Fasting during Ramadan Induces a Marked Increase in High-Density Lipoprotein Cholesterol and Decrease in Low-Density Lipoprotein Cholesterol

Abstract

We demonstrated for the first time in a Moroccan population that fasting during Ramadan, the ninth lunar month of the Muslims’ year, affected lipid and lipoprotein metabolism in a group of 32 healthy adult male volunteers. This investigation was conducted to study the changes in serum total cholesterol, triglycerides, cholesterol in high-density lipoprotein (HDL) and low-density lipoprotein (LDL), glucose, and body weight during Ramadan. The results showed a significant decrease (7.9%, p < 0.001) in serum total cholesterol concentration during Ramadan as compared with the prefasting period. Also, we obtained a significant decrease of serum triglyceride concentration (30%, p < 0.001) during Ramadan fasting as compared to the period before Ramadan. The reduction of both serum triglycerides and total cholesterol was maintained 1 month after Ramadan. By the end of Ramadan, serum HDL cholesterol had markedly increased (14.3%, p < 0.001) and remained elevated 1 month after Ramadan in contrast to LDL cholesterol which showed a significant decrease (11.7%, p < 0.001) also maintained 1 month after Ramadan. Mean body weight declined by 2.6% (p < 0.01) on day 29 of Ramadan, whereas during Ramadan, the diet pattern used by our subjects showed an increase of total energy intake due to carbohydrates (+1.4% of total energy), proteins (+0.4% of total energy) but not fat (-0.7% of total energy) compared to a usual diet used throughout the rest of the year. Moreover, the fat diet is high in monounsaturated (p < 0.05) and polyunsaturated fatty acid in contrast to saturated fatty acid which significantly (p < 0.05) decreased during Ramadan. These findings suggest that feeding behavior that occurs during Ramadan beneficially affects plasma lipids and lipoproteins.

Beneficial changes in serum apo A-1 and its ratio to apo B and HDL in stable hyperlipidaemic subjects after Ramadan fasting in Kuwait

“…It was therefore with some surprise that weight gain was not observed in our patients post-Ramadan. This observation has however been well documented elsewhere (Husain et al, 1987;Finch et al, 1998;Adlouni et al, 1997Adlouni et al, , 1998Maislos et al, 1993Maislos et al, , 1998el Ati et al, 1995) and is believed due to an increase in fat oxidation during Ramadan, as an adaptive mechanism for body weight maintenance (el Ati et al, 1995). Another explanation offered is a reported reduced appetite observed in groups of fasting moslems in the UK, especially towards the end of the Ramadan period (Finch et al, 1998), but we were unable to document this in our subjects.…”

“…Most of the reports (Frost & Pirani, 1987;Husain et al, 1987;Finch et al, 1998;Adlouni et al, 1997Adlouni et al, , 1998Maislos et al, 1993Maislos et al, , 1998el Ati et al, 1995) on the in¯uence of Ramadan fasting on blood lipid and lipoprotein levels have been on healthy volunteers. In studies performed on Ramadan fasting individuals, Frost and Pirani (1987) indicated that a signi®cant increase in caloric, fat, carbohydrate and protein intake during Ramadan resulted in a mean weight gain of about 2 kg.…”

“…There have been many reports on metabolic changes during and after Ramadan in healthy subjects (Frost & Pirani, 1987;Husain et al, 1987;Finch et al, 1998;Adlouni et al, 1997Adlouni et al, , 1998Maislos et al, 1993Maislos et al, , 1998el Ati et al, 1995) and in patients with diabetes (Laajam, 1990;Mafauzy et al, 1990;Belkhadir et al, 1993). In diabetes, assessing such changes is particularly important, since the quantity, quality and timing of meals constitute a most important component of any diabetes management strategy.…”

Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia

“…The majority of Indonesian people are Muslims, who are obliged to fast (total abstinence from food and drink) for as long as 14 h (from 0330 to 1730) each day for a month. Many studies have been conducted to evaluate the impact of Ramadan fasting on various aspects of health, including lipid metabolism (Fedail et al, 1982;El Arnoaty and Johnson, 1991;Adlouni et al, 1997), acute coronary heart disease and respiratory system (Temizhan et al, 1999;Ramadan and Barac-Nieto, 2000), water balance (Duncan et al, 1990;Schmahl and Metzler, 1991;Leiper et al, 2003;Basiri et al, 2004), dietary intake, endocrine function, serum fructosamine, and clinical, anthropometrical, and most biological parameters (Habbal et al, 1998;Perk et al, 2001;Beltaifa et al, 2002;Ramadan, 2002;Gharbi et al, 2003;Gustaviani et al, 2004;Kassab et al, 2004;Yucel et al, 2004).…”

The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives

“…However, there have been only a few studies that examined the effect of the fast on basic homeostatic functions. [1][2][3] There have been several animal studies that have shown that hypertension can be caused or exacerbated by cycles of fasting and refeeding. [4][5][6][7] Initially, during the fast, there is a reduction in blood pressure.…”