Access Type

Open Access Dissertation

Date of Award

January 2021

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Nutrition and Food Science

First Advisor

Pramod Khosla

Abstract

During Ramadan R month, Muslims abstain from eating, drinking, and medication from sunrise to sunset, and this causes some changes in their lifestyle and often eating habits (quantity and quality). These changes could lead to affect their health and nutritional status. Among Hemodialysis (HD) patients, malnutrition is common, and it is associated with mortality. Some HD patients opt to fast R which could have an impact on their nutritional and health status. Thus, the primary objective of this study was to document nutritional changes before, during, and after Ramadan on biochemical and health parameters in HD patients. A prospective cohort study was included 45 KF undergoing HD patients from an out-patient HD clinic in Saudi Arabia, who were 18 years of age or older, not pregnant, and who had been on dialysis treatment for three months at least. Subjects were evaluated for routine biochemical, anthropometric including hand-grip strength (HGS), mid-arm muscle circumference (MAMC), plasma lipids, and lipoproteins on a monthly basis every four weeks before, during as well as one and two months after R. in addition, the dietary assessment was carried out using 24 h recalls. Then the changes of these markers were evaluated by dividing the subjects depend on first: their reporting energy intake (calculated from their ratio of energy intake (EI) and total energy expenditure (TEE)) to acceptable- reporters (AR: EI/TEE > 0.76) and under-reporters (UR: EI/TEE < 0.76). Second, depending on their malnutrition indicators according to protein-energy wasting (PEW) using the International Society of Renal Nutrition and Metabolism (ISRNM) criteria to PEW and Non-PEW group. The findings of this study revealed no changes were seen in terms of clinical and biochemical markers during R; however, there was only a temporary change in lipoprotein particle size distribution and MIS during Ramadan. Moreover, the intake of energy and nutrients was higher during Ramadan. This high intake showed a significant change in LDL particle size and malnutrition inflammation score (MIS). Finally, PEW was prevalent in our samples with no change in the food intake during the study period. The data suggests that there is transient change and most of them are not clinically significant and Ramadan does not have an impact on health and nutritional status.

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