metabolism in the broader context of timely intervention and timed treatment. In: Schottauer. FK, ed. Diabetes research today, meeting of the Minkowski. Prize.
Increased fat oxidation women: an adaptative maintenance1’2 Jalila
El Mi,
Chiraz
ABSTRACT
Beji,
Possible
pometnic
and
metabolic
and
faber
effects
during Ramadan fasting in healthy mechanism for body-weight
Danguir
of Ramadan
variables
were
fasting
investigated
on anthro-
anthropometnic,
metabolic,
in healthy
ables
women.
concomitant ratory and
decrease of plasma energy expenditure
insulin during
evolution of nutrient oxidation was increased and carbohydrate the
light
span
of the
concentrations Ramadan.
rates was oxidation
nycthemeron.
Qualitative
and
body
weight
and
Sixteen (BMI,
f Cliii
hormonal
vari-
METHODS
women
Institute
of Nutrition,
measurements Ramadan (Ti),
Nutr
fasting,
and,
25-39
of 22.7 had
0.3,
who
finally,
body
were
mass
metabolic
after
of the
for this
disease.
on four different days: day (T2) and the 28th
1 mo
index
employees
to be subjects
a chronic
were made the second
a mean
y with
±
volunteered
of the subjects
might be to preserve 1995;
aged
in kg/m2)
None
quantitative
Ramadan in order
Am
composition.
AND
and
Subjects
with respiThe circadian
modified. Fat oxidation was decreased during
circadian changes in feeding associated with counterbalanced by specific metabolic changes normal
SUBJECTS
energetic,
Ramadan
(T4).
at the same
time
study.
All of the 2 d before day (T3) of
62:302-7.
Anthropometric KEY tnient
WORDS oxidation,
circadian
Ramadan body weight,
fasting, body
energy expenditure, composition, food
nuintake,
Body
variables
weight
was
fluctuations
sites: subscapular, was calculated (9). Percentage the equation
INTRODUCTION The
effects
of a change
physiological
and
explored
both
context, investigate
Ramadan provides the metabolic
eating healthy and fluid
in
in the
metabolic
in humans
of the have
(1-3)
and
an effects
in with
(4,
Energy
widely 5).
to of
Thus, food Furthermore,
sleep activity
eaten.
a (7), day
Ramadan In view
fasting on metabolic of the fact that a given
quantity, but metabolic
at an unusual effects (4,
302
remains to be answered, physiological modifications
inversion of of the present
of Ramadan-induced
eating work exclusive
time an
ie, what are induced
the by
habits during a whole was to investigate the
Am
feeding J C/in
Nutr
Tunis, 2
on
Institute
from
Body density and Rahaman density
by using
1995;62:302-7.
were
and
estimated
days,
the
exact
times
from
developed France) table
of Statistics
biochemical
12 h of fasting.
From
experimental quantities
of Tunis
subjects
the
re-
of all food coded
dietary
for the IBM PS/2 with values based published by the in 1978.
assays
blood
Plasma
were
Institute
were
always
glucose
(11),
cholesterol
requests
Received
September for publication in USA.
enzymatically
of Experimental
12,
1006
Tunis
(12), Uric
Institute
Department Bab
determined
(13).
Nutrition,
to J Danguir,
of Nutrition,
Accepted
Printed
indexes
determined
the Department
Tunisia. Address reprint
Nutrition,
on
these
intakes
triglycerides
6),
nocturnal
calculated
using a program Nutnisoft, Cenelles, the food-composition
Biochemical
‘
important question true metabolic and
effects
by
National
after
of
approximate
Nutrient
The
nutrient ingested in an equal is known to induce different
the spontaneous month? The aim
the
records (BJLNUT; mainly
and
duration during the
each
corded
(8)
effects of not known.
triceps, and suprailiac. the equation of Dumin
body fat was of Sin (10).
0830
intake
During
In this
opportunity the time
a holy lunar month, to abstain from food
and
biceps, by using
(between
Skinfold thickness was meaa Harpenden caliper at four
on various
been
in animals
and sunset. nocturnal.
meal frequency (6) a reduction in physical
are reported. Hitherto, the variables were
diet
appropriate of changing
humans. During Ramadan, adult Moslems are expected
drink daily between dawn intakes become exclusively
decrease together
timing variables
measured
and 0900), to the nearest 0.2 kg. sured to the nearest 1 mm with
of
Saadoun,
and acid
of Nutrition, Experimental Tunisia.
