The specific physiology and psychology of the Ramadan fast.
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51 to 75 of 889Energy Metabolism and Intermittent Fasting: The Ramadan Perspective.
Intermittent fasting (IF) has been gaining popularity as a means of losing weight. The Ramadan fast (RF) is a form of IF practiced by millions of adult Muslims globally for a whole lunar month every year. It entails a major shift from normal eating patterns to exclusive nocturnal eating. RF is a state of intermittent liver glycogen depletion and repletion. The earlier (morning) part of the fasting day is marked by dominance of carbohydrate as the main fuel, but lipid becomes more important towards the afternoon and as the time for breaking the fast at sunset (iftar) gets closer. The practice of observing Ramadan fasting is accompanied by changes in sleeping and activity patterns, as well as circadian rhythms of hormones including cortisol, insulin, leptin, ghrelin, growth hormone, prolactin, sex hormones, and adiponectin. Few studies have investigated energy expenditure in the context of…
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Interventions for people with type 2 diabetes mellitus fasting during Ramadan.
Background: Fasting during Ramadan is obligatory for adult Muslims, except those who have a medical illness. Many Muslims with type 2 diabetes (T2DM) choose to fast, which may increase their risks of hypoglycaemia and dehydration.
Objectives: To assess the effects of interventions for people with type 2 diabetes fasting during Ramadan.
Search methods: We searched CENTRAL, MEDLINE, PsycINFO, CINAHL, WHO ICTRP and ClinicalTrials.gov (29 June 2022) without language restrictions.
Selection criteria: Randomised controlled trials (RCTs) conducted during Ramadan that evaluated all pharmacological or behavioural interventions in Muslims with T2DM.
Data collection and analysis: Two authors screened and selected records, assessed risk of bias and extracted data independently. Discrepancies were resolved by a third author. For meta-analyses we used a random-effects model, with risk ratios (RRs) for…
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Sex as a Biological Factor in the Changes in Disease Patients During Ramadan Intermittent Fasting: A Systematic Review.
Background: During Ramadan, many patients with diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy choose to fast even against their doctor's advice. The impact of this intermittent fasting on health and disease could be different in men and women. The aim of this study was to determine the effect of sex as a factor in diseases outcomes of patients who opt to fast during Ramadan.
Main body: The articles included in this study reported data on six diseases: diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy. A systematic search was performed on PubMed and Scopus for observational and clinical studies mentioning Ramadan, diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy in both men and women. Data was extracted by two independent reviewers using a standardized data-collection form. From 381 o…
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Stekovic S, Hofer SJ, Tripolt N, Aon MA, Royer P, Pein L, Stadler JT, Pendl T, Prietl B, Url J, Schroeder S, Tadic J, Eisenberg T, Magnes C, Stumpe M, Zuegner E, Bordag N, Riedl R, Schmidt A, Kolesnik E, Verheyen N, Springer A, Madl T, Sinner F, de Cabo R, Kroemer G, Obermayer-Pietsch B, Dengjel J, Sourij H, Pieber TR, Madeo F (2019)randomised controlled trialMEDLINE-indexed journal, not yet read by usCell metabolism306 citations Alternate Day Fasting Improves Physiological and Molecular Markers of Aging in Healthy, Non-obese Humans.
Caloric restriction and intermittent fasting are known to prolong life- and healthspan in model organisms, while their effects on humans are less well studied. In a randomized controlled trial study (ClinicalTrials.gov identifier: NCT02673515), we show that 4 weeks of strict alternate day fasting (ADF) improved markers of general health in healthy, middle-aged humans while causing a 37% calorie reduction on average. No adverse effects occurred even after >6 months. ADF improved cardiovascular markers, reduced fat mass (particularly the trunk fat), improving the fat-to-lean ratio, and increased β-hydroxybutyrate, even on non-fasting days. On fasting days, the pro-aging amino-acid methionine, among others, was periodically depleted, while polyunsaturated fatty acids were elevated. We found reduced levels sICAM-1 (an age-associated inflammatory marker), low-density lipoprotein, and the meta…
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Ramadan fasting and diabetes 2019: The year in review.
Introduction: The literature on health aspects of Ramadan fasting is widely spread in many journals making it not readily available to those interested in the subject.
Materials and methods: A narrative, non-systematic review of the international literature from two major online databases (viz. Scopus, PubMed) in one year (2019). The search term "Ramadan fasting AND Diabetes" was used, and relevant literature was narrated in a concise thematic account.
