and body composition.
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D'Souza MS, Dong TA, Ragazzo G, Dhindsa DS, Mehta A, Sandesara PB, Freeman AM, Taub P, Sperling LS. From Fad to Fact: Evaluating the Impact of Emerging Diets on the Prevention of Cardiovascular Disease. Am J Med 2020; 133:1126-1134. [PMID: 32569590 DOI: 10.1016/j.amjmed.2020.05.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 02/06/2023]
Abstract
Cardiovascular disease remains one of the most prevalent and preventable chronic conditions worldwide. Diet modification is the foundation of cardiovascular disease prevention. Several dietary approaches have emerged to promote better cardiovascular health. The rapid dissemination of anecdotal and observational data through the internet and social media has caused confusion amongst providers and patients. The aim of this comprehensive review is to present objective insights into 2 of today's most popular fad diets: ketogenic diet and intermittent fasting. We will evaluate the performance of these diets based on their impact on cardiovascular risk factors.
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Affiliation(s)
- Melroy S D'Souza
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, Ga
| | - Tiffany A Dong
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, Ga
| | | | - Devinder S Dhindsa
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga
| | - Anurag Mehta
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga
| | - Pratik B Sandesara
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga
| | - Andrew M Freeman
- Division of Cardiology, Department of Medicine, National Jewish Health, Denver, Colo
| | - Pam Taub
- Stepfamily Foundation Cardiovascular Wellness and Rehabilitation Center, Division of Cardiovascular Medicine, University of California San Diego
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Ga.
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Binsalih S, Al Sayyari RA, Sheikho M, Hejaili FF, Al Sayyari AA. Effect of Fasting the Whole Month of Ramadan on Renal Function Among Muslim Patients With Kidney Transplant: A Meta-Analysis. EXP CLIN TRANSPLANT 2020; 17:588-593. [PMID: 31570092 DOI: 10.6002/ect.2019.0245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Muslim renal transplant patients often ask whether fasting during Ramadan would be harmful to their kidneys. We performed a meta-analysis on relevant studies to answer this question. MATERIALS AND METHODS We searched 4 databases using comprehensive search terms with predefined eligibility criteria. Two reviewers (FH and RA) independently assessed the relevance of studies obtained during the search. If disagreement occurred, a consensus would be sought; if disagreement persisted, the arbitration would be left to a third author (AAS). RESULTS Eight studies (549 patients) were identified as eligible; these studies measured renal function before and after Ramadan with patients acting as their own controls in 5 studies. Our pooled analyses showed no significant changes after fasting with regard to estimated glomerular filtration rate (70.1 ± 9.1 vs 68.5 ± 7.5 mL/min, respectively; P = .6) or in serum creatinine levels (105.3 ± 8.8 and 106.1 ± 6.0 μmol/L, respectively; P = .47). In 4 self-controlled studies (148 patients) that had analyzed changes in systolic and diastolic blood pressure before versus after fasting, no significant differences were shown. However, in 3 studies that assessed changes in glomerular filtration rate in fasting (n = 358) versus nonfasting patients (n = 355), there was a significant difference in change in glomerular filtration rate following Ramadan fasting (-0.13 ± 1.2 mL/min in those who fasted versus 4.2 ± 4.6 mL/min in those who did not fast; P = .039); however, these results were associated with significant publication bias (systematic heterogeneity). CONCLUSIONS Fasting during Ramadan did not result in significant changes in kidney function or blood pressure in posttransplant patients with good baseline kidney function when patients acted as their own controls.
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Affiliation(s)
- Salih Binsalih
- From the King Saudi Bin Abdulaziz University for Heath Sciences, Riyadh, Kingdom of Saudi Arabia
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Intermittent Fasting Enhanced the Cognitive Function in Older Adults with Mild Cognitive Impairment by Inducing Biochemical and Metabolic changes: A 3-Year Progressive Study. Nutrients 2020; 12:nu12092644. [PMID: 32872655 PMCID: PMC7551340 DOI: 10.3390/nu12092644] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
Intermittent fasting (IF) refers to various dietary regimens that cycle between a period of non-fasting and a period of total fasting. This study aimed to determine the effects of IF on cognitive function among elderly individuals who practice IF who have mild cognitive impairment (MCI). A total of 99 elderly subjects with MCI of Malay ethnicity without any terminal illness were recruited from a larger cohort study, LRGS TUA. The subjects were divided into three groups, comprising those who were regularly practicing IF (r-IF), irregularly practicing IF (i-IF), and non-fasters (n-IF). Upon 36 months of follow-up, more MCI subjects in the r-IF group reverted to successful aging with no cognitive impairment and diseases (24.3%) compared to those in i-IF (14.2%) and n-IF groups (3.7%). The r-IF group’s subjects exhibited significant increment in superoxide dismutase (SOD) activity and reduction in body weight, levels of insulin, fasting blood glucose, malondialdehyde (MDA), C-reactive protein (CRP), and DNA damage. Moreover, metabolomics analysis showed that IF may modulate cognitive function via various metabolite pathways, including the synthesis and degradation of ketone bodies, butanoate metabolism, pyruvate metabolism, and glycolysis and gluconeogenesis pathways. Overall, the MCI-afflicted older adults who practiced IF regularly had better cognitive scores and reverted to better cognitive function at 36 months follow-up.
