By Faizullah Kakar, PhD

Ambassador of the Islamic Republic of Afghanistan to the State of Qatar

Metabolic Syndrome is now a global epidemic, estimated to affect more than a billion people in the world in 2018.(1) Metabolic Syndrome is a cluster of conditions including high blood pressure, high blood sugar, excess body fat around the waist, and high cholesterol or triglyceride levels. This cluster of conditions has been shown to increase the risk of heart disease, type 2 Diabetes, and all-cause mortality.

Improper lifestyle and diet are the major contributory factors to metabolic syndrome. One lifestyle hazard is “lack of outdoor exposure”. City dwellers are especially at risk of metabolic syndrome because they live in protected air-conditioned environments do not experience the harsh elements of sun, extreme heat, extreme cold, thorns, rocks, etc. that our ancestors experienced. This lack of outdoor exposure leads to the reduction of a critical biochemical known as Brain Derived Neurotrophic Factor (BDNF). Reduction of BDNF is associated with metabolic syndrome and cardiovascular disease as well as memory loss and neurodegenerative diseases and accelerated aging.

Fasting is one of the factors that can stimulate the production of BNDF and prevent metabolic syndrome and memory loss. (2) Thus proper fasting, as described later in the article, can be an important health-promoting practice for anyone with a lifestyle lacking outdoor exposure.

Another lifestyle hazard is “late night eating”. Eating full meals late in the evening has been shown to raise the risk of metabolic syndrome as well as other diseases. One way that late eating harms our health is disturbing the quality and rhythm of sleep. When food is consumed it produces energy and raises the body temperature. By eating less than three hours before sleep, the raised body temperature disturbs the quality of sleep. Studies show that disturbed sleep over the long term is associated with obesity and insulin resistance. Insulin is a hormone that transports sugar molecules inside the cells for energy production. Insulin resistance occurs when the cells do not allow insulin to enter the cells. If insulin resistance occurs in the brain, it has the potential to negatively affect memory, and if the insulin resistance is in the rest of the body, it leads to adult-onset diabetes. (3)

In addition to late evening eating, going to bed at different times also interferes with healthy sleep by disturbing the regular circadian rhythm of human sleep and adds the risk of social jet lag.  Social jetlag occurs when people keep markedly irregular hours, for example to sleep very late and wake up very late on the weekends. As the reason for the irregular schedule is often social issues, and the effect on the sleep is similar to jet lag, this situation is referred to as social jetlag. Social jetlag disrupts hormonal balance and has been shown to contribute to metabolic syndrome. (4)

Fasting has been proven scientifically to have numerous health benefits and will help avoid the hazard of “late night evenings”, but only if it is correctly practiced. The correct way of fasting is to eat only at prescribed times, that is, to eat at the fast-breaking time (about 6:00 pm these days) and then to eat sohoor very early in the morning. Thus, the proper way of fasting will prevent sleep disturbances and social jetlag by ensuring early eating and regular time of sleep.

Besides regulation of sleep and its rhythm, fasting has numerous other health protecting and promoting effects. Fasting reduces insulin resistance and thus reduces the risk of diabetes, hypertension, hyperlipidemia, and heart disease. Fasting improves immunity and reduces inflammation, and reduces triglycerides and cholesterol. Fasting also stimulates autophagy in the brain and other parts of the body improving health and memory. Autophagy is a process by which our body selectively destroys and removes aging and damaged cells. (5)

During fasting, growth hormone increases as well as BDNF, mentioned above, and several other biochemically beneficial changes take place leading to the production of new cells in the brain, improving not only memory but also learning.

Improving diet during Ramadan would also help lower the risk of diseases. Unfortunately, in many countries people consume more fried foods and more sugary foods in the month of Ramadan, thus depriving themselves of the physical health blessing of fasting.

Eating foods with lots of sugars causes a 3-fold increased risk of death due to cardiovascular disease. (6)  Fried starches and fried meat form chemicals known as acrylamides and heterocyclic amines, respectively. These chemicals have been shown to contribute to insulin resistance, high blood pressure, type-2 diabetes, and gastric and esophageal cancers. (7)

During fasting the best foods are a great deal of green leafy vegetables, a small amount of protein, and good fats such as olive oil. Also seeds (pumpkins, sunflower) and nuts (almonds, macadamia nuts, walnuts, and pistachios), fruits that contain less sugar (lemons, avocadoes, blueberries) and roots (beets, carrots, onions, garlic, and turnips) are very healthy foods to consume.

Eating food with lots of fiber or adding fiber such as Psyllium to water will be helpful to slow the digestion of food so it will provide energy throughout the day. Fiber is also necessary for beneficial gut bacteria which manufacture several hormones for our wellbeing.

In conclusion, proper fasting requires that we observe the time of eating and the content and quality of what we consume. Breaking our fast with healthy foods early in the evening, staying in close touch with nature, and being physically and mentally active is a lifestyle that will synergistically protect and promote our health. The practice of eating evening meals early is a healthy habit to carry-on even after the month of fasting.

I wish every one of the readers a happy and healthy Ramadan month.

References:

1. Saklayen MG. (2018). The Global Epidemic of the Metabolic Syndrome. Current hypertension reports, 20(2), 12. doi:10.1007/s11906-018-0812-z
2. Bastani A, Rajabi S, Kianimarkani F. (2017). The Effects of Fasting During Ramadan on the Concentration of Serotonin, Dopamine, Brain-Derived Neurotrophic Factor and Nerve Growth Factor. Neurology international, 9(2), 7043. doi:10.4081/ni.2017.7043

3. Koren D, Taveras EM. (2018). Association of sleep disturbances with obesity, insulin resistance and the metabolic syndrome. Metabolism, Jul;84:67-75. doi:10.1016/j.metabol.2018.04.001. Epub 2018 Apr 6.

4. Koopman ADM, Rauh SP, van ‘t Riet E, et al. (2017). The Association between Social Jetlag, the Metabolic Syndrome, and Type 2 Diabetes Mellitus in the General Population: The New Hoorn Study. J Biol Rhythms. 32(4):359–368. doi:10.1177/0748730417713572

5. Mattson MP, Longo VD, Harvie M. (2016). Impact of intermittent fasting on health and disease processes. Ageing research reviews, 39: 46–58. doi:10.1016/j.arr.2016.10.005

6. DiNicolantonio JJ, Lucan SC, O’Keefe JH. (2015). The Evidence for Saturated Fat and for Sugar Related to Coronary Heart Disease. Prog cardiov dis, 58(5), 464–472. doi:10.1016/j.pcad.2015.11.006

7. Cahill LE, Pan, A, et. al. (2014). Fried-food consumption and risk of type 2 diabetes and coronary artery disease: a prospective study in 2 cohorts of US women and men, The Am J Clin Nut, Aug; 100:(2): 667–675. doi:10.3945/ajcn.114.084129