Results: Research design included qualitative, quantitative, and mixed methods. Articles included controlled trials, critical appraisals, literature narrations, and systematic reviews, and meta-analyses. The publications spanned a vast array of topics related to Ramadan fasting, including assessments of current safety and efficacy profiles of newer diabetes therapies, modes of insulin delivery, and utilization of advanced technology for th…
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Fasting and Its Impact on Skin Anatomy, Physiology, and Physiopathology: A Comprehensive Review of the Literature.
Skin serves as the first protective line and barrier of the body. Like many other organs, skin can be affected by several disorders in response to external factors such as pathogens, ultraviolet light, and pollution, as well as endogenous alterations related to aging and/or oxidative stress disturbance. Researchers have reported new insights into how skin cells are altered in response to caloric restriction diets in mammals. One of the most well-known caloric restriction diets is the Ramadan intermittent fasting, which is a radical change in the diet plan of practitioners for the period of one lunar month. Ramadan fasting represents the fourth of the five pillars of the Islamic creed. Even though infirm individuals are waived to take part in this religious duty, patients with various health problems, including those with different skin disorders, might choose to share this event with pee…
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Comparison of Intermittent Fasting Versus Caloric Restriction in Obese Subjects: A Two Year Follow-Up.
Objective: Caloric restriction (CR) is proven to be effective in increasing life span and it is well known that, nutritional habits, sleeping pattern and meal frequency have profound effects on human health. In Ramadan some Muslims fast during the day-light hours for a month, providing us a unique model of intermittent fasting (IF) in humans. In the present study, we have investigated the effects of IF versus CR on the same non-diabetic obese subjects who were followed for two years according to the growth hormone (GH)/Insulin like growth factor (IGF)-1 axis and insulin resistance.
Design: Single-arm Interventional Human Study.
Participants: 23 female subjects (Body Mass Index (BMI) 29-39, aged between 28-42years).
Setting: Follow-up is designed as 12 months of CR, after which there was a month of IF and 11 months of CR again, to be totally 24 months. Subjects' daily diets were aligned a…
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Effects of intermittent fasting on HbA1c and weight in insulin versus oral hypoglycemic therapy-treated patients with type 2 diabetes mellitus: a systematic review and meta-analysis.
Aim: Intermittent fasting (IF) has emerged as a beneficial dietary strategy for managing type 2 diabetes mellitus (T2DM), with improvements in certain indicators of body composition and cardiometabolic health. However, limited research compares the different effects of IF in oral hypoglycemic agents (OHAs) versus insulin-treated patients.
Methods: A comprehensive search was performed across PubMed, Scopus, and Cochrane Library (January 2010-January 2025). Randomized controlled trials (RCTs) involving adults (>18-years) with T2DM undergoing IF, time-restricted feeding (TRF), alternate-day fasting (ARF), fasting-mimicking diets (FMD), and Ramadan fasting were included.
Results: In total, 12 studies (n = 1,441 participants) met the inclusion criteria. IF improved glycemic control in both groups, with HbA1c reductions of 0.54% in OHA-users and 2.8% in insulin-users. In the meta-analysis of f…
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Impact of caloric and dietary restriction regimens on markers of health and longevity in humans and animals: a summary of available findings.
Considerable interest has been shown in the ability of caloric restriction (CR) to improve multiple parameters of health and to extend lifespan. CR is the reduction of caloric intake - typically by 20 - 40% of ad libitum consumption - while maintaining adequate nutrient intake. Several alternatives to CR exist. CR combined with exercise (CE) consists of both decreased caloric intake and increased caloric expenditure. Alternate-day fasting (ADF) consists of two interchanging days; one day, subjects may consume food ad libitum (sometimes equaling twice the normal intake); on the other day, food is reduced or withheld altogether. Dietary restriction (DR) - restriction of one or more components of intake (typically macronutrients) with minimal to no reduction in total caloric intake - is another alternative to CR. Many religions incorporate one or more forms of food restriction. The followin…
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Ramadan fasting model exerts hepatoprotective, anti-obesity, and anti-hyperlipidemic effects in an experimentally-induced nonalcoholic fatty liver in rats.
Background: The epidemic of nonalcoholic fatty liver disease (NAFLD) and its metabolic effects present a serious public health concern. We hypothesized that the Ramadan fasting model (RFM), which involves fasting from dawn to dusk for a month, could provide potential therapeutic benefits and mitigate NAFLD. Accordingly, we aimed to validate this hypothesis using obese male rats.
