The effects of fasting in Ramadan

Gumaa, K.A.; Mustafa, K. Y.; Mahmoud, N. A.; Gader, A. M. A.

doi:10.1079/bjn19780161

Cited by 87 publications

(21 citation statements)

References 27 publications

(3 reference statements)

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“…Studies on Ramadan-type fasting in practicing Muslims have given conflicting data, with some reporting beneficial effects [11], [12], [48] while others reporting deleterious effects [49]–[51] on metabolic and hormonal variables. This could be due to differences in dietary and sleeping patterns and habits in different countries [52]–[54].…”

Section: Discussionmentioning

confidence: 99%

Health Impact of Fasting in Saudi Arabia during Ramadan: Association with Disturbed Circadian Rhythm and Metabolic and Sleeping Patterns

et al. 2014

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BackgroundMuslims go through strict Ramadan fasting from dawn till sunset for one month yearly. These practices are associated with disturbed feeding and sleep patterns. We recently demonstrated that, during Ramadan, circadian cortisol rhythm of Saudis is abolished, exposing these subjects to continuously increased cortisol levels.HypothesisSecretory patterns of other hormones and metabolic parameters associated with cortisol, and insulin resistance, might be affected during Ramadan.ProtocolRamadan practitioners (18 males, 5 females; mean age ±SEM = 23.16±1.2 years) were evaluated before and two weeks into Ramadan. Blood was collected for measurements of endocrine and metabolic parameters at 9 am (±1 hour) and again twelve hours later.ResultsIn Ramadan, glucose concentration was kept within normal range, with a significant increase in the morning. Mean morning concentration of leptin was significantly higher than pre-Ramadan values (p = 0.001), in contrast to that of adiponectin, which was significantly lower (p<0.001). These changes were associated with increased insulin resistance in morning and evening. Concentrations of hsCRP were lower during Ramadan than those during regular living conditions, however, normal circadian fluctuation was abolished (p = 0.49). Even though means of liver enzymes, total bilirubin, total protein and albumin were all decreased during Ramadan, statistically lower means were only noted for GGT, total protein, and albumin (p = 0.018, 0.002 and 0.001 respectively).DiscussionSaudi Ramadan practitioners have altered adipokine patterns, typical of insulin resistance. The noted decreases of hsCRP, liver enzymes, total protein, and albumin, are most likely a result of fasting, while loss of circadian rhythmicity of hsCRP is probably due to loss of circadian cortisol rhythm.ConclusionsModern Ramadan practices in Saudi Arabia, which are associated with evening hypercortisolism, are also characterized by altered adipokines patterns, and an abolished hsCRP circadian rhythm, all likely to increase cardiometabolic risk.

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Section: Discussionmentioning

confidence: 99%

Health Impact of Fasting in Saudi Arabia during Ramadan: Association with Disturbed Circadian Rhythm and Metabolic and Sleeping Patterns

et al. 2014

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“…Some researchers have reported increased concentrations of serum cholesterol, which may have been related to loss of weight during Ramadan fasting. However, some researchers have found either no change or decreased values of serum cholesterol during Ramadan fasting [23][24][25][26][27].…”

Section: Resultsmentioning

confidence: 99%

Effect of Ramadan Fasting on Body Weight, (BP) and Biochemical Parameters in Middle Aged Hypertensive Subjects: An Observational Trial

