Temporal assessment of body composition changes before, during and after Ramadan: effects on cellular health and blood pressure among healthy male subjects

Abstract

ABSTRACT Background: Ramadan fasting is a religious practice that involves abstaining from food and drink from dawn to sunset for a month. Millions of Muslims around the world observe this practice every year, but its effects on human physiology and health are not well understood. Previous studies have shown inconsistent and inconclusive results on the effects of Ramadan fasting on various physiological parameters, such as blood pressure, total body water, phase angle, and body fat percentage. Moreover, these studies have not considered the potential role of health behaviors, such as physical activity, and sleep patterns, in mediating or moderating the effects of fasting. Objective: To evaluate the effects of Ramadan fasting and accompanying lifestyle changes on body composition, cellular health, and blood pressure in healthy males, and to determine if these physiological parameters are correlated and their state before, during and after Ramadan. Materials and Methods: A quasi-experimental study was conducted on 26 healthy male Muslims aged 18-45. Participants were assessed a week before, the 3rd week of Ramadan, and 2 weeks after 30 days of Ramadan fasting. Blood pressure was assessed using a sphygmomanometer whereas fat free mass, total body water, phase angle, and body fat percentage were measured using bioelectrical impedance analyzer. Participants also provided demographic and health behaviors information via questionnaires. Statistical analysis was performed with STATA version 15, employing paired t-tests and Wilcoxon signed-rank tests to compare changes in body composition and blood pressure. Relationships between variables were examined using Pearson correlation coefficients. Significance was determined at p < 0.05 with a 95% confidence interval. Results: Significant reductions were observed during Ramadan in waist circumference (81.76 cm to 80.72 cm; p = 0.02), hip circumference (96.84 cm to 95.57 cm; p = 0.01), and fat-free mass (59.55 kg to 58.11 kg; p < 0.01), while fat mass increased (9.20 kg to 10.37 kg; p < 0.01). Diastolic blood pressure showed moderate positive correlations with BMI, waist circumference, and total body water (r = 0.45, p = 0.02). After Ramadan, weight increased (68.45 kg to 69.25 kg; p < 0.01), along with fat-free mass percentage (85.96% to 88.04%; p < 0.01) and total body water (42.60 L to 44.56 L; p < 0.01). Phase angle improved significantly post-Ramadan (7.12 to 7.53; p < 0.01). No significant changes were observed in blood pressure, BMI, or systolic blood pressure across the phases. Conclusion: Ramadan fasting significantly impacts body composition and cellular health, with notable decreases in muscle mass and hydration during fasting. However, in healthy individuals, these changes tend to return to normal after the fasting period ends and are largely reversible, demonstrating the body's ability to recover in healthy individuals. Future studies should investigate whether the physiological flexibility observed in healthy individuals during Ramadan is maintained in individuals with underlying health conditions