Effect of Ramadan fasting on Macronutrients & Micronutrients intake: an essential lesson for healthcare professionals

Document Type: Research Paper

Authors

1 Department of Nutrition, Faculty of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran

2 1Department of Nutrition, Faculty of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran

3 The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran

4 The Persian Gulf Tropical and Infectious Diseases Research Centre, Bushehr University of Medical Sciences, Bushehr, Iran

5 Department of Nutrition, Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, I.R. Iran

Abstract

Introduction: The study was aimed to assess the intakes of nutrients of individuals in month of Ramadan. Materials and Methods: In total, 119 participants visited twice: once before Ramadan and then the 3rd week of Ramadan. A food frequency questionnaire (FFQ) and 3-day food intake recall used to determine the nutrient intake during Ramadan and other months. Weight, height and other demographic parameters were also gathered. Results: One sample T-test showed a significantly higher intake of Calorie, total fat, saturated fatty acids, cholesterol, vitamin A carotene, vitamin A total, vitamin B2, B12, C, niacin and phosphorous were significantly higher than RDA before Ramadan (P<0.05). However, Carbohydrate, fiber, polyunsaturated fat, folate, cooper, magnesium, potassium, selenium and sodium of subjects’ diets were significantly lower than RDA before Ramdan. paired sample T-test illustrated that Calories, carbohydrate, fiber, total fat, monounsaturated fatty acids, saturated fatty acids, cholesterol, vitamin A carotene, total vitamin A, vitamin B1, C, E, folate, calcium, iron, magnesium, phosphorous, potassium, selenium and sodium intake all significantly decreased after 3 weeks of fasting. However, only Calories, protein, carbohydrate, fiber, total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, vitamin A carotene, vitamin B2, B6, C, E, folacin, calcium, copper, iron, magnesium, phosphorous, potassium, selenium and sodium intake in 3rd week of Ramadan were significantly lower than RDA and vitamin A and niacin were significantly higher than RDA during Ramadan. Conclusion: The present study demonstrates a significant decrease in some micronutrients during the month of Ramadan and indicates to imply nutritional recommendation in selecting foods.

