The Importance Of Fasting In Ramadan

Introduction:

Ramadan is a month for Muslims during which they abstain from eating, drinking and smoking from dawn to dusk. During month of Ramadan there are changes in the quality of food and eating patterns(1). As would be expected, caloric intake is often reduced during this month(2).

The food habits are not similar outside and the proportion of fat, protein and carbohydrate intake can differ during Ramadan. There is a tendency to consume foods and drinks that are richer in carbohydrates than those consumed during other months of the year. The quality of ingested nutrients can also differ during Ramadan compared with the rest of the year(3).

Nonalcoholic fatty liver disease (NAFLD) is gaining increasing recognition as a component of the epidemic of obesity in the United States as well as in other parts of the world.

Steatosis is defined asa hepatic TG level exceeding the 95th percentile for lean, healthy individuals (i.e., >55 mgper g of liver) or as the presence of cytoplasmic TG droplets in more than 5%of hepatocytes(11)Fasting in Ramadan has been shown to have some effects on the circulating levels of several biochemical markers known to be associated with vascular and metabolic disorders including lipid profile (1, 13, 14).Farshidfar et al reported a significant increase in high density lipoprotein - cholesterol (HDL-C) and a decrease in low density lipoprotein – cholesterol (LDL- C) at day 28 of Ramadan (15). Also, studies among patients with type II diabetes mellitus reported decreased total cholesterol (TC), triglyceride (TG), and LDL-C as well as increased HDL-C levels after fasting in Ramadan (16). It has been established that a given nutrient ingested at an unusual time can induce different metabolic effects(3). Lipid profile is affected by dietary habit, percentage of fat in the daily diet and its

Pre Ramadan sampling in Ramadan was performed in the morning after an overnight fasting, while post Ramadan blood sampling was performed in the afternoon, after at least 10 h fasting during day time. This difference in the time of blood sampling was inevitable to have at least 10 h fasting. As the circadian rhythms of nutrition-related biological variables shows some degree of changes during Ramadan (44), there might be concerns about amount of daily activities or circadian rhythm of hormones like cortisol which might affect FBS levels. In the present study, we had only two measurements during the study, possibly evaluation in the middle of the month and after a time after Ramadan would reveal more details and shows us the trend of changes. Level of physical activity of the study population was not measured in this study.

For the better understanding of change and improvement in liver function, Ultrasound images and liver fat content was needed.

Conclusion:

This study for the first time shows significant effectson NAFLD patient parameters during Ramadan fasting such as decreasing in insulin, ALT enzyme, SBP and DBP and increase in HDL-c after an average of 27 d fasting, Result from this study suggested that Ramadan fasting may be useful to improve NAFLD, but further studies are needed in this