Abstract

During Ramadan, many pregnant Muslim women fast between dawn and sunset. Although the impacts of prolonged maternal intermittent fasting (IF) on fetal growth and placental function are under-researched, reported effects include reduced placental weight and birth weight. In the present study, pregnant Wistar rats were used to model repeated cycles of IF on fetal development and placental function and to examine sex-specific effects. In the IF group, food was withdrawn daily from 17:00 to 09:00 over 21 days of gestation, while the control group received food ad libitum. Both groups had free water access. IF dams consumed less food, had significantly reduced weight compared with controls, with reduced plasma glucose and amino acids. Both fetal sexes were significantly lighter in the IF group with reduced fetal plasma amino acids. Placental weights and morphology were unchanged. The profile of placental metabolites was altered in the IF group with sex-specific responses evident. Transplacental flux of 14C-methylaminoisobutyric acid (14C-MeAIB), a system A amino acid transporter substrate, was significantly reduced in both fetal sexes in the IF group. Sodium-dependent 14C-MeAIB uptake into isolated placental plasma membrane vesicles was unchanged. The gene expression of system A transporter Slc38a1, Slc38a2 and Slc38a4 was up-regulated in IF male placentas only. No changes were observed in placental SNAT1 and SNAT2 protein expression. Maternal IF results in detrimental impacts on maternal physiology and fetal development with changes in the placental and fetal metabolite profiles. Reduced placental system A transporter activity may be responsible for fetal growth restriction in both sexes.

Highlights

  • Fasting during the month of Ramadan is one of the five pillars of Islam

  • To assess whether the expression and functional changes observed in the intermittent fasting (IF) group were accompanied by altered sodium-dependent neutral amino acid transporter (SNAT) protein expression, we examined SNAT1 and SNAT2 expression in rat placental vesicles, applying the reasoning that these SNAT isoforms were most likely to be implicated functionally as SNAT1 and SNAT2 have shared functional transport characteristics and a much higher affinity for methylaminoisobutyric acid (MeAIB) as a substrate relative to SNAT4 [44]

  • The primary aim of the present study was to recapitulate in an animal model aspects of maternal IF that occur during Ramadan fasting, in order to elucidate the impact of repeated dietary ‘fasting-feeding’ cycles during pregnancy on placental function and fetal development

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Summary

Introduction

Fasting during the month of Ramadan is one of the five pillars of Islam During this period, it is a religious requirement that healthy adult Muslims abstain from consuming food and drink from dawn to sunset for the duration of this holy month. There are no restrictions on food and fluid intake [1] This religious mandate excludes pregnant women who are allowed to postpone their Ramadan fast until after delivery, many still elect to partake in the fast with their families for spiritual and cultural reasons [2,3], as well as other motivational considerations [4,5]. Fasting pregnant women potentially expose their developing babies in utero to an altered nutrient and metabolic environment [6,8]

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