Fasting Period Research Articles

Analysis of physiological and biochemical changes and metabolic shifts during 21-Day fasting hypometabolism

This study aimed to evaluate the impact of prolonged fasting on the physiological and biochemical alterations and metabolic shifts in healthy adults and to provide experimental data and theoretical support for the hypometabolic state induced by prolonged fasting. Thirteen volunteers were selected through public recruitment to undergo a 21-day complete fasting experiment. The experimental period lasted 34 days, including a 3-day baseline, 21-day completing fasting, 5-day calorie restriction and 5-day full recovery diet. Physiological indicators such as body weight, blood pressure, blood glucose, blood ketones, and blood uric acid were evaluated along with resting metabolic rate, routine blood tests, liver function, and heart function indexes employing traditional approaches. During the 21-day complete fasting period, there was a significant decrease in body weight (average − 14.96 ± 1.55%), a reduction in blood glucose (average − 21.63 ± 0.058%), an increase in blood ketones (from baseline 0.1 ± 0.04 mmol/L to 6.61 ± 1.25 mmol/L) and blood uric acid (from baseline 385.38 ± 57.78 µmol/L to 866.31 ± 172.01 µmol/L), a continuous decline in resting energy expenditure (average − 20.3 ± 11.13%), and the respiratory quotient tending towards fat metabolism. Most of the items in the complete blood count and liver indicators remained stable and within the normal range. Heart function showed functional adaptive changes without structural damage. Prolonged fasting can reduce the body’s resting energy expenditure and adapt to body weight loss through physiological regulatory mechanisms without adverse effects on basic physiological functions or the structure of important organs. Under medical supervision, healthy adults can safely engage in prolonged fasting for up to 21 days with metabolic adaption and no damage to pivotal organ, which could provide potential technical support for human health and survival strategies in extreme conditions such as food shortages during long-duration manned spaceflight.

Effect of fasting on cardiovascular risk factors among healthy adult Muslims attending primary care, Kano, Northern Nigeria

BackgroundCardiovascular diseases (CVD) are among the most prevalent and preventable chronic diseases in the 21st century The global burden of disease: 2004 update. The Report in Sections. A person’s risk of developing CVD can be reduced by adopting healthy lifestyles, spiritual and religious practices The American Heart Association Life’s Simple 7 in African Americans of the Jackson Heart Study. Fasting as a spiritual practice is not exempted from these benefits. Most world’s religions recommend a period of fasting. The obligatory Ramadan fasting in Islam may provide an interesting opportunity to reduce food intake and increase physical activity. The main objective of this study is to investigate the effect of Ramadan fasting on cardiovascular risk factors on healthy adult Muslims.MethodThe study was pre/post-test single arm intervention conducted at the staff clinic of Family Medicine department, AKTH, and Northwest, Nigeria. Kano. The study recruited healthy adults 18yrs and above not on any medications that can affect metabolic profiles consecutively from two weeks before Ramadan fasting of 2018 and the last week of Ramadan of the same year. The questionnaire included information on sociodemographic, clinical parameters and Lifestyle pattern.ResultThirty healthy volunteers were included in this study, 25 males (83.3%) and 5 females (16.7%). The mean age was 38.23 ± 6.35(SD). Twenty-five participants were married (83.3%) with 4 singles (13.3%) and 1 divorcee (3.3%). During Ramadan fasting, weight reduced (67.90 ± 11.61 versus 66.53 ± 12.13 4th week of Ramadan p-value < 0.002) Body Mass Index (22.89 ± 3.63 versus 4th week of Ramadan 22.38 ± 3.64 p-value < 0.002) and systolic blood pressure (120.33 ± 19.91versus 4th week of Ramadan 115.33 ± 14.32 p-value 0.003) reduced significantly compared to baseline. The waist circumference, pulse rate, fasting blood sugar and cholesterol were reduced but were not statistically significant.ConclusionThe result from this study suggested that Ramadan fasting may be a useful means of reducing burden of cardiovascular diseases, as the improved cardiovascular risk factors associated with fasting may translate into a significant health benefit.

Measuring Changes in Upper Body Movement Due to Fasting Using a Camera.

