Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study

Nurul Iman Hafizah Adanan, Mohamad Syafiq Md Ali, Jun Hao Lim, Nor Fadhlina Zakaria, Christopher Thiam Seong Lim, Rosnawati Yahya, Abdul Halim Abdul Gafor, Tilakavati Karupaiah, Zulfitri ‘Azuan Mat Daud

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Studies investigating the health effects of prolonged intermittent fasting during Ramadan among Muslim patients on hemodialysis (HD) are limited and reported heterogeneous findings. This study aimed to evaluate the effects of intermittent fasting during Ramadan on nutritional and functional status of patients on maintenance HD. Design and Methods: This was a 12-week, multicenter, prospective observational study. The study setting included three HD centers. Adult Muslim patients, who were undergoing HD session thrice weekly and planned to fast during Ramadan, were screened for eligibility and recruited. Nutritional and functional status assessments were carried out 2 weeks before (V0), at the fourth week of Ramadan (V1), and 4 weeks after Ramadan (V2). Nutritional status parameters included anthropometry (body mass index, interdialytic weight gain, waist circumference), body composition (mid-arm circumference, triceps skinfold, body fat percentage), blood biochemistry (albumin, renal profile, lipid profile, and inflammatory markers), blood pressure, dietary intake, and handgrip strength. Changes in nutritional and functional status parameters across study timepoints were analyzed using repeated-measures analysis of variance. Results: A total of 87 patients completed the study, with 68 patients (78.2%) reporting fasting ≥20 days. Ramadan fasting led to significant reductions (all P < .05) in body mass index, interdialytic weight gain, waist circumference, mid-arm circumference, fat tissue mass, and body fat percentage, but these were not accompanied by any significant change in lean tissue mass (P > .05). Significant improvement was observed in serum phosphate levels, but serum albumin, urea, and creatinine were also reduced significantly during Ramadan (P < .05). There were no significant changes in lipid profile and inflammatory markers. Interestingly, energy and protein intakes remain unchanged during Ramadan. Handgrip strength improved significantly during Ramadan and further improved after Ramadan. Conclusion: Intermittent Ramadan fasting leads to temporary changes in nutritional status parameters and poses nondetrimental nutritional risk for patients on maintenance HD.

Original languageEnglish
JournalJournal of Renal Nutrition
DOIs
Publication statusAccepted/In press - 1 Jan 2019

Fingerprint

Renal Dialysis
Fasting
Nutritional Status
Cohort Studies
Prospective Studies
Islam
Maintenance
Lipids
Anthropometry
Waist Circumference
Body Composition
Energy Intake
Serum Albumin
Biochemistry
Weight Gain
Observational Studies
Urea
Adipose Tissue
Albumins
Creatinine

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Nephrology

Cite this

Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients : A Prospective Cohort Study. / Adanan, Nurul Iman Hafizah; Md Ali, Mohamad Syafiq; Lim, Jun Hao; Zakaria, Nor Fadhlina; Lim, Christopher Thiam Seong; Yahya, Rosnawati; Abdul Gafor, Abdul Halim; Karupaiah, Tilakavati; Daud, Zulfitri ‘Azuan Mat.

In: Journal of Renal Nutrition, 01.01.2019.

Research output: Contribution to journalArticle

Adanan, Nurul Iman Hafizah ; Md Ali, Mohamad Syafiq ; Lim, Jun Hao ; Zakaria, Nor Fadhlina ; Lim, Christopher Thiam Seong ; Yahya, Rosnawati ; Abdul Gafor, Abdul Halim ; Karupaiah, Tilakavati ; Daud, Zulfitri ‘Azuan Mat. / Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients : A Prospective Cohort Study. In: Journal of Renal Nutrition. 2019.
@article{e2efc1f2cbd442f19ea7981e35aca63b,
title = "Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study",
abstract = "Objective: Studies investigating the health effects of prolonged intermittent fasting during Ramadan among Muslim patients on hemodialysis (HD) are limited and reported heterogeneous findings. This study aimed to evaluate the effects of intermittent fasting during Ramadan on nutritional and functional status of patients on maintenance HD. Design and Methods: This was a 12-week, multicenter, prospective observational study. The study setting included three HD centers. Adult Muslim patients, who were undergoing HD session thrice weekly and planned to fast during Ramadan, were screened for eligibility and recruited. Nutritional and functional status assessments were carried out 2 weeks before (V0), at the fourth week of Ramadan (V1), and 4 weeks after Ramadan (V2). Nutritional status parameters included anthropometry (body mass index, interdialytic weight gain, waist circumference), body composition (mid-arm circumference, triceps skinfold, body fat percentage), blood biochemistry (albumin, renal profile, lipid profile, and inflammatory markers), blood pressure, dietary intake, and handgrip strength. Changes in nutritional and functional status parameters across study timepoints were analyzed using repeated-measures analysis of variance. Results: A total of 87 patients completed the study, with 68 patients (78.2{\%}) reporting fasting ≥20 days. Ramadan fasting led to significant reductions (all P < .05) in body mass index, interdialytic weight gain, waist circumference, mid-arm circumference, fat tissue mass, and body fat percentage, but these were not accompanied by any significant change in lean tissue mass (P > .05). Significant improvement was observed in serum phosphate levels, but serum albumin, urea, and creatinine were also reduced significantly during Ramadan (P < .05). There were no significant changes in lipid profile and inflammatory markers. Interestingly, energy and protein intakes remain unchanged during Ramadan. Handgrip strength improved significantly during Ramadan and further improved after Ramadan. Conclusion: Intermittent Ramadan fasting leads to temporary changes in nutritional status parameters and poses nondetrimental nutritional risk for patients on maintenance HD.",
author = "Adanan, {Nurul Iman Hafizah} and {Md Ali}, {Mohamad Syafiq} and Lim, {Jun Hao} and Zakaria, {Nor Fadhlina} and Lim, {Christopher Thiam Seong} and Rosnawati Yahya and {Abdul Gafor}, {Abdul Halim} and Tilakavati Karupaiah and Daud, {Zulfitri ‘Azuan Mat}",
year = "2019",
month = "1",
day = "1",
doi = "10.1053/j.jrn.2019.06.003",
language = "English",
journal = "Journal of Renal Nutrition",
issn = "1051-2276",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients

