Pediatrics International (2006) 48, 278283

doi: 10.1111/j.1442-200X.2006.02204.x

Original Article

The effect of Ramadan on maternal nutrition and composition of

breast milk
LU,1 GLHAN SAMUR,1 ALI TOPU2 AND AYLIN AYAZ TOPU1
NESLISAH RAKICIOG
1
Departments of Nutrition and Dietetics and 2Food Engineering, Hacettepe University, Ankara, Turkey
Abstract

Background: There are many advantages of breast milk for infants. Many factors can affect the volume and
composition of breast milk. One of them is the maternal diet. The objective of this study is to determine the
effect of Ramadan fasting on maternal nutrition and breast milk composition.
Methods: A total of 21 breast-feeding mothers aged between 17 and 38 years who fasted during Ramadan month
and volunteered to give milk samples were surveyed. The ages of the infants were between 2 and 5 months. The
study was performed during Ramadan and 2 weeks after the end of Ramadan.
Results: The results showed that during Ramadan, zinc, magnesium and potassium levels in breast milk
decreased significantly (P < 0.05). The mothers weight increased approximately 1 kg after Ramadan. Changes
in body mass index of the mother were not statistically significant. A significant decrease in vitamin A
intake was observed after Ramadan (P < 0.05). During Ramadan, energy and most nutrient intakes except
protein and vitamins A and C were found below daily recommended dietary allowances necessary for lactating women.
Conclusions: Ramadan fasting had no significant effect on the macronutrient composition of the breast milk
and consequently the growth of the infants. There were significant differences in some of the micronutrients
such as zinc, magnesium and potassium. The nutritional status of lactating women was affected by Ramadan
fasting. All of the nutrient intakes (except vitamins A, E and C) decreased during Ramadan. For these reasons,
it would seem prudent to excuse lactating women from fasting during Ramadan.

Key words

breast milk composition, fasting, maternal nutrition, Ramadan.

Ramadan is the most important holy month in the Islamic calendar. Falling on the ninth month of the Hijra calendar, which
is shorter than the Gregorian year, Ramadan moves forward
about 11 days every year. Therefore, fasting duration can vary
from 11 to 18 h, depending on the season during which
Ramadan occurs. Ramadan fasting is one of the five pillars of
Islam and every year all healthy adult Muslims are obliged to
fast from sunrise to sunset during a period of 30 days.1 Food
and fluid intakes are permitted only from sunset (iftar) to sunrise (sahur). The common practice in Turkey is to eat one large
meal after sunset and a lighter meal before sunrise.
According to Islamic tradition, pregnant and lactating
women are allowed to be excused from fasting in Ramadan.
However, it is common that many Muslim women fast during

Correspondence: Neslisah Rakcog lu, Department of Nutrition

and Dietetics, Hacettepe University, 06100 Samanpazari, Ankara,
Turkey. Email: neslisah@hacettepe.edu.tr
Received 7 December 2004; revised 7 May 2005; accepted 20
June 2005.

these periods. It is well known that breast-feeding is very

important for infants. Breast-feeding of infants is associated
with their better biological, psychological and intellectual
development.14 Many factors can affect the volume and composition of human milk such as stage of lactation and maternal
diet.5,6 Three aspects of maternal nutrition could have an
impact on human milk composition: current dietary intake,
body stores, and alterations in nutrient utilization as influenced
by hormonal changes which is an important characteristic of
lactation. Although maternal nutrition may be frequently compromised, the concentration of nutrients in milk and milk volume remain unchanged, and nutrients (such as proteins, lipids,
lactose etc.) for milk synthesis are furnished by maternal stores
or body tissues.7,8
The numbers of studies on the effect of Ramadan fasting on
nutritional status have increased in recent decades. But these
investigations do not reflect the effect of fasting on maternal
nutrition and breast milk composition in Turkey. The objective of this study is to determine the effect of Ramadan fasting
on maternal nutrition and breast milk composition.

