Association of Ramadan Participation with Psychological Parameters: A Cross-Sectional Study during the COVID-19 Pandemic in Iran

Abstract

COVID-19 restrictions are associated with poor physical-activity (PA). Less is known about the relationship between the combination of these restrictions with Ramadan intermittent fasting (RIF), PA, mental health, and sleep-quality. The present study aimed to evaluate whether COVID-19 restrictions and RIF during the fourth wave of the COVID-19 pandemic in Iran are associated with poor PA, anxiety, well-being, and sleep-quality outcomes. A total of 510 individuals participated in an online questionnaire that was disseminated to adults (≥18 years) residing in Iran from 13 May 2021 to 16 May 2021 (~3 days), just after the end of Ramadan 2021. PA behavior (Godin-Shephard Leisure-Time Exercise Questionnaire), anxiety (General Anxiety Disorder-7), well-being (Mental Health Continuum-Short Form), and sleep-quality (Pittsburgh Sleep Quality Index). Of 510 individuals included in the study (331 female (64.9%); mean ± SD, 31 ± 12 years), 172 (33.7%) reported less PA during the Ramadan 2021. PA was associated with better well-being and sleep-quality outcomes. Regardless of PA, participants who fasted for all of Ramadan had less anxiety and better well-being outcomes than those who fasted part of Ramadan or did not fast at all. However, the fasting part of Ramadan decreased the sleep-quality of active participants. The Ramadan 2021 was associated with poor PA, well-being, and sleep-quality of Iranians. However, PA was associated with better well-being and sleep-quality outcomes, and those who fasted all Ramadan had better anxiety and well-being outcomes. Therefore, PA during Ramadan might be an essential and scalable mental health resilience builder during COVID-19 restrictions which should be encouraged.

The impact of COVID-19 pandemic restrictions on physical activity and mental health status of Iranian people

“…For first aim of the present study, as predicted, the results showed that all the measured indices were different before and during the pandemic, lower levels of physical activity and self-esteem and higher levels of social anxiety from before to during the COVID-19. The findings indicating detrimental effects of the COVID-19 pandemic on the levels of physical activity and of psychological indicators are in line with previous studies [ 6 , 15 , 29 – 31 , 33 , 34 ]. For example, Di Franco et al [ 10 ] in their study examined the effects of social distance on mental health status and physical activity during the COVID-19 pandemic.…”

“…However, others have shown that the pandemic has mainly affected the intensity of physical activity and not its frequency in Iran [ 32 ]. Since, research has also shown that physical activity is associated with decreased hospitalisation and can significantly reduce the mortality rates of patients with COVID-19 [Rahmati], and also considering that it has been determined, physical activity can bring many benefits, including improving the levels of well-being and sleep quality as well as reducing people anxiety [ 33 , 34 ]. Therefore, it is suggested that people, especially the older adults try to increase their resistance to various diseases, including COVID-19 pandemic, by increasing their level of physical activity throughout their lives [ 46 , 47 ].…”

“…To date, however, much research has been conducted worldwide on the impact of the COVID-19 pandemic on levels of physical activity and mental health [ 6 , 29 – 31 ]. Also, to our knowledge, there is little information about this, especially for Iran [ 32 – 34 ]. Therefore, this study is designed to achieve the following two goals.…”

Review of the Literature on Ramadan Fasting and Health in 2022

“…Whether COVID-19 restrictions and RF during the fourth wave of the COVID-19 pandemic were associated with poor physical activity, anxiety, well-being, and sleep-quality outcomes were tested. 69 A total of 510 individuals participated in an online questionnaire disseminated to adults (!18 years) residing in Iran 3 days after the end of Ramadan 2021. Physical activity behavior, anxiety, well-being, and sleep quality were used.…”

Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males

“…Observers refrain from eating food, drinking liquids, and other physical needs such as smoking and sexual intercourse ( Ghram et al, 2021 ; Jahromi et al, 2014 ). Ramadan fasting (RF) as intermittent fasting is mandatory for all healthy adult Muslims ( Akbari et al., 2022 ; Lessan & Ali, 2019 ). Several studies have been conducted over the last decade to investigate the impact of RF on physiological performance ( Maughan et al, 2010 ; Zerguini et al, 2007 ).…”