Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study

Nutrition Journal

Abdolreza Norouzy³  Mohsen Moohebati⁵  Neda Shalaey³  Seyed Amir R Mohajeri³  Maryam Sabery¹  Saeed Akhlaghi⁴  Seyedeh Sania Sajjadi³  Mostafa Mozhdehifard³  Masoud Mahdavi Rashed³  Maryam Alinezhad-Namaghi³  Mohsen Nematy² 

[1] Iranian Applied Research Center for Health and Sustainable Development (IRCPHD), North Khorasan University of Medical Sciences, North Khorasan, Iran;Department of Nutrition, Mashad, Biochemistry and Nutrition, Endoscopic & Minimally Invasive Surgery, and Cancer Research Centers, University of Medical Sciences, Mashad, 91779-48564, Iran;Biochemistry and Nutrition Research Center and Department of Nutrition, Mashad, University of Medical Sciences, Mashad 91779-48564, Iran;Department of Community Medicine, Mashad, University of Medical Sciences, Mashad, 91779-48564, Iran;Department of Cardiology, Ghaem Teaching Hospital, Mashad, University of Medical Sciences, Mashad, 91766-99199, Iran

关键词: Risk factors;    Cardiovascular diseases;    Insulin resistance;    FBS;    Homocysteine;    hs-CRP;    Fasting;    Ramadan;   

Others  :  824010
DOI  :  10.1186/1475-2891-11-69

 received in 2011-09-17, accepted in 2012-07-30,  发布年份 2012

【 摘 要 】

Background

Previous research has shown that Ramadan fasting has beneficial effects on cardiovascular risk factors, however there are controversies. In the present study, the effect of Ramadan fasting on cardiovascular risk factors has been investigated.

Method

This is a prospective observational study that was carried out in a group of patients with at least one cardiovascular risk factor (including history of documented previous history of either coronary artery disease (CAD), metabolic syndrome or cerebro-vascular disease in past 10 y). Eighty two volunteers including 38 male and 44 female, aged 29–70 y, mean 54.0 ± 10 y, with a previous history of either coronary artery disease, metabolic syndrome or cerebro-vascular disease were recruited. Subjects attended the metabolic unit after at least 10 h fasting, before and after Ramadan who were been fasting for at least 10 days. A fasting blood sample was obtained, blood pressure was measured and body mass index (BMI) was calculated. Lipids profile, fasting blood sugar (FBS) and insulin, homocysteine (hcy), high-sensitivity C-reactive protein (hs-CRP) and complete blood count (CBC) were analyzed on all blood samples.

Results

A significant improvement in 10 years coronary heart disease risk (based on Framingham risk score) was found (13.0 ± 8 before Ramadan and 10.8 ±7 after Ramadan, P <0.001, t test).There was a significant higher HDL-c, WBC, RBC and platelet count (PLT), and lower plasma cholesterol, triglycerides, LDL-c, VLDL-c, systolic blood pressure, body mass index and waist circumference after Ramadan (P <0.05, t test). The changes in FBS, insulin,Homeostasis Model Assessment Insulin Resistance (HOMA-IR), hcy, hs-CRP and diastolic blood pressure before and after Ramadan were not significant (P >0.05, t test).

Conclusions

This study shows a significant improvement in 10 years coronary heart disease risk score and other cardiovascular risk factors such as lipids profile, systolic blood pressure, weight, BMI and waist circumference in subjects with a previous history of cardiovascular disease.

