THE EFFECT OF RAMADAN FASTING ON BODY ANTHROPOMETRIC MEASUREMENTS, HEMATOLOGICAL INDICES AND SERUM LIPID PROFILE IN GHANAIANS – Book Sample
Ramadan is the ninth month of the lunar calendar during which fasting is prescribed for every healthy adult Muslim. Intermittent fasting and caloric restriction, or alternate-day feeding, had been shown to have effect on some physiological and biochemical parameters in the body. Ramadan fasting is considered a unique model of intermittent fasting as food and fluid intake becomes exclusively nocturnal without restriction on the type or amount of food intake. During this fasting period Muslims refrain from food, liquids and smoking during daylight hours and eat a large meal after sundown. This custom provides a unique opportunity to study the hematological and serum lipid profile changes as well as caloric intake over Ramadan time.
The aim of this study is to determine the effect of Ramadan fasting on hematological indices, caloric intake, lipid profile and anthropometric parameters among Ghanaian Muslims.
Types of fasting
Trepanowski and Bloomer, (2010) classified fasting into four types. These are the caloric restriction form of fasting, the alternate- day fasting, dietary restriction form of fasting and religious fasting. The religious fasting includes the Islamic Ramadan fasting, the three principal fasting period of the Greek Orthodox Christianity (navity, lent and assumption) and the Biblical based Daniel fast.
Ramadan is the ninth month of the Islamic lunar calendar during which fasting is prescribed for every healthy adult Muslim (Khaled et al., 2012). Fasting during Ramadan is one of the five fundamental rituals (pillars) of the Islamic faith. It is stated in the Noble Qur’an that “O you who believe! Fasting is prescribed to you as it was prescribed to those before you so that you can learn Taqwa (good deeds and God-consciousness)” (Quran 2: 183). During this period of fasting, all Muslims must abstain daily from food, drinks and smoking from the period between dawn to dusk and also to abstain from sexual relationship and any forms of misconduct and also from consuming medicines, nutritional fluids and from all addictions (Ahmad et al., 2012).
Ramadan fasting is observed by over 400 million Muslims spread across the globe and Muslims living under various geographical, climatic, social, cultural and economic conditions. . The period of fasting during Ramadan is variable according to season and geographical profile and can range from 11 to18 hours a day (Khaled et al., 2012; Lahdimawan et al., 2013), with a duration of 29 to 30 days (Trepanowski and Bloomer, 2010).
Fasting during the month of Ramadan is obligatory for every healthy adult Muslim but, when fasting turns out to significantly affect the health of the fasting individual or when an individual is genuinely sick, Islam exempts him or her from the Ramadan fasting. It is stated in Qur’an that, “Allah does not impose upon any soul a duty but to the extent of its ability” (Quran 2: 286). Fasting during Ramadan is also not obligatory for children, travellers, pregnant women, breast feeding mothers, menstruating women or the debilitated (Azizi, 2002; Khaled et al., 2012). Menstruating women as well as sick and travelling people, pregnant and lactating women are permitted to postpone the fasting during Ramadan. However, they are expected to fast during another month of the year, when they have no reason for exemption to make up for the lost times (Azizi, 2002).
The basic objectives of this month long fasting process are to help shape the behaviour and pattern of life of its practitioners in such a way that they turn out to be ideal beings. In order to achieve this, a fasting individual must restrain him or herself listening, speaking, hearing or thinking bad of others (Ahmad et al., 2012).
The uniqueness of Ramadan fasting is that food and fluid intake is concentrated into the hours between sunset and the following sunrise. Fasting has been shown to have a positive effect on longevity (Khaled et al., 2012).
During Ramadan fasting, only two meals are taken daily and also, the total daily amount of food decreases. Therefore, Ramadan can have anthropometric, physiological, metabolic and endocrine effects on the human body (Sayedda et al., 2013). Ramadan teaches Muslims self–restraint and reminds a Muslim of the feelings of the impoverished (AlNahari and Kouja, 2014). During the month of Ramadan, frequency and quantity of food and daily physical activity are changed. Food and fluid intake are mainly nocturnal.
The food habits, as well as food quality, differ during Ramadan fasting as compared with other months. There is tendency to consume foods that are richer in carbohydrates during this period (Baltaci and Bucaktepe, 2011). The Ramadan fasting is associated with altered meal patterns and sleep (Lahdimawan et al., 2013).
