Review of the Literature on Ramadan Fasting and Health in 2022

Abstract

Objectives The literature on health and disease during Ramadan fasting (RF) is widely spread in many journals making it not readily accessible to those interested in the subject. Here, we provide an overview of the research on the interplay of RF with various aspects of well-being published in 2022.

Materials and Methods A narrative, nonsystematic review of the international literature from a single major medical online database, PubMed, in one calendar year (2022) was conducted. The search term “Ramadan fasting” was used to retrieve the appropriate records. The relevant literature with substantial data-based content was presented in a concise thematic account, excluding those concerned with diabetes.

Results Themes that emerged from the review included the pathophysiology of metabolic changes during RF, nutritional aspects including body composition and energy metabolism, cardiovascular disease and risk factors, renal function and structure, endocrinology (mainly thyroid), neurological disorders, mental health, pregnancy and fetal life, and infections (including COVID). Some miscellaneous clinical themes were identified, such as patients' and professional perspectives.

Conclusions In 2022, the medical interest in RF was again widely spread across specialties. Cardiovascular disease and risk factors attract the most interest in terms of original articles and professional guidelines. We hope with this review to present a concise summary of the scholarly work on the subject in this year.

Keywords

Ramadan fasting - patient's perspectives - thyroid - cardiovascular disease - pregnancy - renal function - pathophysiology

Note

To the best of our abilities, we presented our perception of the published work in good faith. Original authors cannot be held responsible for any misrepresentation.

Authors' Contribution

S.A.B. proposed the study, performed the literature searches, and drafted the manuscript. All authors reviewed the whole document for intellectual content. All authors approved its final version.

Compliance with Ethical Principles

No ethical approval is required.

