Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301Food Choices during Ramadan4949860810.22038/jfh.2017.20739.1077ENThamina RashidDiet and Education Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PakistanMuhammad Yakoob AhmedaniDepartment of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PakistanRubina HakeemDiet and Education Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PakistanMusarrat RiazDepartment of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, PakistanJournal Article20161214<span lang="EN-CA">Few studies have assessed the dietary Practices of people with diabetes during Ramadan (1). A sub study of Ramadan prospective diabetes study (2) which was conducted at the outpatient department of Baqai Institute of Diabetology and endocrinology, Karachi Pakistan in 2009 analyzed the food choices of patients with diabetes during Ramadan. Several irregularities regarding dietary intake and food choices were noted among the study participants. Although, the patients were counseled regarding diet before Ramadan, many did not follow the dietary advice. All patients had taken food at Iftar but majority of them preferred fried items like samosas, pakoras (fried snack), chicken rolls etc. these deeply fried items can lead to post Iftar hyperglycemia. Patients were also opted for fruit chat, dahibara and chanachaat at Iftar, higher load of these items can also worsen glycemic control. The striking finding was almost absence of meat (protein) intake at Iftar but study from India showed increment of all three macronutrients during Ramadan (3). This may result in higher intake of items from carbohydrate and fat groups resulting in hyperglycemia after iftar. Intake of vegetables at Iftar was also negligible and hence the diet was not well balanced. The food choices at sahoor included roti, paratha (fried bread), slices, khajla, pheni, meat, egg and milk. Though it is advisable to take complex carbohydrates, protein and fat at sahoor as these are slowly digestible and can prevent hypoglycemia during fasting but khajla pheni are extremely rich in fat and carbohydrate content and should be avoided (4). However, paratha in 2 teaspoon of oil can be taken at sahoor.Patients with diabetes who fast during the month of Ramadan should have pre Ramadan dietary guidance and counseling session in order to modify their food preferences and choices during the holy month of Ramadan (4).</span>Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301Effects of Ramadan Fasting on Common Upper Gastrointestinal Disorders: A Review of the Literature2023827210.22038/jfh.2017.20258.1075ENNajmeh SeifiDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad HashemiDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-04525-A125-9874Mohammad SafarianDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranVahid HadiDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMojtaba RaeisiGolestan University of Medical Sciences, Department of Nutrition, Gorgan, IranJournal Article20161119<strong>Introduction:</strong> Ramadan is the ninth month of Muslim's calendar during which Muslims fast. Ramadan lasts 29-30 days based on the visual sightings of the crescent moon. Fasting during Ramadan has significant health effects. The present study aimed at reviewing the literature of the impact of Ramadan fasting on upper gastrointestinal disorders. <strong>Methods</strong>: MEDLINE and Google Scholar were searched by using ((“Ramadan” R fasting”) AND( "Upper Gastrointestinal Tract" OR "Gastrointestinal Diseases" OR "Dyspepsia" OR "Gastroesophageal Reflux" OR "Peptic Ulcer" OR "Gastrointestinal Hemorrhage")) as keywords in the title and abstract. Relevant, non- duplicate full articles written in English were reviewed. <strong>Results:</strong> Gastric acid and pepsin secretion increase during Ramadan fasting, probably associated with dyspeptic symptoms. Regarding peptic ulcer frequency, results are inconsistent. However, peptic ulcer complications such as gastrointestinal bleeding and peptic ulcer perforation increase during Ramadan fasting. <strong>Conclusion:</strong> Fasting during Ramadan seems to be beneficial for healthy individuals, but in people with gastrointestinal disorders, it might be harmful as it increases the risk of complications. Therefore, taking medical advice before Ramadan fasting is highly recommended to people suffering from gastrointestinal symptoms.