The Effect of Ramadan Fasting on Hematological Parameters

Document Type: Research Paper

Authors

1 Department of Internal Medicine, Faculty of Medicine, Shaharekord University of Medical Sciences, Shahrekord, Iran

2 Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Epidemiology and Biostatistics, Faculty of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran

4 Department of Pediatrics, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran

Abstract

Background: Ramadan fasting is an obligation for many Muslims around the world who abstain from eating and drinking for one month, which has different medical and physiological effects, such as reducing blood pressure, lipid profile, blood glucose, and body weight. It has also been hypothesized that Ramadan fasting may induce some changes in the hematologic parameters. Thus, we aimed to investigate the effect of Ramadan fasting on blood cell count (CBC), and erythrocyte sedimentation rate (ESR). Methods: In the present study, 59 adult healthy individuals, who had completed one month of Ramadan fasting were included. Fasting blood samples were analyzed for ESR, hemoglobin (Hb), hematocrit (Hct), white blood cell (WBC), platelet count (PLT), mean corpuscular Volume (MCV) and mean platelet volume (MPV), one day before, on the second and last week of Ramadan and one month after Ramadan (phase I , II, III,  and IV, respectively). Results: 34 men and 25 women with an age range of 15 to 24 years participated in the study. Mean ESR increased significantly (except phase IV, in comparison phase III). Mean Hb and Hct levels were significantly greater in phase III than phase I (P<0.001). Also mean MCV decreased significantly (P<0.001). Although MPV decreased in phase II, it returned to baseline in phase IV (P=0.028). Mean WBC count decreased during all phases of the study significantly (P=0.003). Mean platelet count mildly increased during Ramadan fasting (P<0.001). Conclusion: Ramadan fasting has statistically significant effects on hematological parameters, which were within normal range.

Keywords


  1. Laway BA, Ashraf H. Basic rules of Ramadan: A medico-religious perspective. J Pak Med Assoc. 2015;65(5 Suppl 1):S14-7.
  2. Larijani B, Zahedi F, Sanjari M, Amini M, Jalili R, Adibi H, et al. The effect of Ramadan fasting on fasting serum glucose in healthy adults. Med J Malaysia. 2003;58(5):678-80.
  3. Kul S, Savaş E, Öztürk ZA, Karadağ G. Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J Relig Health. 2014;53(3):929-42.
  4. Al Hourani HM, Atoum MF, Akel S, Hijjawi N, Awawdeh S. Effects of ramadan fasting on some haematological and biochemical parameters. Jordan J Biol Sci. 2009;2(3):103-8.
  5. Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Curr Med Res Opin. 2013;29(4):343-54.
  6. Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: a systematic review and meta-analysis. Public Health Nutr. 2014;17(02):396-406.
  7. Azizi F, Rasouli H. Serum Glucose, Bilirubin, calcium, phosphorus, protein and albumin concentrations during Ramadan. Med J Islam Repub Iran. 1987;1(1):38-41.
  8. Mansi KMS. Study the effects of Ramadan fasting on the serum glucose and lipid profile among healthy Jordanian students. Am J Appl Sci. 2007;4(8):565-9.
  9. Mansooreh Samimi M. Effects of Ramadan Fasting on Glucose Homeostasis, Lipid Profiles, In. ammation and Oxidative Stress in Women with Polycystic Ovary Syndrome in Kashan, Iran. Arch Iran Med. 2015;18(12):806.
  10. Benaji B, Mounib N, Roky R, Aadil N, Houti I, Moussamih S, et al. Diabetes and Ramadan: review of the literature. Diabetes Res Clin Pract. 2006;73(2):117-25.
  11. Beshyah SA, Fathalla W, Saleh A, Al-Kaddour A, Noshi M, Al Hatheethi H, et al. Ramadan fasting and the medical patient: An overview for clinicians. Ibnosina J Med BS. 2010;2(5):240-57.
  12. Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutr J. 2010;9(1):1.
  13. Azizi F. Islamic fasting and health. Ann Nutr Metab. 2010;56(4):273-82.
  14. Meo SA, Hassan A. Physiological changes during fasting in Ramadan. J Pak Med Assoc. 2015;65(5 Suppl 1):S6-S14.
  15. Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012;11(1):1.
  16. Ünalacak M, Kara IH, Baltaci D, Erdem Ö, Bucaktepe PGE. Effects of Ramadan fasting on biochemical and hematological parameters and cytokines in healthy and obese individuals. Metab Syndr Relat Disord. 2011;9(2):157-61.
  17. Hosseini S, Hejazi K. The effects of ramadan fasting and physical activity on blood hematological-biochemical parameters. Iran J Med Sci. 2013;16(7):845-49.
  18. Aybak M, Türkoğlu A, Şermet A, Denli O. Effect of Ramadan fasting on platelet aggregation in healthy male subjects. Eur J Appl Physiol Occup Physiol. 1996;73(6):552-6.
  19. Dewanti L, Watanabe C, Ohtsuka R. Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia. Eur J Clin Nutr. 2006;60(7):877-81.
  20. Sarraf-Zadegan N, Atashi M, Naderi GA, Baghai AM, Asgary S, Fatehifar MR, et al. The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Ann Saudi Med. 2000;20(5/6):377-81.
  21. Askari V, Alavinezhad A, Boskabady M. The impact of “Ramadan fasting period” on total and differential white blood cells, haematological indices, inflammatory biomarker, respiratory symptoms and pulmonary function tests of healthy and asthmatic patients. Allergol Immunopathol (Madr). 2016;44(4):359-67
  22. 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(10):735-9.
  23. Schmahl F, Metzler B. The health risks of occupational stress in islamic industrial workers during the Ramadan fasting period. Pol J Occup Med Environ Health. 1990;4(3):219-28.
  24. Iraki L, Bogdan A, Hakkou F, Amrani N, Abkari A, Touitou Y. Ramadan Diet Restrictions Modify the Circadian Time Structure in Humans. A Study on Plasma Gastrin, Insulin, Glucose, and Calcium and on Gastric pH 1. J Clin Endocrinol Metab. 1997;82(4):1261-73.
  25. Maughan RJ, Leiper JB, Bartagi Z, Zrifi R, Zerguini Y, Dvorak J. Effect of Ramadan fasting on some biochemical and haematological parameters in Tunisian youth soccer players undertaking their usual training and competition schedule. J Sports Sci. 2008;26(S3):S39-S46.
  26. Azizi F. Research in Islamic fasting and health. Ann Saudi Med. 2002;22(3-4):186.