Investigating Majhool date (Phoenix dactylifera) consumption effects on fasting blood glucose in animals and humans.

OBJECTIVES: Majhool date (Phoenix dactylifera), renowned for its premium taste and texture, is extensively consumed in the Islamic world, particularly during Ramadan. Despite its popularity, concerns persist regarding its potential to induce diabetes in non-patients. This study aims to explore the diabetogenic effects of prolonged Majhool date (Phoenix dactylifera) consumption, the widely used fruit in the Islamic world, through animal experiments and human clinical data. METHODS: Medjool dates were processed into an ethanolic extract for the animal experiment. Then, 21 Balb/c mice received varying doses of the extract for one month. The fasting blood glucose levels were analyzed at the beginning and after one month of consumption of the Majhool date extract. For the clinical study, 387 healthy participants were recruited, with fasting blood glucose levels assessed before and after Ramadan, a period of heightened Majhool date consumption. RESULTS: all groups of the experimental animals exhibited a significant (p<0.05) weight increase after Majhool date consumption, while no significant (p>0.05) alteration in fasting blood glucose levels among groups. In addition, it was found that fasting blood glucose levels remained statistically unchanged (p>0.05) after heightened Majhool date consumption among humans. CONCLUSIONS: The study challenges the belief that Majhool date induces diabetes, supported by both animal and human data. Findings suggest that Majhool date consumption, even at higher doses, does not induce diabetes. Further investigations could explore the impact of other date varieties on the fasting blood glucose levels.

Effects of Calamintha incana (Sm.) Helder Ethanolic Extract on the mRNA Expression of Drug-metabolizing cyp450s in the Mouse Livers.

BACKGROUND: Alteration in the expression and activity of drug-metabolizing enzymes (DMEs) can alter the pharmacokinetics and hence the response of the drug. Some chemicals found in herbs and fruits affect the expression of DMEs. Calamintha incana is commonly used in Middle Eastern Arabic countries. There is no report regarding the influence of Calamintha incana on the hepatic expression of DMEs. AIMS: The current investigation aimed to investigate the effect of Calamintha incana consumption on the mRNA expression of major hepatic drug-metabolizing cytochrome (cyp) P450 genes in mice. METHODS: The chemical composition of the ethanoic extract was analyzed using liquid chromatography/ mass spectrometry. Then, 21 BALB/c mice were used for the in vivo experiment. The mice were divided into three groups, each consisting of seven mice. The first group (low-dose group) was treated with 41.6 mg/kg of Calamintha incana extract and the second group was administered the high-dose (125 mg/kg) of the extract for one month. The mice in the third "control" group administrated the vehicle 20% polyethylene glycol 200. Then, the expression of cyp3a11, cyp2c29, cyp2d9, and cyp1a1 was analyzed using the real-time polymerase chain reaction. The relative liver weights of the mice and the hepatic pathohistological alterations were assessed. RESULTS: The ethanolic extract of Calamintha incana contained 27 phytochemical compounds. The most abundant compounds were linolenic acid, myristic acid, and p-cymene. It was found that the low dose of Calamintha incana extract upregulated significantly (P < 0.05) the expression of cyp3a11 by more than ten folds in the liver of treated mice. Furthermore, the histological analysis showed that low- and high-dose administration of the C. incana did not cause pathological alterations. CONCLUSION: It can be concluded from these findings that consumption of low doses of Calamintha incana upregulated the mRNA expression of mouse cyp3a11 without causing histopathological alterations in the livers. Further studies are needed to determine the influence of Calamintha incana on the pharmacokinetics and response of drugs metabolized by cyp3a11.

Does Ramadan Intermittent Fasting Affect the Fasting Blood Glucose Level among Type II Diabetic Patients?

BACKGROUND: The level of fasting blood glucose (FBG) is influenced by several factors, including health status, genetics, and diet. Some studies have reported a beneficial effect of Ramadan Intermittent Fasting (RIF) on diabetic patients. However, clinical observations have shown that diabetes is exacerbated in some patients. AIM: This study aims to investigate the influence of RIF on the FBG level, a biomarker of hyperglycemia and diabetes, and to identify factors associated with variations in FBG levels during RIF among diabetic patients. METHODS: This study is a cross-sectional study. We monitored the FBG levels of 181 type II diabetic patients over a two-month period, from 20 February to 20 April 2023, which represents the Islamic lunar months of Shaban (8th month) and Ramadan (9th month). Ramadan provides a prominent month of intermittent fasting practice for studying its physiological effects on diabetes. We collected clinical data from each participant, including demographic information, co-morbidities, and medications used during this period. RESULTS: Based on our findings, diabetic patients were classified into three groups depending on the influence of RIF on FBG levels: the positively affected group (44%), whose average FBG levels were reduced; the neutrally affected group (24%), whose average FBG levels did not change; and the negatively affected group (32%), whose average FBG levels increased during the fasting month of Ramadan compared to the previous month. Furthermore, we found that the positive effect of RIF was more frequent among obese, non-geriatric, and male diabetic patients, while the negative effect of RIF was more frequent among patients who were not adhering to the medication. CONCLUSIONS: This study concludes that RIF affects FBG levels differently among diabetic patients. These findings should be taken into consideration when treating diabetic patients during the fasting month of Ramadan, and further studies are needed to identify (1) factors associated with inter-individual variation in the response to RIF and (2) those who are great candidates for RIF.

Effects of Fasting and Phoenix dactylifera on the Expression of Major Drug- Metabolizing Enzymes in the Mouse Livers.

AIMS: This study aimed to investigate the effects of consuming Phoenix dactylifera and fasting on the mRNA expression of major hepatic drug-metabolizing enzymes in mice. METHODS: Phoenix dactylifera ethanolic extract was analyzed using LC-MS/MS. We used forty-two male Balb/c mice, which were treated with low (300 mg/kg) and high (2583 mg/kg) doses of Phoenix dactylifera and fasted for 24 hours, two weeks, and one month. Then, we analyzed the expression of cyp3a11, cyp2c29, cyp2d9, and ugt2b1 using real-time polymerase chain reaction assay. In addition, we assessed the relative liver weights of the mice and the hepatic phathohistological alterations. RESULTS: We found that Phoenix dactylifera ethanolic extract contained 38 phytochemical compounds, mainly kaempherol, campesterol, lutein, apigenin, genistein, and isoquercetin. Fasting significantly upregulated the mRNA expression of several drug-metabolizing enzymes in a time-dependent manner and we showed that consuming the low dose of Phoenix dactylifera significantly upregulated the expression of drug-metabolizing enzymes more than the high dose. The results of the histological examinations and relative liver weight showed that fasting and consuming of Phoenix dactylifera did not cause any toxicological alterations in the liver of the mice. CONCLUSION: It is concluded from this study that fasting and consuming of Phoenix dactylifera upregulated the mRNA expression of major drug-metabolizing enzymes in mouse livers. These findings may explain, at least partly, the variation of drug response during fasting in the month of Ramadan and would direct future clinical studies in optimizing the dosing of pharmacotherapeutic regimen.