Buddhist Ordination as a Culturally Embedded Model for Improving Diet, Body Composition, and Sleep Quality in Overweight and Obese Adults

Buddhist Ordination as a Culturally Embedded Model for Improving Diet, Body Composition, and Sleep Quality in Overweight and Obese Adults | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Buddhist Ordination as a Culturally Embedded Model for Improving Diet, Body Composition, and Sleep Quality in Overweight and Obese Adults Phrarajvarjirayanamethi Chatchai Moosan, Phim on Suklaew, Charoonsri Chusak, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6629740/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Jul, 2025 Read the published version in Scientific Reports → Version 1 posted 10 You are reading this latest preprint version Abstract Buddhist ordination involves significant lifestyle changes including meal timing, diet, and sleep patterns, yet short-term physiological effects remain poorly understood. This study examined effects of two-week ordination on dietary intake, body composition, and sleep quality in newly ordained Thai Dhammayut monks. Fifty-two participants (mean age 30.03 ± 1.13 years; BMI 26.70 ± 0.46 kg/m²) underwent assessments at baseline, one week, and two weeks post-ordination. While total energy intake remained stable, macronutrient composition shifted significantly: protein decreased > 20%, sugar nearly doubled, and fiber increased substantially. Body composition improved with reductions in weight, BMI, waist and hip circumference. Muscle mass modestly decreased while body fat percentage and visceral fat remained stable. Sleep quality improved significantly, particularly sleep latency and subjective restfulness, despite unchanged duration. Findings suggest Buddhist ordination may produce beneficial short-term physiological adaptations similar to time-restricted eating. Though improvements in abdominal adiposity and sleep quality were observed, declining muscle mass highlights nutritional adequacy concerns. Monastic routines may provide culturally appropriate frameworks for structured lifestyle interventions. Health sciences/Health care/Nutrition Health sciences/Health care/Quality of life Monks Obesity Time-restricted eating Dietary intake Body composition Sleep quality Figures Figure 1 Introduction Obesity poses a major global health burden, with prevalence steadily rising across diverse populations. Current estimates suggest that more than 650 million adults, approximately 13% of the global population, are classified as obese [ 1 ]. This condition is associated with increased risk of noncommunicable diseases such as type 2 diabetes, cardiovascular disorders, and certain cancers, while also diminishing quality of life and elevating healthcare costs [ 2 , 3 ]. The multifactorial nature of obesity, encompassing genetic, behavioral, and environmental contributors, demands multifaceted interventions that extend beyond traditional calorie focused approaches. This has prompted interest in lifestyle-based strategies, particularly those aligned with cultural and religious practices, as potentially sustainable models for metabolic health. Spiritual traditions, which emphasize mindfulness, intentional living, and self-discipline, may offer unique frameworks for influencing behavioral and physiological health outcomes. Conventional strategies for managing obesity typically emphasize achieving a negative energy balance through increased physical activity and reduced caloric intake [ 4 ]. However, emerging evidence highlights the importance of the timing and frequency of food consumption as independent modulators of metabolic health [ 5 ]. Meal timing influences circadian rhythms, hormonal regulation, and energy homeostasis, thereby affecting body composition and disease risk [ 6 ]. In this context, time-restricted eating (TRE), which limits food intake to a defined window of 4 to 12 hours per day without necessarily altering caloric content, has demonstrated promising health outcomes [ 7 ]. Clinical studies have reported improvements in insulin sensitivity, reductions in inflammation, and modest weight loss even in the absence of intentional calorie restriction [ 8 , 9 ]. Notably, short term TRE interventions (2 to 4 weeks) have been shown to induce rapid metabolic and anthropometric changes [ 10 , 11 ]. These findings support the potential of TRE as a simple yet powerful tool to synchronize metabolic processes with the body's internal clock. Buddhist monastic practices, particularly within the Dhammayut tradition of Thai Buddhism, inherently reflect a form of TRE while simultaneously promoting spiritual development through mindfulness, discipline (Vinaya), and detachment from material desires. Monks in this order typically consume two meals per day between dawn and noon, effectively maintaining an 18 to 19 hour fasting period that closely parallels modern TRE protocols [ 12 , 13 ]. However, distinctions remain while modern TRE generally limits intake during fasting periods to water alone, Buddhist traditions often allow herbal teas, clear fruit juices, and medicinal tonics such as honey or ghee [ 14 ]. Nonetheless, the core principle of confining caloric intake to a defined time window remains consistent with TRE principles [ 15 ]. Unlike voluntary TRE in free living populations, monastic practices enforce these dietary patterns through religious discipline, creating a naturally adherent environment ideal for studying metabolic effects. Furthermore, monks typically consume mixed meals provided by laypeople during alms rounds, minimizing personal food selection and reducing variability in dietary behavior. In addition to dietary changes, ordination introduces shifts in physical activity and sleep routines. Monastic life emphasizes meditative and ceremonial practices, typically involving reduced physical exertion [ 16 , 14 ]. Sleep patterns also undergo significant changes, with monks rising at 4:00 AM and concluding evening practices around 8:00 to 9:00 PM [ 14 ]. Such structured routines may initially disrupt circadian alignment and impact sleep quality during the adaptation phase [ 17 ]. However, the predictability and consistency of the monastic schedule may ultimately support circadian stability, contrasting with the irregular routines observed in modern lifestyles. These characteristics make Buddhist ordination a compelling model for studying lifestyle induced physiological changes. Furthermore, the spiritual motivations underpinning ordination may foster intrinsic commitment to behavioral changes, enhancing adherence and potentially amplifying health benefits. Despite the conceptual parallels between monastic discipline and therapeutic fasting, there is a limited understanding of the physiological and spiritual adaptations that occur during the early phase of ordination. Newly ordained monks provide a unique opportunity to observe rapid health-related changes in a controlled lifestyle shift rooted in religious discipline. This population is ideal for investigating the short-term impacts of a highly structured routine involving dietary, physical, spiritual, and sleep modifications in a real-world yet regimented setting. This study aimed to examine the short-term effects of Buddhist ordination on dietary intake, body composition, and sleep quality among newly ordained Thai Dhammayut monks. We hypothesized that this spiritually structured lifestyle transition would lead to measurable improvements in body composition, dietary quality, and sleep parameters during the early adaptation phase. Results Seventy-four individuals were initially screened for eligibility (Figure. 1). Of these, eight were excluded before baseline assessment—five did not meet the inclusion criteria, and three declined participations. During the first week of ordination, five participants withdrew after relocating to other temples. Nine additional participants were excluded due to incomplete dietary records or questionnaires, and six could not be contacted at the two-week follow-up. All analyses presented in this study were conducted based on data obtained from these 52 participants. Baseline characteristics of the participants are presented in Table 1. All were male, newly ordained Dhammayut Buddhist monks with a mean age of 30.03 ± 1.13 years and a mean body mass index (BMI) of 26.70 ± 0.46 kg/m². The majority held a bachelor’s degree, and approximately 21% reported having at least one underlying health condition, such as hypertension, diabetes, or other chronic illnesses. Dietary intake Table 2 illustrates the longitudinal changes in dietary parameters among Thai monks measured at baseline (pre-ordination) and during the subsequent two weeks post-ordination. Total energy intake, carbohydrate intake, and fat intake showed no statistically significant differences throughout the observation period ( p > 0.05). However, Significant alterations were observed in specific macronutrient composition. Protein intake decreased significantly from baseline (79.96 ± 9.85 g) to week 1 (60.90 ± 6.77 g; p = 0.009) and week 2 (62.50 ± 6.37 g; p = 0.005) post-ordination, representing 23.83% and 21.84% reductions, respectively. While protein intake declined significantly, a concurrent and substantial increase in sugar consumption was observed, reflecting a notable shift in the types of foods consumed during the ordination period, likely influenced by the nature of alms-based offerings. Sugar consumption exhibited a significant and substantial increase from baseline (34.60 ± 4.91 g) to week 1 (67.96 ± 11.60 g; p = 0.008) and week 2 (69.85 ± 9.46 g; p < 0.001), corresponding to 96.42% and 101.88% elevations, respectively. Dietary fiber intake demonstrated progressive enhancement, significant increase from baseline (5.07 ± 0.60 g) to week 1 (6.84 ± 0.77 g; p = 0.025) and week 2 (8.32 ± 0.76 g; p < 0.001), reflecting 34.91% and 64.10% increments, respectively. Analysis of variance revealed significant interaction effects between treatment and time ( p < 0.05) for all three parameters exhibiting statistically significant changes (protein, sugar, B ody composition The effects of ordination on body composition parameters in Thai monks is displayed in Table 3. The results demonstrated statistically significant reductions in several anthropometric parameters between baseline and two weeks post-ordination. Body weight significantly decreased from 80.98 ± 1.69 kg at baseline to 80.42 ± 1.75 kg at week 2 ( p < 0.001). Similarly, BMI showed a significant reduction from 26.70 ± 0.46 kg/m² at baseline to 26.47 ± 0.48 kg/m² at week 2 ( p < 0.001). The most notable anthropometric changes were observed in waist and hip circumferences, which significantly decreased from 96.17 ± 1.43 cm at baseline to 91.47 ± 1.39 cm at week 2 ( p < 0.001), and hip circumference, which significantly reduced from 101.98 ± 1.19 cm at baseline to 98.99 ± 1.12 cm at week 2 ( p < 0.001). Consequently, waist-to-hip ratio demonstrated a significant decrease from 0.94 ± 0.01 at baseline to 0.92 ± 0.01 at week 2 ( p = 0.008). Muscle mass also showed significant reduction from 58.29 ± 0.87 at baseline to 57.27 ± 0.82 at week 2 ( p = 0.01). In contrast, percentage of body fat exhibited a no significant increase from 23.51 ± 0.74% at baseline to 24.18 ± 0.65% at week 2 ( p = 0.104), and visceral fat level