【 授权许可】

   
2012 Nematy et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Sarraf-Zadegan N, Atashi M, Naderi GA, Baghai AM, Asgary S, Fatehifar MR, et al.: The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Ann Saudi Med 2000, 20(5–6):377-381.
• [2]Ziaee V, Razaei M, Ahmadinejad Z, Shaikh H, Yousefi R, Yarmohammadi L, et al.: The changes of metabolic profile and weight during Ramadan fasting. Singapore Med J 2006, 47(5):409-414.
• [3]WHO: The global burden of disease: 2004 update. THE REPORT IN SECTIONS. Part 2: Causes of death. 2009. Internet: http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html webcite (accessed 11November 2009)
• [4]Al SJ, Bener A, Hajar HA, Numan MT: Does hospitalization for congestive heart failure occur more frequently in Ramadan: a population-based study (1991–2001). Int J Cardiol 2004, 96(2):217-221.
• [5]Akhan G, Kutluhan S, Koyuncuoglu HR: Is there any change of stroke incidence during Ramadan? Acta NeurolScand 2000, 101(4):259-261.
• [6]Sarraf-Zadegan N, Boshtam M, Rafiei M: Risk factors for coronary artery disease in Isfahan, Iran. Eur J Public Health 1999, 9(1):20-26.
• [7]Afrasiabi A, Hassanzadeh S, Sattarivand R, Mahboob S: Effects of Ramadan fasting on serum lipid profiles on 2 hyperlipidemic groups with or without diet pattern. Saudi Med J 2003, 24(1):23-26.
• [8]Shariatpanahi ZV, Shariatpanahi MV, Shahbazi S, Hossaini A, Abadi A: Effect of Ramadan fasting on some indices of insulin resistance and components of the metabolic syndrome in healthy male adults. Br J Nutr 2008, 100(1):147-151.
• [9]Bouguerra R, Jabrane J, Maatki C, Ben SL, Hamzaoui J, El KA, et al.: Ramadan fasting in type 2 diabetes mellitus. Ann Endocrinol (Paris) 2006, 67(1):54-59.
• [10]Khaled BM, Bendahmane M, Belbraouet S: Ramadan fasting induces modifications of certain serum components in obese women with type 2 diabetes. Saudi Med J 2006, 27(1):23-26.
• [11]Norouzy A, Mohajeri SM, Shakeri S, Yari F, Sabery M, Philippou E, et al.: Effect of Ramadan fasting on glycaemic control in patients with Type 2 diabetes. J Endocrinol Invest 2011. Oct 6.[Epub ahead of print]
• [12]Aksungar FB, Topkaya AE, Akyildiz M: Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Ann NutrMetab 2007, 51(1):88-95.
• [13]Graham IM, Daly LE, Refsum HM, Robinson K, Brattstrom LE, Ueland PM, et al.: Plasma homocysteine as a risk factor for vascular disease. The European Concerted Action Project. JAMA 1997, 277(22):1775-1781.
• [14]Shroff GR, Cen YY, Duprez DA, Bart BA: Relationship between carotid artery stiffness index, BNP and high-sensitivity CRP. J Hum Hypertens 2009, 23(12):783-787.
• [15]Rost NS, Wolf PA, Kase CS, Kelly-Hayes M, Silbershatz H, Massaro JM, et al.: Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: the Framingham study. Stroke 2001, 32(11):2575-2579.
• [16]Koenig W, Sund M, Frohlich M, Fischer HG, Lowel H, Doring A, et al.: C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation 1999, 99(2):237-242.
• [17]Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, et al.: A self-fulfilling prophecy: C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 2002, 106(8):913-919.
• [18]Falk E, Shah PK, Fuster V: Coronary plaque disruption. Circulation 1995, 92(3):657-671.
• [19]The office of the supreme leader, Sayyid Ali Khamenei. Practical lows of Islam. Internet 2009. http://www.leader.ir/langs/en/ webcite (accessed 10 November 2009)
• [20]Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M: The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens 2001, 15(10):723-725.
• [21]Lohman TG, Roche AF, Martorell R: Anthropometric Standardization Reference Manual. Kinetics Books Champaign, IL; 1988.
• [22]Burtis CA, Ashwood ER, Bruns DE: Tietz Textbook of Clinical Chemistry AND Molecular Diagnostics. Fourth edition. Elsevier Saunders, Philadelphia; 2001.
• [23]Frantzen F, Faaren AL, Alfheim I, Nordhei AK: Enzyme conversion immunoassay for determining total homocysteine in plasma or serum. ClinChem 1998, 44(2):311-316.
• [24]Tan Y, Tang L, Sun X, Zhang N, Han Q, Xu M, et al.: Total-homocysteine enzymatic assay. ClinChem 2000, 46(10):1686-1688.
• [25]Azarpazhooh MR, Mobarra N, Parizadeh SM, Tavallaie S, Bagheri M, Rahsepar AA, et al.: Serum high-sensitivity C-reactive protein and heat shock protein 27 antibody titers in patients with stroke and 6-month prognosis. Angiology 2010, 61(6):607-612.
• [26]Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28(7):412-419.
• [27]Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB: Prediction of coronary heart disease using risk factor categories. Circulation 1998, 97(18):1837-1847.
• [28]Manninen V, Huttunen JK, Heinonen OP, Tenkanen L, Frick MH: Relation between baseline lipid and lipoprotein values and the incidence of coronary heart disease in the Helsinki Heart Study. Am J Cardiol 1989, 63(16):42H-47H.
• [29]Kinosian B, Glick H, Garland G: Cholesterol and coronary heart disease: predicting risks by levels and ratios. Ann Intern Med 1994, 121(9):641-647.
• [30]Fakhrzadeh H, Larijani B, Sanjari M, Baradar-Jalili R, Amini MR: Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med 2003, 23(3–4):223-226.
• [31]Adlouni A, Ghalim N, Benslimane A, Lecerf JM, Saile R: Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol. Ann NutrMetab 1997, 41(4):242-249.
• [32]Khatib FA, Shafagoj YA: Metabolic alterations as a result of Ramadan fasting in non-insulin-dependent diabetes mellitus patients in relation to food intake. Saudi Med J 2001, 25(12):1858-1863.
• [33]Ramadan J: Does fasting during Ramadan alter body composition, blood constituents and physical performance? Med PrincPract 2002, 11(Suppl 2):41-46.
• [34]Aksungar FB, Eren A, Ure S, Teskin O, Ates G: Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann NutrMetab 2005, 49(2):77-82.
• [35]Yarahmadi S, Larijani B, Bastanhagh MH, Pajouhi M, Baradar JR, Zahedi F, et al.: Metabolic and clinical effects of Ramadan fasting in patients with type II diabetes. J Coll Physicians Surg Pak 2003, 13(6):329-332.
• [36]Frost G, Pirani S: Meal frequency and nutritional intake during Ramadan: a pilot study. Hum Nutr Appl Nutr 1987, 41(1):47-50.
• [37]Yucel A, Degirmenci B, Acar M, Albayrak R, Haktanir A: The effect of fasting month of Ramadan on the abdominal fat distribution: assessment by computed tomography. Tohoku J Exp Med 2004, 204(3):179-187.
• [38]Aybak M, Turkoglu A, Sermet A, Denli O: Effect of Ramadan fasting on platelet aggregation in healthy male subjects. Eur J Appl Physiol Occup Physiol 1996, 73(6):552-556.
• [39]Iraki L, Bogdan A, Hakkou F, Amrani N, Abkari A, Touitou Y: Ramadan diet restrictions modify the circadian time structure in humans. A study on plasma gastrin, insulin, glucose, and calcium and on gastric pH. J Clin Endocrinol Metab 1997, 82(4):1261-1273.