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301Favorable Cardio-Metabolic Outcomes Following High Carbohydrate Intake in Accordance with the Daniel Fast: A Review of Available Findings3848860910.22038/jfh.2017.22347.1083ENRichard BloomerUniversity of MemphisMatthew ButawanUniversity of MemphisJournal Article20170303The Daniel Fast is a biblically inspired dietary program rich in carbohydrate, most closely resembling a vegan diet but with additional restrictions, including the elimination of processed foods, white flour products, preservatives, additives, sweeteners, caffeine, and alcohol. While no specific requirements are placed on the ingestion of specific percentages of macronutrients, the mean daily carbohydrate intake is by default approximately 60%, while protein and fat intake are 15% and 25%, respectively. Despite a relatively high carbohydrate intake, multiple favorable cardio-metabolic effects are noted when following the plan, in as few as three weeks. This includes improvements in HOMA-IR, which may be at least in part due to the lower glycemic load and high dietary fiber content of the foods consumed. Other notable changes include reductions in systemic inflammation, total and LDL-cholesterol, oxidative stress, blood pressure, and body weight/body fat. Short and moderate-term compliance to the program is excellent-better than most dietary programs, perhaps due to the <em>ad libitum</em> nature of this plan. This paper presents an overview of the Daniel Fast, a carbohydrate-rich dietary program, including relevant findings from both human and animal investigations using this dietary model.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301The Association between Health-Related Quality of Life and Ramadan Fasting in Diabetic Patients: A Survey Using A Structured D-39 Assessment Tool. A Sudanese Cohort2430834310.22038/jfh.2017.21682.1080ENAhmed Osman MahgoubMinistry of health - SudanElamin AbdelgadirDubai Hospital, Dubai Health AuthorityJournal Article20170129<strong>Introduction:</strong> Most cases of chronic diseases result in physical, psychological, financial, and social burdens on the patients and the economy. The overall health-related quality of life of patients can be positively influenced by several variables including glycemic control, economic status, comorbidities, presence of complications, and the quality of medical, psychological, and social support. Studies examining the effects of fasting on diabetes during Ramadan fasting underline the biochemical changes without considering the psychosocial and financial implications. This study aimed to illuminate some of the challenges faced by both fasting and non-fasting diabetic patients during Ramadan.Further, we evaluated the quality of life of diabetes patients, explored the socio-demographic and disease-related variables, and estimated the percentage of diabetic patients who fasted during Ramadan. <strong>Methods:</strong> This was a community-based cross-sectional study conducted from August 2015 to October 2015. Diabetes 39 instrument was administered to 112 patients with diabetes in Khartoum to evaluate their health-related quality of life during Ramadan. <strong>Results:</strong> Fifty-four percent of study participants were female and 64.3% of them were aged between 40-60 years old. Sixty-two participants were able to fast (55.4%) and fasted for more than 15 days. Half of the participants had, at least, one comorbidity, among which hypertension was the most common. Approximately 59% of fasting patients had mild impairment in their health-related quality of life, whereas 60% of non-fasting participants had moderate impairment. Limited stamina, and fear of hypoglycemia were the items with the highest mean scores in both groups. The fasting group had a lower average score (2.88) compared to the non-fasting group (3.66). This difference was statistically significant (p=0.033). <strong>Conclusion:</strong> Over 53% of study patients fasted for at least 1 day during Ramadan. Interestingly, Patients who fasted had a better health-related quality of life when compared to those who did not fast. Patients with hypertension and cardiac diseases were the subjects least able to fast during Ramadan.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301The Effect of Ramadan Fasting on Tuberculin Skin Test and Leukocyte Count15817910.22038/jfh.2017.20130.1072ENJafar NasiriAssistant Professor, Department of Internal Medicine, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranAbolfazl KhoshdelAssociate Professor, Department of Pediatrics, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IranSoleiman KheiriAssociate Professor, Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, IranAmirgholi Jafari BoroujeniAssistant Professor, Islamic Medicine Research Committee, Shahrekord University of Medical Sciences, Shahrekord, IranJournal Article20161113<strong>Introduction</strong>: Annually, many Muslims fast during the month of Ramadan worldwide. This practice has different favorable medical and physiological effects, such as improved serum lipid profile and blood glucose level due to changes in diet and sleep patterns. It has also been hypothesized that Ramadan fasting may affect the immune system. As reported, Ramadan fasting can influence the immunoglobulin and cytokine levels. Accordingly, tuberculin skin test or purified protein derivative (PPD) test, which is a delayed-type hypersensitivity of cellular immune response, may