Effects of Ramadan upon Fluid and Food Intake,Fatigue, and Physical,Mental, and Social Activities: A Comparison between the UK and Libya

Two studies were performed during Ramadan, one in the UK (N=31) and the other in Libya (N=33). The aims were to assess some changes to lifestyle that are produced by fasting as well as effects due to culture. Subjects were studied on eight separate occasions: four control days (two before and two after Ramadan) and four days during the four weeks of Ramadan itself. A questionnaire was answered that asked about naps and fluid and food intake. The questions elicited if an individual had slept, drank, or eaten, plus the reasons for doing or not doing so. Also, subjects were asked to describe their physical, mental, and social activities, their fatigue, and their perceived abilities to perform physical or mental work. The questionnaire was answered five times per day: at sunrise, at 10:00 h, at 14:00 h, at sunset, and on retiring to sleep at night. Urine samples were collected at sunset and measured for osmolality. Differences between control and Ramadan days, as well as between subjects studied in UK and Libya, were assessed by analysis of variance. Correlations between fatigue and physical, mental, and social activities were also assessed, as were differences in urine osmolality. Fasting during Ramadan resulted in fewer activities and increased fatigue and frequency of napping during daytime. Changes in fluid and food intake indicated some degree of preparation for fasting before sunrise and a marked “recuperation” from fasting after sunset. The reasons given for napping in the daytime, for drinking or not drinking, and for eating or not eating, changed during Ramadan compared with control days; as a result, links between fatigue and activities, and fatigue and fluid and food intake, were all altered during Ramadan, particularly after sunset. Subjects become dehydrated during the daytime, but this was not reduced when females who were menstruating drank during this time. Several differences between the two studies were found. There was a greater frequency of napping during the daytime in the Libya study, and evidence for the conservation of energy during the daytime and reduced physical, mental, and social activities. Subjects' preparations for fasting and recovering from it—their fluid and food intakes and associated reasons for these—also differed. Possible explanations of these differences are discussed. (Author correspondence: waterhouseathome@hotmail.com)     

Ramadan fasting alters endocrine and neuroendocrine circadian patterns. Meal-time as a synchronizer in humans?

Muslims must refrain from eating, drinking, smoking, and sexual relations from sunrise to sunset during the month of Ramadan. Serum concentrations of melatonin, steroid hormones (cortisol, testosterone), pituitary hormones (prolactin, LH, FSH, GH, TSH) and thyroid hormones (free thyroxin and free triiodothyronine) were documented around the clock at six 4-hourly intervals before Ramadan began and on the twenty-third day of Ramadan (daytime fasting). Time series were analysed with repeated measures ANOVA. Statistically significant differences were found in some variables: the nocturnal peak of melatonin was diminished and may have been delayed; there was a shift in the onset of cortisol and testosterone secretion; the evening peak of prolactin was enhanced, FSH and GH rhythmic patterns were affected little or not at all by Ramadan fasting and only the serum TSH rhythm was blunted over the test time span. These data show that daytime fasting, modifications in sleep schedule and psychological and social habits during Ramadan induce changes in the rhythmic pattern of a number of hormonal variables.     

Relative Metabolic Stability,but Disrupted Circadian Cortisol Secretion during the Fasting Month of Ramadan

Background

Chronic feeding and sleep schedule disturbances are stressors that exert damaging effects on the organism. Practicing Muslims in Saudi Arabia go through strict Ramadan fasting from dawn till sunset for one month yearly. Modern era Ramadan practices in Saudi Arabia are associated with disturbed feeding and sleep patterns, namely abstaining from food and water and increasing daytime sleep, and staying awake and receiving food and water till dawn.

Hypothesis

Strict Ramadan practices in Saudi Arabia may influence metabolism, sleep and circadian cortisol secretion.

Protocol

Young, male Ramadan practitioners were evaluated before and two weeks into the Ramadan. Blood samples were collected at 9.00 am and 9.00 pm for measurements of metabolic parameters and cortisol. Saliva was collected serially during the day for cortisol determinations.

Results

Ramadan practitioners had relative metabolic stability or changes expected by the pattern of feeding. However, the cortisol circadian rhythm was abolished and circulating insulin levels and HOMA index were increased during this period.

Discussion

The flattening of the cortisol rhythm is typical of conditions associated with chronic stress or endogenous hypercortisolism and associated with insulin resistance.

