The specific physiology and psychology of the Ramadan fast.
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276 to 300 of 889Changes in dietary and lifestyle behaviors and mental stress among medical students upon Ramadan diurnal intermittent fasting: a prospective cohort study from Taif/Saudi Arabia.
Background: Intermittent fasting (IF) is a popular dietary plan for weight loss. In fact, fasting is a common practice in different religions such as Buddhism, Hinduism, Judaism, Christianity, and Islam. During the month of Ramadan, more than 1.5 billion Muslims worldwide fast from dawn to sunset. Ramadan diurnal intermittent fasting (RDIF) has health benefits, including a reduction in cardiovascular disease (CVD) risk and an improvement in mood. However, little is known about the effects of RDIF on lifestyle behaviors, such as regular exercise, consuming healthy diet, and avoiding harmful substances, as well as mental stress, and academic performance in high school and university students.
Methods: In this prospective cohort study, two self-reported questionnaires were sent one week before and during the last week of Ramadan (April 2022; Ramadan 1443 in Hijri Islamic Calendar) to assess…
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Women's fasting habits and dietary diversity during Ramadan in rural Bangladesh.
Little is known about fasting practices and dietary changes during Ramadan in low- and lower-middle-income countries. Although pregnant women are exempt from fasting, they may still fast. This is of interest as dietary habits during pregnancy may affect the development of the unborn child. In a community-based sample of young women in rural Sylhet division, Bangladesh, we described fasting practices and beliefs (n = 852). We also examined reported food group consumption and minimally adequate dietary diversity for women (MDD-W) by Ramadan occurrence (n = 1,895) and by fasting adherence (n = 558) using logistic regression with Hindu women as a seasonal control. During Ramadan in 2018, 78% of pregnant Muslim women fasted every day. Over 80% of Muslim women believe that they should fast during pregnancy and over 50% expect positive health effects on the mother and the unborn child. We found…
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Construction and evaluation of an online module addressing counseling patients with diabetes observing religious fasting.
Introduction: Little research has been conducted on training students of different health professions to deliver culturally appropriate care to patients observing religious fasting. This study aimed to formulate an online educational module on caring for patients with diabetes observing religious fasting and evaluate the module's impact.
Methods: Third-year doctor of pharmacy students participated in an online module at the end of their core pharmacist-patient communication class. The module involved discussions and case scenarios addressing Muslim, Jewish, and Hindu patients with diabetes considering fasting. Students were provided with Ramadan Communication (RAMCOM), a tool designed to facilitate counseling of patients on religious fasting and were encouraged to use principles of motivational interviewing in addressing cases. A 13-item questionnaire was administered before and after th…
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Kermansaravi M, Omar I, Mahawar K, Shahabi S, Bashir A, Haddad A, Abbass A, Abbas SI, Abbas M, Abouzeid T, Akin F, Aghajani E, Aminian A, AlAnsari M, Asghar ST, Balta AZ, Bukhari W, Elfawal MH, Gado W, Gawdat K, Gee T, Ghavami B, Goel R, AlHadad M, AlHadhrami B, AlHaifi M, AlHamdani A, Hassan I, Illan SJ, Inam A, Ismaeil A, Kayyal Y, Mohammad K, Khan AU, Khoursheed M, Khwaja H, Kular KS, Layani LA, Maazulhassan, Mahdy T, Maher M, Mansoor E, Mirza S, Niam MS, Omarov T, Pazouki A, Alqahtani AR, Qassem M, Rezvani M, Sabry K, Salim S, Shabbir A, Skalli M, Taha O, Talebpour M, Taskin HE, Taskin M, Yunus T, Jazi AHD, Kassir R, Nimeri A (2021)MEDLINE-indexed journal, not yet read by usObesity surgery11 citations Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus.
Background: Fasting during Ramadan is one of the five pillars of the Muslim faith. Despite the positive effects of fasting on health, there are no guidelines or clear recommendations regarding fasting after metabolic/bariatric surgery (MBS). The current study reports the result of a modified Delphi consensus among expert metabolic/bariatric surgeons with experience in managing patients who fast after MBS.
Methods: A committee of 61 well-known metabolic and bariatric surgeons from 24 countries was created to participate in the Delphi consensus. The committee voted on 45 statements regarding recommendations and controversies around fasting after MBS. An agreement/disagreement ≥ of 70.0% was regarded as consensus.
Results: The experts reached a consensus on 40 out of 45 statements after two rounds of voting. One hundred percent of the experts believed that fasting needs special nutritional …
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Pediatric Muslim Fasting Practices in Southeast Michigan: A Community Survey.
