Fasting Evidence

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Is-sawm tar-Ramadan u s-saħħa: x'tgħid l-evidenza

Aġġornat 4 min read 40 ċitazzjonijiet

Postazzjoni tal-laboratorju għall-kimika tal-formulazzjoni
Cjp24 · CC BY-SA 3.0 · Wikimedia Commons

Madwar żewġ biljun persuna josservaw ir-Ramadan, u għal xahar kull sena huwa l-akbar esperiment naturali wieħed fl-imġiba ta' sawm tal-bniedem kullimkien fid-Dinja — astinenza mill-ikel u l-ilma mill-bkejja sal-għabex, kuljum, għal erba' sa ħames ġimgħat skont il-latitudni u l-istaġun. Kważi ma jieħu l-ebda kopertura ddedikata fuq siti tal-evidenza, li ħafna minnhom jaqbdu awtomatikament il-protokolli ddisinjati minn riċerkaturi (16:8, 5:2, jum wieħed iva u ieħor le) li dan is-sit ikopri band'oħra. Ir-Ramadan huwa mudell differenti bil-letteratura tiegħu stess, u s-sommarju onest huwa inqas favorevoli għall-istorja ta' "is-sawm ifisser reset metaboliku awtomatiku" milli n-naħa l-oħra tad-dibattitu online normalment tammetti.

Mhuwiex l-istess forma tal-ikel ristrett fil-ħin

Il-protokolli koperti fil-paġni ta' ikel ristrett fil-ħin u ħinijiet tal-ikliet ta' dan is-sit tipikament jikkompressaw l-ikel f'tieqa matul il-jum u jestendu s-sawm matul il-lejl. Ir-Ramadan jagħmel eżatt il-kontra: l-ikel jiġi mbuttat fis-sigħat wara l-għabex u qabel il-bkejja, ta' spiss jinkludi ikla sostanzjuża qabel il-bkejja (suħur) u ikla wara l-għabex (iftar) li tista' ddum sa tard il-lejl. Reviżjoni sistematika, meta-analiżi u meta-regressjoni tal-enerġija u l-assunzjoni ta' makronutrijenti matul is-sawm tar-Ramadan eżaminat eżattament din il-bidla fil-mudell tal-ikel madwar l-istudji disponibbli [6]. Il-mudell li joħroġ minn din il-letteratura huwa ridistribuzzjoni tal-assunzjoni lejn il-lejl minflok tnaqqis affidabbli fl-assunzjoni totali — in-nies mhumiex sajmin fis-sens li jħaddmu defiċit kbir ta' kaloriji għal xahar, qed iċaqilqu l-ikliet tagħhom.

Dik id-distinzjoni hija importanti għall-aspettattivi. Hija konsistenti mal-letteratura ċirkadjana dwar iċ-ċaqliq tal-ikel aktar tard fil-ġurnata b'mod ġenerali: prova randomizzata sabet li l-ikel tard u iżokaloriku żied il-ġuħ u naqqas l-infiq tal-enerġija relattiv għal ikel aktar bikri bl-istess kaloriji [22], u prova separata li tqabbel ikel ikkontrollat matul il-jum kontra ikel imdewwem sabet effetti metaboliċi li jiffavorixxu l-mudell aktar bikri [24]. La waħda u lanqas l-oħra ma saru matul ir-Ramadan, iżda t-tnejn jiddeskrivu l-mekkaniżmu li l-iskeda tiegħu tinvoka: it-tbuttar tal-assunzjoni lejn il-lejl minflok il-jum.

X'ifisser dan għaż-żewġ affarijiet li n-nies verament jistaqsu dwarhom

Il-Piż. Jekk l-assunzjoni totali ta' enerġija ma tonqosx b'mod affidabbli — għax is-suħur u l-iftar jikkumpensaw għall-astinenza matul il-jum — m'hemmx raġuni fiżjoloġika qawwija biex tistenna li l-osservanza tar-Ramadan waħedha tipproduċi telf ta' piż durabbli, indipendentement minn dak li persuna tiekol matul iż-żewġ twieqi permessi. Kull min l-interess tiegħu fil-kontenut tas-saħħa tar-Ramadan huwa t-telf tal-piż għandu jaqrah bħala mudell ta' ħinijiet tal-ikliet b'riskju ta' ikel kompensatorju, mhux bħala defiċit ta' kaloriji ta' xahar sħiħ b'mod awtomatiku.

