Alteration in Body Composition and Metabolic Profile During Ramadan Fasting in Healthy Men
Alteration in Body Composition and Metabolic Profile During Ramadan Fasting in Healthy Men
One of religious duties for all healthy adult Muslims is fasting during Ramadan, the ninth
 month of Islamic lunar calendar. In this month, Ramadan observance fasted (no food and drink)
 from dawn to dusk. Studies demonstrated daytime fasting may pose a positive significant
 effect on metabolic health. Thus, this present study aimed to determine the effect of Ramadan
 fasting on body composition, metabolic profile, serum leptin and adiponectin levels in
 healthy men.
Outcome measurements were taken at before (baseline) and at the end of Ramadan (after Ramadan
 fasting) on body composition, metabolic profile (fasting plasma glucose, insulin, total
 cholesterol, HDL-c, LDL-c, triglycerides, and HOMA-IR), serum leptin and adiponectin, ratio
 of leptin to adiponectin in 27 healthy men (19-31 years) Muslim in Bangkok, Thailand.

 Subjects Twenty-nine subjects fulfilled inclusion criteria including: age 19-40 years, Muslim
 men fasted completely, and no known of any metabolic-related diseases. Subjects with diseases
 and/or intake of any medication and dietary supplement, smoking, and alcohol drinking were
 excluded. After Ramadan fasting, 27 subjects completed the study.

 The study protocol was approved by the Ethical Review Committee for Research Involving Human
 Research Participants, Health Science Group, Chulalongkorn University, Bangkok, Thailand (COA
 no. 136/2558).Written informed consent was obtained from all subjects prior to enrolling to
 the study. Subject's anonymity was preserved.

 Study design Research visit was conducted at Faculty of Allied Health Sciences, Chulalongkorn
 University, Bangkok, Thailand at before (earlier days of Ramadan) and after (third week of
 Ramadan) to collect the outcome measurements including anthropometry, body composition,
 metabolic profile, serum leptin and adiponectin levels, and ratio of leptin to adiponectin.
 The dietary intake of 2 weekday and one weekend day and physical activity were recorded each
 week during Ramadan in food record booklet. Energy intake and macronutrients composition
 including carbohydrate, protein and fat will be analysed by registered dietitian.

 Anthropometry and body composition measurements Weight, Body Mass Index (BMI), and percent
 body fat were measured at baseline (week-0) and the end of Ramadan fasting period (week-4).
 Body weight, and percent body fat mass were assessed using a constant current source with a
 high frequency current (50kHz, 500μA)-bioelectrical impedance analyzer (BIA) (MC-980MA body
 composition analyzer, TANITA corporation, Tokyo, JAPAN). The subject was requested to dress
 in light attire and bare feet. The 8 polar electrodes were positioned so that electric
 current was supplied from the electrodes on the tips of the toes of both feet and the
 fingertips of both hands, and voltage is measured on the heel of both feet and the near side
 of both hands. Body Mass Index (BMI) was calculated as weight/height2 (in kilograms per
 square meter). Waist and hip circumferences were measured by using a standard rounded tape at
 a point right above the iliac crest on the mid-axillary line at minimal respiration (for
 waist) and in a horizontal plane at the level of the maximal extension of the buttocks (for
 hip) to the nearest 1.0 cm.

 Metabolic profile measurements Fasting blood samples were taken from vein puncture at before
 and after a period of Ramadan fasting. Separated serum samples were stored at - 80o C until
 analyses were performed. After withdrawal, blood samples were collected to determine the
 metabolic profile including plasma glucose, total cholesterol, high density
 lipoprotein-cholesterol (HDL-c), and triglycerides (TG) by enzymatic method while serum
 insulin levels were analyzed by Chemiluminescence. Low density lipoprotein-cholesterol
 (LDL-c) was estimated by using the Friedewald equation (LDL-c = [total cholesterol] - [HDL-c]
 - [TG]/5).22 Additionally, HOMA-IR was measured as fasting serum insulin (µIU/mL) x fasting
 plasma glucose (mmol/L)/22.5.23

 Serum leptin and adiponectin measurements Serum leptin and adiponectin levels were assayed at
 the laboratory at Faculty of Allied Health Sciences, Chulalongkorn University. Serum leptin
 was measured using a commercially "Human Leptin Standard ABTS ELISA Development kit"
 (Peprotech, Inc., Rocky Hill, NJ, USA, Cat. no: 900-K90) at a wavelength of 405nm with
 correction set at 650nm, while serum adiponectin was measured using "Adiponectin (human)
 ELISA kit" (Enzo Life Sciences, Farmingdale, NY, USA, Cat. no: ALX-850-377) at a wavelength
 of 450nm with correction set at 630nm. Both serum leptin and adiponectin were measured by the
 enzyme-linked immunosorbent assay, and were carried out according to the manufacturer's
 procedure.

 Statistical Analysis Data were expressed as frequency or percentage for descriptive; mean ±
 standard error mean (SEM), mean percentage change (% change) ± SEM for the
 continuous-normally distributed data; and median (range) for continuous-non normally
 distributed data. Paired student t-test, two related sample (Wilcoxon) test were employed for
 comparison of normally distributed and non-normally distributed data, respectively.
 Differences were considered as statistically significant for two-tailed of probability value
 or P less than 0.05. All analyses were performed using SPSS, version 16.0 (IBM, Chicago, IL,
 USA).
Inclusion Criteria:

 -  age 19-40 years

 -  Muslim men

 -  fasted completely during Ramadan

 -  no known of any metabolic-related diseases.

 Exclusion Criteria:

 -  any diseases

 -  intake of any medication and dietary supplement

 -  smoking

 -  alcohol drinking