Conclusions

Modern Ramadan practices in Saudi Arabia are associated with evening hypercortisolism and increased insulin resistance. These changes might contribute to the high prevalence of chronic stress-related conditions, such as central obesity, hypertension, metabolic syndrome and diabetes mellitus type 2, and their cardiovascular sequelae observed in the Kingdom.     

Effect of Ramadan fasting on feelings,dietary intake,rating of perceived exertion and repeated high intensity short-term maximal performance

The present study was designed to investigate the effect of Ramadan fasting on feelings, dietary intake, rating of perceived exertion (RPE) and repeated high-intensity short-term maximal performance. Thirteen physically active men (age: 21.2 ± 2.9 years, height: 175.6 ± 5.6 cm, body-mass: 72.4 ± 8.6 kg) performed a 5-m shuttle run test (6 × 30-s + 35-s of recovery in-between) during five experimental periods: fifteen days before Ramadan (BR), the first ten days of Ramadan (FR), the last ten days of Ramadan (ER), ten days after Ramadan (AR10) and 20 days after Ramadan (AR20). The study was carried out in Tunisia during the 2016 Ramadan month. During the 5-m shuttle run test, higher distance (HD), total distance (TD) and fatigue index (FI) were recorded. RPE was determined after a 5-min warm-up and after each repetition of the 5-m shuttle run test (the mean RPE score during the test was calculated). Moreover, a feelings scale (FS) was used after the warm-up and after the end of the 5-m shuttle run test. During the five experimental periods, dietary intake was assessed. The results showed that HD, TD and FI during the 5-m shuttle run test were not affected by Ramadan observance (p > 0.05). Likewise, FS scores recorded after the warm-up and the 5-m shuttle run test were not affected by Ramadan fasting (p > 0.05). However, mean RPE scores during the 5-m shuttle run test were significantly lower at ER (4.06 UA), AR10 (3.86 UA) and AR20 (3.71 UA) in comparison to BR (4.51 UA) (p < 0.05). The results showed also that Ramadan fasting has no adverse effect on energy intake, protein (g and %), fat (g and %) and carbohydrate (g). However, the fractional contribution of carbohydrate was significantly higher AR10 than FR (53.1% vs. 45.8%) and ER (53.1% vs. 46.5%) and AR20 than FR (5.92% vs. 45.8%) (p < 0.05). In conclusion, Ramadan fasting has no adverse effect on feelings, dietary intake, and short-term maximal performance. However, the RPE during repeated high intensity short-term maximal exercise was reduced AR20 in comparison to ER.

Abbreviations:

AR: After Ramadan; AR10: Ten days after Ramadan; AR20: Twenty days after Ramadan; BR: Fifteen days before Ramadan; ER: Last ten days of Ramadan; FI: Fatigue index; FR: First ten days of Ramadan; FS: Feelings scale; HD: Higher distance; PSQI: The Pittsburgh Sleep Quality Index; RPE: Rating of Perceived Exertion Scale; TD: Total distance     

The Association between Daytime Napping and Cognitive Functioning in Chronic Fatigue Syndrome

Objectives

The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS) has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length) and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience.

Methods

118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale), sleepiness (Epworth Sleepiness Scale), cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire), and mood (Hospital Anxiety and Depression Scale).

Results

Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001). Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001). Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001). When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group.

Conclusions

Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies.     

Age-specific changes of acidity, phosphoenolpyruvate carboxylase, ribulose-1,5-bisphosphate carboxylase/oxygenase, abscisic acid and leaf water potential in Mesembryanthemum nodiflorum

Age-induced changes in 1) nocturnal and diurnal acidity fluctuations that coincide with the ongoing environmental conditions, 2) the build up of abscisic acid (ABA) in plant roots and leaves during sunrise, midday, and sunset in all growing stages, 3) the changes in phosphoenolpyruvate carboxylase (PEPC) and ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBPCO) activities as key enzymes of the photosynthetic pathways of C3 and CAM, 4) leaf water potential (ψ1), and 5) Km and Vmax for PEPC to express its activity and affinity, were studied in Mesembryanthemum nodiflorum during transition from C3 to CAM mode of CO2 fixation. The acidity during sunset in mature stage was higher than in earlier stages and reflected the impact of environmental conditions on physiological and metabolic changes. Moreover, the higher acidity during sunrise and sunset was observed during the senescence than the mature stage; this might be due to CO2 release and oxygen intake during senescence induced ethylene formation that lead to increased malic acid formation. The ABA concentration was high in M. nodiflorum leaves, but stomatal closure was insensitive to elevated ABA concentrations recorded. Vmax of PEPC, Km, and the affinity of PEPC during later stages indicated the ability of PEPC to fix CO2 taking up at night in CAM cycle of M. nodiflorum. Less affinity during sunrise indicated inhibitory effect of malate on PEPC during the release of CO2. The second peak of PEPC activity before sunset caused CO2 fixation. The RuBPCO was inactive at night. Slight increase in ABA during sunset, and night drop in air temperature and increase in relative humidity reduced markedly transpiration rate without decreasing ψ1. This revised version was published online in July 2006 with corrections to the Cover Date.     