remained relatively stable (11.20 ± 0.44 at baseline versus 11.06 ± 0.44 at week 2, p = 0.532). Sleep quality The effects of ordination on sleep quality parameters in Thai monks as assessed by the Pittsburgh Sleep Quality Index (PSQI), with scores greater than 5 generally indicating poor sleep quality (Buysse et al., 1989) (Table 4). Following 2 weeks of ordination, the global PSQI score showed a statistically significant reduced from 6.88 ± 0.41 at baseline to 6.10 ± 0.33 at week 2 ( p = 0.046). Analysis of individual PSQI components revealed significant improvements in several parameters when compared between baseline and 2 weeks post-ordination. Overall subjective sleep quality significantly improved, with scores decreasing from 1.23 ± 0.09 at baseline to 0.96 ± 0.09 at week 2 ( p = 0.029). Sleep latency showed the most notable improvement, significantly decreasing from 1.38 ± 0.13 to 0.90 ± 0.13 ( p < 0.001). Sleep duration scores significant increase from 1.10 ± 0.12 at baseline to 1.42 ± 0.10 at week 2 ( p = 0.023). No significant trends toward improvement were observed in sleep disturbances, which decreased from 1.31 ± 0.08 at baseline to 1.17 ± 0.07 at week 2 ( p = 0.070). Sleep efficiency showed a no significant change from 0.52 ± 0.14 at baseline to 0.35 ± 0.09 at week 2 ( p = 0.201), while use of sleeping medication remained unchanged (0.15 ± 0.07 at baseline versus 0.15 ± 0.08 at week 2, p = 1.000). Daytime dysfunction also shows no significant increase from 1.13 ± 0.10 at baseline to 1.15 ± 0.10 at week 2 ( p = 0.881). Discussion Despite unchanged total energy, carbohydrate, and fat intake throughout the ordination period, meaningful shifts in macronutrient composition were observed (Table 2 ). Protein intake declined significantly in the first week and remained consistently lower in the second week, representing a reduction of over 20 percent from baseline. This decline is likely attributable to the traditional alms based dietary system, which tends to emphasize carbohydrate rich foods such as rice and sweets, while offering limited quantities of high quality protein sources. Such dietary patterns are consistent with previous studies on monastic food practices in Thailand [ 23 , 24 , 25 ]. Although reduced, average protein intake remained comparable to that of overweight Thai men [ 26 ] and exceeded levels reported in Indian Buddhist monks [ 16 ]. Nevertheless, it fell short of the recommended intake (1.2 g/kg/day) required to preserve lean body mass during periods of restricted physical activity or intermittent fasting [ 27 ], potentially contributing to the observed decline in muscle mass. In contrast, sugar intake nearly doubled by the second week, a trend consistent with prior findings of high sugar consumption among urban monks, often driven by sweetened beverages and desserts received through food offerings [ 23 , 16 ]. While such intake may increase glycemic load and metabolic risk over time, this trend was accompanied by a significant increase in dietary fiber, possibly reflecting greater fruit and vegetable consumption. The nearly twofold increase in sugar intake during ordination is concerning, particularly given the associated risks of increased glycemic load and metabolic dysfunction over time. As monks are reliant on alms offerings and cannot selectively choose their foods, interventions at the community level such as encouraging healthier offerings including fruits, whole grains, and less processed sweets could represent a culturally sensitive strategy to mitigate this nutritional imbalance. Although fiber intake remained below recommended levels [ 28 ], the observed upward trajectory parallels findings from time restricted eating interventions, where improvements in diet quality are often mediated by circadian alignment and reduced evening intake [ 29 ]. Taken together, these findings highlight both the strengths and limitations of the alms based dietary model. The structured eating window imposed by Buddhist monastic practice aligns with core principles of time restricted eating and may naturally facilitate improvements in diet quality. However, imbalances such as insufficient protein and elevated sugar intake should be addressed if monastic dietary patterns are to serve as a practical model for promoting metabolic health. By the end of the two week period, participants exhibited statistically significant reductions in body weight and BMI, with more pronounced decreases in waist and hip circumferences. Waist circumference decreased by approximately 4.9 percent and hip circumference by 2.9 percent, contributing to an improved waist to hip ratio. These changes are particularly relevant to metabolic health, given the well-established association between central adiposity and cardiometabolic risk. Importantly, a reduction of approximately 5 percent in waist circumference is considered clinically meaningful, as increased waist circumference has been linked to greater cardiovascular disease specific mortality in dose response meta-analyses [ 30 ]. Thus, the observed improvements in central adiposity during ordination may not only represent early anthropometric changes but also signal potential longer-term benefits in reducing cardiometabolic and cardiovascular disease risks. Interestingly, no significant changes were observed in visceral fat levels or percent body fat. This may be due to the short duration of the study and the inherent limitations of bioelectrical impedance analysis in detecting small changes in adiposity over brief intervals [ 31 ]. Nevertheless, reductions in waist and hip circumference suggest early improvements in abdominal fat distribution. A modest but statistically significant decline in muscle mass was also observed, likely resulting from the combination of reduced protein intake and decreased physical activity during the ordination period. Monastic routines involve periods of walking and chanting but are largely sedentary compared to preordination lifestyles [ 16 , 14 ]. The muscle loss observed, approximately 1.8 percent, raises concerns about nutritional adequacy and underscores the importance of ensuring sufficient protein intake, even during short-term fasting or lifestyle transitions. Although a modest decline in muscle mass was observed, it is important to note that short term muscle mass reductions may not have long term clinical implications if physical activity levels and nutritional intake are adequately restored following ordination. Future longitudinal studies are warranted to track the recovery of muscle mass and functional capacity after ordination, ensuring a comprehensive understanding of the health impacts of temporary lifestyle changes. These findings are consistent with previous time restricted eating trials reporting 1 to 3 percent reductions in body weight over periods ranging from 2 to 16 weeks [ 32 , 33 ]. Our data suggest that the Buddhist ordination framework may offer a naturalistic and culturally grounded model of time restricted eating that produces measurable improvements in body composition, particularly in abdominal fat, even over a short period. Contrary to expectations, sleep quality improved following ordination despite a more demanding daily schedule. The global PSQI score decreased significantly, with the greatest improvements observed in sleep latency and subjective sleep quality. Participants reported falling asleep more quickly and feeling more rested, despite no significant changes in total sleep duration or efficiency. Several mechanisms may explain these improvements. The structured routine of monastic life promotes consistent sleep wake cycles, which has been shown to enhance circadian alignment and sleep quality [ 34 , 35 ]. Moreover, early morning light exposure during alms collection may strengthen circadian entrainment, thereby reducing sleep latency [ 31 ]. Although sleep duration did not increase, the perception of improved restfulness suggests enhanced sleep architecture, possibly driven by increased time spent in restorative slow wave sleep [ 36 ]. Emerging evidence also links time restricted eating to improved sleep regulation through metabolic pathways. Restricting food intake to early daytime hours may optimize circadian hormone secretion, including melatonin, which is critical for sleep initiation and maintenance [ 6 , 37 ]. The combined effect of time restricted eating patterns and structured daily routines may thus synergistically contribute to improvements in sleep health. Given the established association between sleep quality and weight regulation [ 5 , 38 , 39 ], these results provide further support for the potential of Buddhist ordination to function as a culturally embedded lifestyle intervention with multidimensional health benefits. Beyond the structured routines of monastic life, the spiritual discipline inherent in Buddhist ordination, including practices such as mindfulness, reduced material attachment, and meditative focus, may have contributed to improved stress management and sleep quality. Spiritual motivations may foster greater emotional regulation, adherence to healthy behaviors, and resilience during the adaptation to new daily routines. These intrinsic factors could have synergistically enhanced the physiological benefits observed during the ordination period. Buddhist ordination may provide a culturally embedded model for metabolic health promotion through structured routines and time restricted eating. Short term ordination was associated with improvements in dietary composition, central adiposity, and sleep quality. These findings suggest that integrating spiritual practices into health interventions could enhance holistic outcomes. Monastic living, given its cultural acceptance and accessibility, offers valuable insights for developing structured interventions beyond monastic settings. By fostering physical, psychological, and spiritual well-being, Buddhist ordination presents a comprehensive framework for culturally grounded health promotion. Methods Study Design A prospective observational study was conducted between January and May 2024 at Wat Bowaniwet Wihan Ratchaworawihan, a Dhammayut Buddhist temple in Bangkok, Thailand. The study was designed to capture physiological changes during the early phase of ordination, a period characterized by substantial lifestyle transitions. Participants were assessed at three key time points: baseline (first day of ordination), after one week, and after two weeks (final week of ordination). At baseline, participants maintained their regular lifestyles, including their typical diet, sleep schedule, and physical activity patterns until ordination. During ordination, participants adopted monastic routines as dictated by Buddhist disciplinary codes, including pre-noon food consumption, increased sedentary activity (meditation and chanting), and structured sleep-wake schedules. The duration of the study was set at two weeks, aligning with the minimum period of monastic ordination commonly practiced in Thai Buddhism. According to temple tradition, newly ordained monks must remain in the monastic order for at least two weeks before disrobing ("suek"). This provided a natural and culturally defined timeframe for data collection, ensuring that all participants were observed under consistent monastic conditions