Ramadan and breast milk composition

Methods
Subjects

The study was conducted in the Glveren Health Care Unit,

which is affiliated with Hacettepe University, Ankara, Turkey.
A total of 21 breast-feeding mothers meeting the criteria were
selected and were aged between 17 and 38 years old (mean
27.3 5.4 years), fasted during Ramadan month, and volunteered to give milk samples. All were non-smokers and none
of them was taking any medications and dietary supplements.
The volunteers had no chronic diseases. The infants were between 2 and 5 months of age and were either exclusively
breast-fed (47.6%), or breast-feeding in combination with
supplemental foods (52.4%).

Study design and sample collection

The study was designed in two stages. The first stage was during Ramadan (second week of Ramadan) and the second stage
was 2 weeks after the end of Ramadan.1 Food intakes were recorded during three consecutive days at each stage. Energy
and nutrient intakes were calculated by using a computer program. Results were compared with daily recommended dietary
allowances (RDA) for lactating women.9 Nutrient intakes
above 67% of RDA were accepted as adequate. Milk samples
were obtained by manual extraction from each breast immediately after the first nursing period of the day in the morning
between 09.0011.00 hours until the breast was completely
emptied. Similar samples were obtained from the same mothers
2 weeks after the end of Ramadan. The samples were stored in
sterile polypropylene tubes and kept on ice and transported to
the laboratory in a cool box and analyzed immediately.
Aliquots of each milk samples specimens were also kept frozen at 70C.

279

with a 12% trichloroacetic acid final concentration.12 Protein

content was calculated as (TN-NPN) 6.25.13 Lactose content
was analyzed with a YSI model 2700 select Biochemistry
Analyzer (Yellow Springs Instrument, OH, USA).14 Fat was
determined according to the RoeseGottlieb method11,15 and
the total solid content was determined by oven drying at
100C. Ash content of breast milk samples was determined at
550C and mineral content was determined by using Shimadzu
AA-600 model flame atomic absorption spectrophotometer
(Shimadzu, Kyoto, Japan), after dry ashing.11
Statistical analysis

All the data were analyzed by Statistical Packages for Social

Sciences (SPSS 10, SPSS Inc., Chicago, IL, USA). The results
were given as mean (SD) values. Paired t-test and Wilcoxon
signed rank test were used to compare the differences between
mean values of two paired variables for normally and nonnormally distributed data. The level P < 0.05 was considered
as the cut-off value for significance.

Results
Physical characteristics

The physical characteristics of mothers and infants are given

in Table 1. Age of marriage was 19.5 2.3 years old. Age at the
first pregnancy was low (20.4 2.3 years). All of the subjects
had only primary school education with an average attendance
of 6.1 2.0 years.

Composition of mothers milk

Nutrient composition of breast milk is shown in Table 2.

Significant differences were determined in total ash, zinc,

Anthropometric measurements
Table 1

Mothers heights and weights were measured wearing light

clothes and without shoes. Body Mass Index (BMI; weight/
height2, kg/m2) was calculated for each subject. Children were
weighed with underwear on a digital electronic weighing scale
accurate to 0.1 kg (SECA, Hamburg, Germany) and height
was measured accurate to 0.1 cm with an infantometer.10
Analytical methods

Before analysis, breast milk was brought to room temperature

(~20C) and homogenized. Total nitrogen (TN) and nonprotein nitrogen (NPN) were determined by the micro-Kjeldahl
method.11 NPN was determined after precipitating protein

Physical characteristics of the mothers and infants

Characteristics
Mothers age (years)
Mothers height (cm)
Age of marriage (years)
Age at first pregnancy (years)
Number of surviving child
Years of education
Members in family
Age of child (month)
Birthweight (g)
Birth length (cm)
Exclusively breast-feeding (month)
Suckling frequency (times/d)
Family income ($US)

Mean SD
27.3 5.4
156.0 4.7
19.5 2.3
20.4 2.3
2.3 1.1
6.1 2.0
4.5 1.5
3.5 0.9
3407.9 609.5
50.3 2.2
2.7 1.1
9.9 3.6
300 85

280

N Rakicioglu et al.

