Effect of Pre-Ramadan Education on Dietary Intake and Anthropometry-Comparison Between Two Groups of Diabetic Patients

Open access


Background and aims: Fasting of Ramadan leads to changes in dietary habits, physical activity, sleep and time of drug intake for diabetics. The objective of this study was to evaluate the effect of pre-Ramadan education on dietary intake and anthropometry of two groups of patients.

Material and methods: The entire cohort was divided in a group (G1; n=86) which attended nutritional education sessions and group that did not attend these sessions (G2; n=72). The protocol included three visits before, during and after the month of Ramadan.

Results. Total energy intake of the G1 did not differ significantly between visits, unlike the G2. Patients in the G1 reduced their carbohydrate intake during Ramadan with 32.5g, compared to the G2 which decreased their consumption with17.2g. The intake of saturated fatty acids was significantly higher in the G2 (p=0.001) after Ramadan. The number of obese class 2 of the G1 decreased after Ramadan, however for the G2, the number increased. The waist-to-hip ratio and the body fat (%) were unchanged between the three periods.

Conclusion. The management of diabetes should be multidisciplinary to ensure better continuity of care. Specialized and individual educational actions must be concrete in diabetics wishing to fast.

1. Hassanein M, Al-Arouj M, Hamdy O et al. Diabetes and Ramadan: Practical guidelines. Diabetes Res Clin Pract 126: 303-316, 2017.

2. Watkins PJ, Amiel SA, Howell SL, Turner E. In: Diabetes and its Management. Blackwell Publishing Ltd (Ed). Great Britain, 2003.

3. Codario RA. In: Type 2 Diabetes, Pre-Diabetes, and the Metabolic Syndrome: The Primary Care Guide to Diagnosis and Management. Humana press (Ed). USA, 2005.

4. Karaağaoğlu N, Yücecan S. Some behavioural changes observed among fasting subjects, their nutritional habits and energy expenditure in Ramadan. Intl J Food Sci Nutri 51: 125-34, 2000.

5. Waterhouse J, Alkib L, Edwards B, Reilly T. Diurnal changes in sleep, food and fluid intakes, and activity during Ramadan, 2006, in the UK: some preliminary observations. Biol Rhythm Res 39: 449-467, 2008.

6. Hajek P, Myers K, Dhanji AR, West O, McRobbie H. Weight change during and after Ramadan fasting. J Public Health (Oxf) 34: 377-381, 2011.

7. Bencharif M, Dahili K, Benseghir L, Benabbas Y. Effect of Ramadan fasting on dietary intake and physical activity: Comparison by age and gender. Nutr Clin Metab 31: 140-150, 2017.

8. Salti I, Benard E, Detournay B et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries - Results of the Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study. Diabetes Care 27: 2306-2311, 2004.

9. Wass J, Owen K. In: Oxford handbook of endocrinology and diabetes. Oxford University Press (Ed). UK, 2014.

10. CIQUAL. French Food Composition Table. French Agency for Food, Environmental and Occupational Health & Safety; 2016. Accessed at: https://pro.anses.fr/tableciqual/

11. Souci SW, Fachmann W, Kraut H. In: Food composition and nutrition tables, 7th revised and complete edition. Medpham Scientific Publishers (Ed). Stuttgart, 2008.

13. World Health Organization. Obesity: preventing and managing the global epidemic. Geneva 2000. Accessed at: whqlibdoc.who.int/trs/WHO_TRS_894.pdf

14. Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr 34: 2540-2545, 1981.

15. Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 32: 77-97, 1974.

16. Siri WE. The gross composition of the body. Adv Biol Med Phys 4: 239-280, 1956.

17. Al-Arouj M, Assaad-Khalil S, Buse J et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 33: 1895-1902, 2010.

18. Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan education and awareness in diabetes programme for Muslims with type 2 diabetes who fast during Ramadan. Diabet Med 27: 327-331, 2010.

19. Babineaux SM, Toaima D, Boye KS et al. Multi-country retrospective observational study of the management and outcomes of patients with Type 2 diabetes during Ramadan in 2010 (CREED). Diabet Med 32: 819-28, 2015.

20. Martin A. The “apports nutritionnels conseillés (ANC)” for the French population. Reprod Nutr Dev 41: 119-128, 2001.

21. Bouguerra R, Belkadhi A, Jabrane J et al. Metabolic effects of Ramadan fasting on type 2 diabetes. EMHJ 9: 1099-1108, 2003.

