Journal of Nutrition, Fasting and Health
Volume:9 Issue: 2, Spring 2021

Indirect calorimetry (IC) is the optimal tool for the assessment of the resting energy expenditure, as well as the reference standard for energy expenditure measurement. During the outbreak of coronavirus, performing respiratory tests such as IC has become challenging. The current guidance was designed to prevent the virus spread at calorimetry centers.

This protocol was devised in accordance with the latest recommendations of the World Health Organization (WHO) and Centers for Disease Control (CDC), as well as the related articles.

Due to the specific features of COVID-19, unnecessary ICs should be avoided in the hotspots of the disease. If these tests must be performed, adherence to the validated infection control recommendations is critical.

Millions of Muslims across the world observe Islamic fasting during the holy month of Ramadan and other days of lunar calendar year. The believers of Islam do not eat or drink from just before the sunrise until the sunset during fasting. Absence of fluid intake during Islamic fasting leads to dehydration, which may affect the renal health and though the sick are exempted from Islamic fasting majority of patients may prefer to fast during Ramadan. Hence, this review aims to summarise the effects of Islamic fasting specifically in patients with renal problems including chronic kidney disease (CKD), nephrolithiasis, urolithiasis, end stage renal disease (ESRD) and the patients on kidney transplants, hemodialysis, peritoneal dialysis and intestinal dialysis. This literature review conducted through searching in databases like Medline, PubMed, PMC, Google Scholar, ScienceDirect, DOAJ, Cochrane Library, and reference lists. The restriction of water during Ramadan fasting could result in acute tubular cell injury and hence the patients with Chronic Kidney Disease should consult their healthcare professionals at least a month before Ramadan and should fast under close medical supervision [21]. The patients with renal colic willing to fast during Ramadan should be advised to consume adequate amounts of water during non-fasting hours and to reduce the potential risk of dehydration while the patients on dialysis and the recipients of kidney who are willing to fast during Ramadan should be monitored closely. Overall, the patients with renal problems could fast safely during Ramadan under medical supervision.

Celiac disease (CD) is an immune-mediated enteropathy that occurs in genetically predisposed individuals associated with gluten intake. Currently, the only effective treatment for CD is life-lasting elimination of gluten from the diet, but adhering to it throughout life is burdensome. In addition, strict compliance with a gluten-free diet (GFD) does not lead to a complete restoration of intestinal microbiota. Although gluten is known to be a trigger in CD, various studies have demonstrated that the gut microbiota is involved in gluten metabolism, regulation of intestinal barrier permeability, and modulation of the immune response. Therefore, the gut microbiota has an important role in the pathogenesis, progression, and clinical manifestations of CD. This evidence supports the hypothesis that probiotics act as a strategy to modulate the intestinal microbiota into an anti-inflammatory state. Probiotics such as some bacterial species of the genera Bifidobacterium and Lactobacillus can protect the epithelial cells from gliadin-induced damage and improve symptoms and quality of life in GFD-treated patients, as an adjunctive treatment. This narrative review aims to discuss the recent scientific evidence of the relationship between the intestinal microbiota changes in CD and to understand the role of probiotics in CD treatment.

Kidney transplantation is usually performed as a preferred treatment and last resort in chronic kidney disease after the end stage of renal disease. Considering that nutrition can play an essential role in post-transplant recovery, the aim of this study was to review the nutritional assessment and dietary requirements of kidney transplant patients. Articles were collected via searching in databases such as PubMed-Medline, Google Scholar, Scopus, and Web of Science using relevant keywords and phrases, including kidney transplantation, end stage renal disease, nutrition, dietary intake, nutritional assessment, and nutrition evaluation. Medical nutrition therapy can play a vital role in the recovery after transplantation in kidney failure patients. It seems that nutritional and medical evaluation through laboratory methods, vital signs, and anthropometric measurements are necessary to improve the quality of nutritional interventions after kidney transplantation and can help to decrease the risk of kidney transplant rejection, therefore periodic evaluation and follow-up of these patients can lead to beneficial results.