Table 2

Energy and nutrient intakes

Breast milk composition (Mean SD)

Nutrients
(per 100 mL)
Lactose (g)
Fat (g)
Protein (g)
Total solids (g)
Total ash (g)
Calcium (mg)
Zinc (mg)
Magnesium (mg)
Sodium (mg)
Potassium (mg)

During Ramadan After Ramadan P-values

5.88 0.30
3.62 1.53
1.15 0.12
12.17 1.53
0.21 0.02
25.29 4.17
0.15 0.04
2.90 050
13.22 5.30
23.96 5.27

5.90 0.35
3.23 1.46
1.14 0.18
12.39 1.73
0.27 0.04
24.75 3.77
0.18 0.03
3.30 0.50
13.91 5.42
32.27 5.96

0.765
0.398
0.853
0.625
<0.001*
0.312
0.001*
0.003*
0.876
<0.001*

*P < 0.05.

P-values calculated with the Wilcoxon signed ranks test.

P-values calculated with the paired t-test.

magnesium and potassium values during and after Ramadan.

Zinc, magnesium and potassium levels of human milk increased significantly after Ramadan (P < 0.05). There was a
small increase and a small decrease in other milk nutrients, but
these changes were not significant.

Changes in energy and nutrient intakes of lactating women,

during and after Ramadan, are shown in Table 4. In general, all
nutrient intakes (except vitamins A, E and C) decreased during
Ramadan, but none were statistically significant. Significant
differences were found only in carbohydrate and vitamin A
intakes after Ramadan, compared with during Ramadan
(P < 0.05).
Total fat and carbohydrate intakes constituted 28.6 and
58.8% percent of energy during Ramadan, and 25.2 and 61.7%
after Ramadan, respectively. The total fat energy percentages
decreased after Ramadan, probably depending on an increase
in carbohydrate energy percentages (P < 0.05). A significant
decrease of vitamin A consumption was found after Ramadan,
when compared with values obtained during Ramadan
(P < 0.05).
Energy and most nutrient intakes were found below the
recommended levels for lactating women. Intakes of all nutrients except protein and vitamins A and C were below 67% of
the RDA during Ramadan (Table 5). Energy and iron intakes
increased to adequate levels after Ramadan. Total protein
intake was adequate in each stage of this study (79.5 and
90.5% of the RDA, respectively).

Anthropometric measurements

Mean weight and length values of children increased significantly over the study period (P < 0.01; Table 3). At the end of
Ramadan, an increase of 834.6 358.5 g and 3.7 2.6 cm in the
mean weight and length values of children who were fed only
breast milk were observed, respectively. And also the mean
weight and length of children who were fed breast milk together with supplementary food increased 1550 1230.6 g and
5.7 4.7 cm, respectively (P > 0.05). Increases of body weight
and length in all infants were in the normal range according to
the National Center Health Statistics standards.
Although the mean weight of mothers increased approximately 1 kg, no statistically significant changes in weight or
BMI were determined.

Table 3

The effect of Ramadan on weight changes (Mean SD)

Characteristics
Mothers
weight (kg)
Mothers BMI
(kg/m2)
Childs weight (g)
Childs length (cm)

During Ramadan After Ramadan P-values

62.3 12.0

63.2 13.7

0.143

25.6 4.8

26.0 5.3

0.128

6535.7 921.2
61.8 3.5

7550.0 1035.3 <0.001*

66.2 3.1
<0.001*

*P < 0.05.
P-values calculated with the paired t-test.
BMI, body mass index.

Discussion
The effect of Ramadan on maternal nutrition and human milk
composition was examined in this study. A decrease in the
number of meals (only two meals) resulted in insufficient daily
food intake during Ramadan. In general, an increase was observed in the intake of energy and other nutrients after
Ramadan. Only a significant increase was found in carbohydrate intake (P < 0.05). Carbohydrate intakes mean values
were 243.1 g and 283.3 g during and after Ramadan, respectively (Table 4). Lactating women consumed more fluid with
sugar to increase the secretion of their milk after Ramadan
which could have an effect on their carbohydrate intake.
In this study, an increase of vitamin A intake during Ramadan was found (P < 0.05). For Muslims, sahur and iftar meals
gain priority at Ramadan. People take care of their nutrition
more seriously and prepare special foods to eat in these meals
in Turkey.16 In particular, vegetable dishes with olive oil,
sugar and fat containing desserts and cereal-based dishes are
more likely to be consumed. There may also be an increase in
the percent of fat in the diet during this period. However,
after Ramadan food consumption patterns usually change.
Therefore, vitamin A intake was lower after Ramadan.
Adlouni et al. investigated food intake patterns during
Ramadan.17 In contrast to our findings, they found an increase
of total energy intake which was due to an increase of carbohydrate and protein intake during Ramadan.17 This may