from ordination to the point of potential disrobing. Importantly, participants were permitted to consume unrestricted quantities and types of food and beverages offered through alms during the eating window, reflecting real-world monastic practice. Researchers did not interfere with dietary choices to preserve ecological validity but provided telephone access for any study-related questions. The design aimed to evaluate how these organically structured routines affect dietary patterns, anthropometry, and sleep in a short timeframe. In addition, the study protocol received approval from the Ethics Review Committee for Research Involving Human Research Subjects, Human Science Group, Chulalongkorn University (COA No. 013/67), adhering to the Declaration of Helsinki guidelines. Before enrollment, all participants provided written informed consent, and their information was maintained with strict confidentiality. Sample Size Calculation The sample size was determined based on the 0.05 level of significance (α), 80% power, effect size (0.44), using the BMI of obese men that enrolled in TRE protocol from the previous study [ 18 ]. Using this as the total population and considering an estimated drop-out rate of 30%, a target sample of at least 56 participants was set to ensure adequate statistical power to detect meaningful changes in dietary intake, body composition, and sleep parameters over time. A total of 52 participants completed the full study protocol. Participants Fifty-two newly ordained Dhammayut Buddhist monks were recruited from Wat Bowaniwet Wihan Ratchaworawihan, Bangkok. Inclusion criteria were adults aged 20 years or older, with a BMI greater than 22.9 kg/m² [ 19 ], willingness to undergo ordination for at least two weeks, fluency in Thai, and agreement to participate in the study. Exclusion criteria included early withdrawal from monkhood before the two-week period or incomplete data on questionnaires, dietary records, or body composition measurements. Outcome Measurements The primary outcome of the study was body weight, as a sensitive and direct marker of short-term physiological change. Secondary outcomes included other components of body composition and dietary intake. Secondary outcomes included sleep quality parameters such as sleep timing, duration, onset latency, efficiency, disturbances, use of sleep medications, and daytime functioning. Dietary Intake At baseline, participants received standardized training from registered dietitians on how to accurately record food and beverage consumption. The training utilized visual aids, food models, and standard household measuring tools (e.g., cups, spoons, and bowls) to enhance portion size estimation and recording accuracy. Each participant was provided with a structured food recording handbook and was instructed to complete a 3-day dietary record each week, covering two weekdays and one weekend day. In addition, a 24-hour dietary recall interview was conducted at baseline to capture dietary intake prior to ordination. This recall was administered by registered dietitian to ensure accuracy and minimize recall bias. All dietary records and recall data were reviewed for completeness and consistency before analysis. Nutrient intake—including total energy, macronutrients, dietary fiber, and sugar—was analyzed using the INMUCAL-Nutrients software (version 4.0), developed by the Institute of Nutrition, Mahidol University, Thailand, which is based on a validated Thai food composition database. Body Composition Assessments were conducted in the early morning, prior to breakfast, at two time points: baseline (the day of ordination) and after two weeks of monastic life. Participants wore light clothing and removed any metallic items or accessories to minimize measurement variability. Body composition parameters, including body weight, body mass index (BMI), body fat percentage, visceral fat level, and muscle mass, were measured using a validated bioelectrical impedance analysis (BIA) device (TANITA BC-401, Tokyo, Japan). Waist and hip circumferences were measured using a non-elastic measuring tape. Waist circumference was recorded at the midpoint between the lowest palpable rib and the superior border of the iliac crest, while hip circumference was measured at the widest point of the buttocks. To ensure consistency and cultural appropriateness, all anthropometric measurements were performed by trained male researchers, adhering to Buddhist monastic discipline [ 20 ]. The same equipment and standardized protocols were applied across both time points to minimize inter-rater and device variability. Sleep Quality Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI) [ 21 ], a validated and widely used instrument for evaluating subjective sleep characteristics. The PSQI was administered at two time points: baseline (pre-ordination) and at the end of the second week of ordination. The instrument includes 19 self-rated questions grouped into seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction. Each component is scored from 0 to 3, with higher scores indicating greater impairment. These scores are summed to yield a global PSQI score ranging from 0 to 21. A global score greater than 5 is indicative of poor sleep quality. Sleep onset latency, one of the key subcomponents, was also specifically evaluated, with scores interpreted as follows: 0 = no difficulty falling asleep, 1 = mild difficulty, 2 = moderate difficulty, 3 = severe difficulty. Participants completed the questionnaire independently, with support provided by the research team when needed to ensure accuracy and completeness. All responses were reviewed for consistency immediately after collection. Statistical Analysis Data were presented as mean ± standard error of the mean (SEM), while categorical variables such as education level and underlying disease were expressed as counts and percentages. Normality of distribution for key variables was tested using the Kolmogorov–Smirnov test. Paired samples t -tests were used to assess changes between time points. Repeated measures ANOVA was used to examine the effects of treatment, time, and interaction terms. A P -value < 0.05 was considered statistically significant. Statistical analyses were performed using IBM SPSS Statistics (version 22.0; SPSS Inc., USA). Strengths and Limitations This study is the first prospective investigation to assess short term physiological adaptations to Buddhist ordination, simultaneously evaluating changes in dietary intake, body composition, and sleep quality. The use of validated instruments, repeated measures, and a naturalistic monastic setting enhances both internal validity and real-world applicability. However, the short observation period limits generalizability to long term outcomes. Dietary intake was self-reported, introducing potential recall bias despite standardized procedures. Waist circumference measurements were taken at non-standardized anatomical landmarks, and the absence of biochemical data precludes assessment of metabolic or hormonal responses. Additionally, cultural factors inherent to Buddhist ordination must be acknowledged. Because monks are dependent on the food provided by laypeople during alms collection, they have limited control over the quality and macronutrient composition of their diet. This contextual limitation may influence the nutritional outcomes observed and should be considered when interpreting the findings and designing future intervention studies. Conclusion This two-week study demonstrated that Buddhist ordination, as a natural model of time-restricted eating, led to significant improvements in dietary intake, body composition, and sleep quality. Reductions in protein intake and increases in sugar and fiber reflected shifts in alms based dietary patterns. Anthropometric measures improved, particularly in central adiposity, although muscle mass declined. Sleep quality also improved, especially in latency and subjective restfulness. These findings highlight the potential of short-term monastic practice as a culturally relevant framework for promoting holistic health. Declarations Competing interests The authors declare that they have no conflict of interest related to the content of this manuscript. Ethical declarations The study protocol was approved by the office of Ethics Review Committee for Research Involving Human Research Subjects, Human Science Group, Chulalongkorn University (COA No. 013/67) in accordance with the Declaration of Helsinki. Consent to participate All participants provided written informed consent before enrolling in the study, and all participant information was kept confidential. Author Contribution P.S. contributed to conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, visualization, and writing—both original draft preparation and review/editing. P.R. contributed to conceptualization, project administration, investigation, and resources. C.C. contributed to methodology, investigation, resources, and reviewing/editing. T.K. and K.K. participated in investigation, resources, and reviewing/editing. S.A. contributed to conceptualization, methodology, project administration, funding acquisition, and reviewing/editing. All authors read and approved the final version of the manuscript. Acknowledgement The authors are grateful to all participants for their time. This project is funded by National Research Council of Thailand (NRCT): N42A680622 and the Faculty of Allied Health Sciences Endowment Fund Chulalongkorn University. Data Availability "The data presented in this study are available on reasonable request from the corresponding author." References World Health Organization. WHO acceleration plan to stop obesity (World Health Organization, 2023). Blüher, M. & Obesity Global epidemiology and pathogenesis. Nat. Rev. Endocrinol. 15 , 288–298. 10.1038/s41574-019-0176-8 (2019). Tremmel, M., Gerdtham, U. G., Nilsson, P. M. & Saha, S. Economic burden of obesity: A systematic literature review. Int. J. 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Health survey of monks residing in urban areas: The Bangkok Noi model. Siriraj Med. J. 76 , 746–757. 10.33192/smj.v76i11.269296 (2024). Srimantayamas, V., Fongkaew, W., Suksatit, B., Aree, P. & Kosachunhanun, N. Health behaviors and health-related quality of life among Buddhist monks with metabolic syndrome. Pac. Rim Int. J. Nurs. Res. 24 , 159–171 (2020). Ivanovitch, K., Klaewkla, J., Chongsuwat, R., Viwatwongkasem, C. & Kitvorapat, W. The intake of energy and selected nutrients by Thai urban sedentary workers: An evaluation of adherence to dietary recommendations. J. Nutr. Metab . 145182; (2014). 10.1155/2014/145182 : (2014). Pasiakos, S. M., Margolis, L. M. & Orr, J. S. Optimized dietary strategies to protect skeletal muscle mass during periods of unavoidable energy deficit. FASEB J. 29 , 1136–1142. 10.1096/fj.14-266890 (2015). Stephen, A. M. et al. Dietary fibre in Europe: Current state of knowledge on definitions, sources, recommendations, intakes and relationships to health. Nutr. Res. Rev. 30 , 149–190. 10.1017/S095442241700004X (2017). Mengi Çelik, Ö., Köksal, E. & Aktürk, M. Time-restricted eating (16/8) and energy-restricted diet: Effects on diet quality, body composition and biochemical parameters in healthy overweight females. BMC Nutr. 9 , 97. 