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Gholampoor N, Sharif AH, Mellor D. The effect of observing religious or faith-based fasting on cardiovascular disease risk factors: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2024; 34:1097-1109. [PMID: 38508992 DOI: 10.1016/j.numecd.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 03/22/2024]
Abstract
AIMS Cardiovascular diseases (CVD) are the leading cause of death worldwide. Fasting is common in many religions and is associated with health benefits. This systematic review to compares the impact of different religious fasting practices, on risk of cardiometabolic diseases. DATA SYNTHESIS The search covered five databases following PRISMA guidelines to identify papers published in English from inception to March 2023 (updated January 2024). Inclusion criteria were healthy adults in observational studies, who engaged in religious fasting practices, studies were included where data on matched non-fasting individuals was available. Outcomes were systolic and diastolic blood pressure, body mass index (BMI), triglycerides, total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc), and fasting plasma glucose levels. A meta-analysis was conducted, and the review was registered (CRD42022352197). Fourteen studies were met the inclusion criteria with ten studies data being suitable for meta-analysis, reporting on 755 adults participating in fasting practices and 661 non-fasting controls. Religious fasting was associated with a reduction in BMI (-0.40 kg/m2, 95% CI [-0.70, -0.10], p < 0.01). Observance of Ramadan fasting was associated with decreased systolic blood pressure (-3.83 mmHg, 95% CI [-7.44, -0.23], p = 0.04). The observance of Orthodox Christian fasting was associated with a reduction in TC (-0.52 mmoL/l, 95%CI [-0.64, -0.39], p < 0.01). No difference was found for the other outcomes. CONCLUSION This review found religious fasting practices which were associated with a reduction in some biomarkers of cardiometabolic diseases risk. Further research on other fasting practices is needed due to limited data.
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Affiliation(s)
- Negin Gholampoor
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | | | - Duane Mellor
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham, United Kingdom.
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Yao K, Su H, Cui K, Gao Y, Xu D, Wang Q, Ha Z, Zhang T, Chen S, Liu T. Effectiveness of an intermittent fasting diet versus regular diet on fat loss in overweight and obese middle-aged and elderly people without metabolic disease: a systematic review and meta-analysis of randomized controlled trials. J Nutr Health Aging 2024; 28:100165. [PMID: 38308923 DOI: 10.1016/j.jnha.2024.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/31/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVE As the number of adults aged over 40 with obesity increases dramatically, intermittent fasting interventions (IF) may help them to lose fat and weight. This systematic review investigated the most recent research on the effects of intermittent fasting and a regular diet on body composition and lipids in adults aged over 40 with obesity without the metabolic disease. DATA SOURCES Randomized controlled trials (RCTs) on IF on adults aged over 40 with obesity were retrieved from PubMed, Web of Science, EBSCO, China Knowledge Network (CNKI), VIP database, Wanfang database with the experimental group using IF and the control group using a regular diet. Revman was used for meta-analysis. Effect sizes are expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). STUDY SELECTION A total of 9 articles of randomised controlled trials that met the requirements were screened for inclusion. Studies typically lasted 2-6 weeks. The experimental population was aged 42-66 years, with a BMI range of 25.7-35 kg/m2. SYNTHESIS A total of 9 RCTs were included. meta-analysis showed that body weight (MD: -2.05 kg; 95% CI (-3.84, -0.27); p = 0.02), BMI (MD: -0.73 kg/m2; 95% CI (-1.05, -0.41); p < 0.001), fat mass (MD: -2.14 kg; 95% CI (-3.81, 0.47); p = 0.01), and TG (MD = -0.32 mmol/L, 95% CI (-0.50, -0.15, p < 0.001) were significantly lower in the experimental group than in the control group. No significant reduction in lean body mass (MD: -0.31 kg; 95% CI (-0.96, 0.34); p = 0.35). CONCLUSION IF had a reduction in body weight, BMI, fat mass, and TG in adults aged over 40 with obesity without metabolic disease compared to RD, and IF did not cause a significant decrease in lean body mass, which suggests healthy and effective fat loss. However, more long-term and high-quality trials are needed to reach definitive conclusions.