Ramadan and breast milk composition

Table 4

281

Daily energy and nutrient intakes of mothers (Mean SD)

Nutrients
Energy (kcal)
Total protein (g)
Animal protein (g)
Plant protein (g)
Percentage of energy (%)
Total fat
Polyunsaturated (g)
Monounsaturated (g)
Saturated (g)
Percentage of energy (%)
Cholesterol (mg)
Carbohydrate g
Percentage of energy (%)
Crude fiber (g)
Calcium (mg)
Iron (mg)
Magnesium (mg)
Zinc (mg)
Sodium (mg)
Potassium (mg)
Vitamin A (mcg)
Vitamin E (mg)
Thiamine (mg)
Riboflavin (mg)
Pyridoxine (mg)
Niacin (mg)
Vitamin C (mg)
Folic acid (mcg)

During Ramadan

After Ramadan

P-values

1683 410.8
51.7 15.2
17.9 8.5
33.8 13.1
12.5 2.1
53.9 14.7
19.3 6.9
16.0 5.4
14.9 5.2
28.6 5.7
124.0 75.4
243.1 66.7
58.8 5.9
21.3 9.1
396.4 136.9
9.8 3.6
194.2 71.8
6.9 2.1
1604.7 749.9
1908.2 752.1
996.1 765.0
16.7 6.6
0.77 0.25
0.84 0.20
1.09 0.42
8.4 4.5
77.1 55.4
110.7 35.0

1886 434.7
58.8 18.4
19.9 9.8
38.9 14.1
12.6 2.5
54.5 14.5
18.0 7.2
17.0 4.2
15.8 4.4
25.2 3.9
141.7 85.6
283.3 66.4
61.7 4.1
23.8 10.1
422.9 118.5
11.0 4.5
219.0 81.2
8.0 2.4
1970.5 516.4
1942.8 792.4
589.2 549.9
15.5 7.6
0.89 0.36
0.97 0.25
1.10 0.34
11.7 9.1
65.3 35.9
124.9 50.31

0.058
0.124
0.425
0.080
0.899
0.871
0.532
0.419
0.490
0.025*
0.385
0.016*
0.037*
0.110
0.426
0.201
0.170
0.063
0.076
0.794
0.018*
0.588
0.104
0.056
0.919
0.161
0.322
0.259

*P < 0.05.
P-values calculated with the Wilcoxon signed ranks test.

P-values calculated with the paired t-test.

Table 5 Percentages of Recommended Daily Allowance of some

nutrients (Mean SD)
Nutrients
Energy
Total protein
Calcium
Iron
Magnesium
Zinc
Vitamin A
Thiamine
Riboflavin
Pyrodixine
Vitamin C
Folic acid

%RDA
During Ramadan After Ramadan
62.5 15.1
79.5 23.4
33.8 11.7
65.9 23.8
55.0 20.0
36.7 10.7
77.2 58.2
48.3 15.4
47.4 10.9
52.5 19.7
84.6 55.8
40.1 11.8

69.5 16.1
90.5 28.2
34.5 9.7
72.9 30.5
61.4 23.2
42.0 12.8
44.7 35.4
55.8 23.2
53.8 14.0
50.9 16.7
65.3 40.1
43.9 18.4

P-values
0.075
0.121
0.797
0.245
0.232
0.077
0.010*
0.154
0.068
0.735
0.115
0.498

*P < 0.05.

P-values calculated with the Wilcoxon signed ranks test.

P-values calculated with the paired t-test.

