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Results
Fasting caused a significant reduction in weight and BMI
in men, and in waist circumference in women (Table 1).
Neither systolic nor diastolic blood pressure was affected by
Ramadan fasting. Fasting plasma glucose decreased
significantly in both men (P<0.0001) and women
(P<0.0001). None of the participants reported symptoms of
hypoglycaemia during fasting. There was a significant
correlation in women between fasting serum glucose and total
calorie intake (P=0.001). We detected improvements in the
lipid profile of both men and women. Serum T-C, TG and
LDL-C decreased and HDL-C increased significantly with
Ramadan fasting. There was a significant correlation between
reduced calorie intake and increased HDL-C in women
(P<0.03). Reduction of calorie intake also correlated with a
decrease in LDL-C in men (P=0.08). A significant reduction
in total daily calorie intake occurred during Ramadan in both
women and men (Table 2). The average duration of the daily
fast was 11.50.5 hours.
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Fakhrzadeh et al.
Effect of Ramadan Fasting on Clinical and Biochemical Parameters
TABLE 1. Anthropometric and biochemical parameters before and at the end of Ramadan (meanSD).
Men
Weight (kg)
Waist circumsference (cm)
BMI (kg/m2)
TG (mg/dL)
T-C (mg/dL)
LDL-C (mg/dL)
HDL-C (mg/dL)
FPG (mg/dL)
Systolic BP (mmHg)
Diastolic BP (mmHg)
Women
Baseline
28th day
P value
Baseline
28th day
P value
64.9 8.4
74.2 10.4
21.8 2.6
118.6 45.6
182.6 32.2
119.3 28.5
39.9 7.1
87.5 8.8
117.7 11.4
74.9 9.8
63.7 7.9
75.0 6.0
21.4 2.5
74.4 31.0
139.6 29.3
76.4 23.5
48.3 7.2
60.8 6.5
117.2 10.6
80.1 7.9
0.002
NS
0.004
<0.0001
0.0001
<0.0001
<0.0001
<0.0001
NS
NS
60.7 13.0
81.2 12.0
24.0 4.5
130.0 85.1
202.7 28.6
127.6 28.8
48.1 10.5
89.7 9.3
103.8 12.1
68.4 12.6
60.3 14.2
78.1 12.5
23.8 5.0
105.2 64.7
143.8 40.8
80.4 28.8
62.9 18.3
65.7 18.4
103.7 11.2
70.7 8.2
NS
<0.001
NS
<0.02
<0.0001
<0.0001
<0.0001
<0.0001
NS
NS
BMI=body mass index; TG=triglycerides; T-C=total cholesterol; LDL-C=low density lipoprotein cholesterol; HDL-C=high density
lipoprotein cholesterol; FPG=fasting plasma glucose
TABLE 2. Total daily calorie intake before and at the end of Ramadan
Baseline
Men
14th day
P value
Women
Baseline
1438.0 453.0
1212.8 549.1
<0.0001
1605.6 1176.0
Discussion
In most studies on the effects of Ramadan fasting, body
weight is either lost 7-10 or unchanged 11,12 in healthy
individuals. El-Ati et al showed increased fat oxidation and
decreased carbohydrate oxidation rates with a concomitant
decrease in plasma insulin concentration during Ramadan
fasting, as adaptive mechanisms to preserve normal body
weight and composition.11
We only detected a significant decrease in weight and
body mass index (BMI) in male participants, but did record
a significant reduction in waist circumference in female
participants. Waist circumference is a more accurate
reflection of visceral obesity, which is more strongly
associated with insulin resistance, hypertension and
dyslipidaemia, and is a better predictor than BMI of vascular
events such as stroke.13-15 Reduction of visceral adipocytes
leads to a decreased concentration of free fatty acids (FFAs)
in the portal vein due to a reduction in the rate of lipolysis,
which leads to a reduction in hepatic gluconeogenesis and
VLDL secretion.
Habbal et al showed by ambulatory monitoring that any
variation in blood pressure during the month of Ramadan is
at best minimal.16 Perk et al. showed that Ramadan fasting
does not have any undesirable effects in hypertensive patients
who continued to take their medication once a day during
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14th day
1149.8 493.5
P value
<0.005
Fakhrzadeh et al.
Effect of Ramadan Fasting on Clinical and Biochemical Parameters
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