Iz-zokkor fid-demm, għal nies bid-dijabete. Din hija l-mistoqsija b'aktar riskju u dik fejn il-gwida medika, mhux kontenut ġenerali dwar is-sawm, għandha tirregola d-deċiżjoni. Il-periklu ewlieni huwa identiku għal dak kopert fil-paġna tas-sikurezza ta' dan is-sit: astinenza twila matul il-jum flimkien ma' doża ta' insulina jew sulfonylurea mhux mibdula hija riskju ta' ipogliċemija, u r-riskju matul ir-Ramadan huwa aggravat mis-sħana, ir-riskju ta' deidratazzjoni min-nuqqas ta' ilma, u l-ħin tal-ikla qabel il-bkejja li jċaqlaq l-iskedi tal-mediċini. Provi ta' sawm intermittenti ssorveljat mediċinament f'dijabete tat-tip 2 ittrattata bl-insulina, bħal INTERFAST-2, juru li s-sawm strutturat jista' jsir b'mod sigur f'din il-popolazzjoni speċifikament għax id-doża ġiet aġġustata taħt sorveljanza — is-sikurezza ġejja mis-sorveljanza, mhux mill-mudell tas-sawm li huwa inerentement ħafif [21].

Kaxxa ta' deċiżjoni: sawm tar-Ramadan jeħtieġ konverżazzjoni medika l-ewwel?

Is-sitwazzjoni tiegħekX'għandek tagħmel
Adult f'saħħtu, l-ebda kundizzjoni kronika, l-ebda mediċina li taffettwa z-zokkor fid-demmĠeneralment riskju mediku baxx; l-idratazzjoni u l-ħin tal-irqad huma l-kwistjonijiet prattiċi ewlenin
Dijabete tat-tip 2, ikkontrollata bid-dieta jew bil-metformin waħduRiskju ta' ipogliċemija aktar baxx mill-insulina/sulfonylurea, iżda ikkonferma mal-preskrittur tiegħek qabel jibda x-xahar
Dijabete tat-tip 1 jew tat-tip 2 ittrattata bl-insulinaTbiddilx il-mudell tal-ikel tiegħek mingħajr ma tabib jaġġusta r-reġim tiegħek l-ewwel — ara min m'għandux isum
Tqila jew qed tredda'Jeżistu eżenzjonijiet reliġjużi għal raġuni li tallinja mal-evidenza medika; din hija konverżazzjoni ma' fornitur ostetriku
Fuq mediċina li trid tittieħed mal-ikel, jew li għandha tieqa dejqa ta' dożaġġStaqsi lil spiżjar dwar il-ħinijiet qabel, mhux matul, ix-xahar
Taħriġ ta' reżistenza jew xogħol manwali tqil matul is-sigħat tal-jumAra eżerċizzju bis-sawm — it-tnaqqis fil-prestazzjoni huwa aktar konsistenti fi stati ta' idratazzjoni fqira u glikoġenu mnaqqas milli f'ikla waħda mitlufa

Dan jirrifletti l-kontraindikazzjonijiet ġenerali tas-sawm li dan is-sit diġà jiddokumenta; ir-Ramadan japplika l-istess riskji ġewwa tieqa fissa fil-kalendarju u mgħaddsa kulturalment li persuna tista' tħoss li tista' tagħżel li ma tidħolx fiha anqas minn protokoll ta' benesseri diskrezzjonarju.

Il-post wieħed fejn l-evidenza hija ġenwinament irqiqa

Pretensjonijiet li s-sawm tar-Ramadan iqajjem awtofaġija sinifikanti, "diżintossikazzjoni," jew effetti kontra x-xjuħija distinti minn dak li kwalunkwe sawm prolongat jista' jagħmel mhumiex appoġġjati minn evidenza speċifika għall-mudell tar-Ramadan fir-referenzi disponibbli hawn — ara t-trattament separat ta' dan is-sit ta' il-pretensjonijiet dwar l-awtofaġija b'mod ġenerali għaliex "is-sawm iqajjem l-awtofaġija fil-bnedmin, għalhekk isegwi l-benefiċċju X" normalment huwa qabża akbar milli tappoġġja l-bijoloġija ta' taħt. Xejn dwar il-kuntest reliġjuż jew tal-kalendarju ma jbiddel dik il-lakuna ta' evidenza.