10.1186/s40795-023-00753-6 (2023). Wang, L. et al. Associations of obesity indices change with cardiovascular outcomes: A dose-response meta-analysis. Int. J. Obes. 48 , 635–645. 10.1038/s41366-024-01485-8 (2024). He, M., Ru, T., Li, S., Li, Y. & Zhou, G. Shine light on sleep: Morning bright light improves nocturnal sleep and next morning alertness among college students. J. Sleep. Res. 32 , e13724. 10.1111/jsr.13724 (2023). Hutchison, A. T. et al. Time-restricted feeding improves glucose tolerance in men at risk for type 2 diabetes: A randomized crossover trial. Obesity 27 , 724–732. 10.1002/oby.22449 (2019). Nematy, M. et al. Effects of Ramadan fasting on cardiovascular risk factors: A prospective observational study. Nutr. J. 11 , 1–7. 10.1186/1475-2891-11-69 (2012). Cappuccio, F., Miller, M. A. & Lockley, S. W. Sleep, Health, and Society: From Aetiology to Public Health (Oxford University Press, 2010). Phillips, A. J. et al. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Sci. Rep. 7 10.1038/s41598-017-03171-4 (2017). Baron, K. G., Reid, K. J., Kern, A. S. & Zee, P. C. Role of sleep timing in caloric intake and BMI. Obesity 19 , 1374–1381. 10.1038/oby.2011.100 (2011). Charlot, A., Hutt, F., Sabatier, E. & Zoll, J. Beneficial effects of early time-restricted feeding on metabolic diseases: Importance of aligning food habits with the circadian clock. Nutrients 13 , 1405. 10.3390/nu13051405 (2021). Knowlden, A. P., Ottati, M., McCallum, M. & Allegrante, J. P. The relationship between sleep quantity, sleep quality and weight loss in adults: a scoping review. Clin. Obes. 14 , e12634. 10.1111/cob.12634 (2024). Leger, D., Bayon, V. & de Sanctis, A. The role of sleep in the regulation of body weight. Mol. Cell. Endocrinol. 418 , 101–107. 10.1016/j.mce.2015.06.030 (2015). Tables Participant characteristics Values Age (years) BMI (kg/m 2 ) Education level -Bachelor degree - Master degree - Ph.D. - Others Underlying diseases -No underlying disease -Hypertension -Diabetes mellitus -Heart disease -Others (Ex. Gerd and allergy) 30.03 ± 1.13 26.70 ± 0.46 39 (75.00%) 12 (23.08%) 1 (1.92%) 0 (0.00%) 41 (78.85%) 3 (5.77%) 2 (3.84%) 0 (0.00%) 6 (11.54%) Table 1. Baseline Characteristics of Participants. Results for continuous variables (age, body mass index, and ordination duration) are presented as mean ± Standard Error of the Mean (SEM), n =52. Categorical variables (education level and underlying diseases) are reported as frequencies and percentages. Parameters Before ordination 1 week ordination 2 weeks ordination P- value a Total energy (kcal) Carbohydrate (g) Fat (g) Protein (g) Sugar (g) Dietary fiber (g) 1,954.69 ± 221.90 145.00 ± 13.80 65.45 ± 6.88 79.96 ± 9.85 34.60 ± 4.91 5.07 ± 0.60 1,662.19 ± 97.14 152.42 ± 14.09 59.75 ± 5.75 60.90 ± 6.77* 67.96 ± 11.60* 6.84 ± 0.77* 1,739.46 ± 108.15 162.25 ± 17.17 63.29 ± 5.61 62.50 ± 6.37* 69.85 ± 9.46* 8.32 ± 0.76* 0.259 0.286 0.582 0.005 0.008 <0.001 Table 2. Changes in Dietary Intake Before and During Ordination in Thai Monks. Results are presented as mean ± Standard Error of the Mean (SEM), n =52. * indicates a statistically significant difference compared to baseline (before ordination), with P -value < 0.05. ᵃ P -value represents the significance of the interaction effect between time and treatment, assessed using repeated measures ANOVA. Parameters Before ordination 2 weeks ordination P- value Body weight (kg) 80.98 ± 1.69 80.42 ±1.75* <0.001 BMI (kg/m 2 ) 26.70 ± 0.46 26.47 ± 0.48* <0.001 Waist circumference (cm) 96.17 ± 1.43 91.47 ± 1.39* <0.001 Hip circumference (cm) 101.98 ± 1.19 98.99 ± 1.12* <0.001 Waist to hip ratio 0.94 ± 0.01 0.92 ± 0.01* 0.008 % Fat 23.51 ± 0.74 24.18 ± 0.65 0.104 Visceral fat level 11.20 ± 0.44 11.06 ± 0.44 0.532 Muscle mass 58.29 ± 0.87 57.27 ± 0.82* 0.01 Table 3. Changes in Body Composition Before and After Two Weeks of Ordination in Thai Monks. Results are presented as mean ± Standard Error of the Mean (SEM), n =52. * indicates a statistically significant difference compared to baseline (before ordination), with P- value < 0.05 based on paired samples t -test. Parameters Before ordination 2 weeks ordination P- value Sleep quality 1.23 ± 0.09 0.96 ± 0.09* 0.029 Sleep latency 1.38 ± 0.13 0.90 ± 0.13* <0.001 Sleep duration 1.10 ± 0.12 1.42 ± 0.10* 0.023 Sleep efficiency 0.52 ± 0.14 0.35 ± 0.09 0.201 Sleep disturbances 1.31 ± 0.08 1.17 ± 0.07 0.070 Use of sleeping medication 0.15 ± 0.07 0.15 ± 0.08 1.000 Daytime dysfunction 1.13 ± 0.10 1.15 ± 0.10 0.881 PSQI score 6.88 ± 0.41 6.10 ± 0.33* 0.046 Table 4. Changes in Sleep Quality Before and After Two Weeks of Ordination in Thai Monks. Results are presented as mean ± Standard Error of the Mean (SEM), n =52. * indicates a statistically significant difference compared to baseline (before ordination), with P- value < 0.05 based on paired samples t -test. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6629740","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":469209255,"identity":"eb212329-1fb0-4f18-8901-7e7210935b90","order_by":0,"name":"Phrarajvarjirayanamethi Chatchai Moosan","email":"","orcid":"","institution":"Mahamakut Buddhist University","correspondingAuthor":false,"prefix":"","firstName":"Phrarajvarjirayanamethi","middleName":"Chatchai","lastName":"Moosan","suffix":""},{"id":469209256,"identity":"2c7b85a3-c529-45da-8acc-6542dd295fc9","order_by":1,"name":"Phim on Suklaew","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAnklEQVRIiWNgGAWjYBAC+xmMDWAGPw+QgLLxA4MbUGWSPUDiIHFaYIwzRGu53dy64eMOBnvjM2cMmIEMwsB+zsG2mzPPMCRuO9tjwHDwDDG2SCS23eZtY0gwO88D1NJGghZ7435StTBu4O0hQcvNmW0SiTPOHCs4cJY4LenPbnxss7Hn70ne+KCSGC1QIAEmDxCvYRSMglEwCkYBXgAA5fE6np51Gh8AAAAASUVORK5CYII=","orcid":"","institution":"Kasetsart University","correspondingAuthor":true,"prefix":"","firstName":"Phim","middleName":"on","lastName":"Suklaew","suffix":""},{"id":469209257,"identity":"d17a2c23-8ee3-4a08-9a1c-3bceef046128","order_by":2,"name":"Charoonsri Chusak","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Charoonsri","middleName":"","lastName":"Chusak","suffix":""},{"id":469209259,"identity":"0b9414e9-03e6-458f-a927-d3e0f8c6c610","order_by":3,"name":"Thanaporn Kaewpradup","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Thanaporn","middleName":"","lastName":"Kaewpradup","suffix":""},{"id":469209262,"identity":"5ed1a243-54e5-4075-a252-ad900a38df04","order_by":4,"name":"Kritmongkhon Kamonsuwan","email":"","orcid":"","institution":"Dhurakij Pundit University","correspondingAuthor":false,"prefix":"","firstName":"Kritmongkhon","middleName":"","lastName":"Kamonsuwan","suffix":""},{"id":469209264,"identity":"9c82e0f9-6f79-4b3c-b18a-80df54e94d74","order_by":5,"name":"Sirichai Adisakwattana","email":"","orcid":"","institution":"Chulalongkorn University","correspondingAuthor":false,"prefix":"","firstName":"Sirichai","middleName":"","lastName":"Adisakwattana","suffix":""}],"badges":[],"createdAt":"2025-05-09 14:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6629740/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6629740/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-025-11309-y","type":"published","date":"2025-07-14T15:57:10+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":84448503,"identity":"22eff7e4-4626-4595-98d4-dbd0a9c6617b","added_by":"auto","created_at":"2025-06-12 06:21:55","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":75740,"visible":true,"origin":"","legend":"\u003cp\u003eParticipants flow.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6629740/v1/3501864b42cdcb6bb2463226.jpeg"},{"id":87219317,"identity":"69367f8c-c8b5-4b0b-a48e-102d06fe638d","added_by":"auto","created_at":"2025-07-21 16:03:19","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":895689,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6629740/v1/29307a23-7a5a-4d17-899f-2d7e85d1c547.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Buddhist Ordination as a Culturally Embedded Model for Improving Diet, Body Composition, and Sleep Quality in Overweight and Obese Adults","fulltext":[{"header":"Introduction","content":"\u003cp\u003eObesity poses a major global health burden, with prevalence steadily rising across diverse populations. Current estimates suggest that more than 650\u0026nbsp;million adults, approximately 13% of the global population, are classified as obese [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. This condition is associated with increased risk of noncommunicable diseases such as type 2 diabetes, cardiovascular disorders, and certain cancers, while also diminishing quality of life and elevating healthcare costs [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The multifactorial nature of obesity, encompassing genetic, behavioral, and environmental contributors, demands multifaceted interventions that extend beyond traditional calorie focused approaches. This has prompted interest in lifestyle-based strategies, particularly those aligned with cultural and religious practices, as potentially sustainable models for metabolic health. Spiritual traditions, which emphasize mindfulness, intentional living, and self-discipline, may offer unique frameworks for influencing behavioral and physiological health outcomes.\u003c/p\u003e \u003cp\u003eConventional strategies for managing obesity typically emphasize achieving a negative energy balance through increased physical activity and reduced caloric intake [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, emerging evidence highlights the importance of the timing and frequency of food consumption as independent modulators of metabolic health [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Meal timing influences circadian rhythms, hormonal regulation, and energy homeostasis, thereby affecting body composition and disease risk [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In this context, time-restricted eating (TRE), which limits food intake to a defined window of 4 to 12 hours per day without necessarily altering caloric content, has demonstrated promising health outcomes [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Clinical studies have reported improvements in insulin sensitivity, reductions in inflammation, and modest weight loss even in the absence of intentional calorie restriction [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Notably, short term TRE interventions (2 to 4 weeks) have been shown to induce rapid metabolic and anthropometric changes [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. These findings support the potential of TRE as a simple yet powerful tool to synchronize metabolic processes with the body's internal clock.\u003c/p\u003e \u003cp\u003eBuddhist monastic practices, particularly within the Dhammayut tradition of Thai Buddhism, inherently reflect a form of TRE while simultaneously promoting spiritual development through mindfulness, discipline (Vinaya), and detachment from material desires. Monks in this order typically consume two meals per day between dawn and noon, effectively maintaining an 18 to 19 hour fasting period that closely parallels modern TRE protocols [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. However, distinctions remain while modern TRE generally limits intake during fasting periods to water alone, Buddhist traditions often allow herbal teas, clear fruit juices, and medicinal tonics such as honey or ghee [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Nonetheless, the core principle of confining caloric intake to a defined time window remains consistent with TRE principles [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Unlike voluntary TRE in free living populations, monastic practices enforce these dietary patterns through religious discipline, creating a naturally adherent environment ideal for studying metabolic effects. Furthermore, monks typically consume mixed meals provided by laypeople during alms rounds, minimizing personal food selection and reducing variability in dietary behavior.