Publikationsverlauf

Artikel online veröffentlicht:
24. April 2023

• References

• 1 Beshyah SA, Fathalla W, Saleh A. et al. Ramadan fasting and the medical patient: an overview for clinicians. Ibnosina J Med Biomed Sci. 2010; 2 (05) 240-257
• 2 Beshyah WS, Beshyah SA. Bibliometric analysis of the literature on Ramadan fasting and diabetes in the past three decades (1989-2018). Diabetes Res Clin Pract 2019; 151: 313-322
• 3 Hafidh K, Besheya T, Elmehdawi RR, Beshyah SA. Ramadan fasting and diabetes (2022): the year in review. J Diabetes Endocr Pract 2023;
• 4 Çakan D, Yılmaz HB, Yıldız MG, Yılmaz YZ, Uşaklıoğlu S. The effect of Ramadan fasting on nasal mucociliary activity and peak nasal inspiratory flow. Eur Arch Otorhinolaryngol 2022; 279 (11) 5247-5252
• 5 Madkour MI, Malhab LJB, Abdel-Rahman WM, Abdelrahim DN, Saber-Ayad M, Faris ME. Ramadan diurnal intermittent fasting is associated with attenuated FTO gene expression in subjects with overweight and obesity: a prospective cohort study. Front Nutr 2022; 8: 741811
• 6 Abedelmalek S, Aloui K, Denguezli Bouzgarou M, Adam H, Souissi N, Chtourou H. Exergaming during Ramadan intermittent fasting improve body composition as well as physiological and psychological responses to physical exercise in adolescents with obesity. Front Nutr 2022; 9: 851054
• 7 Soleimanifar N, Assadiasl S, Alamolhoda MH. et al. Effect of Ramadan fasting on salivary IgA, serum IgA, IL-17, and IL-22 levels. Nutr Health 2022;2601060221092203:2601060221092203
• 8 Roky R, Aadil N, Krami AM. et al. Sex as a biological factor in the changes in disease patients during Ramadan intermittent fasting: a systematic review. Front Nutr 2022; 9: 908674
• 9 Alzhrani A, Alhussain MH, BaHammam AS. Changes in dietary intake, chronotype and sleep pattern upon Ramadan among healthy adults in Jeddah, Saudi Arabia: a prospective study. Front Nutr 2022; 9: 966861
• 10 Macit Çelebi MS, Uzdil Z, ErtaŞ ÖztÜrk Y, Sökülmez Kaya P. Is Ramadan fasting associated with low scores of Healthy Eating Index?. Nutr Hosp 2022; 39 (05) 1058-1063
• 11 Sunardi D, Chandra DN, Medise BE. et al. Assessment of water consumption during Ramadan intermittent fasting: result from Indonesian cross-sectional study. Front Nutr 2022; 9: 922544
• 12 Tsitsou S, Zacharodimos N, Poulia KA, Karatzi K, Dimitriadis G, Papakonstantinou E. Effects of time-restricted feeding and ramadan fasting on body weight, body composition, glucose responses, and insulin resistance: a systematic review of randomized controlled trials. Nutrients 2022; 14 (22) 4778
• 13 Chew HSJ, Ang WHD, Tan ZYA, Ang WW, Chan KS, Lau Y. Umbrella review of time-restricted eating on weight loss, fasting blood glucose, and lipid profile. Nutr Rev 2022;
• 14 Jahrami H, Trabelsi K, Alhaj OA, Saif Z, Pandi-Perumal SR, BaHammam AS. The impact of Ramadan fasting on the metabolic syndrome severity in relation to ethnicity and sex: results of a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2022; 32 (12) 2714-2729
• 15 Mindikoglu AL, Park J, Opekun AR. et al. Dawn-to-dusk dry fasting induces anti-atherosclerotic, anti-inflammatory, and anti-tumorigenic proteome in peripheral blood mononuclear cells in subjects with metabolic syndrome. Metab Open 2022; 16: 100214
• 16 Madkour M, Giddey AD, Soares NC. et al. Ramadan diurnal intermittent fasting is associated with significant plasma metabolomics changes in subjects with overweight and obesity: a prospective cohort study. Front Nutr 2023; 9: 1008730
• 17 Hasan H, Madkour M, Awadallah S, Hassanein M, Jahrami H, Faris M. Ramadan intermittent fasting is associated with changes in circulating proprotein convertase subtilisin/kexin type 9 (PCSK9) in metabolically healthy obese subjects. Medicina (Kaunas) 2022; 58 (04) 503
• 18 Alkaf B, Siddiqui M, Ali T. et al. Ramadan fasting and changes in thyroid function in hypothyroidism: identifying patients at risk. Thyroid 2022; 32 (04) 368-375
• 19 Elsherbiny TM. Impact of fasting on thyrotropin and thyroid status during Ramadan in 292 previously well controlled hypothyroid patients. IFTAR study. Endocrine 2023; 79 (03) 484-490
