scholarly journals The effects of fasting in Ramadan

1978 ◽  
Vol 40 (3) ◽  
pp. 583-589 ◽  
Author(s):  
K. Y. Mustafa ◽  
N. A. Mahmoud ◽  
K. A. Gumaa ◽  
A. M. A. Gader

1. Fluid intake, urine output and evaporative water loss were measured and fluid balance calculated in sixteen subjects for 1 d before Ramadan, during weeks 1–5 of fasting and on the 10th day after the end of Ramadan.2. Plasma osmolality at 06.00 hours, the beginning of the fast, at 18.00 hours, before breaking the fast and at 19.00 hours, 1 h after breaking the fast, and urine osmolality during the day and night were measured before, during and after Ramadan.3. All subjects developed an initial negative fluid balance which was maximum at the beginning of week 3 of fasting and that deficit was compensated for during the later weeks.4. Compensation was brought about by an increase in urine concentration, a decrease in urine volume by day, and salt retention.5. No significant changes were observed in plasma osmolality during the days of fasting and the ‘setting’ of plasma osmolality during Ramadan also was not changed.6. It was concluded that healthy young adults maintain good control of fluid and electroytes during Ramadan.

Author(s):  
Aaron R. Caldwell ◽  
Megan E. Rosa-Caldwell ◽  
Carson Keeter ◽  
Evan C. Johnson ◽  
François Péronnet ◽  
...  

<b><i>Background:</i></b> Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [<xref ref-type="bibr" rid="ref1">1</xref>]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [<xref ref-type="bibr" rid="ref2">2</xref>]. In a small (<i>n</i> = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. <b><i>Objectives:</i></b> Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. <b><i>Methods:</i></b> In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D<sub>2</sub>O) was administered to measure TBW. Urine samples were collected immediately prior, and 3–8 h after the D<sub>2</sub>O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. <b><i>Results:</i></b> Twenty-four-hour urine osmolality decreased (−438.7 ± 362.1 mOsm; <i>p</i> &#x3c; 0.001) and urine volume increased (1,526 ± 869 mL; <i>p</i> &#x3c; 0.001) in the experimental group from baseline, while there were no differences in osmolality (−74.7 ± 572 mOsm; <i>p</i> = 0.45), or urine volume (−32 ± 1,376 mL; <i>p</i> = 0.89) in the control group. However, there were no changes in BV (Fig. <xref ref-type="fig" rid="f01">1</xref>a) or changes in TBW (Fig. <xref ref-type="fig" rid="f01">1</xref>b) in either group. <b><i>Conclusions:</i></b> Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [<xref ref-type="bibr" rid="ref2">2</xref>] to 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.


Author(s):  
Jinny Jeffery ◽  
Ruth M Ayling ◽  
Richard J S McGonigle

Hypernatraemia over 160 mmol/L is considered to be severe. This case reports a patient who developed extreme hypernatraemia with a serum sodium concentration of 196 mmol/L. The patient was known to have chronic renal impairment and was admitted with acute deterioration of renal function secondary to dehydration. This was considered to be secondary to poor oral fluid intake (related to depression) and lithium-induced nephrogenic diabetes insipidus with salt-losing nephropathy. The patient had a high urinary sodium excretion but was also in a pure water losing state as evidenced by an inappropriately low urine osmolality for the plasma osmolality and was successfully treated with hypotonic intravenous fluid and desmopressin.


Author(s):  
Hairong He ◽  
Jianfen Zhang ◽  
Na Zhang ◽  
Songming Du ◽  
Shufang Liu ◽  
...  

