Abstract
Objective:
To examine the effect of Ramadan fasting on basic hematological parameters, in addition to the effects on body weight and blood pressure of fasters and nonfasters.
Design, setting, and subjects:
One hundred male outdoor workers at a vehicle terminal in a city in East Java were recruited for this study. Anthropometric measurements and blood sampling were conducted on two separate occasions, just before the start of Ramadan and in the third week of the month of Ramadan (October–November 2004). The degree of subjective compliance with Ramadan fasting (complete, partial, or none) was evaluated using a questionnaire.
Results:
The mean body mass index (BMI) of the fasting group was, as expected, significantly lower at the second sampling period, and the decrease in BMI correlated significantly with decreased blood pressure in this group. The blood pressure was also reduced in the partial fasting and nonfasting groups, which was an unexpected result. While red blood cell production was suppressed, as evidenced by lower levels of hemoglobin, red blood cell (RBC), and packed cell volume (PCV) at the second sampling, the subjects were normocytic and normochromic, based on normal mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) levels.
Conclusions:
These results indicate that, regardless of fasting status, blood pressure is lower and RBC production is suppressed in subjects during the Ramadan period. These findings should be taken into account when evaluating the effects of Ramadan on the general population. To avoid the adverse effects of anemia, increased intake of iron-rich foodstuffs is recommended during the Ramadan month, regardless of fasting practice.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Adair LS (2004). Dramatic rise in overweight and obesity in adult Filipino women and risk of hypertension. Obes Res 12, 1335–1341.
Adlouni A, Ghalim N, Benslimane A, Lacerf JM, Saite R (1997). Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low density lipoprotein cholesterol. Ann Nutr Metab 41, 242–249.
Basiri A, Moghaddam SM, Khoddam R, Nejad ST, Hakimi A (2004). Monthly variations of urinary stone colic in Iran and its relationship to the fasting month of Ramadan. J Pak Med Assoc 54, 6–8.
Beltaifa L, Bouguerra R, Ben Slama C, Jabrane H, El-Kadhi A, Ben Rayana MC et al. (2002). Food intake, and anthropometrical and biological parameters in adult Tunisians during fasting at Ramadan. East Mediterr Health J 8, 603–611.
Bigard AX, Boussif M, Chalabi H, Guezennec CY (1998). Alterations in muscular performance and orthostatic tolerance during Ramadan. Aviat Space Environ Med 69, 341–346.
Capuano V, Bambacaro A, D’Arminio T, Vecchio G, Cappuccio L (2003). Correlation between body mass index and others risk factors for cardiovascular disease in women compared with men. Monaldi Arch Chest Dis 60, 295–300.
Ch’ng SL, Cheah SH, Husain R, Duncan MT (1989). Effect of altered eating pattern on serum fructosamine: total protein ratio and plasma glucose level. Ann Acad Med Singapore 18, 326327.
Duncan MT, Husain R, Raman A, Cheah SH, Ch’ng SL (1990). Ventilatory function in Malay Muslims during normal activity and the Ramadan fast. Singapore Med J 31, 543–547.
El Arnoaty YM, Johnson WA (1991). Nutritional and biochemical changes during Ramadan fasting. FASEB J 5, 1665.
Fang F, Nie J (2003). Study of body mass index and waist circumference in association with blood pressure in adult Guangzhou residents. Di Yi Jun Yi Da Xue Xue Bao 23, 837–840.
Fedail SS, Murphy D, Salih SY, Bolton CH, Harvey RF (1982). Changes in certain blood constituents during Ramadan. Am J Clin Nutr 36, 350–353.
Frost G, Pirani S (1987). Meal frequency and nutritional intake during Ramadan: a pilot study. Hum Nutr Appl Nutr 41, 47–50.
Gharbi M, Akrout M, Zouari B (2003). Food intake during and outside Ramadan. East Mediterr Health J 9, 131–140.
Gustaviani R, Soewondo P, Semiardji G, Sudoyo AW (2004). The influence of calorie restriction during the Ramadan fast on serum fructosamine and the formation of beta hydroxybutirate type 2 diabetes mellitus patients. Acta Med Indonesia 36, 136–141.
Habbal R, Azzouzi L, Adnan K, Tahiri A, Charaibi N (1998). Variations of blood pressure during the month of Ramadan. Arch Mal Coeur Vaiss 91, 995–998.
Hallak MH, Nomani MZ (1988). Body weight loss and changes in blood lipid levels in normal men on hypocaloric diets during Ramadan fasting. Am J Clin Nutr 48, 1197–1210.