also be affected by Ramadan fasting. Regarding this, the present study aimed to investigate the alteration of PPD test during and after Ramadan. <strong>Methods</strong>: A total of 42 males (seminary students) who fasted during Ramadan in 2006 were included in the study; however, only 28 cases completed the study. For data collection, the participants underwent blood and tuberculin tests at the fourth week of Ramadan and three months after this month. The white blood cell (WBC) count and the tuberculin induration were recorded and compared between the two intervals to evaluate the changes. <strong>Results</strong>: According to the results of the study, the mean age of the participants was 19.21±3.83 years. Furthermore, the mean tuberculin induration was 9.3±5.4 mm (size range: 2-22 mm) on the fourth week of Ramadan, which increased to 9.79±6.8 mm (size range: 3-35 mm) three months after this month (P=0.501). The mean count of WBC decreased insignificantly from 5907±1879 mcL to 5601±1362 mcL after Ramadan (P=0.334). Additionally, the mean lymphocytes count decreased significantly from 2292±520/mcL to 2023±486/mcL after this month (P=0.003). Likewise, the lymphocyte (P=0.014) and mean neutrophil percentage also reduced significantly (P<0.001). However, there was no association between PPD test and WBC, lymphocyte, or neutrophil count (P>0.05). <strong>Conclusion</strong>: As the findings of the present study indicated, Ramadan fasting induce some changes in the immune status, including lymphocyte and neutrophil percentage and count; however, it does not affect the PPD results.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301Effects of Fasting and Detraining on Body Composition, Lipid Profile and Maximum Oxygen Uptake of Active Postmenopausal Women611828410.22038/jfh.2017.20231.1074ENSeyyed Reza Attarzadeh HosseiniProfessor in Sport Physiology, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad, IranSamaneh FarahatiPh.D Student of Sport Physiology, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad, IranJournal Article20161118<strong>Introduction:</strong> During Ramadan, type and amount of energy intake dramatically change in Muslims and fasting individuals often reduce the duration and intensity of physical activities or avoid exercise during this month. However, one of the major issues of trainers and athletes is lack of training, which could have adverse effects on some cardiovascular parameters. <strong>Methods:</strong> This research was conducted on 19 healthy menopausal women, selected via convenience and purposive sampling. Two study groups consisted of inactive menopausal women with fasting (n=9) and fasting women with a detraining period (n=10), who regularly exercised before Ramadan, but avoided physical activity during this month. Anthropometric indices, maximum oxygen uptake and lipid profile indicators of the samples were measured before and after Ramadan. Data analysis was performed using Student's t-test. <strong>Results:</strong> In this study, no significant changes were observed in the body composition indicators: body mass index, body fat percentage and waist-to-hip ratio of the study groups. According to our findings, while the maximum oxygen uptake decreased in both groups, this reduction was not statistically significant. In addition, while high-density lipoprotein levels significantly decreased and low-density lipoprotein levels significantly increased, no significant changes were observed in the levels of total cholesterol and triglyceride in the fasting with a detraining period group. <strong>Conclusion:</strong> According to the results of this study, while fasting for one month led to no significant improvement in the cardiovascular risk factors of inactive postmenopausal women, it had no adverse effect on lipid profile indicators.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301The Effect of Regular Walking and Alternate Day Fasting on Health-Related Factors in Overweight and Obese Females1219822610.22038/jfh.2017.21121.1079ENRoya SeighaliDepartment of Physical Education, Rasht Branch, Islamic Azad University, Rasht, Iran0000-0002-4827-5957Zahra Hojjati ZidashtiDepartment of Physical Education, Rasht Branch, Islamic Azad University, Rasht, Iran0000-0002-7058-1416Journal Article20170103<strong>Introduction: </strong>Obesity is a complex health problem. The aim of this study was to determine the effects of regular walking with alternate day fasting (ADF) on health-related factors of overweight and obese females. <strong>Methods</strong>: 30 healthy inactive, overweight and obese women were divided randomly into three equal groups. The groups were: control group (BMI: 30.72±4.40 kg/m<sup>2</sup>); the experimental group I: ADF along with regular walking with 50% to 65% maximal heart rate (BMI: 28.69 ±2.81 kg/m<sup>2</sup>) and the experimental group II: ADF (BMI: 30.56 ±3.66 kg/m<sup>2</sup>). Participants were under the