RDA, Recommended daily allowance.

originate from the ethnic differences of kitchen cuisines of

the two study populations.
In general, energy and other nutrient content (except for total
protein and vitamins A and C) of the diet were found to be insufficient during Ramadan compared with RDA values9 for lactating mothers. Important minerals for lactating women such as
calcium, iron, and zinc were consumed in insufficient levels
during Ramadan. Those mineral intakes were below 67% of the
RDA (33.8, 65.9 and 36.7%, respectively). In this study, calcium and zinc were the most deficient nutrients taken during
and after Ramadan. Karaag aog lu and Ycecan determined the
behavioral changes and nutritional habits of 750 adults (320
males and 430 females) aged between 2075 years during Ramadan and obtained similar results for calcium intake.16 Iron
intake was nearly sufficient in this study but food intake sources
were plant-based for which the bioavailability is lower than in
animal-based foods. Also, women consumed a lot of tea either
during or just after iftar and sahur meals. It is another factor that
tannins in tea might cause a decrease in iron absorption.

282

N Rakicioglu et al.

Plasma biochemical parameters were not measured in the

present study but dietary food consumption results showed
that there was an insufficient intake of some nutrients, probably due to the low socioeconomic status of women surveyed
in this study (Table 1). This can increase the risk of nutritional
diseases such as anaemia, osteopenia, and osteoporosis in later
ages. In Turkey, the prevalence of anaemia in pregnant and
lactating women is 50%.18 Also, zinc is an important mineral
for growth and development, and a healthy immune system for
both mothers and children.7,19
In one study, it was found that the intakes of energy, protein, calcium, iron, zinc, riboflavin, and vitamin C were less
than 67% of RDA for pregnant women fasting during Ramadan in Turkey (78.8, 63.6, 84.8, 100.0, 69.7, 72.7 and 30.3%
of pregnancies, respectively).20 It was suggested in that study
that pregnant women should be excused from fasting during
Ramadan.20
Despite an increase in energy intake and body weight of
women after Ramadan, results for this study were not statistically significant and the data are inconclusive and contradictory on this issue. Frost and Pirani reported a significant
increase in energy, fat, carbohydrate, and protein intake.21
Also, a significant increase in body weight was noted during
Ramadan depending on feeding pattern in the same study. But,
in other studies, it was found that there were no significant
changes in body weight over Ramadan.22,23 In one study, a
decrease was observed in body weights of male and female
subjects with a reduction in energy intake during Ramadan.24
In some studies it was found that total body weights
decreased significantly.2527 Maislos et al. demonstrated that
dietary changes did not affect BMI.28 In the present study,
despite an insufficient energy intake of 21 nursing mothers during and after Ramadan (62.5 and 69.5% of RDA, respectively),
body weights did not change significantly. This may be
explained by the fact that all the women were housewives and
had lower physical activity levels and longer duration of sleep.
In the present study, the childrens weights and lengths
increased significantly (P < 0.05; Table 3). Ramadan fasting
did not affect the childrens anthropometric measurements
because the infants were either exclusively breast-fed or
breast-feeding with supplementary foods. Some mineral levels
in breast milk were decreased but macronutrients (lactose, fat
and protein) remained unchanged. Therefore, the growth of a
child may not have been effected.
In another study, it was shown that although fasting was
excused for pregnant and lactating women in Islam, fasting by
nursing mothers was common during Ramadan in Turkey.29 It
was also found that in Ramadan, fasting caused a decrease in
breast-feeding frequency and an increase in supplementing
with solid foods.29
In the present study, it was found that zinc, magnesium,
and potassium levels of breast milk decreased significantly
during Ramadan (P < 0.05). Sodium levels of milk decreased