1994. March
© 1995
22,
1995.
American
Society
for Clinical
Nutrition
Downloaded from www.ajcn.org by guest on July 14, 2011
Tunisian Moslem women. Total daily energy intake remained unchanged whereas the qualitative components of nutrients were markedly affected. Neither body weight nor body composition were influenced by Ramadan fasting. Results also indicate the
in healthy
NUTRITION, TABLE
variables
Weight
TI
(kg)
Fat mass body
BMI
(kg/m2)
mass
(kg)
Waist:hip
was
TI,
2 d before
measured
Plasma
by
fatty
acids
scnibed a kinetic
by Falholt method
by
Tronchet
the
cortisol
were
303
± 1.3
± 1.4
± 0.6
43.4
± 0.6
43.2
± 0.7
43.1
± 0.7
22.6
± 0.2
22.5
± 0.3
22.5
± 0.4
± 0.0()8
0.745
second
day
of fasting;
acid
colonimetnically
T3,
method
(14). as
insulin the
to the method by Amersham
± ().0()8 d of fasting;
and
Substrate
de-
T4,
determination
throughout the protein oxidation.
and
was
circadian
obtained
0.733
± 0.008
after
Ramadan.
0.733
of urinary
made
fat oxidation the formula
nitrogen
excretion
nycthemeron was used to The nonprotein respiratory
by subtracting
contribution
of Hales and International
1 mo
± 0.()()5
oxidation
The
by using measured
Immunoreactive 3 h throughout
28th
from
the respiratory
by oxidation
of protein.
rates were calculated from of Consolazio et al (21).
every
calculate quotient
3 h
rates of (nPRQ)
exchange
the
Carbohydrate
the nPRQ
and
according
to
UK.
During
the
four
rate and energy chamber by using
test
was determined were allowed
days,
nesting
expenditure were indirect calonimeenergy
expenditure
± SEM. Comparisons T3, and T4 were tested Mann Whitney U tests
(22).
for 30 mm between 0830 and 0900. All 1 h nest in the metabolic chamber before
the determination of oxygen values (type MT/G 1 1-2; Bnaun, Frankfurt, Genmany). expenditure The energy
the
analysis
All results are presented as mean between means observed at TI , T2, by using both Knuskal Wallis and
(V02) and carbon dioxide (VCO2) metabolism tester; Hartmann and The evolution ofcincadian energy
was evaluated at 3-h intervals from expenditure was calculated by using
formula (19, 20): Energy expenditure ratio, under standard temperature and
=
RESULTS As
0800 to 2300. the following
shown
in
Table
mained unaffected body weight non
VO2Xenergy-oxygen pressure of dehydrated
during served
conditions.
total
1, the
anthropometnic
or 1 mo after Ramadan, compared before the beginning of fasting. Data daily
variables
ne-
by Ramadan fasting. Indeed, neither fat on lean masses changed significantly
energy
intake
remained
with values showed that
comparable
obthe
before,
2
composition’ Nutrient
Tl
(ii
=
16)
1.93
T2 (,z
=
16)
T3
(ii
=
16)
T4
(ii
=
16)
Energy (Mild)
10.20
±
10.24
±
(kcalld)
244()
± 461
2451
± 363
1.32
10.19
± 0.74
10.99
± 1.41
2437
± 178
2630
± 375
(g/d)
85.4
± 9.3
104.1
(% of energy)
14.1
± 0.7
17.1
± 10.52
96.8
± 8.6
93.3
± 7.5
±
0,92
16.9
± 0.8
14.2
± 0.7
38.6
± 7.7
48.9
±
39.1
± 5.2
33.3
± 3.1
41.1
± 7.1
70.7
±
67.8
±
52.1
± 9.4
Protein
Vegetable Animal
protein protein
Animal-vegetable
(gld) (g/d) protein
ratio
11.5
1.3 ± 0.2
1.8 ±
19.12
2.1
0,32
l3.3
± 0.2
1.2 ± 0.1
Total fat
(gld) (% ofencrgy) Saturated
100.5 fatty
Monosaturated Polyunsaturated
acids
(gld)
fatty
acids
fatty
(gld)
acids
(gld)
± 30.1
120.3
35.62
1 19.6
109.2
± 23.7
1.6
44.1
± 2.42
43.2
± 2.2
37.4
± 2.1
30.1
± 2.9
37.4
± 2.6
38.2
± 2.8
41.3
± 2.6
18.3
± 2.7
21.9
± 3.7
24.7
± 2.9
18.2
± 3.1
51.6
± 3.9
56.9
± 2.7
54.7
± 3.5
48.5
± 1.7
318.2 48.4
± 51.1 ± 3.2
37.1
±
±
±
28.7
Carbohydrates
(gld) (% of energy) ‘ _t ± SEM. TI,
2 d before
297.6 ± 58.7 48.8 ± 1.8 second day of fasting;
Ramadan;
T2,
2
Significantly
different
from
before
fasting,
3
Significantly
different
from
before
Ramadan,
P < 0.05. P < 0.05.