Hussain R, Duncan MT, Cheah SH, Ch’ng SL (1987). Effects of fasting in Ramadan on tropical Asiatic Moslems. Br J Nutr 58, 41–48.
Iraki L, Abkari A, Vallot T, Amrani N, Khlifa RH, Jellouli K et al. (1997). Effect of Ramadan fasting on intragastric pH recorded during 24 hours in health subjects. Gastroenterol Clin Biol 21, 813–819.
Jedrychowski W, Mroz E, Bojanczyk M, Jedrychowska I (1991). Excessive weight and hypertension in the elderly-the results of the community study. Arch Gerontol Geriatr 13, 61–69.
Kamal HM, Curb JD, Chiu D, Petrovich H, Rodriguez BL (1997). Association of Body Mass Index With Blood Pressure in Elderly Japanese American Men. Hypertension 29, 673–677.
Kassab S, Abdul-Ghaffar T, Nagalla DS, Sachdeva U, Nayar U (2004). Interactions between leptin, neuropeptide-Y and insulin with chronic diurnal fasting during Ramadan. Ann Saudi Med 24, 345–349.
Leiper JB, Molla AM, Molla AM (2003). Effects on health of fluid restriction during fasting in Ramadan. Eur J Clin Nutr 57 (Suppl 2), S30–S38.
Penuela URM, Giraldo PJA, Rivera AJC, Perez CJA (2003). Excess of weight and their relationship with high blood pressure in schoolchildren and adolescents of Medellin, Colombia. Arch Latinoam Nutr 53, 376–382.
Perk G, Ghanem J, Aamar S, Ben-Ishay D, Burztyn M (2001). The effect of the fast of Ramadan on ambulatory blood pressure treated hypertensives. J Hum Hypertens 15, 723–725.
Ramadan J (2002). Does fasting during Ramadan alter body composition, blood constituents and physical performance? Med Princ Pract 11 (Suppl 2), 41–46.
Ramadan JM, Barac-Nieto M (2000). Cardio-respiratory responses to moderately heavy aerobic exercise during the Ramadan fasts. Saudi Med J 21, 238–244.
Reisin E, Abel R, Modan M, Silverberg DS, Eliahon HE, Modan B (1978). Effects of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N Engl J Med 298, 1–6.
Roky R, Houti I, Moussamih S, Qotby S, Aadil N (2004). Physiological and chronobiological changes during Ramadan Intermittent fasting. Ann Nutr Metab 48, 296–303. (E-pub 2004 Septe 24).
Schmahl FW, Metzler B (1991). The health risks of occupational stress in Islamic industrial workers during the Ramadan fasting period. Pol J Occup Med Environ Health 4, 219–228.
Sharaby Y, Grotto I, Huerta M, Grossman E (2004). Susceptibility of the influence of weight on blood pressure in men versus women: lesson from a large-scale study of young adults. Am J Hypertens 17, 404–408.
Temizhan A, Donderici O, Ouz D, Demirbas B (1999). Is there any effect of Ramadan fasting on acute coronary heart disease events? Int J Cardiol 70, 149–153.
Yucel A, Degirmenci B, Acar M, Albayrak R, Haktanir A (2004). The effect of fasting month of Ramadan on the abdominal fat distribution : assessment by computed tomography. Tohoku J Exp Med 204, 179–187.
Acknowledgements
We thank all the workers who participated in this study.
Author information
Authors and Affiliations
Corresponding author
Additional information
Guarantors: R Ohtsuka and C Watanabe.
Contributors: LD, CW, and RO were involved in developing the study protocol. Preparing and collecting data were conducted by LD and St. The draft manuscript was written by LD, CW, and RO. None of the authors had any financial interests in organizations sponsoring this research.
Rights and permissions
About this article
Cite this article
Dewanti, L., Watanabe, C., Sulistiawati et al. Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia. Eur J Clin Nutr 60, 877–881 (2006). https://doi.org/10.1038/sj.ejcn.1602393
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1602393
Keywords
This article is cited by
-
Fasting during Ramadan and acute kidney injury (AKI): a retrospective, propensity matched cohort study
BMC Nephrology (2022)
-
Beneficial effect of time-restricted eating on blood pressure: a systematic meta-analysis and meta-regression analysis
Nutrition & Metabolism (2022)
-
Physiological impacts on construction workers under extremely hot and humid weather
International Archives of Occupational and Environmental Health (2022)
-
Effects of Ramadan Fasting on Physical Performance: A Systematic Review with Meta-analysis
Sports Medicine (2020)
-
A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16Â years and above
European Journal of Nutrition (2020)