• 20 Elsherbiny TM. Twice or thrice weekly versus daily thyroxine in hypothyroid fasting Ramadan: a pilot study. Indian J Endocrinol Metab 2022; 26 (03) 265-268
• 21 Al-Qahtani KM, Aldeeri IA, Alshaibi AM. et al. Optimal timing of thyroid hormone replacement during Ramadan fasting: a randomized controlled trial in patients with prior total thyroidectomy. Thyroid 2022; 32 (09) 1029-1036
• 22 Floyd R, Gryson R, Mockler D, Gibney J, Duggan SN, Behan LA. The effect of time-restricted eating on insulin levels and insulin sensitivity in patients with polycystic ovarian syndrome: a systematic review. Int J Endocrinol 2022; 2022: 2830545
• 23 Betesh-Abay B, Shiyovich A, Davidian S, Gilutz H, Shalata W, Plakht Y. The association between acute myocardial infarction-related outcomes and the Ramadan period: a retrospective population-based study. J Clin Med 2022; 11 (17) 5145
• 24 Aydin E, Aydin S, Gül M. et al. Influence of intermittent fasting during Ramadan on circadian variation of symptom-onset and prehospital time delay in acute ST-segment elevation myocardial infarction. Angiology 2022; 33197221114087: 33197221114087
• 25 Alam S, Hussain S, Abbas J. et al. Clinical outcomes of fasting in patients with chronic heart failure with preserved ejection fraction: a prospective analysis. Ann Med Surg (Lond) 2022; 81: 104373
• 26 Ben Ahmed H, Allouche E, Bouzid K. et al. Impact of Ramadan fasting on lipid profile and cardiovascular risk factors in patients with stable coronary artery disease. Ann Cardiol Angeiol (Paris) 2022; 71 (01) 36-40
• 27 Papazoglou AS, Moysidis DV, Tsagkaris C. et al. Impact of religious fasting on metabolic and hematological profile in both dyslipidemic and non-dyslipidemic fasters. Eur J Clin Nutr 2022; 76 (06) 891-898
• 28 Dote-Montero M, Sanchez-Delgado G, Ravussin E. Effects of intermittent fasting on cardiometabolic health: an energy metabolism perspective. Nutrients 2022; 14 (03) 489
• 29 Mengi Çelik Ö, Koçak T, Köksal E. Effects of diurnal Ramadan intermittent fasting on cardiometabolic risk factors and sleep quality in healthy Turkish adults. Ecol Food Nutr 2022; 61 (05) 595-607
• 30 Akhtar AM, Ghouri N, Chahal CAA. et al. Ramadan fasting: recommendations for patients with cardiovascular disease. Heart 2022; 108 (04) 258-265
• 31 Zakhama L, Hammami R, Mzoughi K. et al. Management of patients with cardiovascular diseases during Ramadan. Tunis Med 2022; 100 (05) 358-373
• 32 Naz H, Haider R, Rashid H. et al. Islamic fasting: cardiovascular disease perspective. Expert Rev Cardiovasc Ther 2022; 20 (10) 795-805
• 33 Hammami R, Bahloul A, Charfeddine S. et al. Cardiovascular disease and Ramadan. A literature review. Ann Cardiol Angeiol (Paris) 2022; 71 (03) 166-172
• 34 AlAbdan NA, Almohammed OA, Altukhaim MS. et al. Fasting during Ramadan and acute kidney injury (AKI): a retrospective, propensity matched cohort study. BMC Nephrol 2022; 23 (01) 54
• 35 Ansari FA, Latief M, Manuel S. et al. Impact of fasting during Ramadan on renal functions in patients with chronic kidney disease. Indian J Nephrol 2022; 32 (03) 262-265
• 36 Emara AA, Ghareeb AH, Fayez M, Elsharabasy RM. Ramadan fasting in hemodialysis population: single-center study. Egypt J Intern Med 2022; 34 (01) 63
• 37 Tarabeih M, Qaddumi J, Hamdan Z. et al. Increasing overnight fluid intake and kidney function during ramadan fasting: a randomized controlled trial. Transplant Proc 2023; 55 (01) 80-86
• 38 Chu H, Goli S, Rammohan A. In utero Ramadan exposure and child nutrition. J Dev Orig Health Dis 2023; 14 (01) 96-109
• 39 Yate Z, Abdelghani Soliman SM. Lactation assessment for Muslim breastfeeding women who fast during Ramadan: understanding an Islamic legal dispensation. J Hum Lact 2022; 38 (03) 525-530
• 40 Uludağ E, Göral Türkcü S. Ramadan fasting as a religious obligation: a qualitative study on opinions and experiences of Muslim pregnant women about fasting in Turkey. J Relig Health 2022; 61 (04) 2960-2974
• 41 Alenezi A, Livesay K, McGrath I, Kimpton A. Ostomy-related problems and their impact on quality of life of Saudi ostomate patients: a mixed-methods study. J Clin Nurs 2022;
• 42 Dişçi E, Atamanalp SS. Factors precipitating volvulus formation in sigmoid volvulus. Ulus Travma Acil Cerrahi Derg 2022; 28 (03) 281-284