T3,
28th
237.7 ± 42.32 38.8 ± 2.62 d of fasting; and
T4,
I mo
243.1 ± 44,33 39.9 ± 2.1 after Ramadan.
Downloaded from www.ajcn.org by guest on July 14, 2011
Statistical
nesting metabolic in a metabolic
TABLE
58.6
± 0.3
determined
according supplied
± 1.2
16)
=
22.7
T2,
(1 7).
58.9
T4 (n
43.3
phosphotungstic
every
± 1.2
16)
=
16.1 ± 1.2
the
reaction
T3 (n
16.2 ± 1.3
Ramadan;
measured
16)
=
16.3 ± 1.2
expenditure
Both measured (REE) subjects
58.9
(ii
16.7 ± 1.3
et al (15). Creatinine was estimated (16). Calcium and phosphorus were
Amersham,
try.
T2
were
cycle and were assayed Randle (18) with reagents
Energy
16)
=
0.745 SEM.
±
‘
(a
59.3
(kg)
Lean
Diet
RAMADAN
of subjects’
Variable
gas
AND
1
Anthropometric
Co,
METABOLISM,
304
EL
TABLE
AT!
ET
AL 600
3
Meal
frequency
before
(TI),
during
(T2
and
T3),
and
after
(T4) 550#{149}
Ramadan’ Ramadan Eating
time
Before
During
% Breakfast
0600-0800
7.5
-
18.2
Lunch
41.6
-
52.3
15()0-17(X)
11.1
18(10-20(X)
Night
eating
I
during,
after
Ramadan
(Table
However, both protein
200
16.0
(Table
-
E
Results
are shown increased indexes
fasting plasma
conditions. cortisol contrary,
6
in
7
The
effect
increase
protein
Ramadan
No differences concentrations
intake
whereas
of an increase fasting
in Table 4 Except exclusively during showed no significant
blood
eaten showed that increased during
of protein
in animal
of
FIGURE before and
(Table 2). Conversely, a sigof carbohydrate intake was
was the result fatty acids.
of the
ables which studied
Ramadan decrease
increase
crease of fat intake well as unsaturated
decrease
8
9
10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Time
analysis of food were significantly
Ramadan.
to an
the
was the
of saturated on
plasma
as
were
(Ti);
after
not
Ramadan
a significant
pant
and
of the
fat oxidation
circadian
the
marked
changes
ically
Thus,
periods negate
Ramadan. not
However,
change Ramadan
quotient circadian
circadian of nutrient
(Figure
biochemical
Blood Glucose
decrease
1 100
energy
to
expenditure decline
1700
in
during
values
did
5). Although
results crease
in respiratony
protein
oxidation
2 d
of fasting;
of carbohydrate
were
oxi-
of fat oxidation were changes in both car-
evidenced
duning
a large
is the absence of an effect of and body composition despite
intake
increase decrease feeding.
daily with
habits.
The
in terms contradict of total
energy that of
of food
intake
latter
of protein and of carbohydrate intake during the pre- and
despite the reduction of meal frequency. the common local belief that Moslems
pensate
during
this
consisted
particularly intakes,
fat and
Ramadan post-Ramadan
re-
These findings tend to overcomfasting
previous findings that showed energy intake in Saudi subjects
month.
