Metabolomics of Ramadan fasting and associated risk of chronic diseases

Al-Jafar, Rami; Pinto, Rui Climaco; Elliott, Paul; Tsilidis, Konstantinos K; Dehghan, Abbas

doi:10.1016/j.ajcnut.2024.01.019

Cited by 3 publications

(2 citation statements)

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“…In LORANS, we investigated earlier changes in metabolites, anthropometry and blood pressure after RIF. We reported significant changes in 14 metabolite levels (normalized between 0 and 1) after RIF ( 26 ), namely lactate, acetate, glycoprotein acetyls, triglycerides in large high-density lipoprotein (HDL), triglycerides in intermediate-density lipoprotein (IDL), triglycerides in medium HDL, triglycerides in large low-density lipoprotein (LDL), triglycerides in HDL, tyrosine, pyruvate, acetone, triglycerides in LDL, phospholipids in very small very-low-density lipoprotein (VLDL), triglycerides in very small VLDL ( β = −0.31, P = <0.001; −0.22, <0.001; −0.07, 0.006; −0.06, 0.006; −0.06, 0.007; −0.08, 0.013; −0.05, 0.014; −0.07, 0.019; −0.1, 0.019; −0.09, 0.019; 0.10, 0.019; −0.05, 0.035; −0.05, 0.041; −0.05, 0.041). However, the current study found that changes in metabolites after RIF are sex-dependent.…”

Section: Discussionmentioning

confidence: 94%

“…As described previously ( 22 , 25 , 26 ), we measured systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), fat mass (FM), fat percentage (F%), fat-free mass (FFM), and total body water (TBW). Also, we collected two blood samples from LORANS participants a few days before and 8–12 days after Ramadan.…”

Section: Methodsmentioning

confidence: 99%

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The dietary changes during Ramadan and their impact on anthropometry, blood pressure, and metabolic profile

Al-Jafar,

Yuqi,

Elliott

et al. 2024

Front. Nutr.

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BackgroundThe effect of Ramadan intermittent fasting (RIF) on the metabolic profile, anthropometry and blood pressure has been investigated in multiple studies. However, it is still unknown to what extent changes in nutrient intakes contribute to these changes.MethodsThis observational study was conducted in London (UK) in 2019. The study collected diverse data from a community-based sample in London before and during/after Ramadan. Collected data included a 3-day food diary (before and during Ramadan), as well as blood samples, anthropometric measurements and blood pressure (before and after Ramadan). The food diary was translated into nutritional data using nutrition software “Nutritics.” The changes in nutrient intakes were investigated using a mixed-effects regression model. The impact of adjusting for nutrient intake change was investigated on the absolute difference of metabolites (Nightingale platform), systolic/diastolic blood pressure and anthropometric measures.ResultsThe study collected data on food intake before and during Ramadan from 56 participants; the mean age was 44.7 ± 17.3, and 51.8% (n = 29) were females. We found a change in the intake of 11 nutritional factors, glucose, fructose, betaine, sugars, sugars as monosaccharide equivalents, lutein/zeaxanthin, starch, starch as monosaccharide equivalents, proline, glutamic acid and lycopene. No changes in quantities or proportions of macronutrients, carbohydrates, protein and fat. Mainly, the changes in diet during Ramadan are characterized by more consumption of sugars (62%, p < 0.001) and a lower intake of starch (−21%, p = 0.012). The changes in 14 metabolite levels (two glycolysis-related metabolites, one amino acid, two ketone bodies, two triglyceride, six lipoprotein subclasses, and an inflammation marker) after Ramadan were partially associated with some changes in nutrient intakes during Ramadan, especially betaine, fructose, glucose, starches and sugars. The lutein/zeaxanthin intake change explained inversely 14% of systolic blood pressure changes. Moreover, BMI and weight changes were partially explained by changes in intake of fat (7%; 9%), monounsaturated fat (6%; 7%), starch (8%; 9%), and starch as monosaccharide equivalents (8%; 9%) intakes in a direct relationship.ConclusionDiet changes during Ramadan were associated partially with the observed changes in the metabolic profile, blood pressure and anthropometry. This confirms the changes associated with RIF in the metabolic profile, blood pressure and anthropometry are not an absolute physiological response to the diet transition occurring during Ramadan.

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Section: Discussionmentioning

confidence: 94%

Section: Methodsmentioning

confidence: 99%

The dietary changes during Ramadan and their impact on anthropometry, blood pressure, and metabolic profile

Al-Jafar,

Yuqi,

Elliott

et al. 2024

Front. Nutr.

