Abstract

Background: Lenten fasting is commonly practiced by Ethiopian Orthodox Christian with energy restriction and only vegan diets as ritual activities. In addition to religious benefits, protective role of Lenten fasting on some noncommunicable diseases, cardio-metabolic and serum biochemicals have not been well explored.

Methods: A prospective longitudinal study design was conducted from February 27 to April 30, 2019 among n=52(n=27 fasting group and n=25 non-fasting group) T2DM patients. Structured questionnaire was used to collect all relevant data. The study followed at two time points: at baseline (week 0) and at the end (last week of fasting). Body fat composition determined by Bio-electric impedance analyzer (Tanita® BC-418®, Japan), while serum biochemicals analyzed by random access chemistry analyzer (A25™ Biosystem, Spain). Epidata version 3.4 and SPSS 23 were used for data entry and statistical analysis.

Results: Calorie restriction with vegan diets significantly drops systolic blood pressure (SBP), body fat mass and lean mass among fasters compared to controls (p<0.01). Body fat percentage decreased (p=0.025) significantly among fasters compared to non-fasters. Serum levels of total cholesterol, LDL-cholesterol, non-HDL-cholesterol, total cholesterol/HDL-cholesterol, triglycerides, fasting blood sugar and uric acid also significantly decreased in fasting group than non-fasting (p<0.01). While BMI, diastolic blood pressure, HDL-c, hip and waist circumference insignificantly differed among fasting group compared to non-fasting. Moreover, fasting led to a decreased cardiovascular risks among fasters like SBP ≥130mmHg (26.9%), DBP ≥85mmHg (3.8%), TC ≥200 mg/dL (38.5%) and TC/HDL-c (7.7%) when compared to baseline.

Conclusion: Simultaneous energy restriction (ER) and vegan dietary (VD) pattern during Lenten fasting improved lipid profiles, glycemic control and blood pressure among T2DM patients. This may reflect ER+VD become non-pharmacological option to protect/avert risks of established cardiometabolic risks and morbidity.