During the holy month of Ramadan, Muslims fast from all water, food, and medications from dawn till dusk. To date, the existing medical literature focuses on adult fasting with little attention paid to pediatric fasting practices. An anonymous, digital, bilingual survey was conducted using Qualtrics software. Participants were recruited in-person at various community clinics, businesses, and mosques as well as online via social media. To be eligible for the study, participants must identify as Muslim and be parents or guardians of child/ren between the age/s of 7 and 18. Between July 2017 and May 2018, 918 people took part in the initial survey, with 70% (524/751) of participants living in Wayne County, MI. Approximately 80% (624/779) identified as Arab American and 57% (437/773) as immigrants to the US. Over 63% (522/827) of participants reported that their child's health care provider …
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Hanif W, Patel V, Ali SN, Karamat A, Saeed M, Hassanein M, Syed A, Chowdhury TA, Farooqi A, Khunti K (2020)MEDLINE-indexed journal, not yet read by usDiabetes research and clinical practice12 citations The South Asian Health Foundation (UK) guidelines for managing diabetes during Ramadan.
Background: Fasting in the holy month of Ramadan is among the five pillars of Islam and is considered as a religious obligation by the Muslim population. People with diabetes observing the practice of fasts are at a higher risk of complications such as hypoglycaemia, hyperglycaemia and ketoacidosis due to changes in eating patterns and circadian rhythms. With the objective of mitigating these complications, the South Asian Health Foundation (UK) has developed the present guidelines based on robust evidence derived from epidemiological studies and clinical trials.
Methods: We have highlighted the role of pre-Ramadan risk stratification and counselling by healthcare professionals with emphasis on the need for advice on adequate dietary and fluid intake, blood glucose monitoring and awareness of when to break the fast.
Results: We reviewed the current literature and have given clinically-re…
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Ramadan exposure and birth outcomes: a population-based study from the Netherlands.
Background: Ramadan, the Islamic month of daytime fasting, is observed by many pregnant Muslims. Although pregnant women are exempt, many prefer to fast. Previous research has shown long-term adverse effects on various health outcomes among the offspring, but evidence on effects on perinatal outcomes is mixed. This study investigates effects of Ramadan during pregnancy among Muslims in the Netherlands.
Methods: Data from the Perinatal Registry of the Netherlands (Perined) on all births between 2000 and 2010 to mothers recorded as Mediterranean (i.e. of Turkish/Moroccan descent, a proxy for Muslim) (n = 139,322) or as ethnically Dutch (n = 1,481,435) were used. Ramadan exposure was defined using an intention-to-treat approach as the occurrence of a Ramadan during gestation. Muslims with versus without a Ramadan occurring during gestation were compared using difference-in-differences analy…
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Experiences of people with type 1 diabetes fasting Ramadan following structured education: A qualitative study.
Background and aims: Although people with type 1 diabetes are exempt from fasting the month of Ramadan due to the risk to their health, many wish to fast nonetheless. Little is known about the impact of structured education on the fasting experiences of people with type 1 diabetes. This study aimed to explore how the Dose Adjustment for Normal Eating (DAFNE) course affected people with type 1 diabetes' fasting experiences to provide insight into the benefits of structured education for people wishing to fast while managing their diabetes.
Methods: Semi-structured interviews were conducted with 40 DAFNE graduates who fasted Ramadan. The purposive sample was selected from the DAFNE registry at Dasman Diabetes Institute in Kuwait. The interviews were transcribed verbatim and analysed thematically in an iterative process. Topics discussed included fasting experiences prior to attending the D…
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Tourkmani AM, Alharbi TJ, Bin Rsheed AM, AlRasheed AN, AlBattal SM, Abdelhay O, Hassali MA, Faya SI, Assiri ES, Al Ghishiayan KI, Alrasheedy AA, Abbas MA (2019)MEDLINE-indexed journal, not yet read by usDiabetes & metabolic syndrome11 citations Impact of Ramadan Focused Education Program on medications adjustment for patients with type 2 diabetes in a primary health care institution in Saudi Arabia.
Aims: To examine the impact of Ramadan Focused Education Program (RFEP) on medications adjustment in type 2 diabetes patients in Ramadan.
Methods: This is a controlled, intervention based study. It was run on three phases: before, during, and after Ramadan on 262 type 2 diabetes patients. The intervention group (n = 140) received RFEP on medications doses & timing adjustment before and after Ramadan, while the control group (n = 122) received standard care.