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Ramadan during pregnancy and offspring health outcomes over the life course: a systematic review and meta-analysis

Pradella,

Witte,

van Ewijk

2024

Human Reproduction Update

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BACKGROUND Intermittent fasting, such as during Ramadan, is prevalent among pregnant women. However, the association between Ramadan during pregnancy and offspring health along the life course has not been fully established. OBJECTIVE AND RATIONALE Fetal programming research indicates that prenatal exposures, particularly during early pregnancy, can cause long-term structural and physiological changes that adversely affect offspring health. Our objective was to systematically identify and assess the evidence regarding Ramadan during pregnancy. SEARCH METHODS A total of 31 studies were sourced from PubMed, EMBASE, Web of Science, and EconLit. Included studies evaluated outcomes in individuals with prenatal Ramadan exposure, compared to unexposed Muslim controls. Main outcomes were birth weight, gestational length, and sex ratio in newborns; height, mortality, and cognition in children; and disabilities, chronic diseases, and human capital accumulation in adults. Each study was evaluated for risk of bias. The overall quality of evidence was appraised using the GRADE system. Random-effects meta-analyses were conducted for outcomes analyzed in at least three primary studies. OUTCOMES The initial search identified 2933 articles, 1208 duplicates were deleted. There were 31 publications fulfilled the eligibility criteria for the qualitative synthesis; 22 studies were included in meta-analyses. The overall quality of the evidence was low to moderate and differed by study design and outcome. Among newborns, prenatal Ramadan exposure was not associated with birth weight (mean difference (MD) −3 g (95% CI −18 to 11; I2 = 70%) or the likelihood of prematurity (percentage point difference (PPD) 0.19 (95% CI −0.11 to 0.49; I2 = 0%)). The probability that the newborn is male was reduced (PPD −0.14 (95% CI −0.28 to −0.00; I2 = 0%)). This potentially reflects sex-specific mortality rates resulting from adverse in utero circumstances. In childhood, the exposed performed slightly poorer on cognitive tests (MD −3.10% of a standard deviation (95% CI −4.61 to −1.58; I2 = 51%)). Height among the exposed was reduced, and this pattern was already visible at ages below 5 years (height-for-age z-score MD −0.03 (95% CI −0.06 to −0.00; I2 = 76%)). A qualitative literature synthesis revealed that childhood mortality rates were increased in low-income contexts. In adulthood, the prenatally exposed had an increased likelihood of hearing disabilities (odds ratio 1.26 (95% CI 1.09 to 1.45; I2 = 32%)), while sight was not affected. Other impaired outcomes included chronic diseases or their symptoms, and indicators of human capital accumulation such as home ownership (qualitative literature synthesis). The first trimester emerged as a sensitive period for long-term impacts. WIDER IMPLICATIONS Despite the need for more high-quality studies to improve the certainty of the evidence, the synthesis of existing research demonstrates that Ramadan during pregnancy is associated with adverse offspring health effects in childhood and especially adulthood, despite an absence of observable effects at birth. Not all health effects may apply to all Muslim communities, which are diverse in backgrounds and behaviors. Notably, moderating factors like daytime activity levels and dietary habits outside fasting hours have hardly been considered. It is imperative for future research to address these aspects. REGISTRATION NUMBER PROSPERO (CRD42022325770).

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Ramadan Fasting and Its Impact on Patients With Chronic Kidney Disease: Insights and Guidelines

Alobaidi

2024

Cureus

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Fasting during the month of Ramadan is a religious practice observed by millions of Muslims worldwide, including those with chronic kidney disease (CKD). This comprehensive review aims to reflect upon the impacts of Ramadan fasting on CKD patients, excluding those on renal replacement therapy, through an analysis of clinical trials, observational studies, and expert reviews from diverse geographic and methodological backgrounds. It addresses renal function stability, broader health considerations, hydration and electrolyte balance, individual variability in fasting responses, clinical and biochemical effects, nutritional considerations, and metabolic effects. This review reveals that, with appropriate monitoring, dietary management, and individualized care plans, many CKD patients can safely participate in Ramadan fasting without adversely affecting their renal function or overall health. It emphasizes the need for a multidisciplinary approach to patient education, pre-Ramadan assessment, and post-Ramadan follow-up. Furthermore, it highlights the importance of considering individual variability and comorbidities in fasting guidance and underscores the necessity of future research to develop robust, patient-centered fasting guidelines. This review aims to provide healthcare professionals with evidence-based recommendations to support CKD patients wishing to observe Ramadan fasting, ensuring patient safety and optimizing care outcomes.

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Metabolomics of Ramadan fasting and associated risk of chronic diseases

Cited by 3 publications

References 29 publications

The dietary changes during Ramadan and their impact on anthropometry, blood pressure, and metabolic profile

The dietary changes during Ramadan and their impact on anthropometry, blood pressure, and metabolic profile

Ramadan during pregnancy and offspring health outcomes over the life course: a systematic review and meta-analysis

Ramadan Fasting and Its Impact on Patients With Chronic Kidney Disease: Insights and Guidelines

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