22. Sebbani M, El Ansari N, El Mghari G, Amine M. Food intake during the month of Ramadan in Moroccan patients with type 2 diabetes. EMHJ 19: 276-281, 2013.

23. Alsafadi H, Wilson J, Patel V. Managing diabetes in people fasting during Ramadan. Diabetes & Primary Care 13: 152-159, 2011.

24. Beltaifa L, Bouguerra R, Ben Slama C et al. Food intake, and anthropometrical and biological parameters in adult Tunisians during fasting at Ramadan. EMHJ 8: 603-611, 2002.

25. Ouhdouch F, Adarmouch L, Errajraji A, Amine M, El Ansari N. No deleterious effects of Ramadan fasting on glycemic control in diabetic patients: The role of consultations in preparation for fasting. Médecine des Maladies Métaboliques 5: 448-452, 2011.

26. Sadiya A, Ahmed S, Siddieg HH, Babas IJ, Carlsson M. Effect of Ramadan fasting on metabolic markers, body composition, and dietary intake in Emiratis of Ajman (UAE) with metabolic syndrome. Diabetes Metab Syndr Obes 4: 409-416, 2011.

27. Dhingra D, Michael M, Rajput H, Patil RT. Dietary fibre in foods: a review. J Food Sci Technol 49: 255-266, 2012.

28. Institut National de Santé Publique. Transition épidémiologique et système de santé : Projet TAHINA. Résumé de l’enquête nationale santé, 2007. Accessed at : http://www.sante.dz/enquete_tahina.pdf

29. Hansel B, Giral P. Dietary cholesterol and cardiovascular disease. OCL 22: 1-7, 2015.

30. Rossi F. Alimentation et insulino-résistance chez le diabétique non insulino-dépendant. Diabetes Metab 24: 89-93, 1998.

31. Nomani MZA. Dietary fat, blood cholesterol and uric acid levels during Ramadan fasting. InternationalJournal of Ramadan Fasting Research 1: 1-6, 1997.

32. Bencharif M, Fenaghra A, Boudaoud C, Hadji NEH, Benyaya H, Benabbas Y. Impact of Ramadan fasting on energy intake and anthropometry of type 2 diabetics-Study in two regions of the central highlands and southeastern Algeria. Journal of Fasting and Health 5: 31-37, 2017.

33. Khaled BM, Belbraouet S. Effect of Ramadan fasting on anthropometric parameters and food consumption in 276 type 2 diabetic obese women. Int J Diabetes Dev Ctries 29: 62-68, 2009.

34. McEwen LN, Ibrahim M, Ali NM et al. Impact of an individualized type 2 diabetes education program on clinical outcomes during Ramadan. BMJ Open Diabetes Res Care 3: 1-8, 2015.

35. Traoré M, Lemieux S, Galibois I. Metabolic and clinical profiles before, during and after Ramadan in Malians with type 2 diabetes. Nutr Clin Metab 28: 83-89, 2014.

36. Uysal AR, Erdoğan MF, Şahin G, Kamel N, Erdoğan G. Clinical and Metabolic Effects of Fasting in 41 Type 2 Diabetic Patients during Ramadan. Diabetes Care 21: 2033-2034, 1998.

37. Ait Saada D, Selselet Attou G, Mouhtadi F, Kassoul S, Italhi M, Kati D. Effect of the Ramadan fasting on the variations of certain anthropometric and biochemical parameters in type 2 diabetic patients treated with medications mixture (biguanides and sulfamides). Advan Biol Res 2: 111-120, 2008.

38. Hassanein M, Al-Arouj M, Hamdy O et al. Diabetes and Ramadan: Pratical guidelines. Diabetes Res Clin Pract 126: 303-316, 2017.

39. Pinar R. Management of people with diabetes during Ramadan. Br J Nurs 11: 1300-1303, 2002.

Romanian Journal of Diabetes Nutrition and Metabolic Diseases

The Journal of Romanian Society of Diabetes Nutrition and Metabolic Diseases

Journal Information

CiteScore 2018: 0.19

SCImago Journal Rank (SJR) 2018: 0.128
Source Normalized Impact per Paper (SNIP) 2018: 0.229


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 343 269 12
PDF Downloads 199 179 5