We evaluated the effect of the Ramadan fasting on plasma lipids and lipoproteins in normal individuals. Twenty-four healthy subjects were studied before the end of the Ramadan month (Ram) and for 1 mo thereafter. Plasma total cholesterol (TC), triglycerides, low-density-lipoprotein cholesterol (LDL-C), and very-low-density-lipoprotein cholesterol (VLDL-C) did not change. High-density-lipoprotein cholesterol (HDL-C) was 30% higher (P < 0.005) at the end of Ram; apolipoprotein A-I also increased (P < 0.0001). Both the ratios of TC to HDL-C and LDL-C to HDL-C (P < 0.001) decreased at Ram. There was a striking nonpharmacologic improvement in plasma HDL-C and ratios of TC to HDL-C and LDL-C to HDL-C, which were most probably induced by eating one large evening meal a day. Further studies to determine the mechanism of this observation are underway.
Ritual female genital operations are common in many parts of the world, with varying degrees of mutilation from clitoridectomy and removal of the labia to removal of the clitoral prepuce. Interviews of 21 Bedouin women in southern Israel revealed the practice to be normative in several tribes. However, physical examination of 37 young women from those tribes at a gynecological clinic revealed only small scars on the labia in each woman. Bedouin in southern Israel may offer a model of evolution of female circumcision into a nonmutilative ritual incision.
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