also, but the changes were not statistically significant (Table 2).
Bener et al. studied the breast milk composition of 26 nursing
mothers aged between 2038 years in the United Arab Emirates during and after Ramadan.1 They indicated that no significant changes were found in total fat, protein, lactose, total
solids, non-fat solids, triglycerides, and cholesterol content of
breast milk. They concluded that Ramadan fasting did not
affect breast milk quality.1
However, Tzn30 and Hachey et al.31 reported that nutritional habits of lactating mothers affected their milk composition. Hachey et al. noted that the total fat concentration of
breast milk was 2.5% in a low fat diet and 3.3% in a high fat
diet.31 Tzn indicated that an increase in the intake of dietary
ascorbic acid of mothers increased the ascorbic acid content of
breast milk.30 It has been reported in previous studies that dietary changes during lactation and daily feeding frequencies
have no effect on milk lactose concentration.8,32,33 Lactose is
one of the nutrients that is least affected by maternal dietary
changes.7 The results of our study showed that dietary changes
during lactation and daily feeding frequencies had no affect on
major milk nutrients such as lactose, fat and protein.

Conclusion
In summary, Ramadan fasting had no significant effect on the
macronutrient composition of the breast milk and consequently
the growth of the infants. There were significant differences in
some of the micronutrients such as zinc, magnesium and potassium. This study also indicated that nutritional status of lactating
women might be affected by Ramadan fasting. All of the nutrient
intakes (except vitamins A, E and C) decreased during Ramadan.
For these reasons, it would seem prudent to excuse lactating
women from fasting during Ramadan and nutrition education on
the importance of breast-feeding and healthy nutrition for lactating women should be encouraged. This study was conducted in a
local area of Turkey, but further studies are required regarding
the effects of Ramadan in different countries with different climates, socioeconomic levels, traditions and food habits.

Acknowledgments
The authors wish to express their appreciation to Professor
Dr Glden Pekcan for her valuable recommendation and
contributions.

References
1 Bener A, Galadari S, Gillett M et al. Fasting during the holy
month of Ramadan does not change the composition of breast
milk. Nutr. Res. 2001; 21: 85964.

Ramadan and breast milk composition

2 Anderson JW, Johnstone BM, Remley DT. Breastfeeding and
cognitive development: a meta analysis. Am. J. Clin. Nutr. 1999;
70: 52535.
3 Drane DL, Logeman JA. A critical evaluation of the evidence
on the association between type of infant feeding and cognitive
development. Paediatr. Epidemiol. 2000; 14: 34956.
4 Heining MJ. Host defence benefits of breastfeeding for the
infant: effect of breastfeeding duration and exclusivity. Pediatr.
Clin. North Am. 2001; 48: 10523.
5 Jensen G. The Lipids of Human Milk. CRC Press, Boca Raton,
1989.
6 Samur Eroglu G, Aksoy M, Kilic Z. The effect of maternal dietary fatty acids intakes on the fatty acids composition of colostrum and mature milk as well as serum in Turkish Women.
(Poster) 16th International Congress of Nutrition; 27 Jul 1
Aug, Montreal, Canada. 1997.
7 Lnerdal O. Effects of maternal dietary intake on human milk
composition. J. Nutr. 1986; 116: 499513.
8 Subcommittee on Nutrition During Lactation. Nutrition During
Lactation. National Academy Press, Washington, 1991.
9 National Research Council. Recommended Dietary Allowances
(RDA), 10th edn. National academy Press, Washington, 1989.
10 Lee RD, Nieman CD. Nutritional Assessment. WBC Brown &
Benchmark Publishers, Dubuque, USA, 1993.
11 AOAC. Official Methods of Analysis, 15th edn. Association of
Official Analysis Chemists, Washington, 1990.
12 Hambraeus L, Forsum E, Abrahamsson L, Lnnerdal B. Automatic total nitrogen analysis in nutritional evaluations using a
block digester. Anal. Biochem. 1976; 72: 7885.
13 Ronayne de Ferrer PA, Baroni A, Sambucetti ME, Lopez NE,
Ceriani Cernadas JM. Lactoferrin levels in term and preterm
milk. J. Am. Coll. Nutr. 2000; 19: 37073.
14 Kartal IB, Saldamli I, Temiz A. Comparison of biochemistry
analyzer with the Teles method for the determination of Lactose. Milchwissenschaft 1999; 54: 79.
15 Muslimatun S, Schmidt MK, West CE, Schultink W, Hautvast
JGAJ, Karyadi D. Weekly vitamin A and iron supplementation
during pregnancy increases vitamin A concentration of breast
milk but not iron status in Indonesian lactating women. J. Nutr.
2001; 131: 26649.
16 Karaag aog lu N, Ycecan S. Some behavioural changes observed among fasting subjects, their nutritional habits and energy expenditure in Ramadan. Int. J. Food Sci. Nutr. 2000; 51:
12534.
17 Adlouni A, Ghalim N, Saile R, Had N, Parra HJ, Benslimane A.
Beneficial effect on serum apo AI, apo B, and Lp AI levels of
Ramadan fasting. Clin. Chim. Acta. 1998; 271: 17989.
18 State Planning Organization (SPO). Working Group Report
of National Food and Nutrition Strategies. Publ. No. 2632,

