This study investigated the effect of Ramadan on the haematological and steroid module of the Athletes Biological Passport (ABP) of the World Anti-Doping Agency (WADA). Nine healthy physically active subjects were tested in the morning and afternoon for two days before and three days during Ramadan. Sample collection and all analyses were performed according to WADA technical documents. Although there were significant changes in the haemoglobin concentration during Ramadan, especially during the first fasting week, none of the subjects in this study exceeded the individually calculated thresholds of the ABP. No significant effects on testosterone/epitestosterone (T/E) ratio were observed but only the afternoon specific gravity (SG) of the urine was elevated. Thus, when urinary steroid concentrations are required, SG corrections need to be performed. The haematological and the steroid module of the ABP can be reliably applied during Ramadan as the observed changes are only marginal.

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Background. periods of voluntary abstinence from food, such as intermittent fasting, has been practiced since earliest antiquity by people around the globe. The benefits of restricting energy intake severely for two days a week while eating normally the rest of week has been popularised. However, the evidence for the health benefits of fasting in humans is often extrapolated from animal studies, based on observational data on religious fasting, or derived from experimental studies. Furthermore, periods of prolonged daily fasting may be especially beneficial to improving sensitivity to insulin. However, whether the reduced water consumption and physical activity during ramadan may mitigate these health is less well studied. Therefore, This study tested the hypothesis that prolonged daily fasting, for greater than 12 h in a 24 h cycle, without calorie restriction, reduces hyperinsulinaemia even in the absence of weight loss.Methods. All participants were non-Caucasians males. The study consisted of three phases: phase1:2 visit in the 10 days prior to the start of ramadan, phase 2:3 visits (1 per week) during the 30 days of ramadan and phase 3:1 vist one month after ramadan, when normal patterns of eating and exercising had been resumed. At each study day subjects attended twice, once in the morning (between 08:30 and 10 AM) and once in the afternoon (between 2.00 to 4.30 PM). All subjects completed a questionnair detailing age, smoking habits, medical history, sleeping patterns, dietary intake and training schedule. The studies were approved by National research Ethics Committee and written informed consent was obtained for all participants. 10 subjects completed the study.Weight (Kg) and body composition was measured by electrical bio-impedance (Tanita MC-980 MA) with light cloths at each AM visit. Height (m) was measured on the first visit and BMI was calculated by using formula body weight (kilometres) divided by height (meters) squared. All the participants remained seated for 10 minutes prior to determination of systolic and diastolic blood pressure, and heart rate using an automatic digital blood pressure monitor from the non-dominate arm and mean atrial BP (MAP). blood samples were drawn at all occasions through the ante cubical vein into tubes containing no anti-coagulant or EDTA, separated and stored until analysis. Plasma glucose (mmol/L), serum triglycerides (mmol/L), high density lipoprotein cholestrol (mmol/L), total and direct bilirubin (umol/L), Alanine transaminase (U/L), Aspartate aminotransferase (U/L), urea (mmol/L), uric acid (umol/L), and creatinine (umol/L) concentrations were determined on a chemistry analyser. Insulin (mU/L) concentrations were determined by ELISA. Results are experssed as mean and standard deviattion for normally distributed data and median and iterquartile ranges for skewed data. Significance was defined as P <  0.05.Results. There was significant reduction in body weight during the 2nd and 3rd weeks of ramadan. This weight loss was not sustained in the period immediately following the fasting months as all weight loss was regaind. Body mass index followed the same pattern as body weight. Body fat, both % and mass, decreased soon after the start of fasting (within 2 - 3 days) and was sustaind through the three ramadan testing phases. However, like body weight this loss in body fat was regained in the period immediately after normal eating patterns were resumed.There were no significant changes in muscle mass or body water as a consequence of fasting during Ramadan.There were no significant changes in blood pressure, pulse or basal metabolice rate throughout the entire study.Please (see Table 1) for details.Of note is that all participants were hyperinsulinaemic through the periods of testing prior to and after the cessation of the fasting month. However, during the fasting period insulin levels were significatly reduced. Similar trends were also apparent for alanine transaminase and triglycerides (see Table 2). No changes were seen for all other measured variables. All subjects remained euglycaemic and normotentive.Conclusions. This study shows, for the first time that, prolonged periods of fasting during the day, even without reducing overall daily calorie intake, favours loss of body fat, while preserving muscle mass. This was accompanied by significant improvement in systemic hyperinsulinaemia and indices of liver function.

