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.

Objectives: To evaluate the effect of a single evening meal (gorging) on plasma lipids and lipoproteins in normal individuals observing the Ramadan Fast. During the Ramadan month, Muslims refrain from food and liquids during the day and eat a large meal after sundown. Design: Sequential measurement of plasma lipids and lipoproteins in Muslims observing the Ramadan Fast and non-fasting individuals. Setting: The study was conducted in the Bedouin town of Rahat, in the northern Negev area of Israel. Subjects: Twenty-two healthy subjects who fasted during Ramadan and 16 non-fasting laboratory workers, were studied before Ramadan, at week 1, 2 and 4 of the Ramadan month, and again four weeks after the end of Ramadan.Results: Plasma high-density lipoprotein cholesterol (HDL) rose signi®cantly (P`0.001) at the week 4 measurement, returning to basal levels 4 weeks after the end of Ramadan. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL), very-low density lipoprotein cholesterol (VLDL), and lipoprotein (a) [Lp(a)] did not change signi®cantly. Conclusions: Plasma HDL increased by 23% after four weeks of gorging. The dietary change did not affect the composition of other lipoproteins, such as LDL, VLDL or Lp(a), other plasma biochemical parameters, or BMI. Prolonged gorging, well tolerated by all individuals, is a very effective non-pharmacological method to increase plasma HDL-cholesterol. Sponsorship: This work was supported by funds from the Ben

We studied the effect of one large evening meal (gorging‐type diet) on patients with diabetes mellitus, during the month of Ramadan. Observant Muslims refrain from food and drink during the day and eat a large meal after sundown. It was an observational study carried out under field conditions in the Bedouin town of Rahat, in the northern Negev area of Israel. Fasting diabetic subjects were studied before, at the end of, and one month after Ramadan. Body weight, changes in medication, frequency of acute complications, plasma glucose and hemoglobin A1c were determined. Sixty‐seven fasting Muslim diabetic patients were studied. A significant decrease in hemoglobin A1c (HbA1c; p<0.001) was observed at the end of the month of fasting. There was no significant change in the total daily dose of antidiabetic agents, or in the incidence of acute diabetic complications. The gorging‐type diet, followed for one month, was well tolerated and safe. A statistically significant decrease in HbA1c suggests a beneficial effect of the Ramadan fast in these patients. Copyright © 2001 John Wiley & Sons, Ltd.

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