Understanding activity levels during fasting is important for promoting healthy fasting practices. While most existing studies focus on step counts to objectively assess the impact of fasting on activity levels and behavioral changes, the results have been mixed. Despite evidence showing that individuals spend a significant amount of time sitting while fasting, there has been no objective measurement of body movement or activity levels during sitting and fasting. This research employs a video-based, unobtrusive human body movement measurement system to monitor upper body movements during fasting and non-fasting periods over several days. Key movement features, such as inactivity, movement speed, and movement scale, were automatically extracted from the video monitoring data using a computer vision pipeline. These features were then statistically compared using t tests between fasting and non-fasting periods, analyzed by hour of the day and across different days. The results of the monitoring of five participants during typical daily sitting office work and fasting for 3-5 days indicate no consistent pattern of upper body movement changes due to fasting among the participants.

Effects of fasting on the interplay between temperature and Trypanosoma cruzi infection on the life cycle of the Chagas disease vector Rhodnius prolixus.

Rhodnius prolixus, a triatomine insect, is one of the most important vectors of Chagas disease in South America. Its interaction with the parasite Trypanosoma cruzi, the causative agent of this disease, is known to be deeply affected by ambient temperature and the nutritional status of the insect vector. In this study, we investigated how starvation affects the life cycle of R. prolixus and the population dynamics of the parasite inside the intestine of the vector at four temperatures ranging from 24°C to 30°C. The weights and molting times of chronically infected and uninfected insects were monitored through repeated 30-day fasting periods from first instar to adult stage, assessing their capacity to retain blood meal weight between developmental stages and tracking parasite concentrations in their urine. Our results demonstrate that ambient temperature is a crucial factor affecting the resistance of R. prolixus to starvation, as survival, body weight, and weight retention greatly decreased in high temperature treatments. Furthermore, we showed that temperature significantly influenced whether T. cruzi established an infection in early instars, with few insects developing infections at the lowest and highest temperature treatments. Additionally, we discovered that a fasting period of 30 days induces a steady decrease in parasite populations in the vector over its lifetime. Infection by T. cruzi had no effect on the survival, molting time, and nutritional factors monitored in our protocol. Our results highlight the importance of nutrition as a determining factor for the development of the vector and the parasite, providing valuable insights for elucidating the complex interplay between temperature and nutrition in shaping the epidemiology of Chagas disease in a changing climate.

Activated charcoal application in gastric ulceration areas in horses: preliminary experimental study

Gastric ulceration is frequent in adult horses, bringing significant economic and welfare implications to these animals. Treatment may employ several drugs, but adsorbents, such as activated charcoal, are not mentioned. Activated charcoal may be a valuable therapeutic option mainly because of its few adverse effects, fecal elimination, and low cost. This study aimed to evaluate the use of activated charcoal in experimentally induced gastric ulceration in horses and perform the microscopic characterization of charcoal particles in the injured epithelium. Five adult, undefined breed horses underwent a gastric ulcer induction protocol based on alternating fasting and free food access periods. Next, we performed a gastroscopic examination and applied activated charcoal diluted in water at the ulcers through a probe passed through the working channel of the gastroscope. The gastric mucosa was washed with water after a contact period of 5 min until the complete lack of macroscopic product visualization. Then, we performed a biopsy of the aglandular mucosa in erosive to ulcerative injury sites and a microscopic assessment of the fragments. Macroscopically, all animals presented ulcerative lesions in the greater or lesser gastric curvature along the margo plicatus and hyperkeratosis in the aglandular portion. Microscopically, all animals had hyperplasia, hyperkeratosis, epithelial erosion, desquamated epithelial cells, inflammatory cells, and variable amounts of charcoal particles, either free or adhered to the epithelium. We concluded that activated charcoal remains adhered to aglandular gastric lesions in horses even after lavage with water and histological processing, allowing its microscopic visualization. Therefore, activated charcoal’s effectiveness as a therapy for equine gastric lesions warrants evaluation.