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Effects of Time-Restricted Feeding during Ramadan on Dietary Intake, Body Composition and Metabolic Outcomes. Nutrients 2020; 12:nu12082478. [PMID: 32824528 PMCID: PMC7468808 DOI: 10.3390/nu12082478] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022] Open
Abstract
Ramadan fasting is a form of time-restricted feeding which combines a fast and feast period daily for a duration of one month every year. During Ramadan, Muslims abstain from food and drink consumption from dawn till sunset and this change in the meal schedule and frequency results in significant changes to the composition of the diet, such as energy and nutrient intake. These changes in dietary habits and their corresponding effects on cardiometabolic disease risk are compiled in this review. Ramadan fasting shows limited benefits to body composition via reductions in body mass in both healthy and obese individuals, although the results are often found to be transient and heterogeneous. There is, however, a more consistent improvement in blood lipid profile during Ramadan fasting, which often lasts beyond the Ramadan period. The results for glucose homeostasis, on the contrary, are more conflicting and inconclusive. The heterogeneity in the findings from the various studies can be generally attributed to cultural variations in dietary habits, differences in the duration of fasting due to seasonal/climatic differences at various geographical locations, age, gender and socioeconomic status, as well as other health and lifestyle factors of the various study populations.
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Ramadan Intermittent Fasting Affects Adipokines and Leptin/Adiponectin Ratio in Type 2 Diabetes Mellitus and Their First-Degree Relatives. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1281792. [PMID: 32775407 PMCID: PMC7407010 DOI: 10.1155/2020/1281792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 07/07/2020] [Accepted: 07/20/2020] [Indexed: 12/02/2022]
Abstract
Background In view of the association of Ramadan intermittent fasting with profound changes in lifestyle both in nondiabetic and diabetic patients, the aim of this study was to investigate the effect of Ramadan fasting on adiponectin, leptin and leptin to adiponectin ratio (LAR), growth hormone (GH), human-sensitive C-reactive protein (hs-CRP), and diabetic and metabolic syndrome factors in patients with Type 2 Diabetes Mellitus (Type 2 DM), their first-degree relatives (FDRs), and healthy controls. Methods This cohort study involved 98 Yemeni male subjects aged 30-70 years old: 30 Type 2 DM, 37 FDRs of Type 2 diabetic patients, and 31 healthy control subjects. Subjects' body mass index (BMI), waist circumference (WC), and blood pressure (BP) were measured, and venous blood samples were collected twice: the first samples were collected a couple of days prior to Ramadan fasting (baseline) and the second samples after 3 weeks of fasting. Results Ramadan fasting did not affect BMI, WC, and BP in Type 2 DM and their FDRs with respect to the baseline levels prior to Ramadan, whereas triglyceride and cholesterol were borderline significantly decreased in Type 2 DM with no effect in FDRs. Fasting blood glucose was not affected in Type 2 DM but was significantly increased in FDRs and control groups, whereas glycated haemoglobin (HbA1c) was slightly decreased in Type 2 DM, FDRs, and healthy controls. C-peptide, insulin, and insulin resistance (HOMA-IR) were significantly increased in Type 2 DM and FDRs, with no effect in the control group, whereas β-cell function (HOMA-β) was significantly decreased in FDRs and controls with no change in Type 2 DM. Ramadan fasting significantly decreased GH in both FDRs and control groups, and significantly increased hs-CRP in the control with no effect in Type 2 DM and FDRs. Adiponectin was significantly decreased, and leptin and LAR were significantly increased in Type 2 DM, FDRs, and control groups. Conclusion Ramadan intermittent fasting decreased adiponectin and increased leptin, LAR, insulin, and insulin resistance in both Type 2 DM and FDRs as well as decreased GH in both FDRs and healthy controls and increased hs-CRP in healthy controls. Moreover, Ramadan intermittent fasting neither worsens a patient's glycemic parameters nor improves it, with the exception of a slight improvement in HbA1c in Type 2 DM, FDRs, and healthy controls.
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