Water is a critical nutrient that is important for the maintenance of the physiological function of the human body. This article aimed to investigate the effects of the amount and frequency of fluid intake on cognitive performance and mood. A double-blinded randomized controlled trial was designed and implemented on college students aged 18–23 years in Baoding, China. Participants were randomly assigned into one of three groups: the recommended behavior group (RB group) who drank 200 mL of water every 2 h, the half amount group (HA group) who drank 100 mL of water every 2 h, and the high frequency group (HF group) who drank 110 mL of water every 1 h. The intervention lasted 2 days. Urine osmolality, cognitive performance, and mood of participants in each group were compared using the one-way analysis of variance (ANOVA). A total of 92 participants (46 females, 46 males) completed this study with a completion rate of 95.8%. The urine osmolality of the HA group was higher than that of the RB group and the HF group at two time points (p < 0.05). At time point 1, the scores in the portrait memory test and vigor were statistically different (F = 20.45, p < 0.001; F = 5.46, p = 0.006). It was found that the scores for the portrait memory test in the RB group were lower than those in the HA group and the HF group (p = 0.007; p < 0.001), while the scores of the HF group were higher than those of the HA group (p < 0.001). The scores for vigor in the RB group were significantly higher than those of the HA group (p = 0.006), and they were also significantly higher than those of the HF group (p = 0.004). At time point 2, only the scores for vigor were statistically different (F = 3.80, p = 0.026). It was found that the scores for vigor in the RB group were higher than those in the HA group and HF group (p = 0.018; p = 0.019). Both the amount and frequency of fluid intake may affect urine osmolality and vigor, but these factors have limited impacts on cognitive performance. Rational fluid intake behavior may be beneficial to improve the hydration status and mood of young adults. More research is needed, especially experimental research, to allow causal conclusions to be drawn.


1988 ◽  
Vol 255 (5) ◽  
pp. E674-E679 ◽  
Author(s):  
M. G. Ross ◽  
D. J. Sherman ◽  
M. G. Ervin ◽  
R. Castro ◽  
J. Humme

Pregnant women may be exposed to exercise, thermal, or gastrointestinal (hyperemesis) water loss, all of which commonly induce a greater than 10 mosmol increase in plasma osmolality. Although fetal osmolality is dependent on maternal osmolality, the impact of maternal dehydration and subsequent maternal rehydration on the fetus has not been explored. Five pregnant ewes with singleton fetuses (136 +/- 1 day) were water deprived for 36 h resulting in a significant increase in plasma osmolality (298 +/- 3.4 to 313 +/- 5.0 mosmol). In response to maternal dehydration, fetal plasma osmolality (297.0 +/- 4.1 to 309.3 +/- 4.1 mosmol), arginine vasopressin (AVP) levels (1.5 +/- 0.2 to 7.9 +/- 1.0 pg/ml), hematocrit (35.1 to 38.6%), and urine osmolality (161.3 +/- 10.7 to 348.9 +/- 21.9 mosmol) significantly increased. Subsequently, ewes were rehydrated over 4 h with intravenously infused 0.45% saline (20 ml.kg-1.h-1). In response to maternal rehydration, maternal and fetal plasma osmolality decreased to basal values (298.9 +/- 3.2 and 300.1 +/- 3.8 mosmol, respectively) and fetal glomerular filtration rate (1.72 +/- 0.30 to 3.08 +/- 0.66 ml/min) and urine volume significantly increased (0.33 +/- 0.02 to 0.71 +/- 0.13 ml/min). However, fetal hematocrit (37.4%), plasma AVP (3.1 +/- 0.9 pg/ml), and urine osmolality (255.4 +/- 28.8 mosmol) did not return to basal levels during the observation period. These results demonstrate fetal hyperosmolality, blood volume contraction, AVP secretion, and altered urine production in response to maternal dehydration. Despite maternal rehydration and normalization of maternal and fetal plasma osmolality, fetal endocrine and fluid responses are prolonged.(ABSTRACT TRUNCATED AT 250 WORDS)


2018 ◽  
Vol 72 (Suppl. 2) ◽  
pp. 21-27 ◽  
Author(s):  
Sofia Enhörning ◽  
Olle Melander

Background: Type 2 diabetes, chronic kidney disease (CKD) and its cardiovascular complications are increasing as health problems worldwide. These diseases are interrelated with overlapping occurrence and once diabetes is established, the risk of cardiorenal disease is dramatically elevated. Thus, a search for unifying modifiable risk factors is key for effective prevention. Summary: Elevated fasting plasma concentration of vasopressin, measured with the marker copeptin, predicts new onset type 2 diabetes as well as renal function decline. Furthermore, we recently showed that increased plasma copeptin concentration independently predicts the development of both CKD and other specified kidney diseases. In consequence, high copeptin is an independent risk factor for cardiovascular disease and premature mortality in both diabetes patients and in the general population. Vasopressin is released when plasma osmolality is high, and the easiest way to lower plasma vasopressin and copeptin concentration is to increase water intake. In a human water intervention experiment with 1 week of 3 L/day increased water intake, the one third of the participants with the greatest copeptin reduction (water responders) were those with a phenotype of low water intake (high habitual plasma copeptin and urine osmolality, and low urine volume). The water-responders had a copeptin reduction of 41% after 1 week of increased water intake compared to a control week; in contrast, a 3% reduction occurred in the other two thirds of the study participants. Among water responders, increased water intake also induced a reduction in fasting glucagon concentration. Key Messages: Elevated copeptin, a measure of vasopressin, is a risk marker of metabolic and cardiorenal diseases and may assist in the detection of individuals at higher risk for these diseases. Furthermore, individuals with high copeptin and other signs of low water intake may experience beneficial glucometabolic effects of increased water intake. Future randomized control trials investigating effects of hydration on glucometabolic and renal outcomes should focus on individuals with signs of low water intake including high plasma copeptin concentration.


Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1068 ◽  
Author(s):  
William M. Adams ◽  
Derek J. Hevel ◽  
Jaclyn P. Maher ◽  
Jared T. McGuirt

The purpose of this study was to examine 24 h urinary hydration markers in non-Hispanic White (WH) and non-Hispanic Black (BL) males and females. Thirteen males (BL, n = 6; WH, n = 7) and nineteen females (BL, n = 16, WH, n = 3) (mean ± SD; age, 20 ± 4 y; height, 169.2 ± 12.2 cm; body mass, 71.3 ± 12.2 kg; body fat, 20.8 ± 9.7%) provided a 24 h urine sample across 7 (n = 13) or 3 (n = 19) consecutive days (148 d total) for assessment of urine volume (UVOL), urine osmolality (UOSM), urine specific gravity (USG), and urine color (UCOL). UVOL was significantly lower in BL (0.85 ± 0.43 L) compared to WH college students (2.03 ± 0.70 L) (p < 0.001). Measures of UOSM, USG, and UCOL, were significantly greater in BL (716 ± 263 mOsm∙kg−1, 1.020 ± 0.007, and 4.2 ± 1.4, respectively) compared to WH college students (473 ± 194 mOsm∙kg−1, 1.013 ± 0.006, 3.0 ± 1.2, and respectively) (p < 0.05). Differences in 24 h urinary hydration measures were not significantly different between males and females (p > 0.05) or between the interaction of sex and race/ethnicity (p > 0.05). Non-Hispanic Black men and women were inadequately hydrated compared to their non-Hispanic White counterparts. Our findings suggest that development of targeted strategies to improve habitual fluid intake and potentially overall health are needed.


1987 ◽  
Vol 63 (6) ◽  
pp. 2262-2268 ◽  
Author(s):  
M. L. Riedesel ◽  
D. Y. Allen ◽  
G. T. Peake ◽  
K. Al-Qattan

Glycerol was tested as an agent to promote hyperhydration of male and female subjects. Series I experiments involved ingesting 0.5, 1.0, or 1.5 g glycerol/kg body wt and within 40 min drinking 0.1% NaCl, 21.4 ml/kg. In series II, 1.0 g glycerol/kg body wt was ingested at time 0, and 25.7 ml/kg of 0.1% NaCl was ingested over a 3.5-h period. Experiments were of 4-h duration and included controls without glycerol as each subject served as his/her control. Blood samples were taken at 40- or 60-min intervals for hemoglobin (Hb), hematocrit (Hct), plasma osmolality, glycerol, and multiple blood chemistry analyses. Urine was collected at 60-min intervals. Glycerol ingestion increased plasma osmolality for 2 h and reduced the total 4-h urine volume. There were no significant changes in Hb or Hct as a result of the glycerol or excess fluid intake. This study demonstrates that glycerol plus excess fluid intake can produce hyperhydration for at least 4 h.


1998 ◽  
Vol 23 (1) ◽  
pp. 66-73 ◽  
Author(s):  
John G. Seifert ◽  
Maurie J. Luetkemeier ◽  
Andrea T. White ◽  
Liz M. Mino