Study on optimization of maize irrigation scheduling in Shaanxi Province

With the impact of climate change in recent years, the instability of precipitation and the increase of evaporation have made water resources in Shaanxi Province more and more stressed. How to maintain stable economic development while ensuring the sustainable development of agriculture within the limited water resources has become an important issue facing Shaanxi Province. This paper analyzes the temporal and spatial distribution characteristics of maize irrigation water requirement in Shaanxi Province based on meteorological data and obtains the ideal irrigation water requirement. However, considering the agricultural water scarcity issue in this region, this paper establishes different water scarcity scenarios, adopts the Jensen model to construct an objective function aimed at minimizing crop yield reduction, and solves it using a genetic algorithm to obtain the optimized maize irrigation scheduling under different water scarcity scenarios. The results analysis indicates the following: (1) The effective rainfall in Shaanxi Province from 1960 to 2019 shows a slight upward trend, while the maize water requirement and maize irrigation water requirement shows a downward trend. (2) The spatial distribution of maize irrigation water requirement in Shaanxi Province decreases gradually from north to south. High-value areas are mainly distributed in the northern regions of Yulin City and Yan’an City in Shanbei. Low-value areas are distributed in Ankang City in Shannan. (3) In the face of water scarcity, spring maize should ensure water use during the middle growth period, fast development period, and initial growth periods. Under the same water scarcity conditions, the yield reduction rate is the highest in Guanzhong, followed by the Shannan, and the lowest in Shanbei. This paper aims to provide a scientific and reasonable optimization plan for maize irrigation in Shaanxi Province by calculating and analyzing the maize irrigation water requirement in Shaanxi Province, combined with optimization tools such as genetic algorithms, to address the challenges brought by water resource constraints.

Religiosity vs tobacco use: Religion’s impact on tobacco use among adult Indian population – A cross sectional study

ABSTRACT Background: Tobacco use is major serious threats to health and well-being killing approximately 1 million people each year. One of the better ways for tobacco cessation is by promoting the cultural-religious belief that may influence a person’s tobacco-related habits. Methods: A Descriptive cross-sectional study was conducted among 174 adult subjects of smoking and smokeless tobacco users. The questionnaire consisted of demographic information and the Duke University Religion Index was used to assess the influence of religious belief and the use of tobacco products. The appropriate statistical tests were done using the Chi square test and ANOVA. Result: The study involved 174 participants of smoking and smokeless tobacco users. The participants were predominantly males (96%) with a mean age of 36 years, and more than half were Hindus (71.85). Among the study participants, 37.4% were graduates and 17.8% were illiterates. With regard to Occupation, the majority of the respondents were Professionals (24.7%). Majority of tobacco users had religious beliefs and strongly accepted that using tobacco during the fasting period was against their religious beliefs. Conclusion: The study concluded that there is a strong influence of religious belief on tobacco usage. Hence, there is a need to conduct community awareness programs for the adult population about the consequences of tobacco use.

Evaluation of an Active Rehabilitation Program With Early Weightbearing and No Immobilization After Tibial Tubercle Distalization.

Abnormal patellar height (patella alta) has been reported to be one of the main predisposing factors for recurrent patellar dislocation, and it can be surgically corrected by distalizing tibial tubercle osteotomy (DTTO). Rehabilitation after DTTO often includes limitations on weightbearing and restrictions on knee range of motion by means of bracing, increasing the risk of slow progression of the rehabilitation. An active rehabilitation program with no restrictions on weightbearing and range of movement would yield a low risk of postoperative complications and a fast recovery period. Case series; Level of evidence, 4. Included were 102 consecutive knees in 80 patients who underwent DTTO between January 2010 and December 2017. In the majority of knees (89.2%), the patient underwent simultaneous medial patellofemoral ligament reconstruction. The mean age of the patients at the time of surgery was 19.39 ± 8.02 years, and 80.4% of the knees (82/102) were of female patients. The patients underwent an active rehabilitation program with immediate weightbearing as tolerated and active quadriceps and hip muscle exercises with no immobilization or bracing. The protocol was active (patient unsupervised), including daily exercises, as instructed by a physical therapist. Crutches were recommended for the first 3 to 4 weeks. There were 3 acute failures of fixation (2.9% of knees) requiring revision surgery. In these cases, the patients had a fall, slip, or knee-twisting accident during the first 6 weeks after surgery. Two late failures characterized by tibial stress fracture at the distal part of the osteotomy level occurred at 2 and 3 months postoperatively and were considered unrelated to the early rehabilitation process. The stress fracture rate was 2%, and the overall DTTO failure rate was 6.9%. With the active rehabilitation program, adverse effects such as knee stiffness, arthrofibrosis, or delayed ability to perform daily activities were rare. An active rehabilitation program after DTTO was found to be safe and effective. Furthermore, the risk of failure related to surgical fixation strength and of later stress fracture was low.

