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☪️ #4 and #5!
One of my personal favorite intersections: #Ramadan and #NAFLD
Things that are established: Ramadan fasting does not make fatty liver disease worse
But does it make it better?
The empiric answer would be YES, but how? let’s dive into the nuance
🧵1/
One of my personal favorite intersections: #Ramadan and #NAFLD
Things that are established: Ramadan fasting does not make fatty liver disease worse
But does it make it better?
The empiric answer would be YES, but how? let’s dive into the nuance
🧵1/
Observational data suggest that in patients with #fattyliverdisease, Ramadan tends to ⬇️ LFTs and ⬆️glycemic function
tinyurl.com/bdctcav8
Retrospective data seems to agree with this:
tinyurl.com/2nwd5zhc
These changes involve ⬇️ in A1c, BMI, and FIB4 scores❗️
2/
tinyurl.com/bdctcav8
Retrospective data seems to agree with this:
tinyurl.com/2nwd5zhc
These changes involve ⬇️ in A1c, BMI, and FIB4 scores❗️
2/
So the available data (though limited) establishes that Ramadan fasting seems to improve LFTs and leads to valuable reductions in disease-related indices like fibrosis scores
The more interesting question though, is
HOW❓🧐
3/
The more interesting question though, is
HOW❓🧐
3/
To the untrained eye, ⬇️ caloric intake explains it — but wait❗️
✴️ Caloric intake often INCREASES during Ramadan - people binge at night!
So how are these people losing weight and improving their metabolic profiles⁉️
Because biology is absurd and crazy and fascinating!
4/
✴️ Caloric intake often INCREASES during Ramadan - people binge at night!
So how are these people losing weight and improving their metabolic profiles⁉️
Because biology is absurd and crazy and fascinating!
4/
Three primary drivers during Ramadan fasting seem to account for the metabolomic changes
1️⃣ regulation of inflammatory cytokines
2️⃣ allowing for the hepatic circadian rhythm to “reset”
3️⃣ circadian rhythm changes associated with alternations in the microbiome
5/
1️⃣ regulation of inflammatory cytokines
2️⃣ allowing for the hepatic circadian rhythm to “reset”
3️⃣ circadian rhythm changes associated with alternations in the microbiome
5/
Down-regulation of inflammatory cytokines 1️⃣ seems to be the common pathway for improvements in any chronic illness that responds to fasting (IL-6, TNF-alpha)
Consumption can cause oxidative stress, and so can the substrate being consumed
6/
Consumption can cause oxidative stress, and so can the substrate being consumed
6/
The hepatic circadian rhythm 2️⃣ caught me by surprise -
of COURSE energy demands are going to vary based on time of day (humans that are 💤 aren’t using the same ⚡️ as those that are 🕺🥊🏋🏾♀️)
These circadian rhythms work best when SET feeding times exist & are spaced apart
7/
of COURSE energy demands are going to vary based on time of day (humans that are 💤 aren’t using the same ⚡️ as those that are 🕺🥊🏋🏾♀️)
These circadian rhythms work best when SET feeding times exist & are spaced apart
7/
Finally the microbiome 3️⃣ really threw me for a loop but
Swarming activity (bacterial growth) in the gut highly tied to melatonin release which itself is tied to circadian activity
Fasting seems to have a 📈effect on this activity
8/
Swarming activity (bacterial growth) in the gut highly tied to melatonin release which itself is tied to circadian activity
Fasting seems to have a 📈effect on this activity
8/
So there you have it! Ramadan fasting seems to improve LFTs in NAFLD and (if you buy the mouse models), it has everything to do with circadian rhythm regulation and ⬇️cytokines and the microbiome❗️#GITwitter
FIN/
tinyurl.com/yywr555x
FIN/
tinyurl.com/yywr555x
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