Effects of food supplementation on behavioural decisions of hoopoe-larks in the Arabian Desert: balancing water, energy and thermoregulation

Patterns of time allocation to different activities can help reveal how natural selection has solved optimality problems that involve simultaneous environmental constraints. To investigate how time budgets of desert birds are affected by ambient temperature, lack of drinking water and low food availability, we provided food and water to hoopoe-larks,Alaemon alaudipes , in the Arabian Desert during years in which no larks reared young. We followed birds continuously from sunrise to sunset on unsupplemented and supplemented days, and recorded their behaviour every 15 s. Taking into account the variation in temperature between days, hoopoe-larks decreased foraging time by 13-29% of total daytime, and increased resting and preening time by 7-16 and 8%, respectively, when they had access to supplemental food. When birds had access to extra food, they began and ended their midday resting period when shade temperature was on average 2.2°C lower, and operative temperature was on average 3.1°C lower, than on unsupplemented days, a significant effect of food supplementation. We concluded that birds optimized time spent on foraging and thermoregulating based on a combination of physiological state variables, including body temperature, hydration state and level of energy reserves. Our results do not support a previous hypothesis that activity budgets of desert birds are dictated by thermal constraints alone.     

Conducting an acute intense interval exercise session during the ramadan fasting month: what is the optimal time of the day?

This study examines the effects of Ramadan fasting on performance during an intense exercise session performed at three different times of the day, i.e., 08:00, 18:00, and 21:00?h. The purpose was to determine the optimal time of the day to perform an acute high-intensity interval exercise during the Ramadan fasting month. After familiarization, nine trained athletes performed six 30-s Wingate anaerobic test (WAnT) cycle bouts followed by a time-to-exhaustion (T(exh)) cycle on six separate randomized and counterbalanced occasions. The three time-of-day nonfasting (control, CON) exercise sessions were performed before the Ramadan month, and the three corresponding time-of-day Ramadan fasting (RAM) exercise sessions were performed during the Ramadan month. Note that the 21:00?h session during Ramadan month was conducted in the nonfasted state after the breaking of the day's fast. Total work (TW) completed during the six WAnT bouts was significantly lower during RAM compared to CON for the 08:00 and 18:00?h (p?相似文献   

Muslims with non-insulin dependent diabetes fasting during Ramadan: treatment with glibenclamide.

OBJECTIVE--To compare the efficacy of two glibenclamide regimens in patients with non-insulin dependent diabetes who were fasting during Ramadan and regular glibenclamide treatment in the non-fasting group. DESIGN--Non-randomised control group of patients who did not fast during Ramadan and two groups of patients who fasted randomised equally to one of two regimens: to take their usual morning dose of glibenclamide in the evening and their usual evening dose before dawn; or to follow this pattern but to reduce the total dose by a quarter. SETTING--Two university hospitals, one private hospital, and two private clinics in Casablanca and Rabat, Morocco. SUBJECTS--591 diabetic patients (198 men, 391 women, two unspecified) with similar duration of diabetes and length and amount of glibenclamide treatment, of whom 542 completed the study. MAIN OUTCOME MEASURES--Serum fructosamine and total glycated haemoglobin concentrations and number of hypoglycaemic events. RESULTS--At the end of Ramadan there were no significant differences between the groups in fructosamine concentration (400 mumol/l in controls and 381 mumol/l and 376 mumol/l in the fasting groups); percentage of glycated haemoglobin (14.7%, 14.0%, and 13.6%); or number of hypoglycaemic events during Ramadan (11, 14, and 10). CONCLUSION--Glibenclamide is effective and safe for patients with non-insulin dependent diabetes who fast during Ramadan. The easiest regimen is to take the normal morning dose (together with any midday dose) at sunset and any evening dose before dawn.     