Biological traits of a commercial mussel species Mytilus platensis from the South Atlantic Ocean: Environmental drivers affecting on its intertidal population

Population density, morphometric relationships, maximum age and shell growth rate were studied in an intertidal commercial mytilid species, the blue mussel Mytilus platensis d’Orbigny, 1842, at Villa Gesell (37° 15′S; 56° 57′W), Argentina, Southwest Atlantic Ocean. The population density and mean shell length showed variation across the year, i.e., the month with the highest density (December) was mostly characterized by smaller sized individuals, representing the newly settled recruits during the austral summer months. Shell cross sections and acetate peels of M. platensis revealed an internal shell growth pattern alternating broad opaque and narrow translucent bands, corresponding to fast and slow-growing periods, respectively. Translucent bands representing external rings were formed mostly during July, coinciding with a decrease in sea water temperature (austral winter) and gonadal maturation processes. Data confirmed the annual formation of translucent bands in this species, showing a maximum age of 8 years. The generalized von Bertalanffy growth curve showed values of SL∞ = 38.46 mm, k = 0.28 yr−1 and t0 = −0.57 yr−1 (R2 = 0.80). Compared to studies of subtidal populations, lower shell growth rate in this intertidal population were observed, which may be associated with the stressful environmental conditions in this habitat, such as desiccation, exposure to waves and fluctuating sea water temperature. The characteristics described throughout the study highlight that the variability associated with intertidal environments could limit the sustainability of commercial exploitation of M. platensis in these ecosystems compared with conspecific subtidal populations.

Size effect of accelerated seismic release from failures under compression in naturally fractured media.

It is crucial to understand the scaling behaviors of acoustic emissions (AEs) preceding damage localization in order to predict failures of brittle solids under compression. Yet, the effect of length scale on the complex interplay between the initiation, propagation, and coalescence of pre-existing fracture networks and corresponding AE behaviors is poorly understood. In this study, we perform laboratory compressional experiments on naturally fractured rocks at four sample sizes from 50 to 300mm whose strength generally exhibits a finite-size effect. We analyze the time history of AE energy distribution and accelerated seismic release (ASR) until catastrophic failures of the specimens. We find their time evolution towards failure resembles the observations from specimens containing a single fault and highly microstructurally disordered materials. We observe clear evidence that a size effect exists at small AE magnitude, where larger specimens tend to produce a higher proportion of smaller microcracks. However, the AE energy distribution is scale-independent at high energies. Near to failure, the power-law component of the AE energy population is almost stationary. The temporal evolution of the AE activity rate is independent of sample size; instead, there exist fast and slow periods of the AE activity rate that could be attributed to the stress heterogeneities around the fracture network. ASRs are exclusively observed in the AE activity rate and are more general in the lack of criticality. Our interpretation of observed foreshock activities at varying sample sizes in fractured media may have significance for understanding and predicting failures from natural hazards and engineering instabilities.

Clinical Consequences of Delayed Gastric Emptying With GLP-1 Receptor Agonists and Tirzepatide.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are established therapeutics for type 2 diabetes and obesity. Among other mechanisms, they slow gastric emptying and motility of the small intestine. This helps limiting postprandial glycemic excursions and reducing chylomicron formation and triglyceride absorption. Conversely, motility effects may have detrimental consequences, e.g., retained gastric contents at endoscopy or general anesthesia, potentially complicated by pulmonary aspiration, or bowel obstruction. We searched the PubMed database for studies involving GLP-1RA therapy and adverse gastrointestinal/biliary events. Retained gastric contents at the time of upper gastrointestinal endoscopy are found more frequently with GLP-1 RAs, but rarely are associated with pulmonary aspiration. Well-justified recommendations for the peri-procedural management of GLP-1RAs (e.g., whether to withhold these medications, and for how long) are compromised by limited evidence. Important aspects to be considered are (a) their long half-lives, (b) the capacity of GLP-1 receptor agonism to slow gastric emptying even at physiological GLP-1 concentrations, (c) tachyphylaxis observed with prolonged treatment, and (d) the limited effect on gastric emptying in individuals with slow gastric emptying before initiating treatment. Little information is available on the influence of diabetes mellitus itself (i.e., in the absence of GLP-1 RA treatment) on retained gastric contents and pulmonary aspiration. Prolonged fasting periods regarding solid meal components, point-of-care ultrasound examination for retained gastric content, and the use of prokinetic medications like erythromycin may prove helpful, and are an important area needing further study to increase patient safety for those treated with GLP-1 RAs.

