Alterations in anthropometric, inflammatory and mental health parameters during Ramadan intermittent fasting in a group of healthy people: a prospective cohort study

Abstract

Fasting has been practiced with different time span in different areas of the world and for various reasons. One of the types of fasting regimens is Ramadan intermittent fasting (RIF), which is described as intermittent dry fasting and known as the most commonly practiced form of religious fasting. Different studies have shown its effects on body composition parameters and mental health, fatigue and quality of life (QoL). Elucidating the relationship of RIF on biological parameters would also be of importance to show its mechanism. Therefore, we evaluated several biological mediators related to mental health, such as ß-nerve growth factor (ß-NGF), brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and insulin-like growth factor-1 (IGF-1), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and matrix-metalloproteinase-9 (MMP-9). This study consisted of fasting (FG; n = 25) and non-fasting group (NFG; n = 25). Four different time points were assessed for FG: one week before (T1), mid (T2), last days (T3), and one week after (T4) RIF. T1 and T3 were the assessment time points for NFG. Biological mediators were determined from serum samples by using Human Magnetic Luminex and enzyme-linked immunosorbent assay. Furthermore, we then performed correlation analyses between biological mediators and our previously published clinical parameters including body composition and mental health parameters at all time points. Significant alterations were shown in FG for ß-NGF (T2vsT3, p < 0.05; T2vsT4, p < 0.05), GDNF (T1vsT4, p < 0.05; T2vsT4, p < 0.05), IL-8 (T2vsT3, p < 0.05; T3vsT4, p < 0.05), TNF-α (T1vsT3, p < 0.05; T1vsT4, p < 0.001; T2vsT4, p < 0.001), and MMP-9 (T1vsT4, p < 0.01). There were no statistically significant differences between FG and NFG in all biological mediators at T1 and T3. Correlation analysis showed that MMP-9 levels had negative correlation with body mass index (BMI) at T3. At T3 BDNF levels had negative correlation with Epworth Sleepiness Scale (ESS) as one of measured QoL parameters. ß-NGF, GDNF, TNF-α, and MMP-9 had positive correlation with some of body composition and mental health parameters. Findings demonstrate that RIF altered different biological mediators could give benefit to health. Its benefit is mediated by the alteration of biological mediators.

Keywords: Interleukin-8 (IL-8); Ramadan intermittent fasting; TNF-α – tumor necrosis factor alpha; anthropometric; matrix metalloprotein-9 (MMP-9); mental health parameters and quality of life (QoL) parameters; neurotrophic factors (NTFs).

Figure 1

Study design.

Figure 2

Level of ß-NGF (A), BDNF (B), GDNF (C), and IGF-1 (D) in fasting group (FG). Data presented as median + interquartile range (IQR). * p < 0.05.

Figure 3

Level of ß-NGF (A), BDNF (B), GDNF (C), and IGF-1 (D) in fasting (FG) and non-fasting group (NFG) at T1 and T3. Data presented as median + interquartile range (IQR).

Figure 4

Level of IL-8 (A), TNF-a (B) and MMP-9 (C) in fasting group (FG). Data presented as median + interquartile range (IQR). Data presented as median + interquartile range (IQR). * p < 0.05; ** p < 0.01; ***p < 0.001.

Figure 5

Level of IL-8 (A), TNF-α (B), and MMP-9 (C) in fasting (FG) and non-fasting group (NFG) at T1 and T3. Data presented as median + interquartile range (IQR). ** p < 0.01.