The Effects of Ramadan Intermittent Fasting (RIF) on Spirometric Data of Stable COPD Patients: A Pilot Study

Abstract

No previous study has raised the effects of RIF on lung function data of chronic obstructive pulmonary disease (COPD) patients. The objective of the present study was to assess the effects of RIF on spirometric data measured in male patients with a stable COPD. Sixteen patients with stable COPD (mean ± SD of age: 64 ± 7 years) who fasted during Ramadan volunteered to the study. Three sessions (Before-R, End-R, and After-R) were selected for spirometry tests that were consistently performed 2.5–4.5 hr before fasting break. Assessment sessions comprised: forced vital capacity (FVC), 1st s forced expiratory volume (FEV1), FEV1/FVC, peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEFx%). A reversibility test was performed only during the Before-Ramadan session. Spirometric data were expressed in percentages of local reference values. Findings were analyzed by applying repeated measures analysis of variance. The mean ± SD of the postbronchodilator FEV1/FVC ratio and the FEV1 were, respectively, 0.52 ± 0.14 and 48 ± 19%. The mean ± SD of FEV1 (Before-R: 47 ± 19, End-R: 45 ± 18, After-R: 44 ± 19%), FVC (Before-R: 73 ± 18, End-R: 71 ± 16, After-R: 69 ± 17%), FEV1/FVC (Before-R: 67 ± 16, End-R: 66 ± 16, After-R: 65 ± 16%), PEF (Before-R: 46 ± 19, End-R: 47 ± 22, After-R: 45 ± 21%), MMEF (Before-R: 19 ± 10, End-R: 18 ± 8, After-R: 18 ± 9%), FEF25% (Before-R: 16 ± 6, End-R: 16 ± 5, After-R: 15 ± 5%), FEF50% (Before-R: 21 ± 14, End-R: 20 ± 12, After-R: 20 ± 12%) and FEF75% (Before-R: 27 ± 19, End-R: 27 ± 19, After-R: 27 ± 19%) were not significantly influenced by RIF. RIF did not bring about any significant changes in the spirometric data of stable COPD male patients fasting the 2016 holy month of Ramadan.

The Effects of Ramadan-Fasting (RF) on Inflammatory and Hematological Indices of Stable Chronic Obstructive Pulmonary Disease (COPD) Male Patients: A Pilot Study

“…Discussion concerning the season and the duration of RF, the timing of achieved tests and the number of sessions carried out were addressed in previous papers ( Latiri et al, 2017 ; Zouari et al., 2018 ). Discussion about the spirometric measurements is available in the Supplementary Data section.…”

“…The spirometric data [FVC; FEV 1 ; maximal mid-expiratory flow (MMEF), peak expiratory flow (PEF), FEV 1 /FVC] were expressed in percentages of local reference values ( Ben Saad et al, 2013 ). The FVC maneuver was described elsewhere ( Latiri et al, 2017 ; Zouari et al, 2018 ). The BD test was detailed elsewhere ( Ben Saad, Prefaut, Tabka, Zbidi, & Hayot, 2008 ; Pellegrino et al, 2005 ; Zouari et al, 2018 ).…”

“…The FVC maneuver was described elsewhere ( Latiri et al, 2017 ; Zouari et al, 2018 ). The BD test was detailed elsewhere ( Ben Saad, Prefaut, Tabka, Zbidi, & Hayot, 2008 ; Pellegrino et al, 2005 ; Zouari et al, 2018 ).…”

“…According to the Islamic principles, patients suffering from chronic conditions are discharged from RF ( Official Website of The Presidency of Religious Affairs of the Republic of Turkey, n.d .). In practice, several patients with chronic respiratory diseases refuse these exemptions and insist on fasting (and/or want to fast and/or prefer fasting) during Ramadan ( Adeli, Aghaali, & Nasab, 2015 ; Askari, Alavinezhad, & Boskabady, 2016 ; Aydin et al, 2014 ; Baay, 2017 ; Bener et al, 2006 ; Erkekol et al, 2006 ; Norouzy et al, 2013 ; Zouari et al, 2018 ). For example, almost 93% of Muslim with chronic obstructive pulmonary disease (COPD) are Ramadan fasters ( Aydin et al, 2014 ).…”

“…During the month of Ramadan, it continues to be normally done on COPD patients who prefer fasting. As far as it is known, only one study examined the RF effects on the spirometric data of stable male COPD patients ( Zouari et al, 2018 ). It appeared that RF did not bring about any important changes in COPD spirometric data ( Zouari et al, 2018 ).…”