Ramadan fasting: Evidence or Expert Opinion? Results of preliminary Studies

Document Type : Review Article


1 Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, University Paradise, Azadi Square, Mashhad, Iran

2 Department of Nutrition, School of Medicine, Biochemistry and Nutrition, Endoscopic & Minimally Invasive Surgery, and Cancer Research Center, Mashhad University of Medical Sciences, University Paradise, Azadi Square, Mashhad, Iran

3 Department of Nutrition, School of Medicine, Cardiovascular Research Center, Mashhad University of Medical Sciences, University Paradise, Azadi Square, Mashhad, Iran

4 School of Medicine, Mashhad University of Medical Sciences, University Paradise, Azadi Square, Mashhad, Iran

5 Department of Medical Informatics, School of Medicine, Mashhad University of Medical Sciences, University Paradise, Azadi Square, Mashhad, Iran


Each year, over a billion Muslims fast worldwide during the month of Ramadan. Through this religious practice, not only will one have spiritual growth, but can improve his/her diet, which is of pivotal importance in this month. Conversely, the available evidence regarding the health benefits of Ramadan fasting is scarce and highly contentious. Although Islam exempts patients from fasting, many of them fast conceivably and their clinical condition is prone to deteriorate. This is due to the persistent gap between current expert knowledge and conclusive, strong evidence regarding the pathophysiologic and metabolic alterations by fasting, and the consensus that healthcare professionals should reach, in order to manage various patient groups during this month. In this review, we summarize the results of our initial studies regarding the effects of Ramadan fasting on some clinical conditions including alterations of body composition. We also go through the important clinical results of patients who have had previous history of cardiovascular disease, type 2 diabetes, asthma and renal colic. Our studies have presented some evidence in favor of Ramadan fasting and encourage those with mentioned diseases to consult their physicians and follow medical and scientific recommendations. We attempt to present some relevant evidence clarify future scopes in this area of study, and provide suggestions for future investigations.


