Effect of Islamic Fasting on the Severity of Rheumatoid Arthritis

Document Type : Research Paper

Authors

1 Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.

2 Research Center of Environmental Determinants of Health,Kermanshah University of Medical Sciences,Kermanshah, Iran.

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory peripheral polyarthritis with unclear etiology. RA usually leads to joint deformity and cartilage destruction in joints of RA patients. The aim of this study was to determine the effect of Islamic fasting on RA (rheumatoid arthritis) severity. Methods: A total number of 28 RA patients in an observational study were randomly divided into two groups. The duration of the study was from 2 weeks prior to start of Ramadan month in 2015 until one month after end of Ramadan. One group followed Islamic fasting during the Ramadan month and another group did not fast. The two groups were visited twice: first before Ramadan and the second time after Ramadan. The number of tender and swollen joints, DAS-28 score, patient-VAS, physician-VAS, and ESR and CRP values were recorded. Results: Mean (±SD) number of tender joints decreased from 1.36 (±1.94) to 0.42 (±0.85) in fasting group (P= 0.02). Mean (±SD) number of swollen joints decreased from 0.79 (±1.05) to 0.07 (±0.26) in fasting group (P= 0.02). DAS-28 and physician-VAS also showed significant decrease in fasting group only. Patient-VAS did not show significant decrease in either group. Mean (±SD) DAS-28 score decreased from 2.74 (±1.06) to 2.18 (±0.64) (P= 0.003) in fasting group. In contrast, mean (SD) DAS-28 score decreased from 2.71 (±0.8) to 2.27 (±1.01) (P= 0.24) in non-fasting group. Conclusion: Islamic fasting during the holy month of Ramadan was effective in decreasing RA severity, but further evidence is required to recommend this type of dietary intervention for RA patients.

Keywords

References

1. Uhlig T, Kvien T. Is rheumatoid arthritis disappearing? Ann Rheum Dis. 2005; 64(1): 7-10.
2. Aletaha D, Smolen J. Rheumatoid arthritis. Target outcome for treatment. Z Rheumatol. 2009; 68(1): 10-5.
3. Nishimura K, Sugiyama D, Kogata Y, Tsuji G, Nakazawa T, Kawano S, et al. Meta-analysis: diagnostic accuracy of anti-cyclic citrullinated peptide antibody and rheumatoid factor for rheumatoid arthritis. Ann Intern Med. 2007; 146(11): 797-808.
4. Saag KG, Teng GG, Patkar NM, Anuntiyo J, Finney C, Curtis JR, et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008; 59(6): 762-84.
5. Nichols VP, Williamson E, Toye F, Lamb SE. A longitudinal, qualitative study exploring sustained adherence to a hand exercise programme for rheumatoid arthritis evaluated in the SARAH trial. Disabil Rehabil. 2017; 39(18): 1856-63.
6. Ferwerda M, van Beugen S, van Middendorp H, Spillekom-van Koulil S, Donders ART, Visser H, et al. A tailored-guided internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumatological care: results of a randomized controlled trial. Pain. 2017; 158(5): 868-78.
7. Tedeschi SK, Costenbader KH. Is There a Role for Diet in the Therapy of Rheumatoid Arthritis? Curr Rheumatol Rep. 2016; 18(5): 23.
8. Rojahn R. Dietary interventions for rheumatoid arthritis. Am J Nurs. 2011; 111(3): 69.
9. Smedslund G, Byfuglien MG, Olsen SU, Hagen KB. Effectiveness and safety of dietary interventions for rheumatoid arthritis: a systematic review of randomized controlled trials. J Am Diet Assoc. 2010; 110(5): 727-35.
10.  Abendroth A, Michalsen A, Ludtke R, Ruffer A, Musial F, Dobos GJ, et al. Changes of Intestinal Microflora in Patients with Rheumatoid Arthritis during Fasting or a Mediterranean Diet. Forsch Komplementmed. 2010; 17(6): 307-13.
11.  Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G. Dietary interventions for rheumatoid arthritis. Cochrane Database Syst Rev. 2009; (1): CD006400.
12.  Rennie KL, Hughes J, Lang R, Jebb SA. Nutritional management of rheumatoid arthritis: a review of the evidence. J Hum Nutr Diet. 2003; 16(2): 97-109.
13.  McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M. Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med. 2002; 8(1): 71-5.
14.  Sköldstam L, Hagfors L, Johansson G. An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Ann Rheum Dis. 2003; 62(3): 208-14.
15.  Darlington LG, Ramsey NW, Mansfield JR. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet. 1986; 1(8475): 236-8.
16.  Zolfaghari S, Pourazizi M, Kokhaei P. Islamic Fasting and Presentations of Rheumatoid Arthritis. Middle East Journal of Rehabilitation and Health. 2015; 2(1): e24843.
17.  Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Laerum E, Eek M, Mowinkel P, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet. 1991; 338(8772): 899-902.
18.  Al-Dubeikil KY, Abdul-Lateef WK. Ramadan Fasting and Rheumatoid Arthritis. Bahrain Med Bull. 2003; 25(2): 68-70.
19.  Mattson MP, Longo VD, Harvie M. Impact of intermittent fasting on health and disease processes. Ageing Res Rev. 2017; 39: 46-58.
20.  Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010; 69(9):1580-8.
21.  Michalsen A, Li C. Fasting therapy for treating and preventing disease - current state of evidence. Forsch Komplementmed. 2013; 20(6): 444-53.
22.  Persynaki A, Karras S, Pichard C. Unraveling the metabolic health benefits of fasting related to religious beliefs: A narrative review. Nutrition. 2017; 35: 14-20.
23.  Jokar MH. Fasting and rheumatic diseases. Journal of Nutrition Fasting and Health. 2015; 3(3): 115-7.
Journal of Nutrition,Fasting and Health
Volume 8, Issue 1
March 2020
Pages 28-33

Files

History

  • Receive Date: 17 March 2019
  • Revise Date: 16 July 2019
  • Accept Date: 21 July 2019

Share

How to cite

Statistics