Our
either an in(23) or a de-
crease of daily energy intake in Indian Moslems (24) during Ramadan fasting. Obviously, these discrepancies can probably be explained by the food habits in different Islamic countries.
cycle (Figure 4). Similarly, the oxidation rates were modified rates
variables’
variables2
Tl
(mmol/L)
Cholesterol
(mmoIlL)
Triglycerides Creatininc
(mmoIlL) (pmol/L)
Calcium
(mmol/L)
Phosphorus acid ‘ I
a significant from
d (T3)
4
Blood
Uric
the nightly
Ramadan
TABLE
observed
significantly (Figure 3). fasting induced a significant during the variations
during
fasting.
rates
in food
Interestingly, the mained comparable
was
the nycthemeron
the 28th
decrease
The main finding of this report Ramadan fasting on body weight
reduced
before Ramadan. However, the the cincadian cycle was dramat-
during
and
DISCUSSION
after Ramadan, compared with energy expenditure throughout expenditure
along
(12)
cycle.
of principally 1) a large intakes, 2) a proportional 3) exclusively nocturnal
affected
day
(T4).
mainly between 0800 and 1700, and were slightly but significantly increased after the termination of fasting during T2 as well as T3 (Figure 2). The REE measured at 0800 remained unchanged during and
energy
(hours)
concentrations
the second
affected,
bohydrate
van-
for the uric acid rates, Ramadan, all of the variation under these
concentrations
I mo
cortisol
dation together with a significant increase observed during Ramadan fasting. These
were detected in circadian during fasting (Figure 1). On
insulin
Ramadan
were
in-
1. Plasma
±
(mmollL) (j.mol/L) SEM. TI,
2
Blood
removal
3
Significantly
2 d before was different
done
Ramadan; after
from
(n
=
16)
(n
=
16)
T3 (n
=
15)
T4
(n
=
14)
4.86
± 0.39
5.22
± 0.56
5.21
± 0.62
4.62
± 0.72
4.62
± 0.62
4.52
± 0.28
5.02
± 0.32
4.66
± 0.27
0.68
± 0.05
0.55
± 0.05
0.66
± 0.07
0.82
± 0.05
73.8
± 5.9
73.8
± 8.1
79.1
± 7.8
74.9
± 8.9
2.21
± 0.08
2.45
± 0.13
2.52
± 0.14
2.41
± 0.17
1.18
± 0.13
1.24
± 0.16
1.14
± 0.26
1.03
± 0.11
170.3
± 18.2
184.4 ± 10.2 12, second day
12 h of starvation,
before
T2
Ramadan
of fasting;
ie, at 0830 (TI),
P < 0.01.
T3, under
260.6 ± 17.7 28th day of fasting; normal
eating
conditions
and
T4,
254.6 1 mo after
(Ti
and
T4)
and
± 13.3 Ramadan. at 1230
during
Ramadan
(T2
and
T3).
Downloaded from www.ajcn.org by guest on July 14, 2011
during
mainly
2) despite
3).
the qualitative and fat intakes
the entire duration of nificant and proportional
the
250
150’
frequency
due
300
0 U)
a.
and
observed
C 0 0
14.2
16.
=
meal
84.0
-
T2
40-13 ..14
350
7.8
-
21.8
20()0-2400
400’
0.
(S
9.4
Dinner
.
of energy
16.1
Snack
450’
C
SnackO900-llOO 12()0-14(X)
.50o E After
NUTRITION,
METABOLISM,
AND
450
305
RAMADAN
1.0
400 -o’-
T2 T3
-o-
T4
-00
E
350
5
300
0.9
250
-
C
g
200’
a)
150
‘5
S
0.8
.-
100#{149}
a
0.7
50
67
9
8
13
14
15
16
17
18 19
20 21
22
23
2. Plasma
before
Significantly
S
FIGURE
(hours)
*
concentrations
during
different
(T2 from
and
for
T3),
before
the
and
fasting
day
after
(Ti
and
evening
Ramadan
compared
P *
Significantly
different
from
before
Ramadan
(Ti
compared
with
**
T3),
variations
and
after
different
0.05, Significantly