Methods: Rats were split into two groups (n = 24 per group), and they were given either a standard (S) or high-fat diet (HFD) for 12 weeks. During the last four weeks of the study period, both S- and HFD-fed rats were subdivided into eight groups to assess the effect of RFM with/without training (T) or glucose administration (G) on the lipid profile, liver enzymes, and liver structure (n = 6/group).
Results: The HFD+RFM group exhibited a significantly lower final body weight than that in the HFDC group. Serum cho…
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Fasting as a Multisystem Health Modulator: A Narrative Review of Metabolic, Cardiovascular, Immune, Neurocognitive, and Psychospiritual Effects.
Background: Fasting, practiced in clinical, cultural, and faith-based contexts, has emerged as a non-pharmacological strategy capable of modulating multiple physiological systems. Contemporary evidence suggests that diverse fasting patterns (intermittent and time-restricted fasting, Ramadan fasting, alternate-day and periodic fasting, dry fasting, and fasting-mimicking diets) converge on shared metabolic-circadian-immune pathways and can be conceptualized within an integrated resilience framework.
Aim: This narrative review synthesizes current experimental and human data on fasting as a multisystem health modulator, linking metabolic, cardiovascular, immune, gut-liver-microbiome, neurocognitive, endocrine, and psychospiritual effects to common regulatory axes, particularly the Metabolic-Circadian-Immune (MCI) and Energy-Information-Resilience (EIR) models.
Results: Across fasting modalit…
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Religious and culturally conscious sleep care for Muslim patients: Clinical considerations and recommendations.
The paper explores the impact of religious practices on sleep among Muslim patients and develops strategies for delivering religio-culturally conscious sleep care. We aim to enhance understanding among healthcare providers to improve patient outcomes through tailored sleep interventions. A quasi-scoping, narrative review of clinical perspectives, existing empirical studies, and patient-reported experiences from relevant literature, including empirical studies in PubMed, on the influence of Islamic practices such as the five daily prayers, Ramadan fasting, and Qailulah (midday naps) on sleep patterns was conducted. These practices were analyzed for their contribution to circadian misalignment, sleep deprivation, and alterations in sleep architecture. Strategies for integrating cultural and religious practices into sleep care are proposed, focusing on education, collaboration, and personal…
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Ramadan fasting and pregnancy: an evidence-based guide for the obstetrician.
Pregnant Muslim women may be religiously exempt from fasting during the Islamic month of Ramadan, especially if there is concern for undue hardship or harm to maternal or fetal health. However, several studies demonstrate that most women still choose to fast during pregnancy and avoid discussing fasting with their providers. A targeted literature review of published studies on fasting during Ramadan and pregnancy or maternal and fetal outcomes was performed. We generally found little to no clinically significant effect of fasting on neonatal birthweight or preterm delivery. Conflicting data exist on fasting and mode of delivery. Fasting during Ramadan has been mainly associated with signs and symptoms of maternal fatigue and dehydration, with a minimal decrease in weight gain. There is conflicting data regarding the association with gestational diabetes mellitus and insufficient data on …
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Impact of Fasting on Cardiovascular Outcomes in Patients With Hypertension.
Fasting has been frequently practiced for religious or medical purposes worldwide. However, limited literature assesses the impact of different fasting patterns on the physiologic and cardiac-related parameters in patients with hypertension. This review aims to examine the effect of fasting on cardiovascular outcomes in hypertensive patients. Medline, Embase, and Cochrane library were systematically screened until March 2021 for observational prospective cohorts investigating the effect of fasting on cardiovascular outcomes. Articles were assessed by searching for hypertension and fasting, both as Medical Subject Headings (MeSH) terms and text words. The review included studies assessing Ramadan, intermittent, and water-only fasting. Water-only fasting reduces body weight, blood pressure, and lipolytic activity of fasting hypertensive patients without affecting average heart rate. Ramada…
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Emara MH, Soliman HH, Elnadry M, Mohamed Said E, Abd-Elsalam S, Elbatae HE, Zaher TI, Ezzeldin S Bazeed S, Abdel-Razik A, Youssef Mohamed S, Elfert A, “Egyptian Ramadan Fasting, Liver Diseases Interest Group” (2021)reviewMEDLINE-indexed journal, not yet read by usLiver international : official journal of the International Association for the Study of the Liver13 citations Ramadan fasting and liver diseases: A review with practice advices and recommendations.