Adult Muslims have a religious obligation to fast every day for 29-30 days in Ramadan. In fasting individuals, the level of cognition may be affected, which in turn influences the performance of individuals. The present study aimed to assess the possible adverse effects of Ramadan fasting on the cognitive functions of medical students in Morocco. The study was conducted on 41 male Muslim medical students, who took a neuropsychological test one week before, during (second and third weeks of Ramadan) and after Ramadan. In addition, the participants were assessed in terms of the sleep patterns, working hours, and meals. According to the findings, Ramadan fasting decreased the body weight and body mass index of the students. The tests were performed using a CogState computerized cognitive tasks battery, which examined the psychomotor function (processing speed), attention, visual learning and memory, working memory (executive function), and verbal learning and memory of the participants. The obtained results indicated no significant changes at the four test periods (P<0.05). Despite the disturbances observed in the meals, working hours, and sleep duration, Ramadan fasting had no impact on the cognitive function of the medical students.

Exercise and nutrition can be two factors influencing bone metabolism in old age. The present study aimed to investigate the effects of high-intensity interval training (HIIT) with genistein (Ge) on serum levels ofosteocalcin (OCN) and bone alkaline phosphatase (BALP) in female elderly rats.  In this experimental study, 40 elderly female rats with a mean age of 18- 24 months and mean weight of 220.15 ± 15.28 g were divided into five groups of eight rats including 1) control (C), 2) sham (Sh), 3) HIIT, 4) HIIT+Ge, and 5) Ge. During eight weeks, groups 3 and 4 performed HIIT for three sessions per week with an intensity of 90- 95% of maximum oxygen consumption (VO2max) in high-intensity intervals and 40- 45% of VO2max in low-intensity intervals as well as groups 4 and 5 received 60 mg/kg/day Ge peritoneally. OCN and BALP were measured by the ELISA method.  HIIT significantly increased BALP (P=0.001) and OCN (P=0.04); Ge and HIIT + Ge significantly increased BALP (P=0.001); although Ge had a more favorable effect on increasing BALP compared to HIIT (P=0.001) HIIT had a more favorable effect on increasing OCN compare to Ge (P=0.008).  Although HIIT simultaneously with Ge consumption can increase serum BALP levels in female elderly rats the effects of HIIT and Ge alone on BALP and OCN are different from each other.

Arsenic (As), as a toxic metal, causes disorders in various tissues of the body, including the liver. However, studies have shown that exercise and herbs such as Tribulus Terrestris (T) have antioxidant effects in some diseases. Therefore, the present study aimed to investigate the effect of endurance training (ET) and T extract on oxidative stress and apoptosis markers in the liver tissue of rats exposed to As. 

In this experimental study, 49 rats were randomly assigned into seven groups including: (1), control (C), (2) As, (3), As + 5 mg / kg T (As+T5), (4) As+ 10 mg / kg T  (As + T10), (5) As+ ET, (6) As+ ET+ 5 mg / kg T (As + ET + T5), and (7) As+ ET+ 10 mg / kg T (As + ET + T10). Over a period of eight weeks, groups 2-6 consumed 68 mg/L of sodium arsenite per day dissolved in drinking water. Also, groups 5-7 ran on the treadmill five sessions per week and 30 minutes per session at a speed of 23 meters per minute. 

Exposure to As led to a significant increase in O-6-methylguanine-DNA methyltransferase ( MGMT), cytochrome C, Malondialdehyde (MDA), prooxidant-antioxidant balance (PAB), and decreased hepatic Adenosine triphosphate (ATP) (P= 0.001). However, training and consumption of T reduced the concentration of MGMT, cytochrome C, MDA, PAB, and increased hepatic ATP concentration (P= 0.001). T with a dose of 10 mg/kg had a greater effect than 5 mg/kg dose on increasing ATP concentration and decreasing cytochrome C, MDA, and PAB in the liver tissue (P= 0.001). Also, the interaction of training and consumption of T was significant in reducing the concentration of MGMT, cytochrome C, MDA, PAB, and increasing the hepatic ATP concentration in rats poisoned with As (P= 0.001). 

