Effect of islamic fasting on glucose, lipid profiles and Body Mass Index, adiponectin and leptin in obese individuals

Effects of Islamic Fasting on Glucose and Lipid Profiles, Body Mass Index, Adiponectin and Leptin Levels in Obese Individuals Naeeme Ganjali1, Hassan Mozaffari-Khosravi1,2*, Mohammad Afkhami-Ardakani3, Mansur Shahraki4, Hosein Fallahzadeh5 1. 2. 3. 4. 5. Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Yazd Diabetic Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Internal Medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Department of Nutrition, Health School, Medical University of Zahedan, Zahedan, Iran Department of Biostatistics & Epidemiology, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ARTICLEINFO ABSTRACT Article type: Original article Introduction Fasting is an Islamic practice, which causes various metabolic changes in fasting individuals. Numerous studies have examined different aspects of fasting, but its effect on individuals with different characteristics such as obesity has remained unknown. The impact of fasting on adipose tissue hormones such as leptin and adiponectin is still controversial. In this study, we aimed to examine the effect of Islamic fasting on glucose and lipid profiles, as well as plasma adiponectin and leptin concentrations in fasting obese and normal-weight individuals. Methods: Obese and normal-weight individuals from Yazd, Iran, who fasted during Ramadan were divided into two groups (n=24). Blood samples were taken from all the participants after 10-12 fasting hours two days before and one day after Ramadan to assess glucose and lipid profiles and plasma adiponectin and leptin concentrations. The individuals who were not able to fast for at least 21 days due to inflammatory or infectious diseases and those who received oral medications or supplements during Ramadan were excluded from the study. Results: Variations in weight, body mass index (BMI), total cholesterol, high-density lipoprotein cholesterol (HDL-c), the ratio of total cholesterol to HDL-c were significant in the obese group (P<0.05). There were no significant changes in leptin and adiponectin levels in obese cases. Variables such as weight, BMI, and triglycerides and leptin levels decreased significantly, while adiponectin level did not change significantly in normal-weight cases. Conclusion: Islamic fasting can prevent cardiovascular diseases in obese and normal-weight individuals through reducing weight, BMI, and some blood lipids, elevating HDL-c level, and changing the concentration of some adipokines. Article History: Received: 19 May 2016 Accepted: 15 June 2016 Published: 20 June 2016 Keywords: Adiponectin Body mass index Islamic fasting Leptin Lipid profile Please cite this paper as: Ganjali N, Mozaffari-Khosravi H, Afkhami-Ardekani M, Shahraki M, Fallahzadeh H. Effects of Islamic Fasting on Glucose and Lipid Profiles, Body Mass Index, Adiponectin and Leptin Levels in Obese Individuals. J Fasting Health. 2016; 4(2): 57-63. Introduction High-caloric intake and subsequent obesity increase incidence of diabetes, metabolic syndrome, and insulin resistance and elevate plasma lipid and inflammatory mediators’ levels (1, 2), which significantly enhances the risk of cardiovascular diseases. If individuals are not able to resolve risk factors of cardiovascular diseases, they can at least modify their lifestyle to prevent these complications (3). Fasting can be referred to as transformation of lifestyle and dietary habits among Muslims. Individuals are mainly encouraged to fast due to Islamic reasons; this ritual practice significantly affects well-being. There are more than one and a half billion Muslims around the globe, most of whom are living in Asia (69%) and Africa (27%) (4). Assuming that millions of Muslims fast during * Corresponding author: Hassan Mozaffari-Khosravi, Yazd Diabetic Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Email: © 2016 mums.ac.ir All rights reserved. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Ganjali N et al Ramadan, Islamic fasting is a unique physiological model (5). During Ramadan, Muslims abstain from eating, drinking, and smoking from dawn (sunrise) to sunset (Iftar (The time when fasted individuals are allowed to break fasting and begin eating is called Iftar)). Fasting individuals are only allowed to eat from Iftar to dawn (6). Fasting, as an obligation in Islam, has various physiological effects on the body through changing sleep-wake cycle and eating and drinking habits (7). Normally, every individual fasts for 29 or 30 days from 13 to 18 hours per day depending on seasonal conditions or geographical location. There are confounding factors on the relationship between fasting and health; different possible reasons for the confounding factors are as follows: heterogeneity of findings in fasting hours, smoking times, drug or intravenous fluids intake, eating habits, and changes in lifestyle (8). Adipose tissue is known as an endocrine organ rather than an inactive energy reservoir. Adipocytes produce macrophages and mesenchymal cells, which penetrate each other. Adipocytes also produce cytokines and adipocytokines with essential regulatory effects on inflammation, insulin sensitivity, coagulation, vascular homeostasis, appetite, energy, etc. Disturbance in these regulatory effects leads to insulin resistance and cardiovascular diseases. Adipocytes produce important proinflammatory adipocytokines such as leptin, tumor necrosis factor (TNF) alpha, resistin, angiotensinogen, interleukin 6, and plasminogen activator inhibitor-1, which are atherogenic as C-reactive protein (CRP) and non-ester fatty acids (2). Adipose tissue mainly secretes leptin hormone, which increases body fat mass (9). Leptin is described as a factor instigating feeling of fullness and stimulating energy consumption. Serum leptin concentration varies due to hunger or overeating, either of which requires different energy levels (10). Adiponectin is a protein hormone enhancing insulin function and causing anti-atherogenic and anti-inflammatory effects (11); this hormone regulates blood glucose level (9). Plasma adiponectin level diminishes in obese and diabetic patients as well as in those with metabolic syndrome and cardiovascular diseases (11). In fact, plasma adiponectin level is an independent risk factor for cardiovascular 58 Islamic Fasting and Lipid profiles, Adiponectin and Leptin in Obese Individuals diseases (12). The inverse relationship between plasma adiponectin level and incidence of diabetes and cardiovascular events (11) and visceral fat mass (13) was shown in epidemiological studies. Although the effects of fasting o (...truncated)