Temizhan A, Tandogan I, Dönderici Ö, Demirbas B The effects of Ramadan fasting on blood lipid levels. Gokakin AK, Kurt A, Akgol G, et al Effects of Ramadan fasting on peptic ulcer disease as diagnosed by upper gastrointestinal endoscopy. AlAlwan I, Banyan AA effects of Ramadan fasting on children with type 1 diabetes. Bloomer RJ, Trepanowski JF The impact of religious fasting on human health. Kobeissy A, Zantout MS, Azar ST Suggested insulin regimens for patients with type 1 diabetes mellitus who wish to fast during the month of Ramadan. Azizi F Medical aspects of Islamic fasting. Azizi F, Siahkolah B Ramadan fasting and diabetes mellitus. Alkandari JR, Maughan RJ, Roky R, Aziz AR, Karli U The implications of Ramadan fasting for human health and well-being. Barkia A, Mohamed K, Smaoui M, Zouari N, Hammami M, Nasri M Change of diet, plasma lipids, lipoproteins, and fatty acids during Ramadan: a controversial association of the considered Ramadan model with atherosclerosis risk. Ramadan J Does Fasting during Ramadan Alter Body Composition, Blood Constituents and Physical Performance. Fazel M Medical implications of controlled fasting. Sakr AH Fasting in Islam. Norouzy A, Salehi M, Philippou E, et al Effect of fasting in Ramadan on body composition and nutritional intake: a prospective study. Benaji B, Mounib N, Roky R, et al Diabetes and Ramadan: review of the literature. Oosterbeek H, van der Klaauw B Ramadan, fasting and educational outcomes. Suliman M, Abdu T, Elhadd T, Ibrahim S, Ahmed M, Malik R Diabetes and fasting in Ramadan: Can we provide evidence-based advice to patients. Salti I, Bénard E, Detournay B, et al A Population-Based Study of Diabetes and Its Characteristics During the Fasting Month of Ramadan in 13 Countries Results of the Epidemiology of Diabetes and Ramadan 1422/2001 (EPIDIAR) study. Al-Hourani H, Atoum M Body composition, nutrient intake and physical activity patterns in young women during Ramadan. el Ati J, Beji C, Danguir J Increased fat oxidation during Ramadan fasting in healthy women: an adaptative mechanism for body-weight maintenance. Yucel A, Degirmenci B, Acar M, Albayrak R, Haktanir A The effect of fasting month of Ramadan on the abdominal fat distribution: assessment by computed tomography. Frost G, Pirani S Meal frequency and nutritional intake during Ramadan: a pilot study. Bouguerra R, Jabrane J, Maatki C, et al Ramadan fasting in type 2 diabetes mellitus. Al-Arouj M, Assaad-Khalil S, Buse J, et al Recommendations for management of diabetes during Ramadan update 2010. Nematy M, Alinezhad-Namaghi M, Rashed MM, et al Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Fakhrzadeh H, Larijani B, Sanjari M, Baradar-Jalili R, Amini M Effect of Ramadan fasting on clinical and biochemical parameters in healthy adults. Adlouni A, Ghalim N, Benslimane A, Lecerf J, Saile R Fasting during Ramadan induces a marked increase in high-density lipoprotein cholesterol and decrease in low-density lipoprotein cholesterol. Khatib FA, Shafagoj YA Metabolic alterations as a result of Ramadan fasting in non-insulin-dependent diabetes mellitus patients in relation to food intake. Sarraf-Zadegan N, Atashi M, Naderi GA, et al The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Aksungar FB, Topkaya AE, Akyildiz M Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Ziaee V, Razaei M, Ahmadinejad Z, et al The changes of metabolic profile and weight during Ramadan fasting. Rahman M, Rashid M, Basher S, Sultana S, Nomani M Improved serum HDL cholesterol profile among Bangladeshi male students during Ramadan fasting. Husain R, Duncan M, Cheah S, Ch'Ng S Effects of fasting in Ramadan on tropical Asiatic Moslems. Bloomer RJ, Kabir MM, Canale RE, et al Effect of a 21 day Daniel Fast on metabolic and cardiovascular disease risk factors in men and women. Sweileh N, Schnitzler A, Hunter G, Davis B Body composition and energy metabolism in resting and exercising muslims during Ramadan fast. Maughan R, Fallah J, Coyle E The effects of fasting on metabolism and performance. Siddiqui QA, Sabir S, Subhan MM The effect of Ramadan fasting on spirometry in healthy subjects. Bener A, Colakoglu B, Mobayed H, El Hakeem A, Al Mulla A, Sabbah A Does hospitalization for asthma and allergic diseases occur more frequently in Ramadan fasting: a population based study (2000-2004). Subhan MM, Siddiqui QA, Khan MN, Sabir S Does Ramadan fasting affect expiratory flow rates in healthy subjects?. Moosavi S, Kabir A, Moghimi A, Chehrei A, Rad MB Evaluation of the effect of Islamic fasting on lung volumes and capacities in the healthy persons. Herrag M, Lahmiti S, Yazidi AA Ramadan: a different side of the emergencies?. Norouzy A, Mohajeri S, Shakeri S, et al Effect of Ramadan fasting on glycemic control in patients with Type 2 diabetes. Peeters B, Mehuys E, Van Tongelen I, et al Ramadan fasting and diabetes: An observational study among Turkish migrants in Belgium. Al Sifri S, Basiounny A, Echtay A, et al The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: a randomised trial. Basiri A, Moghaddam S, Khoddam R, Nejad S, Hakimi A Monthly variations of urinary stone colic in Iran and its relationship to the fasting month of Ramadan. Boscolo-Berto R, Dal Moro F, Abate A, Arandjelovic G, Tosato F, Bassi P Do weather conditions influence the onset of renal colic? A novel approach to analysis. Cervellin G, Comelli I, Comelli D, Meschi T, Lippi G, Borghi L Mean temperature and humidity variations, along with patient age, predict the number of visits for renal colic in a large urban Emergency Department: Results of a 9-year survey.