Water ingestion by rats fed a high-salt diet may be mediated, in part, by visceral osmoreceptors

After surgical removal of all salivary secretions ("desalivation"), rats increase their consumption of water while eating dry laboratory chow. In the present experiments, desalivated rats drank even more water while they ate "powdered" high-salt food (i.e., <15-mg food particles). The Na+ concentration of systemic plasma in these animals was not elevated during or immediately after the meal, which suggests that cerebral osmoreceptors were not involved in mediating the increased water intake. A presystemic osmoregulatory signal likely stimulated thirst because the Na+ and water contents of the gastric chyme computed to a solution approximately 150 mM NaCl. In contrast, desalivated rats drank much smaller volumes of water while eating "pulverized" high-salt food (i.e., 60-140-mg food particles), and the fluid mixture in the gastric chyme computed to approximately 280 mM NaCl solution. These and other findings suggest that the NaCl ingested in the powdered high-salt diet was dissolved in the gastric fluid and that duodenal osmoreceptors (or Na+-receptors) detected when the concentration of fluid leaving the stomach was elevated after each feeding bout, and promptly stimulated thirst, whereupon rats drank water until the gastric fluid was diluted back to isotonicity. However, when rats ate the pulverized high-salt diet, much of the NaCl ingested may have been embedded in the gastric chyme and therefore was not accessible to visceral osmoreceptors once it emptied from the stomach. Consistent with that hypothesis, fluid intakes were increased considerably when desalivated rats drank 0.10 M NaCl instead of water while eating either powdered or pulverized high-salt food.     

Effect of resistance training during the month of Ramadan on antioxidants and oxidative stress biomarkers in recreational bodybuilders

The aim of this study was to investigate the effect of a hypertrophic training program during Ramadan on levels of circulating antioxidants and oxidative stress biomarkers in trained bodybuilders. Eight male bodybuilders visited the laboratory two days before the start of Ramadan and on the 29th day of Ramadan (end-Ramadan), to undergo anthropometric measurement, to complete a dietary questionnaire, and to provide fasting blood and urine samples. Plasma thiobarbituric acid reactive substance and protein-bound carbonyl concentrations were measured in the plasma to indicate lipid and protein oxidation, respectively. These did not change significantly during Ramadan. Superoxide dismutase and glutathione peroxidase activities, indices of erythrocytes antioxidant status, increased by 24% (p = 0.011) and 12% (p = 0.01), respectively, from before to the end of Ramadan. However, erythrocyte catalase activity did not change significantly. Uric acid values increased by 17% (p < 0.001) from before to the end of Ramadan, but ferric-reducing ability and Vitamin E levels of the plasma remained unchanged. A significant correlation was found between uric acid values and urine specific gravity (r = 0.70; p < 0.05) only at the end of Ramadan. We conclude that continuing a hypertrophic training program during Ramadan fasting does not increase oxidative stress but does increase antioxidant status in bodybuilders.     

Diel activity and reproductive territory of the Japanese bagrid catfish, <Emphasis Type="Italic">Pseudobagrus ichikawai</Emphasis>

The endangered Japanese bagrid catfish, Pseudobagrus ichikawai, is typically nocturnal, emerging from shelters, such as crevices along the shore, at sunset to actively forage in open areas throughout the night with short-term movements of up to 40 m (except for mature males). Just before sunrise, individuals return to their shelters, from which they rarely emerge in daytime. Mature males (3 years-of-age or older) are found only in the vicinity of their shelters of during both day and night, which they defend with strong territorial behaviour. The restricted reproductive resources (shelters) probably severely limit the population size and reproduction in this species.     

Circadian rhythms in disaccharidases of rat small intestine and its relation to food intake.

The activities of maltase and sucrase of the small intestine were low at night and high in the daytime in rats which had been fed from 09.00 h to 15.00 h for 2 weeks. A remarkable rise of enzyme activities was observed at 08.00 h, 1 h before the start of feeding. The rhythmic changes in disaccharidase activities continued for at least 2 days after starvation, but completely disappeared after 5 days of starvation. It was suggested that the disaccharidase rhythms are not a direct consequence of food intake, but that anticipation of food intake acts as a trigger for initiation of the disaccharidase rhythms.     

Health Impact of Fasting in Saudi Arabia during Ramadan: Association with Disturbed Circadian Rhythm and Metabolic and Sleeping Patterns

Background

Muslims go through strict Ramadan fasting from dawn till sunset for one month yearly. These practices are associated with disturbed feeding and sleep patterns. We recently demonstrated that, during Ramadan, circadian cortisol rhythm of Saudis is abolished, exposing these subjects to continuously increased cortisol levels.