It seems that endurance training with Tribulus Terrestris  extract by inhibiting oxidative stress and apoptosis exerts a protective effect on liver tissue in cases of arsenic poisoning. Accordingly, these two interventions can be a good way to reduce the effects of arsenic induction on the liver tissue.

Ramadan, the ninth month of the Islamic lunar calendar, has special religious importance among Muslims. During this month, Muslim adults and adolescents (who have reached the age of adulthood according to the Islamic rules) fast. Gastrointestinal (GI) disorders present with symptoms generally called GI discomforts such as heartburn, abdominal pain, dyspepsia, constipation, bloating, and irritable bowel syndrome. This study aimed to assess the effects of Ramadan fasting on GI discomfort. One hundred fasting subjects were enrolled in the study. Personal information (age, gender, education level, and occupation) was collected from participants and they were assured that their information would remain confidential. Participants had to fill out a food questionnaire before and in the third week of Ramadan. Food patterns were identified by factor analysis. The relationship between dietary food patterns and GI symptoms was assessed by logistic regression analysis. The results of logistic regression analyses of the association between dietary patterns and the development of GI discomforts in Ramadan represented that adherence to high fat and protein dietary patterns significantly reduced dyspepsia and diarrhea (p <0.05) while adherence to relatively healthy dietary pattern caused a marginally significant reduction in constipation (p <0.1). This study showed that total energy intake during Ramadan fasting did not differ compared to before the month while the dietary patterns changed significantly. The full-fat diet reduced hunger pain and constipation but increased diarrhea while a healthy diet reduced dyspepsia and diarrhea during fasting.

The consumption of high-protein foods after resistance training increases training achievement, which may benefit diabetic patients. The present study aimed to investigate the effects of milk consumption after resistance training on the glycemic control and irisin levels of type II diabetic (T2D) men.  This quasi-experimental study was conducted on 36 male patients with T2D, mean age of 53.6±4.8 years and mean body mass index of 27.1±3.6 kg/m2. The patients were randomly divided into three groups of control, resistance training (RT), and resistance training and milk consumption (RTM). Eight weeks of RT was performed in three sets of 12 maximum repetitions three days per week. The RTM group consumed 500 milliliters of low-fat milk after the exercise. Fasting blood glucose, insulin, HbA1c, irisin, weight, waist-to-hip ratio, muscle strength, and limb circumference were measured before and after the intervention. Data analysis was performed using repeated measures analysis of variance (ANOVA).  Compared to the RT group, the leg strength (mean±95% CI: -49.80±31.53; P<0.001), arm circumference (mean±95% CI: -3.41±1.97; P<0.001), and thigh circumference (mean±95% CI: -5.16±2.98; P<0.001) improved significantly in the RTM group. However, no significant interaction effects were observed for the other variables between the RT and RTM groups.  Despite more improvement in the muscle strength and circumference, the beneficial effects of RT were not augmented by additional post-exercise milk consumption in the male patients with T2D.

 According to the worldwide expansion of diabetes, scientists suggest supplementation with minerals and vitamins to control hyperglycemia in diabetic patients.We conducted this study to explore the effect of supplementation of selenium and vitamin C separately and in combination, on glycemic parameters in patients with diabetes type 2.

 Sixty patients with diabetes type 2 were selected from the population of individuals referred to hospitals and clinics in Bushehr port. After justification, the participants were assigned to one of the 4 groups randomly. The patients in groups 1, 2 and 3 received 1000 mg vitamin C, 100 μg Selenium and a mixture of 100 μg Selenium plus 1000 mg vitamin C daily for a period of 3 months, respectively. Group 4 received 500 mg placebo. At the beginning and at the end of study fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) were measured.