The purpose of this study was to investigate the effects of beverage ingestion on fluid balance during 1.5 hr of low intensity cross country skiing. In Part I, 6 skiers drank water ad libitum during ski training. In Part II, 10 skiers were matched by body weight (BW) and assigned to ingest 2.5 ml kg−1 BW of water or a carbohydrate/electrolyte (CE) beverage every 2.5 km. Skiing speed averaged 11.5 km hr−1 for 90 min around a 5 km groomed track. Following 20 min of seated rest, blood samples were collected immediately before and approximately 30 min after skiing. Part I data indicated that subjects ingested 576 ± 189 ml of fluid and produced 266 ± 205 ml of urine: BW, plasma and urine osmolality, and plasma protein decreased significantly. In Part II, the CE group produced less urine (135 u75 vs 450 ± 262 ml) and had smaller decreases in plasma osmolality (−1.0 ± 1.0 vs. −7.0 ± 2.4 mOsm kg H2O) and protein (−0.11 ± 08 vs. −0.42 ± 0.24 g L−1) than the water group. No differences were observed for BW loss, % change in PV, FWC, or change in urine osmolality. It was concluded that ad lib water ingestion was inadequate to minimize fluid balance disruption, Plain water ingestion also led to significant dilution of the plasma and increased urine output. However, the ingestion of CE led to attenuation of fluid balance disruption, presumably due to the maintenance of osmotic balance in the plasma. Key words: fluid balance, cross country skiing


1986 ◽  
Vol 250 (6) ◽  
pp. F1008-F1012 ◽  
Author(s):  
U. Schwertschlag ◽  
J. G. Gerber ◽  
J. S. Barnes ◽  
A. S. Nies

The relationship of renal prostaglandin E2 (PGE2) excretion (UPGEV) to water deprivation, water diuresis, and subsequent antidiuresis by 1-desamino-8-D-arginine vasopressin (dDAVP) was studied in female volunteers. After 16 h of water deprivation, the subjects began a sustained water diuresis for 8 h. This diuresis caused a transient twofold rise in UPGEV at 2 h (P less than 0.05), which then fell back to or below baseline levels. dDAVP given during the water diuresis caused a transient rise of UPGEV as urine volume decreased and plasma osmolality fell from 277 +/- 1.5 to 271 +/- 2 mosmol/kg (P less than 0.01). Another group of subjects had the water diuresis discontinued after 4 h with dDAVP given at the 5th h when urine volume was decreasing and urine osmolality was increasing. In this setting dDAVP did not produce as great a fall in plasma osmolality nor did it increase UPGEV. These data indicate that renal prostaglandin synthesis (as determined by UPGEV) is increased transiently by an acute water load; dDAVP given during continued water ingestion results in a fall in plasma osmolality and increased PGE excretion; however, dDAVP does not increase UPGEV during normal hydration; and UPGEV is independent of changes in urine flow. These findings imply that renal prostaglandins may have a functional role in humans to inhibit the hydroosmotic actions of antidiuretic hormone, and thus hasten the excretion of a water load, and to prevent overhydration when inappropriate antidiuresis occurs. However, there is no evidence that the stimulus for prostaglandin production is dDAVP per se.


2019 ◽  
Vol 29 (6) ◽  
pp. 651-657
Author(s):  
Paola Rodriguez-Giustiniani ◽  
Stuart D.R. Galloway

The present study examined the impact of hormonal differences between late follicular (LF) and midluteal (ML) phases on restoration of fluid balance following dehydration. Ten eumenorrheic female participants were dehydrated by 2% of their body mass through overnight fluid restriction followed by exercise-heat stress. Trials were undertaken during the LF (between Days 10 and 13 of the menstrual cycle) and ML phases (between Days 18 and 23 of the menstrual cycle) with one phase repeated to assess reliability of observations. Following dehydration, participants ingested a volume equivalent to 100% of mass loss of a commercially available sports drink in four equal volumes over 30 min. Mean serum values for steroid hormones during the ML (estradiol [E2]: 92 ± 11 pg/ml, progesterone: 19 ± 4 ng/ml) and LF (estradiol [E2]: 232 ± 64 pg/ml, progesterone: 3 ± 2 ng/ml) were significantly different between phases. Urine tests confirmed no luteinizing hormone surge evident during LF trials. There was no effect of menstrual cycle phase on cumulative urine volume during the 3-hr rehydration period (ML: 630 [197–935] ml, LF: 649 [180–845] ml) with percentage of fluid retained being 47% (33–85)% on ML and 46% (37–89)% on LF (p = .29). There was no association between the progesterone:estradiol ratio and fluid retained in either phase. Net fluid balance, urine osmolality, and thirst intensity were not different between phases. No differences in sodium (ML: −61 [−36 to −131] mmol, LF: −73 [−5 to −118] mmol; p = .45) or potassium (ML: −36 [−11 to −80] mmol, LF: −30 [−19 to −89] mmol; p = .96) balance were observed. Fluid replacement after dehydration does not appear to be affected by normal hormonal fluctuations during the menstrual cycle in eumenorrheic young women.


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