Adherence to Preoperative Fasting Guidelines in Elective Surgical Patients.

Preoperative fasting is recommended by international guidelines as a means to minimize the risk of aspiration of gastric content during induction of anesthesia or surgery. Prolonged preoperative fasting is, however, discouraged due to the associated side effects such as dehydration and electrolyte imbalance, which can negatively impact recovery after surgery. An initial quality improvement study revealed poor implementation of the best practice guidelines on preoperative fasting in three departments of a hospital and an institutional action plan was devised to enforce adherence to these guidelines. This present study aimed to assess compliance with the action plan and for that matter, adherence to international consensus on preoperative fasting in three surgical departments. Adult patients undergoing elective cardiac, thoracic, and vascular surgery at a university teaching hospital were surveyed over four months (September October, November, and December of 2023). Data on the length of preoperative fasting was collected using a standardized questionnaire. A total of 306 patients who were scheduled for elective surgery were included in the study. Of the 306 patients, 139 (45.4%) had vascular surgeries, 108 (35.4%) received cardiac surgeries, and 59 (19.3%) had thoracic surgeries. For clear fluids, the overall median fasting time (Q1, Q3) was 4.5 (2.7, 7.4) hours, and for solid food, 14.5 (12.1, 19.0) hours. Extended abstinence from clear fluids and solid food for more than 12 hours was observed in 43 (14.1%) and 231 (75.5%) instances, respectively, while abstinence from solid food for more than 24 hours was noticed in 40 (13.1%)cases. When compared to patients having operations in the morning, those scheduled for afternoon surgery had longer median fasting periods from clear fluids and solid food, p<0.001: 6.2 (4.0, 12.0) hours vs. 3.4 (2.0, 5.2) hours for clear fluids and 16.7 (12.6, 22.6) hours vs. 13.2 (9.6, 15.2) hours for solid food, respectively. Patients continue to abstain from clear fluids and solid food for extended periods of time, despite the fact that there is worldwide agreement regarding shorter periods of preoperative fasting. Compared to patients undergoing morning surgery, individuals hospitalized for afternoon procedures were more likely to fast for extended periods of time.

Enhanced recovery after fetal spina bifida surgery: global practice.

Enhanced recovery after surgery (ERAS) protocols are multimodal evidence-based care plans that have been adopted for multiple surgical procedures to promote faster and better patient recovery and shorter hospitalization. This study aimed to explore whether worldwide fetal therapy centers offering prenatal myelomeningocele repair implement the ERAS principles and to provide recommendations for improved perioperative management of patients. In this survey study, a total of 53 fetal therapy centers offering prenatal surgery for open spina bifida were identified and invited to complete a digital questionnaire covering their pre-, intra- and postoperative management. An overall score was calculated per center based on compliance with 20 key ERAS principles, extrapolated from ERAS guidelines for Cesarean section, gynecological oncology and colorectal surgery. Each item was awarded a score of 1 or 0, depending, respectively, on whether the center did or did not comply with that principle, with a maximum score of 20. The questionnaire was completed by 46 centers in 17 countries (response rate, 87%). In total, 22 (48%) centers performed exclusively open fetal surgery (laparotomy and hysterotomy), whereas 14 (30%) offered both open and fetoscopic procedures and 10 (22%) used only fetoscopy. The perioperative management of patients undergoing fetoscopic and open surgery was very similar. The median ERAS score was 12 (range, 8-17), with a mean ± SD of 12.5 ± 2.4. Center compliance was the highest for the use of regional anesthesia (98%), avoidance of bowel preparation (96%) and thromboprophylaxis (96%), while the lowest compliance was observed for preoperative carbohydrate loading (15%), a 2-h fasting period for clear fluids (20%), postoperative nausea and vomiting prevention (33%) and early feeding (35%). ERAS scores were similar in centers with a short (2-5 days), medium (6-10 days) and long (≥ 11 days) hospital stay (mean ± SD, 12.9 ± 2.4, 12.1 ± 2.0 and 10.3 ± 3.2, respectively, P = 0.15). Furthermore, there was no significant association between ERAS score and surgical technique or case volume. The perioperative management of fetal spina bifida surgery is highly variable across fetal therapy centers worldwide. Standardized protocols integrating ERAS principles may improve patient recovery, reduce maternal morbidity and shorten the hospital stay after fetal spina bifida surgery. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Click Reaction Inspired Enzyme Inhibitors in Diabetes Care: An Update in the Field of Chronic Metabolic Disorder.

