Ramadan Fasting: Do We Need More Evidence?

Document Type : Review Article

Authors

Department of Nutrition, School of Medicine, Biochemistry and Nutrition, Endoscopic & Minimally Invasive Surgery, and Cancer Research Centers, Mashhad University of Medical Sciences (MUMS), Mashad, Iran

Abstract

Over a billion of Muslims fast worldwide during Ramadan each year. Through this religious custom, fasting contributes to their health as well as their spiritual growth. However, available evidence regarding the health-benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many fast conceivably, and their clinical condition is prone to deteriorate due to persistent gap between current expert knowledge and conclusive strong evidence regarding the pathophysiologic and metabolic alterations of fasting and the consensus that should be taken into account to implements guided managing of various patient groups during Ramadan fasting among health care professionals. In this article, we summarized the results of initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition and clinically important outcomes of patients with a previous history of cardiovascular disease, asthma and renal colic disease. Our studies have shed light on several outcomes in favor of Ramadan fasting, and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. In this review we aimed to present a piece of relevant evidence, clarify future scope and provide suggestions for future investigations.

Keywords

References

  1. Chtourou H, Hammouda O, Chaouachi A, Chamari K, Souissi N. The effect of time-of-day and Ramadan fasting on anaerobic performances. Int J Sports Med; 2012; 33(2):142-7.

  2. Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, et al. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA. 2004; 292: 1440–6.

  3. Hallak MH, Nomani MZ. Body weight loss and changes in blood lipid level in normal men on hypocaloric diets during Ramadan fasting. Am J Clin Nutr. 1988; 48(5):1197-210.

  4. Sweileh N, Schnitzler A, Hunter GR, Davis B. Body composition and energy metabolism in resting and exercising Muslims during Ramadan fast. J Sports Med Phys Fitness. 1992; 32(2):156-63.

  5. Born M, Elmadfa I, Schmal FW. Effects of periodic fluid and food withdrawal. An inquiry conducted during the Lenten month Ramadan on foreign workers (author's transl). MMW. 1979; 121(47): 1569-72.

  6. Sadiya A, Ahmed S, Siddieg HH, Babas IJ, Carlsson M.Effect of Ramadan fasting on metabolic markers, body composition, and dietary intake in Emiratis of Ajman (UAE) with metabolic syndrome. Diabetes Metab Syndr Obes. 2011; 4:409-16.

  7. Al-Hourani HM, Atoum MF. Body composition, nutrient intake and physical activity patterns in young women during Ramadan. Singapore Med J. 2007; 48(10):906-10.

  8. Shariatpanahi ZV, Shariatpanahi MV, Shahbazi S, Hossaini A, Abadi A. Effect of Ramadan fasting on some indices of insulin resistance and components of the metabolic syndrome in healthy male adults. Br J Nutr. 2008; 100(1):147–51.

  9. El Ati J, Beji C, Danguir J. Increased fat oxidation during Ramadan fasting in healthy women: an adaptive mechanism for body weight maintenance. Am J Clin Nutr. 1995; 62(2):302–7.

  10. Unalacak M, Kara IH, Baltaci D, Erdem O, Bucaktepe PG. Effects of Ramadan Fasting on Biochemical and Hematological Parameters and Cytokines in Healthy and Obese Individuals. Metab Syndr Relat Disord. 2011;9(2):157-61.

  11. Fakhrzadeh H, Larijani B, Sanjari M, Baradar-Jalili R, Amini M. Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Ann Saudi Med. 2003; 23(3-4):223–6.

  12. Maislos M, Khamaysi N, Assali A, Abou-Rabiah Y,Zvili I, Shany S. Marked increase in plasma highdensity- lipoprotein cholesterol after prolonged fasting during Ramadan. Am J Clin Nutr. 1993; 57(5):640–2.

  13. Bouhlel E, Salhi Z, Bouhlel H, Mdella S, Amamou A, Zaouali M, et al. Effect of Ramadan fasting on fuel oxidation during exercise in trained male rugby players. Diabetes Metab. 2006; 32(6): 617–24.

  14. Chaouachi A, Coutts AJ, Chamari K, Wong DP, Chaouachi M, Chtara M, et al. Effect of Ramadan intermittent fasting on aerobic and anaerobic performance and perception of fatigue in male elite judo athletes. J Strength Cond Res. 2009; 23(9): 2702-9.

  15. Chennaoui M, Desgorces F, Drogou C, Boudjemaa B, Tomaszewski A, Depiesse F, et al. Effects of Ramadan fasting on physical performance and metabolic, hormonal, and inflammatory parameters in middle-distance runners. Appl Physiol Nutr Metab. 2009; 34(4): 587- 94.

  16. Azizi F. Research in Islamic fasting and health. Ann Saudi Med. 2002; 22(3-4): 186–91.

  17. Klein S, Sheard NF, Pi-Sunyer X, Daly A, Wylie- Rosett J, Kulkarni K, et al. Weight management through lifestyle modification in the prevention and management of type 2 Diabetes: Rationale and strategies. A statement of the American diabetes association, the north American association for the study of obesity and the American Society for Clinical Nutrition. Diabetes Care. 2004; 27(8): 2067–73.

  18. Sawka MN, Francesconi RP, Young AJ, Pandoff KB. Influence of dehydration level and body fluids on exercise performance in the heat. JAMA. 1984; 252(9):1165-9.

  19. Fedail SS, Murphy D, Salih SY, Bolton CH, Harvey RF. Changes in certain blood constituents during Ramadan. Am J Clin Nutr. 1982; 36(2): 350-3.

  20. Husain R, Duncan MT, Cheah SH, Ch'ng SL. Effects of fasting in Ramadan on tropical Asiatic Moslems. Br J Nutr. 1987; 58(1):41-8.