\u003c/p\u003e \u003cp\u003eIn addition to dietary changes, ordination introduces shifts in physical activity and sleep routines. Monastic life emphasizes meditative and ceremonial practices, typically involving reduced physical exertion [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Sleep patterns also undergo significant changes, with monks rising at 4:00 AM and concluding evening practices around 8:00 to 9:00 PM [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Such structured routines may initially disrupt circadian alignment and impact sleep quality during the adaptation phase [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. However, the predictability and consistency of the monastic schedule may ultimately support circadian stability, contrasting with the irregular routines observed in modern lifestyles. These characteristics make Buddhist ordination a compelling model for studying lifestyle induced physiological changes. Furthermore, the spiritual motivations underpinning ordination may foster intrinsic commitment to behavioral changes, enhancing adherence and potentially amplifying health benefits.\u003c/p\u003e \u003cp\u003eDespite the conceptual parallels between monastic discipline and therapeutic fasting, there is a limited understanding of the physiological and spiritual adaptations that occur during the early phase of ordination. Newly ordained monks provide a unique opportunity to observe rapid health-related changes in a controlled lifestyle shift rooted in religious discipline. This population is ideal for investigating the short-term impacts of a highly structured routine involving dietary, physical, spiritual, and sleep modifications in a real-world yet regimented setting. This study aimed to examine the short-term effects of Buddhist ordination on dietary intake, body composition, and sleep quality among newly ordained Thai Dhammayut monks. We hypothesized that this spiritually structured lifestyle transition would lead to measurable improvements in body composition, dietary quality, and sleep parameters during the early adaptation phase.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eSeventy-four individuals were initially screened for eligibility (Figure. 1). Of these, eight were excluded before baseline assessment—five did not meet the inclusion criteria, and three declined participations. During the first week of ordination, five participants withdrew after relocating to other temples. Nine additional participants were excluded due to incomplete dietary records or questionnaires, and six could not be contacted at the two-week follow-up. All analyses presented in this study were conducted based on data obtained from these 52 participants.\u003c/p\u003e\n\u003cp\u003eBaseline characteristics of the participants are presented in Table 1. All were male, newly ordained Dhammayut Buddhist monks with a mean age of 30.03 ± 1.13 years and a mean body mass index (BMI) of 26.70 ± 0.46 kg/m². The majority held a bachelor’s degree, and approximately 21% reported having at least one underlying health condition, such as hypertension, diabetes, or other chronic illnesses.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDietary intake\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable 2 illustrates the longitudinal changes in dietary parameters among Thai monks measured at baseline (pre-ordination) and during the subsequent two weeks post-ordination. Total energy intake, carbohydrate intake, and fat intake showed no statistically significant differences throughout the observation period (\u003cem\u003ep\u003c/em\u003e \u0026gt; 0.05). However, Significant alterations were observed in specific macronutrient composition. Protein intake decreased significantly from baseline (79.96 ± 9.85 g) to week 1 (60.90 ± 6.77 g; \u003cem\u003ep\u003c/em\u003e = 0.009) and week 2 (62.50 ± 6.37 g; \u003cem\u003ep\u003c/em\u003e = 0.005) post-ordination, representing 23.83% and 21.84% reductions, respectively. While protein intake declined significantly, a concurrent and substantial increase in sugar consumption was observed, reflecting a notable shift in the types of foods consumed during the ordination period, likely influenced by the nature of alms-based offerings. Sugar consumption exhibited a significant and substantial increase from baseline (34.60 ± 4.91 g) to week 1 (67.96 ± 11.60 g; \u003cem\u003ep\u003c/em\u003e = 0.008) and week 2 (69.85 ± 9.46 g; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), corresponding to 96.42% and 101.88% elevations, respectively. Dietary fiber intake demonstrated progressive enhancement, significant increase from baseline (5.07 ± 0.60 g) to week 1 (6.84 ± 0.77 g; \u003cem\u003ep\u003c/em\u003e = 0.025) and week 2 (8.32 ± 0.76 g; \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001), reflecting 34.91% and 64.10% increments, respectively. Analysis of variance revealed significant interaction effects between treatment and time (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05) for all three parameters exhibiting statistically significant changes (protein, sugar,\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003cstrong\u003eody composition\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe effects of ordination on body composition parameters in Thai monks is displayed in Table 3. The results demonstrated statistically significant reductions in several anthropometric parameters between baseline and two weeks post-ordination. Body weight significantly decreased from 80.98 ± 1.69 kg at baseline to 80.42 ± 1.75 kg at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001). Similarly, BMI showed a significant reduction from 26.70 ± 0.46 kg/m² at baseline to 26.47 ± 0.48 kg/m² at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001). The most notable anthropometric changes were observed in waist and hip circumferences, which significantly decreased from 96.17 ± 1.43 cm at baseline to 91.47 ± 1.39 cm at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001), and hip circumference, which significantly reduced from 101.98 ± 1.19 cm at baseline to 98.99 ± 1.12 cm at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.001). Consequently, waist-to-hip ratio demonstrated a significant decrease from 0.94 ± 0.01 at baseline to 0.92 ± 0.01 at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= 0.008). Muscle mass also showed significant reduction from 58.29 ± 0.87 at baseline to 57.27 ± 0.82 at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= 0.01). In contrast, percentage of body fat exhibited a no significant increase from 23.51 ± 0.74% at baseline to 24.18 ± 0.65% at week 2 (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e= 0.104), and visceral fat level remained relatively stable (11.20 ± 0.44 at baseline versus 11.06 ± 0.44 at week 2, \u003cem\u003ep\u0026nbsp;\u003c/em\u003e= 0.532).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSleep quality\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe effects of ordination on sleep quality parameters in Thai monks as assessed by the Pittsburgh Sleep Quality Index (PSQI), with scores greater than 5 generally indicating poor sleep quality (Buysse et al., 1989) (Table 4). Following 2 weeks of ordination, the global PSQI score showed a statistically significant reduced from 6.88 ± 0.41 at baseline to 6.10 ± 0.33 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.046). Analysis of individual PSQI components revealed significant improvements in several parameters when compared between baseline and 2 weeks post-ordination. Overall subjective sleep quality significantly improved, with scores decreasing from 1.23 ± 0.09 at baseline to 0.96 ± 0.09 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.029). Sleep latency showed the most notable improvement, significantly decreasing from 1.38 ± 0.13 to 0.90 ± 0.13 (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). Sleep duration scores significant increase from 1.10 ± 0.12 at baseline to 1.42 ± 0.10 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.023). No significant trends toward improvement were observed in sleep disturbances, which decreased from 1.31 ± 0.08 at baseline to 1.17 ± 0.07 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.070). Sleep efficiency showed a no significant change from 0.52 ± 0.14 at baseline to 0.35 ± 0.09 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.201), while use of sleeping medication remained unchanged (0.15 ± 0.07 at baseline versus 0.15 ± 0.08 at week 2, \u003cem\u003ep\u003c/em\u003e = 1.000). Daytime dysfunction also shows no significant increase from 1.13 ± 0.10 at baseline to 1.15 ± 0.10 at week 2 (\u003cem\u003ep\u003c/em\u003e = 0.881).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eDespite unchanged total energy, carbohydrate, and fat intake throughout the ordination period, meaningful shifts in macronutrient composition were observed (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Protein intake declined significantly in the first week and remained consistently lower in the second week, representing a reduction of over 20 percent from baseline. This decline is likely attributable to the traditional alms based dietary system, which tends to emphasize carbohydrate rich foods such as rice and sweets, while offering limited quantities of high quality protein sources. Such dietary patterns are consistent with previous studies on monastic food practices in Thailand [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAlthough reduced, average protein intake remained comparable to that of overweight Thai men [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] and exceeded levels reported in Indian Buddhist monks [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Nevertheless, it fell short of the recommended intake (1.2 g/kg/day) required to preserve lean body mass during periods of restricted physical activity or intermittent fasting [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], potentially contributing to the observed decline in muscle mass. In contrast, sugar intake nearly doubled by the second week, a trend consistent with prior findings of high sugar consumption among urban monks, often driven by sweetened beverages and desserts received through food offerings [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. While such intake may increase glycemic load and metabolic risk over time, this trend was accompanied by a significant increase in dietary fiber, possibly reflecting greater fruit and vegetable consumption. The nearly twofold increase in sugar intake during ordination is concerning, particularly given the associated risks of increased glycemic load and metabolic dysfunction