T2 - A Prospective Cohort Study

AU - Adanan, Nurul Iman Hafizah

AU - Md Ali, Mohamad Syafiq

AU - Lim, Jun Hao

AU - Zakaria, Nor Fadhlina

AU - Lim, Christopher Thiam Seong

AU - Yahya, Rosnawati

AU - Abdul Gafor, Abdul Halim

AU - Karupaiah, Tilakavati

AU - Daud, Zulfitri ‘Azuan Mat

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Studies investigating the health effects of prolonged intermittent fasting during Ramadan among Muslim patients on hemodialysis (HD) are limited and reported heterogeneous findings. This study aimed to evaluate the effects of intermittent fasting during Ramadan on nutritional and functional status of patients on maintenance HD. Design and Methods: This was a 12-week, multicenter, prospective observational study. The study setting included three HD centers. Adult Muslim patients, who were undergoing HD session thrice weekly and planned to fast during Ramadan, were screened for eligibility and recruited. Nutritional and functional status assessments were carried out 2 weeks before (V0), at the fourth week of Ramadan (V1), and 4 weeks after Ramadan (V2). Nutritional status parameters included anthropometry (body mass index, interdialytic weight gain, waist circumference), body composition (mid-arm circumference, triceps skinfold, body fat percentage), blood biochemistry (albumin, renal profile, lipid profile, and inflammatory markers), blood pressure, dietary intake, and handgrip strength. Changes in nutritional and functional status parameters across study timepoints were analyzed using repeated-measures analysis of variance. Results: A total of 87 patients completed the study, with 68 patients (78.2%) reporting fasting ≥20 days. Ramadan fasting led to significant reductions (all P < .05) in body mass index, interdialytic weight gain, waist circumference, mid-arm circumference, fat tissue mass, and body fat percentage, but these were not accompanied by any significant change in lean tissue mass (P > .05). Significant improvement was observed in serum phosphate levels, but serum albumin, urea, and creatinine were also reduced significantly during Ramadan (P < .05). There were no significant changes in lipid profile and inflammatory markers. Interestingly, energy and protein intakes remain unchanged during Ramadan. Handgrip strength improved significantly during Ramadan and further improved after Ramadan. Conclusion: Intermittent Ramadan fasting leads to temporary changes in nutritional status parameters and poses nondetrimental nutritional risk for patients on maintenance HD.

AB - Objective: Studies investigating the health effects of prolonged intermittent fasting during Ramadan among Muslim patients on hemodialysis (HD) are limited and reported heterogeneous findings. This study aimed to evaluate the effects of intermittent fasting during Ramadan on nutritional and functional status of patients on maintenance HD. Design and Methods: This was a 12-week, multicenter, prospective observational study. The study setting included three HD centers. Adult Muslim patients, who were undergoing HD session thrice weekly and planned to fast during Ramadan, were screened for eligibility and recruited. Nutritional and functional status assessments were carried out 2 weeks before (V0), at the fourth week of Ramadan (V1), and 4 weeks after Ramadan (V2). Nutritional status parameters included anthropometry (body mass index, interdialytic weight gain, waist circumference), body composition (mid-arm circumference, triceps skinfold, body fat percentage), blood biochemistry (albumin, renal profile, lipid profile, and inflammatory markers), blood pressure, dietary intake, and handgrip strength. Changes in nutritional and functional status parameters across study timepoints were analyzed using repeated-measures analysis of variance. Results: A total of 87 patients completed the study, with 68 patients (78.2%) reporting fasting ≥20 days. Ramadan fasting led to significant reductions (all P < .05) in body mass index, interdialytic weight gain, waist circumference, mid-arm circumference, fat tissue mass, and body fat percentage, but these were not accompanied by any significant change in lean tissue mass (P > .05). Significant improvement was observed in serum phosphate levels, but serum albumin, urea, and creatinine were also reduced significantly during Ramadan (P < .05). There were no significant changes in lipid profile and inflammatory markers. Interestingly, energy and protein intakes remain unchanged during Ramadan. Handgrip strength improved significantly during Ramadan and further improved after Ramadan. Conclusion: Intermittent Ramadan fasting leads to temporary changes in nutritional status parameters and poses nondetrimental nutritional risk for patients on maintenance HD.

UR - http://www.scopus.com/inward/record.url?scp=85070522588&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070522588&partnerID=8YFLogxK

U2 - 10.1053/j.jrn.2019.06.003

DO - 10.1053/j.jrn.2019.06.003

M3 - Article

AN - SCOPUS:85070522588

JO - Journal of Renal Nutrition

JF - Journal of Renal Nutrition

SN - 1051-2276

ER -