Results: The dose of insulin glargine was reduced from 42.51 ± 22.16 at the baseline to 40.11 ± 18.51-units during Ramadan (p = 0.002) in the intervention group while it remained the same in the control group before Ramadan and during Ramadan (38.51 ± 18.63 and 38.14 ± 18.46, P = 0.428, respectively). The hypoglycemia score was 14.2 ± (8.5) pre-Ramadan in the intervention and reduced to 6.36 ± 6.17 during Ramadan (p < 0.001) while in …
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Development and Assessment of an Interprofessional Curriculum for Managing Diabetes During Ramadan.
Objective. To develop an educational module that would optimize the diabetic management of individuals observing Ramadan, and to evaluate the effectiveness of the module based on the special needs of fasting individuals. Methods. A needs assessment was conducted to understand the knowledge gaps of health care professionals and the perceived usefulness of an interprofessional curriculum focused on the management of diabetes during Ramadan. Following this assessment, an interdisciplinary team developed and implemented a comprehensive curriculum. Pre- and post-surveys were completed to evaluate the course and assess the changes in skill level and knowledge measured on a Likert scale of 0-5 from "none" to "mastery." Results. One hundred percent of residents and 75% of staff who completed pre- and post-test surveys reported at least one point of increased skill in the item: adjusting medicati…
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An evaluation of the translation of continuing education into diabetes public health care by pharmacists.
Background Pharmacists are assuming greater public health roles and partaking in continuing education to advance knowledge and skills necessary for the provision of this patient care. Objective We sought to determine what conditions in a Middle East context influence how community pharmacists actually incorporate new information into practice. Setting Community pharmacies in Qatar. Methods A continuing professional development (CPD) program regarding the management of fasting diabetes patients during Ramadan was developed and delivered. Participants then maintained a record of their patient encounters when attempting to screen fasting diabetes patients for risk and offer medication, lifestyle, and monitoring advice. Diary entries were coded using inductive methods and follow-up focus group discussion was conducted to further corroborate the thematic analysis. Main outcome measure Facilit…
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Pharmacist-patient communication about medication regimen adjustment during Ramadan.
Objectives: During Ramadan, Muslims fast from dawn to sunset while abstaining from food and drink. Although Muslim patients may be aware of their religious exemption from fasting, many patients still choose not to take that exemption and fast. This study examines pharmacists' initiation and timing of communication about medication regimen adjustment (MRA) with patients related to Ramadan. Predictors for initiating this communication with patients were also explored.
Methods: A probability sample of community pharmacists in Alexandria, Egypt was surveyed. The self-administered instrument covered timing and likelihood of initiating discussion about MRA. Using ordered logistic regression, a model was estimated to predict pharmacists' initiation of the conversation on MRA during Ramadan.
Results: Ninety-three percent of the 298 approached pharmacists completed surveys. Only 16% of the pharma…
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Having diabetes and having to fast: a qualitative study of British Muslims with diabetes.
Background: There are approximately 2.7 million Muslims in the UK, constituting 4.8% of the population. It is estimated that 325,000 UK Muslims have diabetes. Whilst dietary practices of Muslims with diabetes have been explored, little work has described the beliefs and decisions to fast during Ramadan, whereby Muslims with diabetes refrain from eating, drinking and taking medication between sunrise and sunset.
Objective: To explore beliefs and experiences of fasting during Ramadan of Muslim respondents with diabetes and their perceptions of the role played by their general practitioner (GP) and/or practice nurse (PN) in supporting them.
Design: Qualitative study.
Setting: General practices and community groups located in Greater Manchester.
Participants: 23 South Asian Muslims.
Methods: Semi-structured interviews were conducted as part of the Collaboration of Applied Health Research and…
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Effect of Ramadan Fasting on Breast Milk.
Introduction: Breast milk is an excellent biofluid that ensures optimal growth, development, and strong immunity of the baby. Breast milk content may alter depending on duration and time of breastfeeding, the infant's age, and maternal health status. There are few studies in the literature investigating the effect of religious fasting on breast milk composition. Method: The study included 21 fasting and 27 nonfasting mothers who exclusively breastfed their babies in 2021 Ramadan month. The energy, carbohydrate, protein, and lipid levels of the collected breast milk samples and the macro- and micronutrient contents of the mothers' diets and the weight gain of the infants during the study were evaluated. Results: The mothers' ages, education levels, and weights at birth and at the time of sampling were similar. There was no significant difference between the energy, carbohydrate, protein, …
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Ramadan fasting improves liver function and total cholesterol in patients with nonalcoholic fatty liver disease.
Background: Nonalcoholic fatty liver disease (NAFLD) is a serious global health problem, thus the prevention and management of the disease is necessary. This study aimed to determine the effects of Ramadan Fasting (RF) on liver function, Visceral Adiposity Index (VAI) and Atherogenic Index of Plasma (AIP) in these patients.