over time. As monks are reliant on alms offerings and cannot selectively choose their foods, interventions at the community level such as encouraging healthier offerings including fruits, whole grains, and less processed sweets could represent a culturally sensitive strategy to mitigate this nutritional imbalance. Although fiber intake remained below recommended levels [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e], the observed upward trajectory parallels findings from time restricted eating interventions, where improvements in diet quality are often mediated by circadian alignment and reduced evening intake [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTaken together, these findings highlight both the strengths and limitations of the alms based dietary model. The structured eating window imposed by Buddhist monastic practice aligns with core principles of time restricted eating and may naturally facilitate improvements in diet quality. However, imbalances such as insufficient protein and elevated sugar intake should be addressed if monastic dietary patterns are to serve as a practical model for promoting metabolic health. By the end of the two week period, participants exhibited statistically significant reductions in body weight and BMI, with more pronounced decreases in waist and hip circumferences. Waist circumference decreased by approximately 4.9 percent and hip circumference by 2.9 percent, contributing to an improved waist to hip ratio. These changes are particularly relevant to metabolic health, given the well-established association between central adiposity and cardiometabolic risk. Importantly, a reduction of approximately 5 percent in waist circumference is considered clinically meaningful, as increased waist circumference has been linked to greater cardiovascular disease specific mortality in dose response meta-analyses [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Thus, the observed improvements in central adiposity during ordination may not only represent early anthropometric changes but also signal potential longer-term benefits in reducing cardiometabolic and cardiovascular disease risks. Interestingly, no significant changes were observed in visceral fat levels or percent body fat. This may be due to the short duration of the study and the inherent limitations of bioelectrical impedance analysis in detecting small changes in adiposity over brief intervals [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Nevertheless, reductions in waist and hip circumference suggest early improvements in abdominal fat distribution.\u003c/p\u003e \u003cp\u003eA modest but statistically significant decline in muscle mass was also observed, likely resulting from the combination of reduced protein intake and decreased physical activity during the ordination period. Monastic routines involve periods of walking and chanting but are largely sedentary compared to preordination lifestyles [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The muscle loss observed, approximately 1.8 percent, raises concerns about nutritional adequacy and underscores the importance of ensuring sufficient protein intake, even during short-term fasting or lifestyle transitions. Although a modest decline in muscle mass was observed, it is important to note that short term muscle mass reductions may not have long term clinical implications if physical activity levels and nutritional intake are adequately restored following ordination. Future longitudinal studies are warranted to track the recovery of muscle mass and functional capacity after ordination, ensuring a comprehensive understanding of the health impacts of temporary lifestyle changes. These findings are consistent with previous time restricted eating trials reporting 1 to 3 percent reductions in body weight over periods ranging from 2 to 16 weeks [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. Our data suggest that the Buddhist ordination framework may offer a naturalistic and culturally grounded model of time restricted eating that produces measurable improvements in body composition, particularly in abdominal fat, even over a short period.\u003c/p\u003e \u003cp\u003eContrary to expectations, sleep quality improved following ordination despite a more demanding daily schedule. The global PSQI score decreased significantly, with the greatest improvements observed in sleep latency and subjective sleep quality. Participants reported falling asleep more quickly and feeling more rested, despite no significant changes in total sleep duration or efficiency. Several mechanisms may explain these improvements. The structured routine of monastic life promotes consistent sleep wake cycles, which has been shown to enhance circadian alignment and sleep quality [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]. Moreover, early morning light exposure during alms collection may strengthen circadian entrainment, thereby reducing sleep latency [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. Although sleep duration did not increase, the perception of improved restfulness suggests enhanced sleep architecture, possibly driven by increased time spent in restorative slow wave sleep [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eEmerging evidence also links time restricted eating to improved sleep regulation through metabolic pathways. Restricting food intake to early daytime hours may optimize circadian hormone secretion, including melatonin, which is critical for sleep initiation and maintenance [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. The combined effect of time restricted eating patterns and structured daily routines may thus synergistically contribute to improvements in sleep health. Given the established association between sleep quality and weight regulation [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e], these results provide further support for the potential of Buddhist ordination to function as a culturally embedded lifestyle intervention with multidimensional health benefits. Beyond the structured routines of monastic life, the spiritual discipline inherent in Buddhist ordination, including practices such as mindfulness, reduced material attachment, and meditative focus, may have contributed to improved stress management and sleep quality. Spiritual motivations may foster greater emotional regulation, adherence to healthy behaviors, and resilience during the adaptation to new daily routines. These intrinsic factors could have synergistically enhanced the physiological benefits observed during the ordination period.\u003c/p\u003e \u003cp\u003eBuddhist ordination may provide a culturally embedded model for metabolic health promotion through structured routines and time restricted eating. Short term ordination was associated with improvements in dietary composition, central adiposity, and sleep quality. These findings suggest that integrating spiritual practices into health interventions could enhance holistic outcomes. Monastic living, given its cultural acceptance and accessibility, offers valuable insights for developing structured interventions beyond monastic settings. By fostering physical, psychological, and spiritual well-being, Buddhist ordination presents a comprehensive framework for culturally grounded health promotion.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design\u003c/h2\u003e \u003cp\u003eA prospective observational study was conducted between January and May 2024 at Wat Bowaniwet Wihan Ratchaworawihan, a Dhammayut Buddhist temple in Bangkok, Thailand. The study was designed to capture physiological changes during the early phase of ordination, a period characterized by substantial lifestyle transitions. Participants were assessed at three key time points: baseline (first day of ordination), after one week, and after two weeks (final week of ordination). At baseline, participants maintained their regular lifestyles, including their typical diet, sleep schedule, and physical activity patterns until ordination. During ordination, participants adopted monastic routines as dictated by Buddhist disciplinary codes, including pre-noon food consumption, increased sedentary activity (meditation and chanting), and structured sleep-wake schedules.\u003c/p\u003e \u003cp\u003eThe duration of the study was set at two weeks, aligning with the minimum period of monastic ordination commonly practiced in Thai Buddhism. According to temple tradition, newly ordained monks must remain in the monastic order for at least two weeks before disrobing (\"suek\"). This provided a natural and culturally defined timeframe for data collection, ensuring that all participants were observed under consistent monastic conditions from ordination to the point of potential disrobing.\u003c/p\u003e \u003cp\u003eImportantly, participants were permitted to consume unrestricted quantities and types of food and beverages offered through alms during the eating window, reflecting real-world monastic practice. Researchers did not interfere with dietary choices to preserve ecological validity but provided telephone access for any study-related questions. The design aimed to evaluate how these organically structured routines affect dietary patterns, anthropometry, and sleep in a short timeframe.\u003c/p\u003e \u003cp\u003e In addition, the study protocol received approval from the Ethics Review Committee for Research Involving Human Research Subjects, Human Science Group, Chulalongkorn University (COA No. 013/67), adhering to the Declaration of Helsinki guidelines. Before enrollment, all participants provided written informed consent, and their information was maintained with strict confidentiality.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample Size Calculation\u003c/h3\u003e\n\u003cp\u003eThe sample size was determined based on the 0.05 level of significance (α), 80% power, effect size (0.44), using the BMI of obese men that enrolled in TRE protocol from the previous study [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Using this as the total population and considering an estimated drop-out rate of 30%, a target sample of at least 56 participants was set to ensure adequate statistical power to detect meaningful changes in dietary intake, body composition, and sleep parameters over time. A total of 52 participants completed the full study protocol.\u003c/p\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eFifty-two newly ordained Dhammayut Buddhist monks were recruited from Wat Bowaniwet Wihan Ratchaworawihan, Bangkok. Inclusion criteria were adults aged 20 years or older, with a BMI greater than 22.9 kg/m\u0026sup2; [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], willingness to undergo ordination for at least two weeks, fluency in Thai, and agreement to participate in the study. Exclusion criteria included early withdrawal from monkhood before the two-week period or incomplete data on questionnaires, dietary records, or body composition measurements.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eOutcome Measurements\u003c/h2\u003e \u003cp\u003eThe primary outcome of the study was body weight, as a sensitive and direct marker of short-term physiological change. Secondary outcomes included other components of body composition and dietary intake. Secondary outcomes included sleep quality parameters such as sleep timing, duration, onset latency, efficiency, disturbances, use of sleep medications, and daytime functioning.