As part of the aims of Ramadan fasting, Muslims are encouraged to be mindful of their health. Islam encourages individuals to do their best to keep up healthy living lifestyle including having healthy balanced diet. Ramadan fasting then becomes a great opportunity for Muslims to focus on returning to a balanced and healthy lifestyle. Through Ramadan fasting one begins to learn how to manage eating habits, how to improve self-control and discipline. During this Ramadan fasting period, the stomach is able to break down and get rid of accumulated toxins from the body as its work load is reduced (Mahroof et al., 2007).
Intermittent fasting has been found to help extend life-span, decrease age-related health diseases and decrease the development of chronic degenerative diseases (Martin et al., 2007). Genetically, the human system is adapted cycles of feast and famine, and physical activity and rest. These cycles are beneficial in modulating metabolic processes in the human body and without these cycles, the human system becomes prone to metabolic derangements such as obesity and diabetes. Intermittent fasting puts the human system in the feast and famine cycle and therefore the need for intermittent fasting (Halberg et al., 2005).
Intermittent fasting is known to be an excellent weight loss regimen that has received extensive attention in recent times. Intermittent fasting can produce excellent decreases in coronary heart disease (CHD) risk, and this is mediated in part by improvements in adipokines (Kroeger et al., 2012). Ramadan fasting can be considered to be a type of intermittent fasting, in which there are periods of fasting and feasting (Longo and Mattson, 2014).
Tajes et al., (2010), carried out a research and came out with a finding that, after eight weeks of intermittent fasting, antioxidant control of oxidative stress was significantly improved.
Intermittent fasting also helps to protect against metabolic toxins (Steinshraus et al., 2008). It helps to lower serum glucose levels, increase insulin sensitivity, increase HDL levels, improves the cholesterol and HDL ratio, lowers homocysteine levels and helps to manage diabetes (Hfaiedh et al., 2008., Aksungar et al., 2005). Intermittent fasting has also been found to improve protein metabolism and it controls blood pressure (Halberg et al., 2005).
Adiponectin, which is a protein hormone known to regulate blood glucose and blood fat metabolism and controls body fat, has been found to increase during intermittent fasting (Tikoo et al., 2007).
Intermittent fasting has been shown to also help in lowering growth hormone and increasing Inhibitory Growth Factor 1(IGF1) levels. This helps to protect against the ageing process. Intermittent fasting has been found to protect against neurodegenerative disorders. Intermittent fasting has also been found to suppress Methylglyoxal (MG) formation which is a glycating agent that is associated with impaired energy production, oxidative stress, and abnormal gene expression and cell signaling (Rocha et al., 2002).
Physiological changes that occur during a fast
Changes in the body physiology occur in response to fasting depending on the length of the fast. The body is said to be in a state of fasting eight hours or more after the last meal. During this period, digestion and reabsorption of nutrients would have taken place. In the non-fasting state, body glucose, which is stored in the liver and muscles, is the body’s main source of energy. However, during fasting, glucose stores get depleted. The body then resorts to the use of fat to generate energy (Mahroof et al., 2007). Protein becomes a source of energy only when there is prolonged fasting of many days to weeks. This then becomes an unhealthy practice. As the Ramadan fasting only extends from dawn till dusk, there is that opportunity to replenish energy stores at dawn and after sunset. This cycle of feeding then becomes a progressive transition from the use of glucose to fat as the main source of energy and thus prevents the breakdown of muscle for protein. The use of fat for energy is very beneficial as it aids in weight loss. It also helps to preserve the muscles and in turn, improves blood cholesterol levels. In addition, weight loss results in better control of diabetes and reduces blood pressure. Fasting also aids to improve level of alertness and general mental well-being. This is achieved as fasting helps to elevate levels of endorphins (Mahroof et al., 2007).
Energy requirements during Ramadan fasting
The balance of food and ﬂuid intake between fasting is very important. The kidney functions in maintaining a balance in the body’s fluids and electrolytes. However, these can be lost through sweating. There is also the tendency for the breakdown of muscles during fasting to provide energy. In order to prevent muscle breakdown, meals must contain adequate levels of “energy food”, such as carbohydrates and some fat. Hence, a balanced diet with adequate amounts of nutrients, salts and water is vital (Zechner et al., 2005).
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