The Effect of Ethiopian Orthodox Christians ‘Abiy Tsom’ (Lent fasting) on Metabolic Syndrome Indices and Serum Electrolytes

Document Type: Research Paper


1 Biomedical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia

2 Biochemistry, Medicine, Addis Ababa University, Addis Ababa, Ethiopia

3 Department of Physiology, School of Medicine, Addis Ababa University

4 department of medical physiology, College of Health Sciences, Addis Ababa University

5 Physiology, Medicine, Addis Ababa University, Addis Ababa, Ethiopia


Background: -Fasting, the voluntary abstention from all restricted foods, is a feature of many religions, and the putative health benefits have attracted both scientific and popular interest. There is no clear understanding that religious fasting has great effects on metabolic syndrome. There is little data available that provides information concerning Ethiopian Orthodox Christians fasting influence on metabolic syndrome indices and serum electrolytes to date. Objective: -To determine the effect of ‘Abiy tsom’ (lent fasting) of Ethiopian Orthodox Christians on metabolic syndrome indices and serum electrolytes in Addis Ababa, Ethiopia Methodology: - 88 Study subjects were included conveniently who were followers of Ethiopian Orthodox Christianity faith and fasting “lent” and longitudinal cross-sectional study design was employed. Data were collected twice, the first during last week of the fasting months and the second during the last week of two months’ time after returning to usual diet. The data and sample were collected, analyzed, interpreted and was displayed by using descriptive and analytical statistical methods. Results: Our study found that Ethiopian Orthodox lent fasting had clear and significant effects on Anthropometric measurements, systolic blood pressure, lipid profiles, and Urea. It was also found that this fasting decreased the levels of Calcium and Chloride ions while Serum sodium and potassium were influenced insignificantly. Conclusion: Ethiopian Orthodox Christians lent fasting is beneficial for weight loss and fighting metabolic syndrome.


  1. Amanda J Baxter BAppSc, Terry Coyne and Christine McClintock.Dietary patterns and metabolic syndrome - a review of epidemiologic evidence.  15, Brisbane: Quens land institute of medical research, 2006, Asia Pac J Clin Nut, Vol. 2, pp. 134-142.
  2. Trepanowski JF, Robert EC, Kate EM, Mohammad MK and Richard JB. Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings. 107, memphis: biomedcenter, 2011, Vol. 10.
  3. Valter DL and Mark PM. Fasting: Molecular Mechanisms and Clinical Applications.  2, Los Angeles: NIH, February 4, 2014, Cell Metab, Vol. 19, pp. 181–192.
  4. Trepanowski JFand Bloomer RJ. The impact of religious fasting on human health. Nutr J. 2010; 9:57.
  5. Sarri KO, Tzanakis NE, Linardakis MK, Mamalakis GD and Kafatos AG. Effects of Greek Orthodox Christian Church fasting on serum lipids and obesity. BMC Public Health. 2003; 3:16.
  6. Morcos NY, Seoudi DM, Kamel I and Youssef MM. Effect of Coptic Orthodox Christian church fasting on healthy and diabetic subjects. Int J Nutr Pharmacol Neurol Dis 2013;3:375-82.
  7. Zimmet P, Alberti KG MM and Serrano RMA new international diabetes federation worldwide definition of the metabolic syndrome: the rationale and the results 12, 2005, Rev Esp Cardiol, Vol. 58, pp. 1371-6.
  8. Izet Aganović and Tina Dušek.Pathophysiology of Metabolic Syndrome. Zagreb, Croatia: University Hospital Center, 2006.
  9. Kallings L, Leijon M. and FaR. [Experiences of Prescribed Physical Activity, FaR.] Report 2003; 53. Stockholm: Swedish: National Institute of Public Health, 2003.
10. Ford ES, Kohl HW, 3rd, Mokdad AH and Ajani UA. Sedentary behavior, physical activity and the metabolic syndrome among U.S. adults. 2005: Obesity Research, Vol. 13, pp. 608-14.

11. Laaksonen DE, Lindstrom J, Lakka TA, Eriksson JG, Niskanen L, Wikstrom K and et al. Physical activity in the prevention of Type 2 diabetes s.l.: The Finnish diabetes prevention study., 2005, Vol. 54, pp. 158-65.

12. Nasser M. Al-Daghri, Nasir Uddin Khan, Khalid M. Alkharfy, Omar S. Al-Attas, Majed S. Alokail ,Hanan A. Alfawaz, Abdulaziz Alothman and Paul M. Vanhoutte.Selected Dietary Nutrients and the Prevalence of Metabolic Syndrome in Adult Males andFemales in Saudi Arabia: A Pilot Study.2013, Nutrients, Vol. 5, pp. 4587-4604.

