Evaluation of the Effects of Ramadan Fasting on Lymphocyte Subpopulations in a Two‐year Follow‐up

Document Type : Research Paper


1 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Immunology Research Center, Department of Immunology and Allergy, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran


Today, the intractions of the immune system of the immune system, nutrition, and nervous system are one of the main research areas of interest in immunology and disease treatment. Due to changes in the mood, behavior, and diet of an individual during fasting period, the body's internal homeostasis is affected. The aim of the present study was to evaluate the effects of Ramadan fasting on lymphocyte subgroups, which are the main specific immune cells in the body. For this purpose, in years 1999 and 2000, thirty‐eight healthy Muslims (9 females and 29 males), within the age range of 17 to 51 years (mean age=35.4 years), were assessed before the start and one day before the end of Ramadan.
The pre‐Lymphocytic subpopulations analysis was conducted using flow cytometery. The results showed that the percentage of total lymphocytes was 25.82% and 26.23% in the pre‐ and late‐Ramadan periods, respectively; the observed difference was insignificant. However, the absolute lymphocyte counts were 2.3×103 and 2.1×103 mm3 before and late Ramadan, respectively, and the difference was considered significant (P‐value=0.06). The percentage of CD3+ cells (T cells) was 70.12% before Ramadan and 70.25% late Ramadan, and the absolute lymphocyte counts were 1.6×103 and 1.5×103 mm3, respectively; therefore, the differences were not significant. Regarding the subgroups of CD4+cells (TH), the percentage ratios of the cells were 53.46% and 52.8% in the pre‐ and late Ramadan periods, and the absolute counts were 0.087×103 and 0.081×103 mm3, respectively; however, the differences were not significant in this cell subgroup. The percentage of CD8+ (TC) cells was 37.7% before Ramadan and 37.8% late Ramadan, and the absolute counts were 0.6×103 and 0.54×103 mm3 in the pre‐ and late‐Ramadan periods, respectively; therefore, the differences were considered insignificant. In addition, the percentage ratios of Blymphocytes cells were 14.56 % and 14.74% in the pre‐ and late‐Ramadan periods, and the absolute count changed from 0.35×103 to 0.3×103 mm3. According to the results, the differences were not significant, therefore, it seems Ramadan fasting does not affect these cells.
Moreover, the percentage of activated T cells or TDR+, which are involved in specific immune responses, has not been affected by fasting. In fact, the percentage ratios were reported as 11.14% and 10.54% in the pre‐ and late‐Ramadan periods, and the absolute count changed from 0.14×103 to 0.11×103 mm3; the differences were not considered significant. Finally, the ratio of CD4+/CD8+ cells or TH/TC changed from 1.48% before Ramadan to 1.5% late this
month; however, this difference was insignificant. Thus, the overall results indicate that Ramadan fasting during winter does not affect the lymphocyte count, percentage ratio, and the main lymphocyte subpopulations.


  1. Blalock J.E. The immune system as a sensory organ. J.Immunol. 1984;132(3):1067-70.
  2. Pawelec G, Adibzadeh M, Pohla H, Schaudt K. immunosenscence: again of the immune system. Immunol.Today. 1995;16(9):420-2.
  3. Blalock J.E. The syntax of immune-neuroendocrine communication. Immunol,Today. 1994;15(11):504-11.
  4. Brines A. Neuroendocrinoimmuno-logytoday. Immunol.Today. 1996;15(11):503.
  5. Guidi L, Tricerri A, Frasca D, Vangeli M, Errani A.R, Bartoloni C. phychoneuroimmunology and aging. Gerontology.1998;44(5)247-61.
  6. Moynihan J.A, Kruszewska B, Brenner G.J, Cohen N. Neural, endocrine. And immune system intractions: Relevance for health and disease. Adv.Exp.Med.Biol. 1998;438:541-9.
  7. Muller N, Ackenheil M. Psychoneuroimmunology and the cytokine action in the CNS: implications for psychiatric disorders. Prog.Neuropsychopharmacol boil.Psychiatry. 1998;22(1):1-33.
  8. Beck M.A. Selenium and host defence towards viruses. Proc.Nutr.Soc. 1999;58(3):707-11.
  9. Chandra R.K. Nutrition and immunology: from the clinic to cellular biology and back again. Proc.Nult.Aoc. 1999;58(3):681-3.
  10. Harbige L.s. Nutrition and immunity with emphasis on infection and autoimmune disease. Nutr.Health. 1996;10(4):285-312.
  11. Kuziv  Oie. The effect of complete fasting on the structural – functional organization of the white pulp of the spleen. Fiziol Zh. 1997;43(1-2):89-100.
  12. De Swart R.L, Ross P.S, Timmerman H.H, Hijman W.C,  de Ruiter E.M, Liem A.K, et al. Short term fasting does not aggravate immunosuppression in harbor seals(Phoca vitulina) with high body burdens of organochlorines. Chemosphere. 1995;31(10)4289-306.
  13. Savendahl L, Underwood L.E. Decrease interlukin-2 production from cultured peripheral blood mononuclear cells in human acute starvation. J.Clin Endocrinol.Matab. 1997;82(4):1177-80.
  14. Fraster D.A, Theon J, Rustan A.C, Forre O, Kjeldsen-Krag J. Changes in plasma free fatty acid concentrations in rheumatoid arthritis patients during fasting and their affects upon T-lymphocyte proliferation. Rheumatology,Oxford. 1999;38(10)948-52.
  15. Trollmo C, Verdrengh M, Tarkowski A. Fasting enhances mucosal antigen specific B cell responses in arthritis. Ann.Rheum.Dis. 1997;56(2):130-4.
  16. Witte-Foster S.R, Garcia P.A, Dove C.R. Lipid profiles, serum immunoglobulins, dietary intake, and drug use of order rural Iowa women. J.Am.Diet.Assoc. 1991;91(6):679-85.
  17. Aybak M, Turkoglu A, Sermet A, Denli O. Effect of Ramadan fasting on platelet aggregation in healthy male subjects. Er.J.Appl.Physiol. Occup.Physiol. 1996; 73(6):552-6.
  18. Husain R, Cheah S.H, Duncan M.T. Cardiovascular reactivity in Malay Moslems during Ramadan. Singapore Med.J. 1996;37(4):398-401.
  19. Nomani M.Z, Hallak M.H, Siddiqui I.P. Effects of Ramadan fasting on plasma uric acid and body weight in healthy man. J.Am.Diet Assoc. 1990;90(10):1435-6.
  20. Celik I, Barista I, Firat D. Cancer therapy during Ramadan. J Natl Cancer Inst. 1996;19;88(12):838.
  21. Harbige L.s. Nutrition and immunity. Immonology News. 1997;4(4):219-21.
  22. Abbas A. K, Lichtman A.H, Pober J.S. Cellular and molecular immunology. 4th ed. WB Saunders Co. Philadelphia. 2000; 466-7.
  23. Hansen K, Sickelmann F, Pietrowsky R, Fehmn H.L, Born J. Systemic immune changes following meal intake in humans. Am.J.Physiol. 1997;273(2 Pt 2):R548-53.
  24. Kjeldsen-Kragh J, Sumar N, Bodman-Smith K, Brostoff J. Changes in glycosylation of IgG during fasting in patients with rheumatoid arthritis. Br.J.Rheumatol. 1996;35(2):117-9.
  25. Abdualla A.H, Shaheen F.A, Rassoul Z, Owda A.K, Popovich W.F, Mousa D.H, al-Khader A.A. Effect of Ramadan fasting on Moslem kidney transplant recipients. Am.J.Nephrol. 1998; 18(2):101-4.