19

20

21
22

23

24

25

26

27

28

29

30

31

32

33

283

Ankara, Turkey, 2001. Available from URL: www.dpt.gov.tr/gida

(in Turkish).
Salgueiro MJ, Zubillaga MB, Lysionek AE, Caro RA, Eng RW,
Boccio JR. The role of zinc in the growth and development of
children. Nutrition 2002; 18: 51019.
Rakicio lu N, ibek A. The effect of Ramadan on Nutritional
status of Pregnant Women. (Poster) 16th International Congress
of Nutrition; 27 Jul1 Aug, Montreal, Canada. 1997.
Frost G, Pirani S. Meal frequency and nutritional intake during
Ramadan: a pilot study. Hum. Nutr. Appl. Nutr. 1987; 41: 4750.
Maislos M, Khamaysi N, Assali A, Abou-Rabiah Y, Zvili I,
Shany S. Marked increase in plasma high-density lipoprotein
cholesterol after prolonged fasting during Ramadan. Am. J.
Clin. Nutr. 1993; 57: 64042.
Finch GM, Day JEL, Razak Welch DA, Rogers PJ. Appetite
changes under free-living conditions during Ramadan fasting.
Appetite 1998; 31: 15970.
Husain R, Duncan MT, Cheah SH, Chng SL. Effects of fasting
in Ramadan on tropical Asiatic Moslems. Br. J. Nutr. 1987; 58:
418.
Fedail SS, Murphy D, Salih SY, Bolton CH, Harvey RF. Changes
in certain blood constituents during Ramadan. Am. J. Clin. Nutr.
1982; 36: 35053.
Nomani MZ, Hallak MH, Siddigui IP. Effects of Ramadan fasting on plasma uric acid and body weight in healthy men. J. Am.
Diet Assoc. 1990; 90: 14356.
Ramadan J, Telahoun G, Al-Zaid NS, Barac-Nieto M. Responses to
exercise, fluid and energy balances during Ramadan in sedentary
and active males. Nutrition 1999; 15: 7359.
Maislos M, Abou-Rabiah Y, Zuili I, Iordash S, Shany, S. Gorging and plasma HDL-cholesterolthe Ramadan model. Eur. J.
Clin. Nutr. 1998; 52: 12730.
Ertem , Kaynak G, Kaynak C, Ulukol B, Glnar B. Attitudes
and practice of breastfeeding mothers regarding fasting in Ramadan. Child Care Health Dev. 2001; 27: 54554.
Tzn N. The effect of nutrition on breast milk composition
(MSc Thesis). Ankara, Turkey, The Institute of Health Sciences,
Hacettepe University, 1989 (in Turkish).
Hachey DL, Silber GH, Wong WW, Garza C. Human lactation.
II: endogenous fatty acid synthesis by the mammary gland.
Pediatr. Res. 1989; 25: 638.
Nommsen LA, Lovelady CA, Heining MJ, Lonnerdal B, Dewey
KG. Determinants of energy, protein, lipid and lactose concentrations in human milk during first 12 months of lactation.
Am. J. Clin. Nutr. 1991; 53: 45765.
Poskit E. Use of cows milk in infant feeding with emphasis on
the compositional differences between human and cows milk.
In: Walker AF, Rolls BA (eds). Infant Nutrition. Chapmen-Hall,
London, 1994; 16386.