Effect of Ethiopian Orthodox Christian (EtOC) religious fasting with vegan diet on changes of blood metabolites and body composition: an observational study

Nutrire https://doi.org/10.1186/s41110-019-0099-0 RESEARCH Effect of Ethiopian Orthodox Christian (EtOC) religious fasting with vegan diet on changes of blood metabolites and body composition: an observational study Wondyefraw Mekonen 1 & Diresibachew Haile 1 Received: 8 February 2019 / Accepted: 25 April 2019 # Springer Nature Switzerland AG 2019 Abstract Purpose Studies on Ethiopian Orthodox Christian (EtOC) religious fasting with vegan diet influencing body composition and blood metabolites remain limited. This study assessed the effect of consuming a vegan diet on changes of body composition and blood metabolites in a group of EtOC religious fasters and associated results with cardio-metabolic health. Methods Participants were 98 EtOCs, with a mean age of 27 years. They 1st consumed a non-vegetarian omnivorous (OM) diet for 7 weeks. Then they switched to a vegan diet (VD) on the occasion of the Ethiopian Orthodox fasting (EOF) again for 7 weeks. Body compositions including height (m), weight (kg), BMI (kg/m2), percent body fat (%BF), and waist-to-hip (W/H) ratio were measured after the end of the OM and VD dietary regimen. Moreover, blood metabolites including TC, TG, LDL-C, HDL-C, glucose, urea, and total protein (TP) were analyzed and calculated for significant differences. Results The Ethiopian OF with vegan diet induced significantly lower BMI, %BF, TC, LDL-C, HDL-C, and blood urea levels compared with the (OM) diet (p < 0.05). Blood TG, glucose, and TP did not reach significance (p > 0.05). Changes in TC were positively and significantly correlated (r = 0.9, p < 0.001) both with LDL-C and BMI following the vegan diet. Conclusion Ethiopian OF with vegan diet induced lower TC, LDL-C, and body composition to optimal levels favoring a better cardio-metabolic health. The decrease in blood urea may reflect insufficient intake of complete protein (essential and nonessential amino acids) during the fasting periods. This indicated the need to consume varieties of plant foods in order to compensate amino acids that vegan diets lack during the Orthodox fasting. Introduction People become vegetarians because of religious beliefs [1, 2], health reasons [3], lifestyle changes [4], or supporting the cause of animal welfare. Concerning religion, Orthodox Christians, Catholics, Adventists, Hindus, and Buddhists fast by consuming vegetarian diets for short- or long-term periods [5, 6]. Fasting in a religious sense means partial or total abstention from prohibited foods [2, 6]. The current Ethiopian population is a little more than 100 million and 43.5% of this belongs to Ethiopian Orthodox Church [7]. Most of the * Wondyefraw Mekonen ; Diresibachew Haile 1 Physiology Department, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia followers consume strict vegetarian (vegan) diets during the Orthodox fasting (OF) and one of these fasting periods include the Lent-fast that takes about 7 weeks. It is known that vegans completely avoid animal products [4], while other vegetarians consume either fish (pescatarian), egg (ovo vegetarians), dairy products (lacto vegetarians), or both dairy and egg products (lacto-ovo vegetarians) in their daily diets [4]. A previous study conducted on Greek Orthodox Christians has shown that long-term fasting (180–200 days/year) by consuming vegetarian diets resulted in lower blood concentrations of TC, LDL-C, and body weight [8]. Egyptian Coptic [9] and other Christian oriented studies [2, 6, 8, 10–12] suggested the benefits of taking vegetarian diets in promoting cardio-metabolic health including hypertension, stroke, obesity, and type II diabetes. Different from EtOC fasting practices, however, subjects in Greek [8] and other studies [3–5] included individuals who consumed seafood and fishes that may have different metabolic effects in the body. Moreover, some plant-based vegetarian diets consumed in developing countries like Ethiopia are different from those in developed Nutrire countries. For example, a cereal called “Tef” (Eragrostis tef), which is gluten-free [13] and possesses high fiber, high carbohydrate (CHO), high protein, and minerals [14], is a staple diet consumed at least two times every day by millions of Ethiopians, Eritreans, and many others living in the Horn of Africa [14]. Because of its chemical composition, such a cereal may have clinical importance in regulating blood metabolites and body composition to optimal levels. To date, however, the impact of Ethiopian Orthodox fasting with a vegan diet in altering different metabolic parameters was not adequately explored. This study has, therefore, assessed the effect of consuming a strict vegetarian (vegan) diet on body composition and blood metabolites on a group of EtOC fasting subjects and related the results with cardio-metabolic health. Blood metabolites analyzed were lipids (TC, TG, LDL-C, HDL-C) and other parameters including glucose, urea, and total protein (TP). For body composition, BMI, percent body fat (%BF), and waist-to-hip (W/H) ratio were considered. We hypothesized that consumption of vegan diet following Ethiopian OF for 7 weeks would be associated with lower body composition and lipid profiles compared with non-fasting (NF) dietary regimen. measurement for W/H ratio was repeated twice and the average was taken. Body mass index (BMI) was calculated from the weight in kilogram (km) divided by the height in meters (m) squared (kg/m2). Percent body fat (%BF) was calculated from the BMI according to the formula provided by Deurenberg et al. [16]. Diet and physical activity Self-reported dietary data was collected through questionnaire from each subject. A vegan platter of one serving size is about 890 g and contains one piece of injera (a local spongy flatbread prepared from the cereal “Tef,” and a stew, locally named as “Wat”), prepared from varieties of cereals like lentils, dry pea, and beans that also involve pepper and different types of spices. Boiled cabbages, carrots, and other vegetables are also provided with the meal. As estimated by a dietitian, each of the non-vegetarians (OM) diet and Ethiopian OF with vegan diet had a caloric content of about 2000 kcal/day. Except for their routine workplace activities, all of the participants led sedentary life and reported to have engaged in no physical exercise in their leisure times. Chemical analysis Methods Subjects A total of 98 subjects (52 females and 46 males) with a mean age of 27 years (range, 18–55) participated in the study. All subjects were members of Ethiopian Orthodox Church, who practice religious fasting by taking a vegan diet. Participants were college students, physicians, nurses, and high-school teachers from the capital city of Addis Ababa, with similar educational backgrounds. Before the test, subjects were informed about the procedures of the test and completed a questionnaire concerning their diet, lifestyle, and medical history. Smokers, (...truncated)