Background. Metabolic syndrome is defined by a constellation of abnormal factors that directly increse the risk for type 2 diabetes and cardiovascular disorders. the the gulf cooperation council region the prevelance of metabolic syndrome in the population is higher than in most developed countries, with generally greater rates for women, often higher than 40%. Thus, early clinical identification of patients is important to adequately implement treatments to reduce their risk of subsequent metabolic disease. Aims/hypothesis. Therefore the aims of this study were to investigate the hypothesis that in sedentry subjects, post-prandial hyperinsulinemia, despite normal levels of glucose, is an indicator of incipient diabetes. further this lesion is associated with markers of adipose and hepatic dysfunction.Methods.Forty two apparently clinically healthy residents of Qatar were studied. After a 10-hour overnight fast, subjects underwent a detailed clinical assessment, including body composition by bioimpedance, anthropometry measurments (height, weight and BMI), and blood pressure. A liquid mixed meal was administered (200 ml of 18g proteins, 17.4g fats and 40g carbohydrates: total energetic value of 400 kcal) and blood sampling carried out prior to and 30 and 120 minutes after the meal. the study was approved by the Institutional Research Ethics Committee and all subjects provided written informed consent prior to participation.Fasting serum levels of lipids (HDL-C, LDL-C,total cholesterol and triglycrides),liver (GGT,ALP,TB,DB and albumin), plasma glucose, insulin and proinsulin were also determined. HOMA-IR (homeostasis model of assessment-insulin resistance) was calculated using the foloowing formula:(fasting insulin in mIU/L *fasting glucose in mmol/L)/22.5.Serum levels of Leptin and adiponectin were measured using human 2-site ELISAs. All inter- and intra-assay CVs were less than 10%. Results.there were no differrence in age, blood pressure and body composition between the two groups. However, 48% of this population showed hyperinsulinemia in the fasting state, as well as relative hyperglycemia, hyperinsulinemia and hyperproinsulinemia 2 hour after the meal challenge.Systemic lipids and markers of liver function were comparable between the groups. while leptin was elevated in the hyperinsulinemia group (26.1 ng/ml versus 20.9 ng/ml), this did not reach significance. However adiponectin was significantly lower in this chohort (5.8 mcg/ml versus 8.5 mcg/ml, P = 0.002).significant correlation were apparent between fasting insulin concentration and height, measures of body fat as well as muscle mass. In addition fasting insulin also correlated significant with SBP, as well as all measures of glucose and HOMA-IR. interestingly fasting insulin also correlated positively and significantly with liver enzymes. inverse, but significant, association was found between insulin with HDL-C and adiponection. Most of these relationships were lost in the postprandial state.conclusions/interpretation. Thus, these data indicate that postprandial hyperinsulinemia and decreased adiponectin levels should be considered in the plethora of the altered biochemical parameters that define the metabolic syndrome. More importantly, since these biochemical alterations occur in seemingly healthy residents, they may well be considered early biomarkers on incipient metabolic syndrome. the reasons for this lesion in a young and healthy population is likely to be the consequence of a sedentry lifestyle. Exercise and training can improve both insulin resistance and increase adiponectin and should be actively advocated for this population.

Insulin resistance is often associated with hypertrophy of adipocytes. Furthermore, hyperinsulinaemia may mediatechanges in cellular mitochondrial biogenesis and function. Therefore, the current study investigated the hypothesis that lower mitochondrial mass and mitochondrial uncoupling (whereby the electron transport is not used to drive ATP synthesis) is a feature of hypertrophied adipocytes.Methods. Adipose tissue (sub-cutaneous and omental) and blood was obtained from morbidly obese patients (BMI ≥ 40 kg/m2, age 29 ± 2.8 years), undergoing bariatric weight reduction surgery. Anthropometric data was recorded. The blood was used for systemic determination of glucose and insulin by commercial methods. The adipose tissue was separated into the adipocyte and stromal vascular fractions by collagenase digestion. Paraffinembedded adipose tissue was stained with Hematoxylin and Eosin and Image J software was used to determine cell size.Total RNA was isolated using Tri-reagent and the transcriptomeanalyzed using Affymetrix whole transcriptome arrays. The ArrayAnalysis.org statistics module using the Limma package of R/Bioconductor was used for the statistical comparison between High insulin subjects vs. Low insulin group. Genes were considered to be differentially expressed when their absolute log2 fold change (FC) > = 1, and p-value < = 0.05.Indices of mitochondrial function was examined in an in vitro model using 3T3-F442A murine differentiated adipocytes.Cellular lipid content and mitochondrial membrane potential(DΨm) were determined by confocal microscopy with 40 μMBodipy 493/503, a neutral lipid dye, and TMRE (30 nM).NADH/flavoprotein autofluorescence was measured in ‘multitracking’ mode, in which fluorescence was excitedalternately at 351 nm (signal measured at 435-475 nm; NADH)and at 458 (emission measured at >505 nm; flavoprotein). Theresting level of each coenzyme was expressed as a function ofthe maximally oxidized (with the uncoupler FCCP, 1 μM) andmaximally reduced signal (with cyanide, 1 mM). Oxygenconsumption was measured using a Clarke electrode and ATP generation using a luciferase assay.Results.The patient population was dichotomized into hyperinsulinaemic(>7.0 μU/ml) and normoinsulinaemic ( < 6.5 μU/ml) groups. The groups were matched for age and BMI. The hyperinsulianemicgroup, compared to those with normoinsulinaemia, had significantly greater numbers of hypertrophied adipocytes (p = 0.04). Pathway analysis showed that genes involved in the mitochondrial biogenesis (e.g: NRF1, GABPA, TFAM, POLRMT, MTERF and SP1) were comparable between the two groups. However several genes related the electron transport chain and ATP synthesis were significantly different between the hyperinsulinaemic and normoinsulinaemic groups (See table below). Expression of genes related to the electron transport and ATP synthesisComplex ? NDUFA4, ND3,ND6Complex IISDHA, SDHB, SDHC. Complex IIIUQCRH, UQCRFS1.Complex IVCOX5A, COX6A, COX7A. Complex VATP5A, ATP5E, ATP5HAdenine Nucleotide TranslocaterSLC25A4 In adipocytes characterized as having >40% intracellular lipid (hypertrophied), compared to those with < 20% (normal adipocyte), lipid, the rate of oxygen consumption increased(380%). DΨm was significantly reduced in cells with high,compared to those with low, intracellular lipid. Assessment ofredox state in lipid-engorged cells showed that flavoproteinswere more oxidized than NADH, consistent with a shift to b-oxidation as a dominant metabolic pathway. Resting levels ofboth coenzymes were significantly oxidized in lipid-engorgedcells compared to those with < span class = »bumpedFont15