Mistoqsijiet komuni

Is-sawm tar-Ramadan jikkawża telf ta' piż?
Mhux b'mod affidabbli bħala mekkaniżmu waħdu. Il-letteratura dwar l-assunzjoni turi l-konsum tal-enerġija jiċċaqlaq lejn is-sigħat tal-lejl minflok jonqos b'mod konsistenti, li ddgħajjef is-suppożizzjoni li sawm mill-bkejja sal-għabex jipproduċi defiċit awtomatiku.
Huwa sigur li tagħmel eżerċizzju waqt is-sawm tar-Ramadan?
Għall-biċċa l-kbira tal-adulti f'saħħithom, iva, b'attenzjoni għall-idratazzjoni u l-ipprogrammar tat-taħriġ madwar il-perjodi tal-ikel; ara l-kopertura ta' dan is-sit dwar l-eżerċizzju bis-sawm għal dak li l-provi tat-taħriġ bis-sawm ġeneralment isibu dwar il-prestazzjoni.
Persuni bid-dijabete jistgħu josservaw is-sawm?
Biss b'input mediku minn qabel għal kull min qed jieħu l-insulina jew sulfonylurea. Il-protokolli ta' sawm issorveljati fid-dijabete tat-tip 2 ittrattata bl-insulina ġew studjati u jistgħu jsiru b'mod sigur, iżda s-sigurtà tiġi mill-aġġustament ippjanat tal-mediċina, mhux mill-fatt li ma tittieħidx.
Il-mudell tal-ikel tard bil-lejl jikkawża ħsara fih innifsu?
L-evidenza ċirkadjana tissuġġerixxi li l-ikel aktar tard huwa metabolikament inqas favorevoli mill-ikel aktar bikri b'kaloriji mqabbla, imma "inqas favorevoli minn alternattiva" mhuwiex l-istess bħal ta' ħsara għal adult f'saħħtu fuq xahar wieħed. Dan l-artiklu huwa għal skopijiet informattivi biss u mhuwiex parir mediku; kellem tabib dwar is-sitwazzjoni tiegħek stess, speċjalment jekk tieħu mediċina li tbaxxi l-glukożju jew inti tqila.
Platt tal-kontinenti bil-tortilla, bajd imħallat, ġobon, ħxejjex u ġuħat ta' oranġjo
Miftuħ biex juri l-ħames gruppi tal-ikel użati fil-gwida dietetika tal-Istati Uniti. U.S. Department of Agriculture · Public domain · Wikimedia Commons

Qari relatat

Il-provi li hemm wara din il-paġna Bar imwaħħal li juri l-kompożizzjoni tal-30 pubblikazzjoni msemmija f'din il-paġna skont it-tip ta' studju. 13138meta-analysis (13)randomised trial (13)review (8)other (1)
35 pubblikazzjonijiet, 2017–2026. Dan huwa ammont li jinkludi kemm provi kif ukoll sinteżi, li huwa l-pożizzjoni minn fejn talba dwar il-kawża hija raġonevoli. Sors: il-lista ta' ċitazzjonijiet ta' din il-paġna, hawn taħt.

Referenzi

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  11. Therapeutic Fasting in Reducing Chemotherapy Side Effects in Cancer Patients: A Systematic Review and Meta-Analysis Ferro Y, Maurotti S, Tarsitano MG, et al. · Nutrients · 2023 · Meta-analysis DOIPubMed 37375570Full text
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  13. Daily Timing of Meals and Weight Loss After Bariatric Surgery: a Systematic Review Cossec M, Atger F, Blanchard C, et al. · Obesity surgery · 2021 · Systematic review DOIPubMed 33604863
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  33. Intermittent fasting plus early time-restricted eating versus calorie restriction and standard care in adults at risk of type 2 diabetes: a randomized controlled trial Teong XT, Liu K, Vincent AD, et al. · Nature medicine · 2023 · Randomised controlled trial DOIPubMed 37024596
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Din il-paġna ġiet tradotta awtomatikament mill-Ingliż. Il-citazzjonijiet u n-numri mhumiex mibdula. Aqra l-original Ingliż jekk xi ħaġa taqra b'mod stramb. Aqra l-original Ingliż