  HbA1c and FPG in group 3 compared to other groups and the control group augmented significantly. There was a non-significant decrease of HbA1c and FPG in group 1 and group 2 following intervention compared to the baseline.  

 Based on the findings of this study we concluded that supplementation with vitamin C and selenium might induce insulin resistance in type 2 diabetic patients.

Autism spectrum disorder refers to a wide range of nervous system disorders. Autistic patients often have a defective antioxidant defense system and manifest symptoms of impaired cognitive interaction. Camel milk has numerous beneficial nutrients and has been used in the treatment of autism. The present study aimed to investigate the effects of camel milk on the antioxidant activity and enzymes of autistic rats.  Pregnant rats were intraperitoneally injected on embryonic day 12.5 with valproic acid (VPA; 500 mg/kg) to induce an autistic state. In addition, 18 male offspring rats were injected with risperidone (0.2 mg/kg) three times per week. Six of these cases were fed daily with raw camel milk (10 ml/kg), and six others were fed with pasteurized camel milk for 42 days. Social interaction and repetitive behaviors were measured using the Y-maze based on catalase (CAT) activity, glutathione (GSH) level, and superoxide dismutase (SOD) activity at the outset and after the treatment period.  Behavioral symptoms (impaired social interaction and repetitive behaviors) were evident after VPA administration. After receiving treatment, impaired social interaction and repetitive behaviors significantly improved in the autistic rats (P<0.01). In addition, VPA enhanced the oxidative stress status in the biochemical tests (P<0.001), and camel milk increased CAT activity (P<0.001), GSH level (P<0.05), and SOD activity (P<0.0001).  According to the results, camel milk could recover the VPA-induced impairment of social interaction and repetitive behaviors in the autistic rats and improve the defects in their antioxidant defense system.

Arsenic (As) is a toxic metal, which causes disorders in various tissues of the body, including the liver. Studies have shown that exercise and herbs such as Tribulus terrestris (T) have antioxidant effects on some diseases. The present study aimed to investigate the effects of endurance training (ET) and T extract on oxidative stress and apoptosis markers in the liver tissues of rats exposed to As.

This experimental study was conducted on 49 rats, which were randomly assigned into seven groups of control, As, As with 5 mg/kg of T extract (As+T5), As with 10 mg/kg of T extract (As+T10), As with ET, As with ET and 5 mg/kg of T extract (As+ET+T5), and As with ET and 10 mg/kg of T extract (As+ET+T10). For eight weeks, study groups 2-6 consumed sodium arsenite (68 mg/l per day) dissolved in drinking water, and groups 5-7 ran on a treadmill five sessions per week (30 minutes per session) at the speed of 23 meters per minute.

Exposure to As significantly increased O-6-methylguanine-DNA methyltransferase (MGMT), cytochrome C, malondialdehyde (MDA), and prooxidant-antioxidant balance (PAB), while decreasing hepatic adenosine triphosphate (ATP) (P=0.001). Training and T extract consumption reduced the concentration of MGMT, cytochrome C, MDA, and PAB, while increasing the hepatic ATP concentration (P=0.001). The T extract at the dose of 10 mg/kg could increase the ATP concentration and decrease cytochrome C, MDA, and PAB more significantly in the liver tissues compared to the dose of 5 mg/kg (P=0.001). In addition, the interactive effects of training and T extract consumption were significant on the reduction of MGMT, cytochrome C, MDA, and PAB concentrations and increasing the hepatic ATP concentration in the rats poisoned with As (P=0.001).

According to the results, endurance training with the consumption of Tribulus terrestris extract could inhibit oxidative stress and apoptosis, thereby exerting protective effects on liver tissues against arsenic poisoning. Therefore, these interventions could effectively diminish the effects of arsenic induction on liver tissues.