Sa¹,

2014

JCDR

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IntrOductIOnThe Islamic month of Ramadan which is dedicated to fasting is strictly observed by millions of Muslims all over the world. With more than a billion people being followers of Islam, there are hundreds of millions of people who practise the Ramadan fast every year [1,2].Fasting involves abstinence from any kind of food and drinks from sunrise to sunset. This leads to repeated fasting and refeeding cycles. Naturally, this alters normal feeding pattern, sleep and behaviour of the people who practise the Ramadan fasting. This becomes particularly important in people with hypertension or other cardiovascular diseases, who decide to fast during the month of Ramadan, as a religious obligation. The most common related question which is asked by a patient with known cardiovascular disease, including hypertension, to a physician, is regarding recommendations for fasting in the light of medical research. Several studies done on animals have shown that fasting and refeeding cycles can cause or aggravate hypertension [3][4][5][6]. However, Ramadan fasting presents a unique model which is different from experimental fasting. Apart from the feeding behaviour, factors affecting BP during Ramadan include changes in medication timing and possibly, salt intake. However, the effect of the fast on the BP in hypertensive subjects is an issue that has rarely been addressed [7,8].Fasting in Ramadan has been shown to have some effects on the circulating levels of several biochemical markers which are known to be associated with vascular and metabolic disorders, including cholesterol [9][10][11]. There are conflicting reports on effect of Ramadan fasting on body weight, with some studies reporting significant decrease and others reporting no significant decrease in body weight [12][13][14]. The present study was done to evaluate the effect of Ramadan fasting on BP, body weight and serum cholesterol in hypertensive subjects. Biochemistry Section MethOdsStudy design: A prospective, observational trial.

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“…This obligatory change in lifestyle, in terms of obtaining the daily calorie intake via two meals in lieu of the customary four or five meals a day or alteration in medication schedule or reduction in daily sleep duration, might affect patients with cardiovascular diseases (CVD). Although more than a billion Muslims observe Ramadan fast the world over, there is still a great deal of controversy in the medical community on the effect of this important Islamic tenet on CVD ( 2 - 4 ) and there is a dearth of data on its impact on patients with coronary artery disease (CAD).…”

Section: Introductionmentioning

confidence: 99%

Ramadan Fast in Patients With Coronary Artery Disease

Mousavi¹,

Mirkarimi²,

Rahmani³

et al. 2014

Iran Red Crescent Med J

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Background:Fasting during the month of Ramadan is of vital significance amongst Muslims; however, little is known about the effects of this kind of fasting on patients with coronary artery disease (CAD).Objectives:This nonrandomized prospective observational pilot study was designed to investigate the effects of Ramadan fast on the symptoms of CAD.Patients and Methods:Patients with documented CAD were consecutively (nonrandomized) included in the study, and those with heart failure (ejection fraction < 50%), renal failure, gout, and insulin-treated diabetes were excluded. Patients had the choice of fasting during Ramadan if they so wished and to break their fast as soon as symptoms such as dyspnea and chest pain occurred (fasting group) or not fasting (control group).Results:A total of 148 patients completed the study. Mean (mean ± SD) age of the patients was 61.5 ± 11.7 years and 50% were male. Finally, 66 patients (44.6%) accomplished Ramadan fast with an average of 22.27 ± 10.46 days of fasting. Occurrence of chest pain was not significantly different between the fasting and non-fasting groups (4 out of 66 [6.1%] vs. 8 out of 82 [9.8%] respectively; P = 0.42). In addition, patients who fasted during Ramadan did not experience a higher frequency of a combined endpoint of chest pain and dyspnea (4 out of 66 cases in the fasting group [6.1%] vs. 11 out of 82 in non-fasting group [13.4%]; P = 0.14).Conclusions:In the present study, the patients with CAD were able to observe Ramadan fast safely and their combined endpoint of chest pain and dyspnea was not significantly different from that of the non-fasting ones. We would suggest that patients with CAD and normal left ventricular function could fast during Ramadan.

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The effects of fasting in Ramadan

Cited by 87 publications

References 27 publications

Health Impact of Fasting in Saudi Arabia during Ramadan: Association with Disturbed Circadian Rhythm and Metabolic and Sleeping Patterns

Health Impact of Fasting in Saudi Arabia during Ramadan: Association with Disturbed Circadian Rhythm and Metabolic and Sleeping Patterns

Effect of Ramadan Fasting on Body Weight, (BP) and Biochemical Parameters in Middle Aged Hypertensive Subjects: An Observational Trial

Ramadan Fast in Patients With Coronary Artery Disease

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