Ramadan fasting is obligatory for Muslim healthy adults. However, there are many exemptions from fasting; including patients, whose diseases will be aggravated by fasting. Muslim patients with different liver diseases are frequently seen in the clinics discussing their intent to fast this month with their treating physicians. To answer our patients' inquiries about the expected benefits and/or risks of fasting and delivering them the best care, we carried out this review and we draw advices and recommendations based on the available evidence. A web-based search, combining multiple keywords representing different liver diseases with Ramadan fasting had been carried out. To answer the research question: Do adult Muslim patients with different liver diseases who fast the month of Ramadan have had a deleterious effect on their health in comparison to those who did not fast? Relevant publicat…
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Effects of Time-Restricted Feeding during Ramadan on Dietary Intake, Body Composition and Metabolic Outcomes.
Ramadan fasting is a form of time-restricted feeding which combines a fast and feast period daily for a duration of one month every year. During Ramadan, Muslims abstain from food and drink consumption from dawn till sunset and this change in the meal schedule and frequency results in significant changes to the composition of the diet, such as energy and nutrient intake. These changes in dietary habits and their corresponding effects on cardiometabolic disease risk are compiled in this review. Ramadan fasting shows limited benefits to body composition via reductions in body mass in both healthy and obese individuals, although the results are often found to be transient and heterogeneous. There is, however, a more consistent improvement in blood lipid profile during Ramadan fasting, which often lasts beyond the Ramadan period. The results for glucose homeostasis, on the contrary, are more…
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Clinical practice points for diabetes management during RAMADAN fast.
Diabetes management during Ramadan is very crucial from the patient perspective as it can present significant risk of hypoglycemia and death when proper care is not taken. Moreover, managing diabetes in fasting Ramadan patients require different mechanisms than the routine diabetes management and pose significant challenge to the health care practitioners. Here we set forth to review the available literature of various clinical trials and studies on different antidiabetic agents in the context of Ramadan. On the basis of available evidence, we suggest that gliclazide is effective and it could be safely recommended in type 2 diabetic patients fasting during Ramadan.
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Recommendations for the Treatment of Patients With Parkinson Disease During Ramadan.
Importance: Every year, Ramadan fasting is practiced by many Muslim individuals. In cases of chronic disease, religious texts allow fasting to be broken. However, many believers still want to fast even at the risk of damaging their health. To our knowledge, there are no published recommendations on the medical management of Parkinson disease (PD) during Ramadan. Effective treatments exist in PD and usually require several daily drug intakes. Apart from worsening symptoms, interrupting PD treatment might lead to a severe withdrawal syndrome.
Observations: Although no specific studies on this topic have led to formal recommendations, we suggest some options for adapting the treatment for patients who fast during Ramadan. The general principle is based on switching the patient's treatment to an equivalent dosage of a dopamine agonist that can be administered once daily or by transdermal pat…
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The implications of Ramadan fasting for human health and well-being.
Unlabelled: Islamic Ramadan is a 29-30 day fast in which food, fluids, medications, drugs and smoking are prohibited during the daylight hours which can be extended between 13 and 18 h · day(-1) depending on the geographical location and season. The majority of health-specific findings related to Ramadan fasting are mixed. The likely causes for these heterogeneous findings lie in the amount of daily time of fasting, number of subjects who smoke, take oral medications, and/or receive intravenous fluids, in the type of food and eating habits and in changes in lifestyle. During Ramadan fasting, glucose homeostasis is maintained by meals taken during night time before dawn and by liver glycogen stores. Changes in serum lipids are variable and depend on the quality and quantity of food intake, physical activity and exercise, and changes in body weight. Compliant, well-controlled type II diabe…
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Sleep in athletes and the effects of Ramadan.
Sleep is now considered as a new frontier in performance enhancement. This article presents background content on sleep function, sleep needs and methods of sleep investigation along with data on the potential effects of Ramadan fasting on sleep in normal individuals and athletes. Accumulated sleep loss has negative impacts on cognitive function, mood, daytime sleepiness and performance. Sleep studies in athletes fasting during Ramadan are very rare. Most of them have demonstrated that during this month, sleep duration decreased and sleep timing shifted. But the direct relation between sleep changes and performance during Ramadan is not yet elucidated. Objective sleep patterns can be investigated using polysomnography, actigraphy, and standardised questionnaires and recorded in daily journals or sleep logs. The available data on sleep indicate that team doctors and coaches should conside…
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The effects of fasting on metabolism and performance.