Keywords


  1. Poh BK, Zawiash H, Ismail MN, et al. Changes in body weight, dietary intake and activity pattern of adolescent during Ramadan. Mal J Nutr 1996; 2:1-10.
  2. Bernieh BO, Mohamed AO, Wafa AM. Ramadan fasting and renal transplant recipients: Clinical and biochemical effects. Saudi J Kidney Dis Transpl 1994, 5:470-473.
  3. Kadri N, Tilane A, El Batal M, Taltit Y, Tahiri SM, Moussaoui D. Irritability during the month of Ramadan. Psychosom Med 2000, 62:280-285.
  4. OosterbeekH,Klaauw B. Ramadan, fasting and educational outcomeS. Economics of Education Review 2013, 34:219-226.
  5. Rehman J and Shafiq M. Changes in blood glucose and lipid profile during Ramadan fasting. JAMC 2000;12(3):13-15.
  6. Ibrahim WH, Habib HM, Jarrar AH, Baz SA. Effect of Ramadan fasting on markers of oxidative stress and serum biochemical markers of cellular damage in healthy subjects. Ann NutrMetab 2008, 53: 175-181.
  7. Al-Hourani HM, Atoum MF. Body composition, nutrient intake and physical activity patterns in young women during Ramadan. Singapore Med J. 2007 Oct;48(10):906-10.
  8. Maislos M, Khamavsi N, AssaliA,et al. Marked increase in plasma high-density-lipoprotein cholesterol after prolonged fasting during Ramadan. Am J Clin Nutr 1993;57:640-2.
  9. Ramadan J, Telahoun G, Al-Zaid NS, Barac-Nieto M. Responses to exercise, fluid, and energy balances during Ramadan in sedentary and active males. Nutrition. 1999, 15:735-739.
  10. Ziaee V, Razaei M, Ahmadinejad Z,et al. The changes of metabolic profile and weight during Ramadan fasting. Singapore Med J 2006; 47(5): 409-414.
  11. Hallak MH, Nomani MZ. Body weight loss and changes in blood lipid levels in normal men on hypocaloric diets during Ramadan fasting. Am J Clin Nutr 1988, 48:1197-1210.
  12. Fedail SS, Murphy D, Salih SY, Bolton CH, Harvey RF. Changes in certain blood constituents during Ramadan. Am J Clin Nutr 1982, 36:350-353.
  13. Chandalia HB, Bhragav A, V Kataria .Dietary pattern during Ramadan fasting and effect on the metabolic control of diabetes. Practical Diabetes 1987; 4: 287-90.
  14. Belkhadir J, EL Ghomari H, klocker N, et al. muslims with not insulin dependent diabetes fasting during Ramadan. Br Med J 1993; 307:292-5.
  15. Mafauzy M, Mohammad WB, Anum MY, et al. a study of fasting diabetic patients during the month of Ramadan. Med J Malaya 1990; 45: 14-7.
  16. El Ati J, Beji C, Danguir J. Increased fat oxidation during Ramadan fasting in healthy women: an adaptative mechanism for body-weight maintenance. Am J ClinNutr 1995, 62:302-307.
  17. Adlouni A, Ghalim N, Benslimane A, Lecerf JM, Saile R. Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol. Ann NutrMetab 1997, 41:242-249.
  18. Esfahani, F.H.; Asghari, G.; Mirmiran, P.; and Azizi, F. (2010) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J. Epidemiol., 20, 150-8.
  19. Khaled BM, Belbraouet S. Effect of Ramadan fasting on anthropometric parameters and food consumption in 276 type 2 diabetic obese women. Int J Diabetes DevCtries 2009, 29:62-68.
  20. Fedial SS, Murphy D, Salih SY, Bolton CH & Harvey RF. Changes in certain blood constituents during Ramadan. Am J ClinNutr  1982;36: 350-353.
  21. Ismail MN, Zawiah H, Mariam A &Junaidah RB. Body weight and body fat changes during the fasting month of Ramadan. Paper presented at the XIII International Congress of Nutrition. 18-23 August 1985, Brighton, U.K.
  22. Husain R, Duncan MT, Cheah SH &Ch'ng SL. Effects of fasting in Ramadan on Tropical Asiatic Moslems. Br J Nutr 1987; 58: 41-48.
  23. Alfarooqi, I. R., 1984. Major world religons - Islam. pp: 27-30. Argus Communications, IL 60648, USA.
  24. Kaandhlawi, M. Z., 1928. Virtues of Ramadhan. In Teachings of Islam, pp.7-17. Library of Islam, Des. Plaines. IL 60017, USA (English Translation,1986).
  25. Nomani MZ. Diet during Ramadan. Int. J. Ramadan Fasting Research 1999, 3:1-6.
  26. Maughan RJ, Bartagi Z, Dvorak J, Zerguini Y.Dietary intake and body composition of football players during the holy month of Ramadan.J Sports Sci 2008;26(3):S29-38.
  27. Fakhrzadeh H, Larijani B, Sanjari M, Baradar-Jalili R, Amini MR. Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med 2003; 23(3-4):223-6.
  28. Smith LE, Shen W, Perruzzi C, Soker S, Kinose F, Xu X et al. Regulation of vascular endothelial growth factor-dependent retinal neovascularization by insulin-like growth factor-1 receptor. Nat. Med. 1999; 5: 1390-5.
  29. Slomiany MG, Rosenzweig SA. IGF-1–induced VEGF and IGFBP-3 secretion correlates with increased HIF-1α expression and activity in retinal pigment epithelial cell line D407. Invest. Ophthalmol. Vis. Sci.  2004; 45: 2838-47.
  30. Baserga R, Hongo A, Rubini M, Prisco M, Valentinis B. The IGF-I receptor in cell growth, transformation and apoptosis. Biochimica. Et. Biophysica. Acta. 1997; 1332: F105-26.
  31. Fontana L, Partridge L, Longo VD. Extending healthy life span--from yeast to humans. Science [New York, NY] 2010; 328: 321-6.
  32. Bouhlel E, Zaouali M, Miled A, Tabka Z, Bigard X, Shephard R.. Ramadan fasting and the GH/IGF-1 axis of trained men during submaximal exercise. Ann. Nutr. Metab. 2008; 52: 261-6.
  33. Maughan RJ, Bartagi Z, Dvorak J, Zerguini Y.Dietary intake and body composition of football players during the holy month of Ramadan.J Sports Sci 2008;26(3):S29-38.
  34. Fakhrzadeh H, Larijani B, Sanjari M, Baradar-Jalili R, Amini MR. Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med 2003; 23(3-4):223-6.
  35. Gumaa KA, Mustafa KY, Mahmoud NA, et al. The effects of fasting in Ramadan. 1. Serum uric acid and lipid concentrations. Br J Nutr 1978;40(3):573-81.
  36. Husain R, Duncan MT, Cheah SH, et al. Effects of fasting in Ramadan on tropical Asiatic Moslems. Br J Nutr 1987;58(1):41-8.
  37. Hallak MH, Nomani MZ. Body weight loss and changes in blood lipid levels in normal men on hypocaloric diets during Ramadan fasting. Am J Clin Nutr 1988;48(5):1197-1210.
  38. Sweileh N, Schnitzler A, Hunter GR, et al. Body composition and energy metabolism in resting and exercising muslims during Ramadan fast. J Sports Med Phys Fitness 1992;32(2):156-63.
  39. Gharbi M, Akrout M, Zouari B.Food intake during and outside Ramadan. East Mediterr Health J. 2003;9(1-2):131-40.
  40. Ahmed Barkia, Kamel Mohamed, Maha Smaoui, et al. Change of Diet, Plasma Lipids, Lipoproteins, and Fatty Acids during Ramadan: A Controversial Association of the Considered Ramadan Model with Atherosclerosis Risk. J Health Popul Nutr 2011;29(5):486-493.
  41. Hozoori, Mohammad, et al. "Nutrient Intake during Ramadan in Fasting People Referring to Health Centers in Qom, Iran." Health, Spirituality and Medical Ethics 4.2 (2017): 9-11.
  42. Ibrahim WH, Habib HM, Jarrar AH,  Baz SA. Effect of Ramadan fasting on markers of oxidative stress and serum biochemical markers of cellular damage in healthy subjects.Ann Nutr Metab. 2008;53(3-4):175-81.
  43. Harifi G, Amine M, Ouazar MA, et al. Comparison of the calcium intake during and before Ramadan in Marrakesh, Morocco. East Mediterr Health J. 2010;16(4):414-9.
  44. Kathleen Mahan L, Reymond JL. Food & the Nutrition Care Process. 2017, 14th Edition, Elsevier co. Canada, 3251, liverport lane.