Methods: Eighty-three NAFLD patients (57 males and 26 females) were enrolled in the study, 42 patients who practiced RF, between Jun 18 through July 17, 2015 and 41 patients in non-fasting groups. Anthropometric parameters and Ultrasound grading were measured before and after Ramadan. The biochemical parameters including lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), liver enzymes (Aspartate aminotransferase, SGOT and Alanine aminotransferase, SGPT) were evaluated before and after Ramadan. AIP and VAI were calculated based on …
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Zhang J, Chen Y, Zhong Y, Wang Y, Huang H, Xu W, Pan W, Chen L, Zhu Y, Bischof E, Pu J (2025)reviewMEDLINE-indexed journal, not yet read by usScience bulletin22 citations Intermittent fasting and cardiovascular health: a circadian rhythm-based approach.
Intermittent fasting (IF) is increasingly recognized as an effective dietary intervention for slowing aging process and alleviating metabolic disturbances in multiple chronic diseases, especially in cardiovascular diseases (CVDs). Despite recent progress, the mechanisms behind its effects on cardiovascular health from the perspective of circadian rhythms are not yet fully understood. This review aims to explore the interaction between IF and circadian rhythms, focusing on their combined effects on cardiometabolic risks and cardiovascular outcomes. Evidence from animal models and clinical trials suggests that IF provides protective effects against cardiac damage and dysfunction. It is also indicated that IF influences key cardiometabolic risk factors, such as insulin sensitivity, inflammation, and lipid metabolism, by aligning with the intrinsic biological rhythms. Additionally, we discus…
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Intermittent fasting and longevity: From animal models to implication for humans.
In recent years, intermittent fasting (IF) and its numerous modifications have been increasingly suggested as a promising therapy for age-related problems and a non-pharmacological strategy to extend lifespan. Despite the great variability in feeding schedules that we describe in the current work, underlying physiological processes are the same and include a periodic switch from glucose metabolism (generated by glycogenolysis) to fatty acids and fatty acid-derived ketones. Many of the beneficial effects of IF appear to be mediated by optimization of energy utilization. Findings to date from both human and animal experiments indicate that fasting improves physiological function, enhances performance, and slows aging and disease processes. In this review, we discuss some of the remarkable discoveries about the beneficial effects of IF on metabolism, endocrine and cardiovascular systems, ca…
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Polycystic Kidney Disease Diet: What is Known and What is Safe.
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by kidney cyst formation and progressive kidney function loss. Dietary interventions such as caloric restriction, intermittent fasting, and ketogenic diet have recently emerged as potential strategies to induce metabolic reprogramming and slow ADPKD progression. We review the available evidence supporting the efficacy and safety of these interventions in ADPKD. Dietary interventions show promise in managing ADPKD by improving metabolic health and reducing oxidative stress. However, while preclinical studies have shown favorable outcomes, limited clinical evidence supports their effectiveness. In addition, the long-term consequences of these dietary interventions, including their effect on adverse events in patients with ADPKD, remain uncertain. To optimize ADPKD management, patients are advised to fo…
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Impact of fasting & ketogenic interventions on the NLRP3 inflammasome: A narrative review.
Overactivation of the NLRP3 inflammasome is implicated in chronic low-grade inflammation associated with various disease states, including obesity, type 2 diabetes, atherosclerosis, Alzheimer's disease, and Parkinson's disease. Emerging evidence, mostly from cell and animal models of disease, supports a role for ketosis in general, and the main circulating ketone body beta-hydroxybutyrate (BHB) in particular, in reducing NLRP3 inflammasome activation to improve chronic inflammation. As a result, interventions that can induce ketosis (e.g., fasting, intermittent fasting, time-restricted feeding/eating, very low-carbohydrate high-fat ketogenic diets) and/or increase circulating BHB (e.g., exogenous ketone supplementation) have garnered increasing interest for their therapeutic potential. The purpose of the present review is to summarize our current understanding of the literature on how ke…
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NADPH and Mitochondrial Quality Control as Targets for a Circadian-Based Fasting and Exercise Therapy for the Treatment of Parkinson's Disease.