An overnight fast of 8-10 h is normal for most people. Fasting is characterised by a coordinated set of metabolic changes designed to spare carbohydrate and increase reliance on fat as a substrate for energy supply. As well as sparing the limited endogenous carbohydrate, and increased rate of gluconeogenesis from amino acids, glycerol and ketone bodies help maintain the supply of carbohydrate. Many individuals undergo periodic fasts for health, religious or cultural reasons. Ramadan fasting, involving 1 month of abstention from food and fluid intake during daylight hours, is practised by a large part of the world population. This period involves a shift in the pattern of intake from daytime to the hours of darkness. There seems to be little effect on overall daily dietary intake and only small metabolic effects, but there may be implications for both physical and cognitive function. The …
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Azizi F (2010)reviewMEDLINE-indexed journal, not yet read by usAnnals of nutrition & metabolism107 citations Islamic fasting and health.
Background: Muslims fast from sunrise to sunset during the month of Ramadan, the 9th lunar month. The duration of fasting varies from 13 to 18 h/day. Fasting includes avoidance of drinking liquids and eating foods. The aim of this article is to review health-related aspects of Ramadan fasting.
Methods: Related abstracts from 1960 to 2009 were obtained from Medline and local journals in Islamic countries. One hundred and thirteen articles meeting the criteria for paper selection were reviewed in depth to identify details of related materials.
Results: During the fasting days of Ramadan glucose homeostasis is maintained by meals taken before dawn and by liver glycogen stores. Changes in serum lipids are variable and depend on the quality and quantity of food consumption and changes in weight. Compliant, well-controlled type 2 diabetics may observe Ramadan fasting, but fasting is not recomm…
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Suggested insulin regimens for patients with type 1 diabetes mellitus who wish to fast during the month of Ramadan.
Objectives: This paper reviews available information on insulin regimens that may enable patients with type 1 diabetes mellitus to fast during the month of Ramadan with minimal complications. It also provides guidance for health care professionals in managing patients who wish to observe the fast.
Methods: Relevant English-language articles were identified through searches of the MEDLINE, EMBASE, and Index Medicus Eastern Mediterranean Region databases (all, 1980-2008) conducted in February 2008 using the terms Ramadan, fasting, type 1 diabetes mellitus, hypoglycemia, and hypotension. Only original research and review articles related to adult patients with type 1 diabetes were considered for review, excluding pregnant women and patients with poorly controlled disease.
Results: The literature review identified 5 clinical trials relevant to type 1 diabetes and fasting. Two main meals are …
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Benaji B, Benaji B, Mounib N, Roky R, Aadil N, Houti IE, Moussamih S, Maliki S, Gressier B, El Ghomari H (2006)reviewMEDLINE-indexed journal, not yet read by usDiabetes research and clinical practice79 citations Diabetes and Ramadan: review of the literature.
During the month of Ramadan, Muslims fast every day from dawn to sunset. In the healthy subject, this fasting does not have any harmful consequences on health. However, it can induce several complications for patients with diabetes. The aim of this review twofold: first, it seeks to give some clues about methodological aspect of research during Ramadan and to show the impact of various diabetes monitoring and treatment, including biochemical and clinical parameters, diet and caloric intake, drug intake when fasting. Second, it intends to determine whether or not Ramadan fasting induces complications in patients with types 1 and 2 diabetes and ultimately to elaborate some advice as to the management of fasting patients. Several studies have shown that Ramadan fasting did not alter biochemical parameters in patients with type 2 diabetes. However, other studies have shown that there is eith…
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Review of Muslim Patient Needs and Its Implications on Healthcare Delivery.
Background: In the rapidly changing environment of healthcare, striving toward health equity and providing patient-centered care is imperative to the patient's experience. To achieve these goals, a comprehensive understanding of the diverse patient populations seeking these services, their needs, and the multitude of religious, cultural, and structural elements that impact their well-being is required. Muslim patients represent a considerable demographic, both in number and complexity of religious and cultural beliefs and practices. This scoping review examines the intersection of religion and cultural values with healthcare delivery in the context of the Muslim patient experience.
Objectives: The objective of this review is to identify key concepts and challenges that impact the Muslim patient experience.
Search methods: The research databases Cochrane Library, OVID Medline, and PubMED …
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