Diabetes is a chronic metabolic disorder that impacts all age groups and affects a large population worldwide. Humans receive glucose from almost every food source, and after absorption from the gut, it reaches the liver, which functions as the distribution center for it. The insulin-responsive glucose transporter type 4 (GLUT-4) is a major carrier of glucose to the various cells (majorly expressed in myocytes, adipocytes, and cardiomyocytes) in a well-fed state. In fasting periods, the glucose supply is maintained by glycogenolysis and gluconeogenesis. In diabetes, the distribution of glucose is hampered due to several reasons. Furthermore, to treat this disorder, several drugs have been synthesized, and click chemistry plays an important role. A more recent concept for producing pharmaceuticals with a click chemistry approach makes any reaction more practical and stereospecific, along with a higher yield of products and a smaller number of by-products. This approach comprises a compiled study of the activity of numerous compelling antidiabetic drugs containing 1, 2, 3-triazole derivatives supported by click chemistry. In this review, we discuss the synthetic antidiabetic drugs made via click chemistry and their commendable role in improving diabetes care.

Types of Intermittent Fasting and Their Effects on Obesity and Type II Diabetes Mellitus

Obesity and type II diabetes mellitus affect millions of people both in Malaysia and worldwide due to sedentary lifestyles and unhealthy diets. Intermittent fasting reduces calorie intake by interweaving eating periods with prolonged fasting periods on a recurring basis. Therefore, it could be a potential solution to induce weight loss, leading to improved blood glucose level as observed in type II diabetes mellitus individuals. However, its feasibility remains unclear. This review aimed to compare the beneficial effects and adverse reactions from different types of intermittent fasting in obese and type II diabetes mellitus studies. The review was carried out by combing through several online databases. Keywords such as “Intermittent fasting”, “Obesity”, “Type II Diabetes Mellitus” were used and relevant articles were selected. The findings of this review showed that intermittent fasting is feasible and effective in reducing body weight and improving blood glucose. The beneficial effects of intermittent fasting appear to outweigh the adverse reactions. Having said that, intermittent fasting is unsuitable for individuals with packed schedules and certain health conditions such as pregnancy. This review will hopefully shed light on intermittent fasting as a potential intervention to combat obesity and type II diabetes mellitus. Further exploration of intermittent fasting could reduce both the morbidity and mortality rates from non-communicable diseases globally.

9179 Type 2 Diabetes Alters Metabolic Fuel Selection During Intermittent Fasting

Abstract Disclosure: M.O. Conn: None. D.M. Marko: None. J.D. Schertzer: None. Type 2 Diabetes Alters Metabolic Fuel Selection During Intermittent Fasting Diabetes is characterized by elevated blood glucose resulting from defective insulin secretion and/or insulin resistance. Intermittent fasting, a popular weight loss strategy involving periodic reduction of caloric intake, can improve glycemia. Fasting shifts metabolism from carbohydrates to free fatty acids and ketones. However, high blood insulin can inhibit lipolysis and alter metabolic substrate selection in prediabetes, resulting in muscle catabolism to maintain energy homeostasis. Clinical studies have observed a significant decrease in muscle mass in subjects with obesity and diabetes. Our research aims to characterize lean mass versus fat loss after intermittent fasting in a mouse model of obesity and type 2 diabetes (T2D) and investigate the role of muscle alanine catabolism. We hypothesized that intermittent fasting would promote less lipolysis and more muscle alanine catabolism, causing more muscle loss in diabetic mice than controls. We compared male db/db mice manifesting obesity, hyperglycemia, and hyperinsulinemia to age-matched db/+ (control) mice. Our lab established a 5:2 repeated fasting protocol of ad-libitum access to food for 5 days a week and 2 days of fasting on non-consecutive days. Blood glucose was monitored weekly in fed and fasted states to assess glycemic control. While intermittent fasting lowered fasted blood glucose in both groups, no significant body weight or metabolic tissue mass changes were observed. Metabolic cage data demonstrated increased reliance on fat-based substrates for energy in control mice that underwent intermittent fasting during feeding and fasting periods. Diabetic mice did not show significant changes in the fasted state, but intermittent fasting led to increased reliance on carbohydrate oxidation during re-feeding periods, indicating impaired metabolic flexibility. After 10 weeks, the mice were sacrificed, and metabolic tissue histology (adipose, liver, skeletal muscle) will be performed. We will also analyze serum markers (alanine, fatty acids, glycerol, glucose, insulin) and the activity of the metabolic enzyme alanine transaminase (ALT) in the muscle and liver. This experiment will improve our understanding of how lipolysis and protein breakdown in muscle regulate lean mass versus fat mass loss in obesity and T2D, leading to more effective tailoring of fasting to specific populations. Presentation: 6/3/2024