13. Al-Nozha, M.; Al-Khadra, A.; Arafah, M.R.; AlMaatouq, M.A.; Khalil, M.Z.; Khan, N.B.; Al-Mazrou, Y.Y.; Al-Marzouki, K.; AlHarthi, S.S. and Abdullah, M. Metabolic syndrome in Saudi Arabia. 2005, Saudi Med. J., Vol. 26, pp. 1918–1925.

14. Al-Daghri, N.M.; Al-Attas, O.S.; Alokail, M.S.; Alkharfy, K.M.; Sabico, S.L. and Chrousos, G.P. Decreasing prevalence of the full metabolic syndrome but a persistently high prevalence of dyslipidemia among adult Arabs. e12159, s.l.: PLoS One, 2010, Vol. 5.

15. Maughan RJ, Fallah J S andCoyle EF. The effects of fasting on metabolism and performance. s.l.: Ramadan and sport, 2010, J Sports Med, Vol. 44, pp. 490–494.

16. Seyyed Reza Attarzadeh Hosseini and Keyvan Hejazi. A Review of the Effects of Ramadan Fasting and Regular Physical Activity on Metabolic Syndrome Indices 1, 2016, J Fasting Health, Vol. 4, pp. 1-16.

17. Tran A, Gelaye B and Girma B. Prevalence of Metabolic Syndrome among Working Adults in Ethiopia.  2011, International J. Hypertension.

18. Guder WG and awta B. The quality of Diagnostic Samples. 1st ed. Darmstadt: GIT Verlag; 2001. p. 22-3.

19. Papadaki A, Vardavas C, Hatzis C and Kafatos A. Calcium, nutrient and food intake of Greek Orthodox Christian monks during a fasting and non-fasting week. Public Health Nutr. 2008;11(10):1022-9.

20. Sow AK, Agne FD, Tiendrébéogo AJF, Diaw M, Ouédraogo V and Toure M. Effects of lenten fasting on body composition and biochemical parameters. Int J Res Med Sci 2016; 4:4724-9.

21. Aksungar FB, Eren A, Ure S, Teskin O and Ates G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann Nutr Metab. 2005;49(2):77-82.

22. Attarzadeh Hosseini SR, Motahari Rad M and Hejazi K. The effects of Ramadan fasting and physical activity on body com ects of Ramadan fasting and physical activity on body composition and hematological biochemical parameters. J Fasting Health, 2014;2(3): 96-103.

  1. 23.  Paul AK, Khan MA and Fariduddin M. Effect of Ramadan fasting on anthropometric measures and metabolic profiles among type 2 diabetic subjects. J Enam Med College. 2015; 5(2):93-8.
24. Kamal S, Ahmad QS, Sayedda K and Haque M. Effect of Islamic fasting on lipid profile, total protein and albumin on healthy Muslim male subjects of Shri Ram Murti Samrak institute of medical sciences, bareilly, uttar pradesh. Nat J Med Res. 2012; 2(4):407-10.

25. Salahuddin M and Javed MH; Effects of Ramadan on some physiological and biochemical parameters in healthy and hypertensive subjects in Aurangabad district of Maharashtra: India, JFH, 2014;2(1): 7-13.

26. Deguitte F, Jouanel P, Begue RJ, Colombier M, Lac G and Pequignot JM. Food restriction, performance, biochemical, physiological and endocrine changes in Judo athletes. Int J sports med 2006:27(1): 38-48.

27. Bernieh B, Boobes Y and Alhakim MR. Fasting Ramadan in kidney patients is safe. Saudi J Kidney Dis transpl. 2009;20(2): 198-200.

28. Nieman DC Dietary status of seventh- day Adventist vegetarian and non-vegetarians’ elderly women. J Am Diet Assoc 1989, 89(12): 1763-9.

29. Samad F, Qazi F, Pervaiz MB, Kella DK, Mansoor M and Osmani BZ. Effects of Ramadan fasting on blood pressure in normotensive males. J Ayub Med coll Abbottabad. 2015;27(2): 338-42.

30. Barnand ND. Effectiveness of low fat vegetarian diet in altering serum lipids and in health premenouposal women. Am J cardiol 2000, 85(8): 969-72.

31. Nicholson AS. Toward improved management of NIDDM: a randomized, controlled, pilot intervention using a low fat vegetarian diet. Prev med 1999; 29(2): 87-91.