• 43 Ojemolon PE, Maghari I, Almoghrabi A. Diurnal fasting during ramadan leading to superior mesenteric artery syndrome. ACG Case Rep J 2022; 9 (10) e00901
• 44 Craggs-Dino L, El Chaar M, Husain FA. et al; American Society for Metabolic and Bariatric Surgery Integrated Health Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery review on fasting for religious purposes after surgery. Surg Obes Relat Dis 2022; 18 (07) 861-871
• 45 Maaloul R, Marzougui H, Ben Dhia I. et al. Effectiveness of Ramadan diurnal intermittent fasting and concurrent training in the management of obesity: Is the combination worth the weight?. Nutr Metab Cardiovasc Dis 2023; 33 (03) 659-666
• 46 Yagin FH, Eken Ö, Bayer R. et al. A thirty-minute nap enhances performance in running-based anaerobic sprint tests during and after Ramadan observance. Int J Environ Res Public Health 2022; 19 (22) 14699
• 47 Dergaa I, Ammar A, Souissi A. et al. COVID-19 lockdown: impairments of objective measurements of selected physical activity, cardiorespiratory and sleep parameters in trained fitness coaches. EXCLI J 2022; 21: 1084-1098
• 48 Kammoun N, Hidouri S, Ghram A. et al. Effects of walking football during Ramadan fasting on heart rate variability and physical fitness in healthy middle-aged males. Am J Men Health 2022; 16 (03) 15 579883221103418
• 49 Martínez-Rodríguez A, Miralles-Amorós L, Vicente-Martínez M, Asencio-Mas N, Yáñez-Sepúlveda R, Martínez-Olcina M. Ramadan nutritional strategy: professional soccer player case study. Nutrients 2022; 14 (03) 465
• 50 Trabelsi K, Ammar A, Glenn JM. et al. Does observance of Ramadan affect sleep in athletes and physically active individuals? A systematic review and meta-analysis. J Sleep Res 2022; 31 (03) e13503
• 51 DeLang MD, Salamh PA, Chtourou H, Saad HB, Chamari K. The effects of Ramadan intermittent fasting on football players and implications for domestic football leagues over the next decade: a systematic review. Sports Med 2022; 52 (03) 585-600
• 52 Trabelsi K, Ammar A, Boukhris O. et al. Dietary intake and body composition during Ramadan in athletes: a systematic review and meta-analysis with meta-regression. J Am Nutr Assoc 2023; 42 (01) 101-122
• 53 Chen S, Ali I, Li X. et al. Shifts in fecal metabolite profiles associated with Ramadan fasting among Chinese and Pakistani individuals. Front Nutr 2022; 9: 845086
• 54 Mousavi SN, Rayyani E, Heshmati J, Tavasolian R, Rahimlou M. Effects of Ramadan and non-Ramadan intermittent fasting on gut microbiome. Front Nutr 2022; 9: 860575
• 55 Negm M, Bahaa A, Farrag A. et al. Effect of Ramadan intermittent fasting on inflammatory markers, disease severity, depression, and quality of life in patients with inflammatory bowel diseases: a prospective cohort study. BMC Gastroenterol 2022; 22 (01) 203
• 56 Besbes A, Khemiss M, Bragazzi N, Ben Saad H. The impacts of Ramadan intermittent fasting on saliva flow-rate and metabolic data: a systematic review. Front Nutr 2022; 9: 873502
• 57 Badran H, Elsabaawy M, Sakr A. et al. Impact of intermittent fasting on laboratory, radiological, and anthropometric parameters in NAFLD patients. Clin Exp Hepatol 2022; 8 (02) 118-124
• 58 Boujelbane MA, Trabelsi K, Jahrami HA. et al. Time-restricted feeding and cognitive function in sedentary and physically active elderly individuals: Ramadan diurnal intermittent fasting as a model. Front Nutr 2022; 9: 1041216
• 59 Alotaibi N, Aldriweesh MA, Alhasson MA. et al. Clinical characteristics and outcomes of ischemic stroke patients during Ramadan vs. non-Ramadan months: Is there a difference?. Front Neurol 2022; 13: 925764
• 60 Magdy R, Kishk NA, Abokrysha NT, Ramzy GM, Rizk HI, Hussein M. Fasting and post fasting effect of Ramadan on different seizure types in patients with active epilepsy. Nutr Neurosci 2022; 25 (05) 1100-1104
• 61 Ben Ammar H, Ben Massoued R, Ben Hamadi A, Khelifa E, Hakiri A, El Hechmi Z. Hospitalizations in psychiatry during the month of Ramadan: a study at the Tunisian mental health hospital. Int J Soc Psychiatry 2022; 68 (02) 341-345