Hypothesis

Secretory patterns of other hormones and metabolic parameters associated with cortisol, and insulin resistance, might be affected during Ramadan.

Protocol

Ramadan practitioners (18 males, 5 females; mean age ±SEM = 23.16±1.2 years) were evaluated before and two weeks into Ramadan. Blood was collected for measurements of endocrine and metabolic parameters at 9 am (±1 hour) and again twelve hours later.

Results

In Ramadan, glucose concentration was kept within normal range, with a significant increase in the morning. Mean morning concentration of leptin was significantly higher than pre-Ramadan values (p = 0.001), in contrast to that of adiponectin, which was significantly lower (p<0.001). These changes were associated with increased insulin resistance in morning and evening. Concentrations of hsCRP were lower during Ramadan than those during regular living conditions, however, normal circadian fluctuation was abolished (p = 0.49). Even though means of liver enzymes, total bilirubin, total protein and albumin were all decreased during Ramadan, statistically lower means were only noted for GGT, total protein, and albumin (p = 0.018, 0.002 and 0.001 respectively).

Discussion

Saudi Ramadan practitioners have altered adipokine patterns, typical of insulin resistance. The noted decreases of hsCRP, liver enzymes, total protein, and albumin, are most likely a result of fasting, while loss of circadian rhythmicity of hsCRP is probably due to loss of circadian cortisol rhythm.

Conclusions

Modern Ramadan practices in Saudi Arabia, which are associated with evening hypercortisolism, are also characterized by altered adipokines patterns, and an abolished hsCRP circadian rhythm, all likely to increase cardiometabolic risk.     

The influence of daylight regime on diurnal locomotor activity patterns of the European hare (Lepus europaeus) during summer

Knowledge on diurnal locomotor activity pattern in wild nocturnal medium-sized mammals, such as the European hare (Lepus europaeus) is scarce. In this study, we tracked nine European hares during the vegetation period using GPS-transmitters. In particular, we focused on the question how the timing of sunset and sunrise influences the activity peaks in this species. The horal distances between two consecutive hare positions were used as a measure of locomotor activity. European hares showed two distinct peaks in their daily activity. If sunset or sunrise were earlier, the maximum activity peaks of individual European hares occurred after sunset or sunrise, whereas activity peaks were shifted before sunset or sunrise when sunset or sunrise were later. During summer, when the nights are probably too short to allow the hares to cover their energetic requirements, the study animals regularly showed activity peaks in full daylight. In conclusion, our results imply that, although daylight regime normally regulates the diurnal locomotor activity pattern in mammals, other additional factors may play a role in modifying this regulation in European hares during summer.     

The COVID-19 pandemic and physical activity during intermittent fasting,is it safe? A call for action

Intermittent fasting (IF) has recently gained popularity, and has been used for centuries in many religious practices. The Ramadan fasting is a mandatory form of IF practiced by millions of healthy adult Muslims globally for a whole lunar month every year. In Islam, the “Sunna” also encourages Muslims to practice IF all along the year (e.g.; two days a week). The 2019-Coronavirus disease (COVID-19) pandemic in the context of Ramadan has raised the question whether fasting is safe practice during the COVID-19 pandemic health crisis, and what would be the healthy lifestyle behaviors while fasting that would minimize the risk of infection. As COVID-19 lacks a specific therapy, IF and physical activity could help promote human immunity and be part of holistic preventive strategy against COVID-19. In this commentary, the authors focus on this dilemma and provide recommendations to the fasting communities for safely practicing physical activity in time of COVID-19 pandemic.     

Does Ramadan fasting affect acylated ghrelin and growth hormone concentrations during short-term maximal exercise in the afternoon?