7769 Natural plant extract alleviates high-fat diet-induced obesity through enhancing PLIN5 expression

Abstract Disclosure: S. Shin: None. H. Jang: None. E. Kwon: None. Obesity is one of the metabolic diseases caused by excessive differentiation and excessive accumulation of adipose tissue due to an imbalance between energy intake and consumption. Various drugs have been developed to effectively treat obesity, but the side effects often outweigh the benefits. Therefore, alternative weight loss supplements that can minimize side effects are needed. In this study, the effects of natural plant extract (NPE) on the high-fat diet (HFD)-induced obesity mice were confirmed to discover new anti-obesity material.After acclimating C57BL/6J mice for 1 week, they were divided into two groups: a normal diet (ND) group and an HFD group. After inducing obesity over 4 weeks, the HFD group was divided into HFD and HFD+NPE and reared together with the ND group for an additional 10 weeks. After a 12-hour fasting period, observations were made on weight, adipose tissue mass, morphological changes in adipocytes, and the expression differences in genes and proteins related to fatty acid oxidation (FAO) in the epididymal white adipose tissue, particularly focusing on the PLIN5 protein.The increase in body weight and epididymal fat mass induced by the HFD was reduced by the administration of NPE. Morphological analysis of the epididymal fat revealed a significant increase in adipocyte size in the HFD group, whereas the NPE group showed a reduction in adipocyte size. The expression of FAO-related genes (PPARa, PGC1a, CPT1, and CPT2) and TCA cycle-related genes (PDHb, ACO, DIST, SUCLG, SDHC, and MDH2) decreased in the epididymal fat due to the HFD, but significantly increased with the administration of NPE. The NPE induced the breakdown of intracellular stored triglycerides by upregulating ATGL, LIPE, and MGL mRNA expression. The resulting liberated fatty acids were translocated to the mitochondria and oxidized through the TCA cycle, ultimately leading to a reduction in body fat. Furthermore, PLIN5 expression exhibited a significantly higher level in the NPE group compared to the other two groups. In other words, elevation in PLIN5 expression, induced by the NPE, appears to enhance lipid breakdown, activate FAO pathways, and stimulate the TCA cycle. Consequently, lipid combustion is increased, improving the weight gain and fat accumulation induced by the HFD.If additional experimental results on human application align with the above findings, NPE holds the potential as a low-side-effect ingredient for weight loss supplements. Presentation: 6/1/2024

The Relationship Between Fasting Duration and The Incidence of Post Operative Nausea and Vomiting in Spinal Anesthesia Patients

Background: Anesthesia, a critical pain management tool during surgeries and procedures, necessitates pre-operative fasting to mitigate the risk of post-operative nausea and vomiting (PONV). The fasting period restricts both solid and liquid intake. Purpose: This study aims to explore the correlation between fasting duration and the incidence of PONV in patients undergoing spinal anesthesia at Dr. Soedirman Regional Hospital, Kebumen. Method: Employing an analytical observational design with quantitative methods, this research included 70 participants selected through cross-sectional sampling. Data collection utilized the Rhodes Index of Nausea, Vomiting, and Retching (RINVR) scale for observation. Findings: The study revealed that the majority of respondents (54.3%) adhered to an adequate fasting duration of 6-8 hours. Among these, 89.5% (34 respondents) did not experience PONV. Conversely, an inadequate fasting period (&gt;8 hours) was associated with a higher incidence of PONV, observed in 38.6% (27 respondents), while only 3.7% (1 respondent) did not experience PONV. The correlation analysis yielded a significant relationship with a coefficient of 0.502. Conclusion: There is a significant correlation between fasting duration and the incidence of PONV in patients receiving spinal anesthesia at Dr. Soedirman Regional Hospital, Kebumen. Adequate pre-operative fasting (6-8 hours) is associated with a lower incidence of PONV, emphasizing the importance of adherence to recommended fasting guidelines to minimize post-operative complications

Association of Androgenetic Alopecia with Metabolic Syndrome.

