Interleukin-6, C-Reactive Protein and Biochemical Parameters during Prolonged Intermittent Fasting

Abstract

Background: It is well known that nutritional habits, sleeping patterns and meal frequency have profound effects on maintaining human health. Ramadan is a religious month for Islam, during which Muslims do not eat and drink during the daylight hours. The duration of restricted food and beverage intake is approximately 12 h/day for 1 month, which makes Ramadan a model of prolonged intermittent fasting. Methods: In order to evaluate the effects of long-lasting modifications of food intake on inflammatory markers and biochemical parameters 40 healthy volunteers of normal weight [20 females aged between 20 and 38 years, 20 males aged between 23 and 39 years, body mass index (BMI) <25 kg/m²] who fasted during Ramadan and another 28 healthy age- and BMI-matched volunteers (14 males, 14 females) who did not fast participated in the study. Venous blood samples were taken 1 week before Ramadan, during the last week of Ramadan and 3 weeks after Ramadan. Serum interleukin-6 (IL-6), C-reactive protein (CRP), homocysteine, vitamin B₁₂, folate, total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels were measured. Results: No significant changes were observed in serum total cholesterol, triglycerides and LDL levels. TC/HDL ratio (HDL risk factor) was decreased during and after Ramadan in both genders in the fasting group while there were no changes in the nonfasting group. IL-6 (p < 0.001), CRP (p < 0.001) and homocysteine (p < 0.01) levels were significantly low during Ramadan in the fasting subjects of both genders when compared to basal values (1 week before Ramadan). Conclusion: Our results demonstrate that prolonged intermittent fasting in a model like Ramadan has some positive effects on the inflammatory status of the body and on the risk factors for cardiovascular diseases such as homocysteine, CRP and TC/HDL ratio.

Transcriptome analysis of peripheral blood mononuclear cells in human subjects following a 36 h fast provides evidence of effects on genes regulating inflammation, apoptosis and energy metabolism

“…These align well with some of the mechanisms proposed, but not yet conclusively demonstrated, to play a role in the increased longevity and reduced incidence of chronic disease associated with caloric restriction and intermittent fasting in animal models and with changes in biomarkers of these conditions in humans (Robertson and Mitchell 2013;Trepanowski et al 2011). In human subjects, longer term intermittent fasting, undertaken for Ramadan or as part of a weight loss study, has been reported to attenuate circulating levels of certain pro-inflammatory cytokines such as IL1B, TNF and IL6 and inflammatory markers such as CRP (Aksungar et al 2007;Faris et al 2012;Kroeger et al 2012). The transcriptomic analysis performed here, together with the targeted proteomic analysis described previously, suggest that moderate reductions in inflammatory cytokines can be detected following just one extended fast.…”

Metabolic Effects of Intermittent Fasting

“…In males, there was a significant decrease in weight, total cholesterol, and TGs. Some studies have reported that Ramadan fasts are associated with significantly lower concentrations of inflammatory markers, such as CRP, IL-6, and TNF-α (1,30). Recent studies have shown that Ramadan fasting practiced by patients with type 2 diabetes for 15-21 days leads to a statistically and clinically significant reduction in hemoglobin A1c (HbA1c) levels of approximately 0.5 points, suggesting that glycemic control is improved substantially during Ramadan fasting in this population (122).…”

Religion, spirituality and cardiovascular disease: research, clinical implications, and opportunities in Brazil

“…At least nine studies have examined relationships between R/S and blood levels of IL-6. Of those, five (56%) reported significant inverse relationships [120,121] or a reduction in IL-6 in response to a R/S intervention [122][123][124]. In contrast, IL-6 levels appear to be increased in cardiac surgery patients undergoing existential stress related to religious struggles [125] or may be increased in response to a spiritual intervention [126].…”

“…Eight studies have now examined relationships with R/S. Of those, four (50%) reported significant inverse relationships [137][138][139] or a reduction in CRP in response to a R/S intervention [140]; the other four studies found no association. More recent research supports an inverse relationship between R/S and CRP [141].…”