Ghrelin is an important stomach hormone that influences several metabolic activities and influences growth hormone (GH) release in response to change in energy homeostasis. The aim of this study was to investigate the effect of Ramadan fasting on acylated ghrelin and GH concentrations during a short-term maximal exercise. Eleven male soccer players (age, 22.11 ± 1.3 years; height, 1.76 ± 0.2 m; body mass, 75.3 ± 2.2; mean ± SD) were asked to perform a 30-s Wingate test, during which we recorded the peak (PP) and mean (MP) powers and fatigue index. Measurements were performed in the afternoon at 18:00 h, after three different occasions: (i) one week before Ramadan (BR), (ii) the first week of Ramadan (FWR), and (iii) the fourth week of Ramadan (ER). Blood samples were taken before, immediately and 60 min after the exercise. Our results show that PP and MP were affected by Ramadan fasting with a significant decrease during Ramadan (i.e. FWR and ER) in comparison with ER (p < 0.05). However, no significant difference was observed between BR and FWR (p > 0.05). Also, a significant decrease in body weight and body fat percentage was observed during Ramadan in comparison with ER. From diet record analysis, protein, fat, and carbohydrate decreased significantly during FWR (p < 0.01), often with further decreases by ER. A significant increase in plasma concentrations of ghrelin was observed during the ER (p < 0.001) compared with BR and FWR, and GH levels were significantly higher during ER (p < 0.01) in comparison with BR and FWR. However, the 30-s Wingate tests had no significant effect on plasma concentrations of ghrelin before or during Ramadan. Our study shows that the concentrations of ghrelin and GH change in the last week of Ramadan fasting, though it is unclear if these changes are related to the changes in body composition during Ramadan, or if they are responsible for the change in performance at the short-duration anaerobic test.     

Activity patterns of the Ryukyu flying fox on a subtropical island: responses to seasonal changes in night length

Almost all chiropteran species are nocturnal, but some species are occasionally active during the daytime. We conducted radio-tracking surveys and direct observations of the Ryukyu flying fox, Pteropus dasymallus, in two different habitats—urbanized and forested areas—on a subtropical island from April 2002 to January 2006. We recorded the departure time and return time from/to day roosts as well as behavioral time budgets during the night. The departure and return times shifted in correspondence with seasonal changes in sunset and sunrise times. The Ryukyu flying fox tended to depart earlier in summer when the night length was shorter, suggesting that it adjusts its active period by departing earlier. On the contrary, the amount of foraging performed by the bats in urbanized areas decreased in the summer when fruits of Ficus microcarpa were more abundant, suggesting that the bats adjust their behavioral time budgets in line with local food availability. Daytime activity was observed only in the forested area. In conclusion, the duration of Ryukyu flying fox activity was found to primarily depend on seasonal changes in the light–dark cycle, and this bat may adjust its behavioral time budget according to local food availability and the intensity of human activities.     

Effect of fasting during Ramadan on sleep architecture,daytime sleepiness and sleep pattern

Sleep and Biological Rhythms - Fasting during Ramadan is distinct from regular voluntary or experimental fasting. This project was conducted to objectively assess the effect of Ramadan fasting on...     

Impact of Ramadan Fasting on Thyroid Status and Quality of Life in Patients with Primary Hypothyroidism: a Prospective Cohort Study from karachi,pakistan

Objective: Ramadan is the ninth month in the lunar calendar, during which Muslims fast from predawn to sunset and major changes occur in their dietary, sleep, and physical activity patterns. Most patients with hypothyroidism are unable to comply with the proper timings of levothyroxine (LT4) administration. The objective of the study was to determine the change in thyroid-stimulating hormone (TSH) level and quality of life (QOL) before and after Ramadan in patients with primary hypothyroidism.Methods: This prospective cohort study included adult patients on stable doses of LT4 who fasted for at least 20 days during the month of Ramadan in the Islamic year 1437 Hijri (June/July 2016). Baseline characteristics and TSH levels were recorded on all consenting patients within 6 weeks prior to Ramadan. Post-Ramadan TSH was tested within 1 to 2 weeks after Eid-ul-Fitr.Results: During the study period, 64 patients with hypothyroidism were enrolled, of which 58 were female. The mean age of participants was 44.2 ± 13.2 years. Average daily dose of LT4 was 95.3 ± 35.4 μg. On average, patients fasted for 26.5 days and missed a dose of LT4 on 1.27 days. Mean TSH pre-Ramadan was 2.37 ± 1.35 mIU/L, and post-Ramadan, it was 4.69 ± 3.87 mIU/L. Mean difference between TSH pre- and post-Ramadan was 2.32 ± 3.80 mIU/L (P<.001). However, the difference in TSH was not significantly different between those who were compliant with meals and LT4 interval versus those who were not (compliant, 2.04 mIU/L; noncompliant, 3.15 mIU/L; P = .30). Overall, an increase in QOL scores in the domains of physical health, psychological health, and social relationships was observed after Ramadan.Conclusion: We observed statistically significant changes in TSH concentrations after the month of Ramadan in hypothyroid patients who fasted. The change in TSH was not affected by timing of LT4 intake and interval from meal.Abbreviations: AKUH = Aga Khan University Hospital; LT4 = levothyroxine; QOL = quality of life; TSH = thyroid-stimulating hormone