A Study of Diurnal Variation in Serum and Urine Osmolalities and in Serum Cortisol During Ramadan Fasting: Evidence Suggesting Increased Intrinsic Water Production
DOI:
https://doi.org/10.5915/24-1-15462Keywords:
Fasting, Ramadan, osmolalities, cortisolAbstract
DOI: http://dx.doi.org/10.5915/24-1-15462
Daily abstinence from food and drink for some 15 hours in Ramadan is a unique type of fasting. Morning (0800 hour) and evening (1900 hour, just preceding sunset) estimation of serum and urine osmolalities and of serum cortisol were conducted on 22 healthy volunteers who fasted Ramadan of 1407 Hijri in Mosul on days 1, 14 and 28 of the month. A diurnal variation in serum and urine osmolalities that narrowed as Ramadan progressed was observed. The evening serum cortisol was high on days 1 and14 but decreased on day 28. In four of the 66 occasions comparing morning and evening serum osmolalities the evening values were 2 mOsmol/kg lower than morning values.
Our results were interpreted as unexplainable by vasopressin action on the kidney alone. Evidence that daily fasting triggers increased capacity to synthesize and store glycogen which is dictated by increased glucose needs
for the new prolonged intermeal interval is given. We maintain that glycogen synthesis during eating hours incorporates water intracellularly; water is released during daytime glycogenolysis in order to help prevent undue increase in serum osmolality during fasting. Our concept offers explanations for many phenomena that are experienced by people who fast Ramadan.
References
Owen ON, Reichard JW, Kinney JM, Boden G, Patel MS, Sapir DG.
Metabolism during catabolic states of starvation, diabetes, and trauma in humans. In: Bleicher SJ, Brodoff BN, eds, Diabetes Mellitus and Obesity. Baltimore: Williams and Wilkins, 1982: 172-84.
Mustafa KY, Mahmoud NA, Gumaa KA, Gader AMA. The effects of fasting Ramadan: fluid and electrolyte balance. Br J Nutr. 1978;40:583-89.
Allawi NS, Khalil HM, Al-Dabbagh EH, AlSulaiveni BK. Some of the effects of fasting Ramadan on blood and urine chemistry. Iraqi Med J. 1985;33:14-22.
Kreiger OT. Rhythms of ACTH and corticosteroid secretion in health and disease and their experimental modification. J Steroid Biochem. 1975;6:785.
Thorell JI, Larson SM. Radioimmunoassay and Related techniques: Methodology and Clinical Applications. Saint Louis: Mosby, 1978.
Montgomery DC. Design and Analysis of Experiments, 2nd ed. New York: John Wiley and sons, 1984: 69.
AJ-Dabbagh TQ, Fahadi K. Seasonal variation in the incidence of ureteric colic. Br J Urol. 1977;49:269-77.
Rudman O. Nutritional requirements. In: Braunwald E et al. Harrison's Principles of Internal Medicine, 11th ed. New York: McGraw-Hill, 1987:387.
Gumaa KA, Mustafa KY, Mahmoud NA, Gader AMA. The effects of fasting in Ramadan: serum uric acid and lipid concentrations. Br J Nutr. 1978;40:573-81.
Jeffersons LS, Neely, JR. Intermediary metabolism. In: Brodoff BE, Bleicher SJ, eds. Diabetes Mellitus and Obesity. Baltimore: Williams and Wilkins, 1982:3.
Stalmans W, Laloux M. Glucocorticoids and hepatic glycogen metabolism. In: Baxter JD, Rousseau GG, eds, Glucocorticoid Hormone Action. New York: Springer-Verlag, 1979:517.
El-Hazmi MAP, AJ-Faleh FZ, AJ-Mofleh IA. Effects of Ramadan fasting on the values of haematological and biochemical parameters. Saudi Med J. 1987;8(2):171-6.
Foster OW, Rubenstein AH. Hypoglycaemia, insulinoma and other hormone secreting tumours of the pancreas. In: Braunwald, et al, Harrison's Principles of Internal Medicine, 11th ed. 1987:1800.
Morgan TE, Short FA, Cobb LS. Muscle adaptation to exercise in man: effects in glycogen and lipid. J Clin Invest. 1968;47:71.
Sulaiman Ml, Zabir Fl, Khairy AM. Effects of a Muslim-style fast on blood sugar and hepatic glycogen in rats. Saudi Med J. 1988;9(5):503-8.
Horton ES, Danforth E. Energy metabolism and obesity. In: Brodoff BN, Bleicher SJ eds. Diabetes Mellitus and Obesity. Baltimore: Williams and Wilkins, 1982;261-8.
Seifter SS, England S. Carbohydrate metabolism. In: Ellenberg M, Rifkin H eds, Diabetes Mellitus: Theory and Practice. New York: Medical Examination Publishing Co, 1983: 21.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