Dysfunctional mitochondrial quality control (MQC) is implicated in the pathogenesis of Parkinson's disease (PD). The improper selection of mitochondria for mitophagy increases reactive oxygen species (ROS) levels and lowers ATP levels. The downstream effects include oxidative damage, failure to maintain proteostasis and ion gradients, and decreased NAD+ and NADPH levels, resulting in insufficient energy metabolism and neurotransmitter synthesis. A ketosis-based metabolic therapy that increases the levels of (R)-3-hydroxybutyrate (BHB) may reverse the dysfunctional MQC by partially replacing glucose as an energy source, by stimulating mitophagy, and by decreasing inflammation. Fasting can potentially raise cytoplasmic NADPH levels by increasing the mitochondrial export and cytoplasmic metabolism of ketone body-derived citrate that increases flux through isocitrate dehydrogenase 1 (IDH1). …
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Effects of Intermittent Fasting on Cardiometabolic Health: An Energy Metabolism Perspective.
This review summarizes the effects of different types of intermittent fasting (IF) on human cardiometabolic health, with a focus on energy metabolism. First, we discuss the coordinated metabolic adaptations (energy expenditure, hormonal changes and macronutrient oxidation) occurring during a 72 h fast. We then discuss studies investigating the effects of IF on cardiometabolic health, energy expenditure and substrate oxidation. Finally, we discuss how IF may be optimized by combining it with exercise. In general, IF regimens improve body composition, ectopic fat, and classic cardiometabolic risk factors, as compared to unrestricted eating, especially in metabolically unhealthy participants. However, it is still unclear whether IF provides additional cardiometabolic benefits as compared to continuous daily caloric restriction (CR). Most studies found no additional benefits, yet some prelim…
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The effects of intermittent fasting regimens in middle-age and older adults: Current state of evidence.
Aging is associated with a host of biological changes that contribute to a progressive decline in cognitive and physical function, ultimately leading to a loss of independence and an increased risk of mortality. The unprecedented growth of the aging population has thus created an urgent need for interventions that can preserve older adults' capacity to live independently and to function well. To date, there is no conclusive evidence supporting the efficacy of an intervention to prevent or reverse physical disability in older persons at risk of functional decline. A growing body of evidence indicates that prolonged fasting periods and different types of intermittent fasting regimens can have positive effects on anthropometric and metabolic health parameters in middle-aged adults similar to that of calorie restriction. For this reason, there is increasing scientific interest in further exp…
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Mini review: The relationship between energy status and adult hippocampal neurogenesis.
The ability to generate new hippocampal neurons throughout adulthood and successfully integrate them into existing neural networks is critical to cognitive function, while disordered regulation of this process results in neurodegenerative or psychiatric disease. Consequently, identifying the molecular mechanisms promoting homeostatic hippocampal neurogenesis in adults is essential to understanding the etiologies of these disorders and developing therapeutic interventions. For example, recent evidence identifies a strong association between metabolic function and adult hippocampal neurogenesis. Hippocampal neural stem cell (NSC) fate dynamically fluctuates with changes in substrate availability and energy status (AMP/ATP and NAD+/NADH ratios). Furthermore, many metabolic hormones, such as insulin, insulin-like growth factors, and leptin exhibit dual functions also modulating hippocampal n…
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Intermittent fasting as a nutrition approach against obesity and metabolic disease.
Purpose of review: Intermittent fasting has been proposed as a potential nutrition approach against obesity and metabolic disease. Although data from studies in rodents convincingly support the antiobesity and cardiometabolic benefits of intermittent fasting, its effects in human health are still debatable.
Recent findings: Recent studies have examined the effect of two intermittent fasting approaches, that is, alternate day fasting (ADF) and time-restricted eating (TRE), on weight loss and cardiometabolic risk factors. ADF seems to be an equally effective weight loss approach to caloric restriction, but adherence to ADF is more challenging. ADF improves cardiometabolic risk factors, whereas it may have superior metabolic benefits compared to caloric restriction in people with insulin resistance. TRE with ad libitum food intake is well tolerated and induces 2-4% weight loss in approximat…
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Freire R (2020)reviewMEDLINE-indexed journal, not yet read by usNutrition (Burbank, Los Angeles County, Calif.)154 citations Scientific evidence of diets for weight loss: Different macronutrient composition, intermittent fasting, and popular diets.
New dietary strategies have been created to treat overweight and obesity and have become popular and widely adopted. Nonetheless, they are mainly based on personal impressions and reports published in books and magazines, rather than on scientific evidence. Animal models and human clinical trials have been employed to study changes in body composition and metabolic outcomes to determine the most effective diet. However, the studies present many limitations and should be carefully analyzed. The aim of this review was to discuss the scientific evidence of three categories of diets for weight loss. There is no one most effective diet to promote weight loss. In the short term, high-protein, low-carbohydrate diets and intermittent fasting are suggested to promote greater weight loss and could be adopted as a jumpstart. However, owing to adverse effects, caution is required. In the long term, …
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