  21. Ramadan J, Telahoun G, Al-Zaid NS, Barac-Nieto M. Responses to Exercise, Fluid, and Energy Balances During Ramadan in Sedentary and Active Males. Nutrition. 1999. 15(10):735–9.

  22. Chaouachi A, Chamari K, Roky R, Wong P, Mbazaa A, Bartagi Z, Amri M. Lipid profiles of judo athletes during Ramadan. Int J Sports Med. 2008; 29(4):282-8.

  23. Trabelsi K, Rebai H, El-Abed K, Stannard SR, Khannous H, Masmoudi L, et al. Effect of Ramadan Fasting on Body Water Status Markers after a Rugby Sevens Match. Asian J of Sports Med. 2011; 2(3): 186-94.

  24. Karli U, Guvenc A, Aslan A, Hazir T, Acikada C. Influence of Ramadan fasting on anaerobic performance and recovery following short time. J Fasting Health. 2015; 3(1):4-10. high intensity exercise. J Sports Sci Med. 2007; 6(1):490-7.

  25. VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA. Height-normalized indices of the body’s fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. 1990; 52(6): 953 –9.

  26. Mirzaei B, Rahmani-Nia F, Moghadam MG, Ziyaolhagh SJ, Rezaei A. The Effect of Ramadan Fasting on Biochemical and Performance Parameters in Collegiate Wrestlers. Iran J Basic Med Sci. 2012; 15(6):1215-20.

  27. Güvenç. A. Effects of ramadan fasting on body composition, aerobic Performance and lactate, heart rate and perceptual responses in young soccer players. J Hum Kinet. 2011;29: 79-91.

  28. Hassanein M, Bravis V, Hui E, Devendra D. Ramadan-focused education and awareness in type 2 diabetes. Diabetologia. 2009; 52(2): 367-38.

  29. Afrasiabi A, Hassanzadeh S, Sattarivand R, Mahboob S. Effects of Ramadan fasting on serum lipid profiles on 2 hyperlipidemic groups with or without diet pattern. Saudi Med J.2003;24(1): 23-6.

  30. Tsai AC, Sandretto A, Chung YC. Dieting is more effective in reducing weight but exercise is more effective in reducing fat during the early phase of a weight-reducing program in healthy humans. J Nutr Biochem. 2003; 14(9): 541-9.

  31. Khaled BM, Bendahmane M, Belbraouet S. Ramadan fasting induces modifications of certain serum components in obese women with type 2 diabetes. Saudi Med J.2006; 27(1): 23-6.

  32. Perk G, Ghanem J, Aamar S, Ben-Ishay D, Bursztyn M. The effect of the fast of Ramadan on ambulatory blood pressure in treated hypertensives. J Hum Hypertens. 2001; 15(10): 723-5.

  33. Al Suwaidi J, Bener A, Suliman A, Hajar R, Salam A M, Numan MT, & Al Binali HA. A population based study of Ramadan fasting and acute coronary syndromes. Heart. 2004; 90(6): 695-6.

  34. Akhan G, Kutluhan S, Koyuncuoglu HR. Is there any change of stroke incidence during Ramadan?. Acta Nneurol Scand. 2000; 101(4): 259-61.

  35. Al Suwaidi J, Zubaid M, Al-Mahmeed WA, Al- Rashdan I, Amin H, Bener A, et al. Impact of fasting in Ramadan in patients with cardiac disease. Saudi Med J. 2005;26(10):1579-83.

  36. Al Suwaidi J, Bener A, Gehani AA, Behair S, Al Mohanadi D, Salam A, Al Binali, HA. Does the circadian pattern for acute cardiac events presentation vary with fasting?. J Postgrad Med. 2006; 52(1): 30-3 .

  37. Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012; 11: 69.

  38. Basiri A, Moghaddam SM, Khoddam R, Nejad ST, Hakimi A. Monthly variations of urinary stone colic in Iran and its relationship to the Fasting month of Ramadan. J Pak Med Assoc. 2004; 54(1):6-8.

  39. Abdolreza N, Omalbanin A, Mahdieh TS, Mohammad Ali MR, Reza MS, Maryam S, Mohsen N. Comparison of the number of patients admitted with renal colic during various stages of peri- Ramadan month. Saudi J Kidney Dis Transpl. 2011; 22(6):1199-202.

  40. Bener A, Colakoglu B, Mobayed H, El Hakeem A, Al Mulla AA, Sabbah A. Does hospitalization for asthma and allergic diseases occur more frequently in Ramadan fasting: a population based study (2000-2004). Eur Ann Allergy Clin Immunol. 2006; 38(4):109-12.

  41. Subhan MM, Siddiqui QA, Khan MN, Sabir S. Does Ramadan fasting affect expiratory flow rates in healthy subjects?. Saudi Med J. 2006; 27(11): 1656-60.

  42. Siddiqui QA, Sabir S, Subhan MM. The effect of Ramadan fasting on spirometry in healthy subjects. Respirology. 2005; 10(4):525-8.

  43. Moosavi SA, Kabir A, Moghimi A, Chehrei A, Rad MB. Evaluation of the effect of Islamic fasting on lung volumes and capacities in the healthy persons. Saudi Med J. 2007; 28(11):1666-70.

  44. Sabety Baygi Z, Karimirad R, Norouzy A, Nematy M, Amini M, Sabery M. Effect of Ramadan fasting on pulmonary function test in asthmatic patients. Students' International Conference on Biomedical and Interdisciplinary Research (SICOBAIR); Tehran; 2009.

Files

History

  • Receive Date: 18 March 2015
  • Accept Date: 20 March 2015

Share

How to cite

Statistics