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eDietary Intake\u003c/h2\u003e \u003cp\u003eAt baseline, participants received standardized training from registered dietitians on how to accurately record food and beverage consumption. The training utilized visual aids, food models, and standard household measuring tools (e.g., cups, spoons, and bowls) to enhance portion size estimation and recording accuracy. Each participant was provided with a structured food recording handbook and was instructed to complete a 3-day dietary record each week, covering two weekdays and one weekend day.\u003c/p\u003e \u003cp\u003eIn addition, a 24-hour dietary recall interview was conducted at baseline to capture dietary intake prior to ordination. This recall was administered by registered dietitian to ensure accuracy and minimize recall bias. All dietary records and recall data were reviewed for completeness and consistency before analysis. Nutrient intake\u0026mdash;including total energy, macronutrients, dietary fiber, and sugar\u0026mdash;was analyzed using the INMUCAL-Nutrients software (version 4.0), developed by the Institute of Nutrition, Mahidol University, Thailand, which is based on a validated Thai food composition database.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eBody Composition\u003c/h2\u003e \u003cp\u003eAssessments were conducted in the early morning, prior to breakfast, at two time points: baseline (the day of ordination) and after two weeks of monastic life. Participants wore light clothing and removed any metallic items or accessories to minimize measurement variability. Body composition parameters, including body weight, body mass index (BMI), body fat percentage, visceral fat level, and muscle mass, were measured using a validated bioelectrical impedance analysis (BIA) device (TANITA BC-401, Tokyo, Japan).\u003c/p\u003e \u003cp\u003eWaist and hip circumferences were measured using a non-elastic measuring tape. Waist circumference was recorded at the midpoint between the lowest palpable rib and the superior border of the iliac crest, while hip circumference was measured at the widest point of the buttocks. To ensure consistency and cultural appropriateness, all anthropometric measurements were performed by trained male researchers, adhering to Buddhist monastic discipline [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The same equipment and standardized protocols were applied across both time points to minimize inter-rater and device variability.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eSleep Quality\u003c/h2\u003e \u003cp\u003eSleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI) [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e], a validated and widely used instrument for evaluating subjective sleep characteristics. The PSQI was administered at two time points: baseline (pre-ordination) and at the end of the second week of ordination. The instrument includes 19 self-rated questions grouped into seven component scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medications, and daytime dysfunction. Each component is scored from 0 to 3, with higher scores indicating greater impairment. These scores are summed to yield a global PSQI score ranging from 0 to 21. A global score greater than 5 is indicative of poor sleep quality. Sleep onset latency, one of the key subcomponents, was also specifically evaluated, with scores interpreted as follows: 0\u0026thinsp;=\u0026thinsp;no difficulty falling asleep, 1\u0026thinsp;=\u0026thinsp;mild difficulty, 2\u0026thinsp;=\u0026thinsp;moderate difficulty, 3\u0026thinsp;=\u0026thinsp;severe difficulty. Participants completed the questionnaire independently, with support provided by the research team when needed to ensure accuracy and completeness. All responses were reviewed for consistency immediately after collection.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard error of the mean (SEM), while categorical variables such as education level and underlying disease were expressed as counts and percentages. Normality of distribution for key variables was tested using the Kolmogorov\u0026ndash;Smirnov test. Paired samples \u003cem\u003et\u003c/em\u003e-tests were used to assess changes between time points. Repeated measures ANOVA was used to examine the effects of treatment, time, and interaction terms. A \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant. Statistical analyses were performed using IBM SPSS Statistics (version 22.0; SPSS Inc., USA).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and Limitations\u003c/h2\u003e \u003cp\u003eThis study is the first prospective investigation to assess short term physiological adaptations to Buddhist ordination, simultaneously evaluating changes in dietary intake, body composition, and sleep quality. The use of validated instruments, repeated measures, and a naturalistic monastic setting enhances both internal validity and real-world applicability. However, the short observation period limits generalizability to long term outcomes. Dietary intake was self-reported, introducing potential recall bias despite standardized procedures. Waist circumference measurements were taken at non-standardized anatomical landmarks, and the absence of biochemical data precludes assessment of metabolic or hormonal responses. Additionally, cultural factors inherent to Buddhist ordination must be acknowledged. Because monks are dependent on the food provided by laypeople during alms collection, they have limited control over the quality and macronutrient composition of their diet. This contextual limitation may influence the nutritional outcomes observed and should be considered when interpreting the findings and designing future intervention studies.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis two-week study demonstrated that Buddhist ordination, as a natural model of time-restricted eating, led to significant improvements in dietary intake, body composition, and sleep quality. Reductions in protein intake and increases in sugar and fiber reflected shifts in alms based dietary patterns. Anthropometric measures improved, particularly in central adiposity, although muscle mass declined. Sleep quality also improved, especially in latency and subjective restfulness. These findings highlight the potential of short-term monastic practice as a culturally relevant framework for promoting holistic health.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no conflict of interest related to the content of this manuscript.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eEthical declarations\u003c/h2\u003e \u003cp\u003eThe study protocol was approved by the office of Ethics Review Committee for Research Involving Human Research Subjects, Human Science Group, Chulalongkorn University (COA No. 013/67) in accordance with the Declaration of Helsinki.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eConsent to participate\u003c/h2\u003e \u003cp\u003e All participants provided written informed consent before enrolling in the study, and all participant information was kept confidential.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eP.S. contributed to conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, visualization, and writing\u0026mdash;both original draft preparation and review/editing. P.R. contributed to conceptualization, project administration, investigation, and resources. C.C. contributed to methodology, investigation, resources, and reviewing/editing. T.K. and K.K. participated in investigation, resources, and reviewing/editing. S.A. contributed to conceptualization, methodology, project administration, funding acquisition, and reviewing/editing. All authors read and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors are grateful to all participants for their time. This project is funded by National Research Council of Thailand (NRCT): N42A680622 and the Faculty of Allied Health Sciences Endowment Fund Chulalongkorn University.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003e\"The data presented in this study are available on reasonable request from the corresponding author.\"\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. \u003cem\u003eWHO acceleration plan to stop obesity\u003c/em\u003e (World Health Organization, 2023).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBl\u0026uuml;her, M. \u0026amp; Obesity Global epidemiology and pathogenesis. \u003cem\u003eNat. Rev. 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Endocrinol.\u003c/em\u003e \u003cb\u003e418\u003c/b\u003e, 101\u0026ndash;107. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.mce.2015.06.030\u003c/span\u003e\u003cspan address=\"10.1016/j.mce.2015.06.030\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e (2015).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"378\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.254%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipant characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.746%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eValues\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68.254%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-Bachelor degree\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;- Master degree\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;- Ph.D.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;- Others\u003c/p\u003e\n \u003cp\u003eUnderlying diseases\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-No underlying disease\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-Hypertension\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-Diabetes mellitus\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-Heart disease\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;-Others (Ex. Gerd and allergy)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 31.746%;\"\u003e\n \u003cp\u003e30.03 \u0026plusmn; 1.13\u003c/p\u003e\n \u003cp\u003e26.70 \u0026plusmn; 0.46\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e39 (75.00%)\u003c/p\u003e\n \u003cp\u003e12 (23.08%)\u003c/p\u003e\n \u003cp\u003e1 (1.92%)\u003c/p\u003e\n \u003cp\u003e0 (0.00%)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41 (78.85%)\u003c/p\u003e\n \u003cp\u003e3 (5.77%)\u003c/p\u003e\n \u003cp\u003e2 (3.84%)\u003c/p\u003e\n \u003cp\u003e0 (0.00%)\u003c/p\u003e\n \u003cp\u003e6 (11.54%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u003c/strong\u003e Baseline Characteristics of Participants. Results for continuous variables (age, body mass index, and ordination duration) are presented as mean \u0026plusmn; Standard Error of the Mean (SEM), \u003cem\u003en\u003c/em\u003e =52. Categorical variables (education level and underlying diseases) are reported as frequencies and percentages.