• 62 Rad MS, Ansarinia M, Shafir E. Temporary self-deprivation can impair cognitive control: evidence from the Ramadan fast. Pers Soc Psychol Bull 2023; 49 (03) 415-428
• 63 Almulhem M, Thayakaran R, Hanif S. et al. Ramadan is not associated with increased infection risk in Pakistani and Bangladeshi populations: findings from controlled interrupted time series analysis of UK primary care data. PLoS One 2022; 17 (01) e0262530
• 64 Slimani M, Znazen H, Azaiez F, Bragazzi NL. The effect of Ramadan and COVID-19 on the relationship between physical activity and burnout among teachers. Nutrients 2022; 14 (13) 2648
• 65 Khatib MA. The impact of Ramadan during COVID-19 confinement on weight, dietary, and lifestyle habits in the Kingdom of Saudi Arabia: a cross-sectional study. BMC Public Health 2022; 22 (01) 1649
• 66 Widhani A, Yunihastuti E, Setiati S, Witjaksono F, Karjadi TH. Ramadan fasting reduces high-sensitivity C-reactive protein among HIV-infected patients receiving antiretroviral therapy. Front Nutr 2023; 9: 964797
• 67 Romdhani M, Ammar A, Trabelsi K. et al. Ramadan observance exacerbated the negative effects of COVID-19 lockdown on sleep and training behaviors: an international survey on 1,681 Muslim athletes. Front Nutr 2022; 9: 925092
• 68 Washif JA, Pyne DB, Sandbakk Ø. et al. Ramadan intermittent fasting induced poorer training practices during the COVID-19 lockdown: a global cross-sectional study with 5529 athletes from 110 countries. Biol Sport 2022; 39 (04) 1103-1115
• 69 Akbari HA, Yoosefi M, Pourabbas M. et al. Association of Ramadan participation with psychological parameters: a cross-sectional study during the COVID-19 pandemic in Iran. J Clin Med 2022; 11 (09) 2346
• 70 Shokoohi-Rad S, Shoeibi N, Ghasemi Nour M, Bakhtiari E. Evaluation of the effect of religious fasting on retinal vessel density and retinal thickness using optical coherence tomography angiography. Neuroophthalmology 2021; 46 (03) 147-153
• 71 Almutairi N, Shaaban D. Clinical implications of intermittent Ramadan fasting on stable plaque psoriasis: a prospective observational study. Postepy Dermatol Alergol 2022; 39 (02) 368-374
• 72 Rabea EM, Abbas KS, Awad DM. et al. Does Ramadan fasting affect the therapeutic and clinical outcomes of warfarin? a systematic review and meta-analysis. Eur J Clin Pharmacol 2022; 78 (05) 755-763
• 73 Ghaffary MR, Talei A, Moradian M, Ghaffari S. The effect of fasting on spirometry indices and respiratory symptoms in asthmatic patients. J Cardiovasc Thorac Res 2022; 14 (02) 116-121
• 74 Ben Nessib D, Maatallah K, Ferjani H, Triki W, Kaffel D, Hamdi W. Sustainable positive effects of Ramadan intermittent fasting in rheumatoid arthritis. Clin Rheumatol 2022; 41 (02) 399-403
• 75 Lachgar A, Ridai S, Mouafik S. et al. [Ramadan fasting during treatment with external beam radiotherapy]. Bull Cancer 2022; 109 (03) 331-337
• 76 Baynouna AlKetbi L, Nagelkerke N, AlZarouni A. et al. Ramadan fasting outcome among high-risk patients. BMC Nephrol 2022; 23 (01) 304
• 77 Mahmood A, Dar S, Dabhad A, Aksi B, Chowdhury TA. Advising patients with existing conditions about fasting during Ramadan. BMJ 2022; 376: e063613
• 78 To TP, Taylor SE, Abdullah A. et al. Qualitative exploration of Australian Muslim patients' perceptions and experiences surrounding medication management during Ramadan. Aust Health Rev 2022; 46 (03) 346-354
• 79 Shalihin N, Sholihin M. Ramadan: the month of fasting for Muslim and social cohesion-mapping the unexplored effect. Heliyon 2022; 8 (10) e10977
• 80 Sulaiman SK, Tsiga-Ahmed FI, Faris ME. et al. Nigerian Muslim's perceptions of changes in diet, weight, and health status during Ramadan: a nationwide cross-sectional study. Int J Environ Res Public Health 2022; 19 (21) 14340
• 81 Nuryakin C, Muchtar PA, Massie NWG, Hambali S. Having exams during Ramadan: the case of Indonesia. Econ Hum Biol 2022; 47: 101183
• 82 Deen M, Moothadeth A, Waqar S, Awad E, Ghouri N. Fasting during Ramadan and fitness for work implications. Occup Med (Lond) 2022; 72 (03) 154-156
• 83 Zainudin SB, Salle DDA, Aziz AR. Walking football during Ramadan fasting for cardiometabolic and psychological health benefits to the physically challenged and aged populations. Front Nutr 2022; 8: 779863