diet for six weeks. The diet ADF means that, they had days of fasting and free day (with regular walking), alternately. Two days before and two days after the end of the study, the participants’ fasting blood sugar were measured after 12 hours. Resting heart rate, blood pressure and body composition were assessed in the same day. The collected data were analyzed using paired t-test and ANOVA test. <strong>Results: </strong>Body mass index in both experimental groups had significant decrease (P<0.05). Decreasing body fat percent, from pre-test to post test was significant only in the experimental group I (P=0.006). The significant difference was found between groups in this reduction (P<0.05). In the experimental group II, lean body mass showed significant increase and blood glucose showed significant decrease (P<0.05). No significant changes were found in other variables (P>0.05). <strong>Conclusion: </strong>The regular walking program and ADF diet is an effective method for improving body mass index, body fat percentage and blood sugar.Mashhad University of Medical Sciences (MUMS)Journal of Nutrition,Fasting and Health2821-27465120170301Impact of Ramadan Fasting on Energy Intake and Anthropometry of Type 2 Diabetics-Study in Two Regions of the Central Highlands and Southeastern Algeria3137860610.22038/jfh.2017.22333.1082ENMeriem BencharifInstitute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother`s Mentouri Constantine (UFMC), Algeria0000-0002-0679-2032Amal FenaghraInstitute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother`s Mentouri Constantine (UFMC), AlgeriaChaima BoudaoudInstitute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother`s Mentouri Constantine (UFMC), AlgeriaNour El Houda HadjiInstitute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother`s Mentouri Constantine (UFMC), AlgeriaHamida BenyayaInstitute of Nutrition, Food and Agro-Food Technologies (INATAA), University of Brother`s Mentouri Constantine (UFMC), AlgeriaYoucef BenabbasService of Internal Medicine, Hospital University, Constantine, AlgeriaJournal Article20170302 <br /> <strong><span style="letter-spacing: 0.2pt; font-family: 'Cambria','serif'; font-size: 9pt;">Introduction:</span></strong><span style="font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52'; mso-bidi-font-weight: bold;">During the month of Ramadan, muslims change their lifestyle. The objective of this study is to evaluate the effect of Ramadan fasting on the energy intake and anthropometry of type 2 diabetics</span><span style="font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52';">. </span><strong><span style="font-family: 'Cambria','serif'; font-size: 9pt;">Methods:</span></strong><span style="font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52';">Epidemiological study by questionnaire were collected before (T0), during (T1) and after (T3) Ramadan 2013. The data were collected during medical consultations in sanitary establishments in two regions of the central highlands (Boussaâda) and the south-east of Algeria (Djamaâ). The survey card concerned a food recording and anthropometry repeated during the 3 time periods mentioned before. </span><strong><span style="letter-spacing: -0.2pt; font-family: 'Cambria','serif'; font-size: 9pt;">Results:</span></strong><span style="letter-spacing: -0.2pt; font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52';">The study concerned 476 diabetics (255 women, 221 men) with the mean age of 54.9±4.7 years old. 66.4% of diabetics of Boussaâda and 61.8% of Djamaâ followed nutritional education sessions preparing for fasting (p˃0.05). The number of fasting days during the month of Ramadan is 24.0±1.7days. By comparing both of the regions, no significant difference was observed in the energy intake distribution and in macronutriments of the diabetics (p>0.05). By comparing the 3 periods, the diabetics of Boussaâda had an energy intake significantly increased at T1 (p=0.000). In Djamaâ, the energy intake decreased from T0 to T2 (p=0.000). The energy distribution of macronutrients remained stable (p>0.05) between the three periods. Body mass index, waist circumference and the waist-to-hip ratio were significantly decreased from T0 to T2 (p<0.05). </span><strong><span style="line-height: 115%; letter-spacing: -0.2pt; font-family: 'Cambria','serif'; font-size: 9pt;">Conclusion:</span></strong><span style="line-height: 115%; letter-spacing: -0.2pt; font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52';">Ramadan had an influence on the energy intake and anthropometry of diabetics. Food consumed during the fast-breaking meal is characterized by its richness in carbohydrates and lipids. Nutritional education sessions provide the diabetic patients deciding to fast with a chance for properly managing their condition</span><span style="line-height: 115%; font-family: 'Cambria','serif'; font-size: 9pt; mso-bidi-font-family: 'Al-Kharashi 52';">.</span><br />