32. Toohey ML. Cardiovascular disease risk factors are lower in African American vegans compared to lacto-ovo-vegetarians: J Am coll. Nutr; 1998,17(5): 425-34.

33. Haddad EH. Dietary intake and biochemical, hematological and immune status of vegans compared with non-vegetarians. Am J clin Nutri; 1999, 70(3): 5865-5935.

34. Azizi F. Research in Islamic fasting and health. Ann Saudi Med. 2002;22(3-4): 186-91

35. Miladipour AH, Shakhssalim N, Parvin M and Azadvari M. Effect of Ramadan fasting on Urinary risk factors of calculus formation. Iran J Kidney Dis. 2012;6(1): 33-8

36. Sarri K, Linardakis M, Codrington C and Kafatos A: Does the periodic vegetarianism of Greek Orthodox Christians benefit blood pressure? Prev Med 2007, 44:341-348.

37. Sarri KO, Linardakis MK, Bervanaki FN, Tzanakis NE and Kafatos AG: Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete. Br J Nutr 2004, 92:277-284. 154.

38. Sarri KO, Kafatos AG and Higgins S: Is religious fasting related to iron status in Greek Orthodox Christians? Br J Nutr 2005, 94:198-203.

39. Shatenstein B and Ghadirian P. Influences on diet, health behaviors and their outcome in select ethno cultural and religious groups. Nutrition 1998; 14(2):223-30 [Abstract]

40. Friedlander Y, Kark JD, Kaufmann NA and Stein Y. Coronary heart disease risk factors among religious groupings in a Jewish population sample in Jerusalem. Am J Clin Nutr 1985; 42(3):511-21.

41. Friedlander Y, Kark JD and Stein Y. Religious observance and plasma lipids and lipoproteins among 17-year-old Jewish residents of Jerusalem. Prev Med 1987; 16(1): 70-79.

42. Maislos M, Khamavsi N, Assali A, Abou-Rabiah Y, Zvili I and Shany S. Marked increase in plasma high-density-lipoprotein cholesterol after prolonged fasting during Ramadan. Am J Clin Nutr 1993; 57:640-2

43. Temizhan A, Donderici O, Ouz D and Demirbas B. Is there any effect of Ramadan fasting on acute coronary heart disease events? Int J Cardiol 1999; 70(2):149-53

44. Mansi KMS. Study the Effects of Ramadan Fasting on the Serum Glucose and Lipid Profile among Healthy. Jordanian Students. American Journal of Applied Sciences 2007; 4 (8): 565-569.

45. Thannoun AM and Mahmoud ES. Effect of Fasting in Ramadan on Blood Glucose and Lipid Profile. Mesopotamia J of Agric 2010; 38 (2): 1-7. 

46. Fraser GE. Diet as Primordial Prevention in Seventh-Day Adventists. Prev Med 1999; 29(6 Pt 2):S18-23.

47. Fraser GE. Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists. Am J Clin Nutr 1999; 70(3 Suppl):532S-538S.

48. WHO. The global burden of disease: 2004 update. World Health Organization Press, 20 Avenue Appia, 1211 Geneva 27, Switzerland 2008; 1-160. 

49. Wai WS, Dhami RS, Gelaye B, Girma B, Lemma S, Berhane Y and et al. Comparison of Measures of Adiposity in Identifying Cardiovascular Disease Risk Among Ethiopian Adults. Obesity 2011; 1-9. doi:10.1038/oby.2011.103. Accessed on June4, 2017 from URL:

50. Arega R. (2009). Fasting in the Ethiopian Orthodox Church. Ethiopian Orthodox Tewahdo Church Sunday School Department – Mahibere Kidusan. Accessed on June 16, 2017 from URL: com_content&task=view &id=56&Itemid=1

51. Sarri K, Linardakis M, Codrington C and Kafatos A. Does the periodic vegetarianism of Greek Orthodox Christians benefit blood pressure? Prev Med 2007; 44(4):341-8. [Abstract]

52. Sarri K, Bertsias G, Linardakis M, Tsibinos G, Tzanakis N and Kafatos A. The effect of periodic vegetarianism on serum retinol and alpha-tocopherol levels. Int J Vitam Nutr Res2009; 79:271-280. [Abstract]

53. Ethiopian Census Report 2007. Accessed on june 2, 2017 from URL:

54. World Health Organization. Chronic diseases and health promotion. STEPwise approach to surveillance (STEPS). STEPS Manual. Geneva, World Health Organization; 2008. Accessed on April 3, 2017, from URL: STEPSmanual.pdf