To determine the association of androgenetic alopecia (AGA) with metabolic syndrome (MetS) in either gender. Descriptive study. Place and Duration of the Study: OPD complex, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from February to August 2021. The study included a total of 90 patients who met the specified criteria for enrolment. Each group (case and control) contains 45 patients. Diagnosis of androgenetic 2 alopecia was done clinically and grading was based on the Norwood-Hamilton classification in males and Ludwig classification in females. Body mass index (BMI) was calculated and blood pressure was measured for all enrolled patients. Following an overnight fasting period, blood samples were collected from each patient to measure clinical parameters including triglycerides (TGs), fasting blood sugar (FBS), and high-density lipoprotein (HDL) levels. There were 85.6% males and 4.4% females with a mean age of 43.38 years. Out of which, 34.4% and 15.6% of patients fell in severity 1 and severity 2 Class. Patients were stratified on the basis of AGA with respect to TGs, FBS, HDL, and BMI. The p-value was significant when stratified on the basis of BMI, FBS, and HDL except TGs. Odd ratio of both groups on the basis of (MetS) 8.1. Odd ratio between androgenic alopecia and metabolic syndrome was of 2.4. An association existed between androgenetic alopecia and metabolic syndrome indicating the potential benefit of early MetS screening for individuals with androgenic alopecia. This proactive approach could help prevent unforeseen complications through timely lifestyle adjustments. Metabolic syndrome, Androgenic alopecia, Cholesterol, Triglycerides.

Effect of Incorporating Soursop (Annona muricata) Leaves Powder on Reproductive Performance of Japanese Quail (Coturnix coturnix japonica)

Introduction: Soursop leaves are rich in various molecules, including total phenols, terpenes, and steroids, which possess a range of pharmacological properties that can be utilized in animal production to enhance both growth and reproduction of animals. The present study aimed to evaluate the effect of incorporating soursop (Annona muricata; A. muricata) leaves powder into feed on the reproductive performance of Japanese quail. Materials and methods: A total of 80 Japanese quails (64 females and 16 males) aged two weeks were randomly divided into four experimental groups, labeled T0, T1, T2, and T3, and received feed additives with 0 mg/kg body weight (bw), 250 mg/kg bw, 500 mg/kg bw, and 750 mg/kg bw of powdered soursop leaves, respectively. Additionally, water was provided ad libitum, and the quails' weights were measured every 7 days for a period of 75 days. At the end of the period, 12 female quails from each group were sacrificed after 24 hours fasting period. Blood was collected for hematological (Leukocyte, Erythrocyte, and Platelet indices) and serum biochemical (total serum cholesterol, total proteins, albumin, and globulin, Aspartate aminotransferase, Alanine aminotransferase, Urea, and Creatinine) analysis. The males were also sacrificed to evaluate the spermatozoa characteristics (mobility, concentration, and viability). Results: No statistical significant changes in growth characteristics or hematological parameters were observed. However, biochemical parameters increased significantly with the inclusion of Soursop (A. muricate) in quail feed, including increased total cholesterol, total protein, and globulin levels, and decreased malondialdehyde levels. This effect was most significant at dosage of 500 mg/kg bw. Serum levels of urea, Alanine aminotransferase, and Aspartate aminotransferase were not significantly affected by A. muricata whatever the concentration considered. A significant increase in fast progressive spermatozoa, along with a decrease in immotile spermatozoa, was observed with A. muricate at dosage of 500 mg/kg bw compared to the control. Sperm viability also increased significantly, particularly in live at dosage of 500 mg/kg bw. Significant increase was observed in fertility parameters, including increased fertility rate, hatchability rate of fertile eggs, total hatchability rate, and chick weight, along with decreased embryonic mortality at 500 mg/kg bw treatment compared to the control. Conclusion: In conclusion, the findings indicated that incorporating A. muricata leaf powder at 500 mg/kg bw into quail feed positively influences reproductive cells and boosts fertility growth promoters.