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 22.1154%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.1154%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 22.1154%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1 week ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 23.0769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2 weeks ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 10.5769%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP-\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1154%;\"\u003e\n \u003cp\u003eTotal energy (kcal)\u003c/p\u003e\n \u003cp\u003eCarbohydrate (g)\u003c/p\u003e\n \u003cp\u003eFat (g)\u003c/p\u003e\n \u003cp\u003eProtein (g)\u003c/p\u003e\n \u003cp\u003eSugar (g)\u003c/p\u003e\n \u003cp\u003eDietary fiber (g)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1154%;\"\u003e\n \u003cp\u003e1,954.69 \u0026plusmn; 221.90\u003c/p\u003e\n \u003cp\u003e145.00 \u0026plusmn; 13.80\u003c/p\u003e\n \u003cp\u003e65.45 \u0026plusmn; 6.88\u003c/p\u003e\n \u003cp\u003e79.96 \u0026plusmn; 9.85\u003c/p\u003e\n \u003cp\u003e34.60 \u0026plusmn; 4.91\u003c/p\u003e\n \u003cp\u003e5.07 \u0026plusmn; 0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 22.1154%;\"\u003e\n \u003cp\u003e1,662.19 \u0026plusmn; 97.14\u003c/p\u003e\n \u003cp\u003e152.42 \u0026plusmn; 14.09\u003c/p\u003e\n \u003cp\u003e59.75 \u0026plusmn; 5.75\u003c/p\u003e\n \u003cp\u003e60.90 \u0026plusmn; 6.77*\u003c/p\u003e\n \u003cp\u003e67.96 \u0026plusmn; 11.60*\u003c/p\u003e\n \u003cp\u003e6.84 \u0026plusmn; 0.77*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 23.0769%;\"\u003e\n \u003cp\u003e1,739.46 \u0026plusmn; 108.15\u003c/p\u003e\n \u003cp\u003e162.25 \u0026plusmn; 17.17\u003c/p\u003e\n \u003cp\u003e63.29 \u0026plusmn; 5.61\u003c/p\u003e\n \u003cp\u003e62.50 \u0026plusmn; 6.37*\u003c/p\u003e\n \u003cp\u003e69.85 \u0026plusmn; 9.46*\u003c/p\u003e\n \u003cp\u003e8.32 \u0026plusmn; 0.76*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10.5769%;\"\u003e\n \u003cp\u003e0.259\u003c/p\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003cp\u003e0.582\u003c/p\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eChanges in Dietary Intake Before and During Ordination in Thai Monks. Results are presented as mean \u0026plusmn; Standard Error of the Mean (SEM), \u003cem\u003en\u003c/em\u003e=52. * indicates a statistically significant difference compared to baseline (before ordination), with \u003cem\u003eP\u003c/em\u003e-value \u0026lt; 0.05. ᵃ\u003cem\u003eP\u003c/em\u003e-value represents the significance of the interaction effect between time and treatment, assessed using repeated measures ANOVA.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e2 weeks ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP-\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBody weight (kg)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80.98 \u0026plusmn; 1.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80.42 \u0026plusmn;1.75*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.70 \u0026plusmn; 0.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.47 \u0026plusmn; 0.48*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWaist circumference (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e96.17 \u0026plusmn; 1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e91.47 \u0026plusmn; 1.39*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHip circumference (cm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e101.98 \u0026plusmn; 1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e98.99 \u0026plusmn; 1.12*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWaist to hip ratio\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.94 \u0026plusmn; 0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.92 \u0026plusmn; 0.01*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e% Fat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23.51 \u0026plusmn; 0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.18 \u0026plusmn; 0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVisceral fat level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.20 \u0026plusmn; 0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11.06 \u0026plusmn; 0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.532\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMuscle mass\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e58.29 \u0026plusmn; 0.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57.27 \u0026plusmn; 0.82*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eChanges in Body Composition Before and After Two Weeks of Ordination in Thai Monks. Results are presented as mean \u0026plusmn; Standard Error of the Mean (SEM), \u003cem\u003en\u003c/em\u003e=52. * indicates a statistically significant difference compared to baseline (before ordination), with \u003cem\u003eP-\u003c/em\u003evalue \u0026lt; 0.05 based on paired samples \u003cem\u003et\u003c/em\u003e-test.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"596\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 596px;\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"580\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 202px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParameters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 162px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBefore ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 150px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2 weeks ordination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP-\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eSleep quality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.23 \u0026plusmn; 0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.96 \u0026plusmn; 0.09*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.029\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eSleep latency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.38 \u0026plusmn; 0.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.90 \u0026plusmn; 0.13*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eSleep duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.10 \u0026plusmn; 0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.42 \u0026plusmn; 0.10*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eSleep efficiency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.52 \u0026plusmn; 0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.35 \u0026plusmn; 0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.201\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eSleep disturbances\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.31 \u0026plusmn; 0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.17 \u0026plusmn; 0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eUse of sleeping medication\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e0.15 \u0026plusmn; 0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.15 \u0026plusmn; 0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003eDaytime dysfunction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e1.13 \u0026plusmn; 0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e1.15 \u0026plusmn; 0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 202px;\"\u003e\n \u003cp\u003ePSQI score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 162px;\"\u003e\n \u003cp\u003e6.88 \u0026plusmn; 0.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e6.10 \u0026plusmn; 0.33*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 596px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eChanges in Sleep Quality Before and After Two Weeks of Ordination in Thai Monks. Results are presented as mean \u0026plusmn; Standard Error of the Mean (SEM), \u003cem\u003en\u003c/em\u003e=52. * indicates a statistically significant difference compared to baseline (before ordination), with \u003cem\u003eP-\u003c/em\u003evalue \u0026lt; 0.05 based on paired samples \u003cem\u003et\u003c/em\u003e-test.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Monks, Obesity, Time-restricted eating, Dietary intake, Body composition, Sleep quality","lastPublishedDoi":"10.21203/rs.3.rs-6629740/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6629740/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBuddhist ordination involves significant lifestyle changes including meal timing, diet, and sleep patterns, yet short-term physiological effects remain poorly understood. This study examined effects of two-week ordination on dietary intake, body composition, and sleep quality in newly ordained Thai Dhammayut monks. Fifty-two participants (mean age 30.03\u0026thinsp;\u0026plusmn;\u0026thinsp;1.13 years; BMI 26.70\u0026thinsp;\u0026plusmn;\u0026thinsp;0.46 kg/m\u0026sup2;) underwent assessments at baseline, one week, and two weeks post-ordination. While total energy intake remained stable, macronutrient composition shifted significantly: protein decreased\u0026thinsp;\u0026gt;\u0026thinsp;20%, sugar nearly doubled, and fiber increased substantially. Body composition improved with reductions in weight, BMI, waist and hip circumference. Muscle mass modestly decreased while body fat percentage and visceral fat remained stable. Sleep quality improved significantly, particularly sleep latency and subjective restfulness, despite unchanged duration. Findings suggest Buddhist ordination may produce beneficial short-term physiological adaptations similar to time-restricted eating. Though improvements in abdominal adiposity and sleep quality were observed, declining muscle mass highlights nutritional adequacy concerns. Monastic routines may provide culturally appropriate frameworks for structured lifestyle interventions.\u003c/p\u003e","manuscriptTitle":"Buddhist Ordination as a Culturally Embedded Model for Improving Diet, Body Composition, and Sleep Quality in Overweight and Obese Adults","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-12 06:13:50","doi":"10.21203/rs.3.rs-6629740/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-06-12T09:01:47+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-10T11:55:43+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-10T03:33:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"332238124379216810865188456793442369183","date":"2025-06-09T14:01:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"20850907728408362481703951957909723731","date":"2025-06-09T04:24:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-09T03:41:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-06T09:59:13+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-05-23T12:27:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-05-22T14:21:56+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-05-09T14:41:25+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"befb03e1-78c4-4587-ab28-5c3bedac81e3","owner":[],"postedDate":"June 12th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":49816557,"name":"Health sciences/Health care/Nutrition"},{"id":49816558,"name":"Health sciences/Health care/Quality of life"}],"tags":[],"updatedAt":"2025-07-21T15:59:31+00:00","versionOfRecord":{"articleIdentity":"rs-6629740","link":"https://doi.org/10.1038/s41598-025-11309-y","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2025-07-14 15:57:10","publishedOnDateReadable":"July 14th, 2025"},"versionCreatedAt":"2025-06-12 06:13:50","video":"","vorDoi":"10.1038/s41598-025-11309-y","vorDoiUrl":"https://doi.org/10.1038/s41598-025-11309-y","workflowStages":[]},"version":"v1","identity":"rs-6629740","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6629740","identity":"rs-6629740","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}