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Affiliation(s)
- Ke Yao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Hao Su
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China.
| | - Kaiyin Cui
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Ye Gao
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Dengyun Xu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Qian Wang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Zhitong Ha
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Teng Zhang
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Shuning Chen
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
| | - Tao Liu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China; The School of Sports Science, Beijing Sport University, Beijing, China
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Jahrami H, Ammar A, Glenn JM, Saif Z, Chtourou H, Trabelsi K. An umbrella review and meta-analysis of meta-analyses of the impact of Ramadan fasting on the metabolic syndrome components. Nutr Rev 2024:nuae001. [PMID: 38335125 DOI: 10.1093/nutrit/nuae001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
CONTEXT Ramadan is a holy month of fasting, spiritual reflection, and worship for Muslims worldwide. However, the Ramadan fast - which involves abstaining from all food and drink, sunrise to sunset for 29 days-30 days annually - may also influence physical health outcomes, especially relating to the risk of metabolic syndrome. OBJECTIVE The literature from the top of the pyramid of evidence was gathered and synthesized for this comprehensive umbrella review and meta-analysis of meta-analyses in order to provide an overall conclusion on the impact of Ramadan fasting with regard to metabolic syndrome components. DATA EXTRACTION Eleven systematic reviews and meta-analyses were included in the current umbrella review. Nine components, including waist circumference, body weight), high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure), and fasting blood plasma glucose were analyzed. DATA ANALYSIS The random-effects meta-analysis results revealed standard mean differences as follows: waist circumference -0.30 (95% confidence interval [CI] -0.33 to -0.27), body weight -0.34 (95% CI -0.39 to -0.29), high-density lipoprotein 0.20 (95% CI 0.10 to 0.30), low-density lipoprotein -0.10 (95% CI -0.13 to -0.07), total cholesterol -0.15 (95% CI -0.21 to -0.09), triglycerides -0.16 (95% CI -0.24 to -0.08), systolic blood pressure -0.20 (95% CI -0.23 to -0.17), diastolic blood pressure -0.20 (95% CI -0.22 to -0.18), fasting blood plasma glucose -0.10 (95% CI -0.12 to -0.08). CONCLUSION Ramadan fasting appears to benefit body weight, lipid profile, blood pressure, and fasting blood glucose levels. Therefore, engaging in fasting during Ramadan may contribute to weight reduction, decreased cardiovascular disease risk, improved blood pressure, and enhanced glycemic control. Nevertheless, the methodological quality of the included reviews ranged from low to critically low, necessitating cautious interpretation of conclusions drawn from these data. SYSTEMATIC REVIEW REGISTRATION Open Science Framework Identifier: DOI 10.17605/OSF.IO/9WVJZ.
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Affiliation(s)
- Haitham Jahrami
- Government Hospitals, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
| | - Jordan M Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | | | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia
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Billingsley HE. The effect of time of eating on cardiometabolic risk in primary and secondary prevention of cardiovascular disease. Diabetes Metab Res Rev 2024; 40:e3633. [PMID: 36914410 DOI: 10.1002/dmrr.3633] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 03/14/2023]
Abstract
Continuous energy restriction is currently considered the first-line dietary therapy for weight loss in individuals with obesity. Recently, interventions which alter the eating window and time of eating occasions have been explored as means to achieve weight loss and other cardiometabolic improvements such as a reduction in blood pressure, glycaemia, lipids and inflammation. It is unknown, however, whether these changes result from unintentional energy restriction or from other mechanisms such as the alignment of nutrient intake with the internal circadian clock. Even less is known regarding the safety and efficacy of these interventions in individuals with established chronic noncommunicable disease states, such as cardiovascular disease. This review examines the effects of interventions which alter both eating window and time of eating occasions on weight and other cardiometabolic risk factors in both healthy participants and those with established cardiovascular disease. We then summarise the state of existing knowledge and explore future directions of study.
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Affiliation(s)
- Hayley E Billingsley
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, USA
- VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
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Alkurd R, Mahrous L, Zeb F, Khan MAB, Alhaj H, Khraiwesh HM, Faris ME. Effect of Calorie Restriction and Intermittent Fasting Regimens on Brain-Derived Neurotrophic Factor Levels and Cognitive Function in Humans: A Systematic Review. Medicina (Kaunas) 2024; 60:191. [PMID: 38276070 PMCID: PMC10819730 DOI: 10.3390/medicina60010191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Background: The potential positive interaction between intermittent fasting (IF) and brain-derived neurotrophic factor (BDNF) on cognitive function has been widely discussed. This systematic review tried to assess the efficacy of interventions with different IF regimens on BDNF levels and their association with cognitive functions in humans. Interventions with different forms of IF such as caloric restriction (CR), alternate-day fasting (ADF), time-restricted eating (TRE), and the Ramadan model of intermittent fasting (RIF) were targeted. Methods: A systematic review was conducted for experimental and observational studies on healthy people and patients with diseases published in EMBASE, Scopus, PubMed, and Google Scholar databases from January 2000 to December 2023. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statements (PRISMA) for writing this review. Results: Sixteen research works conducted on healthy people and patients with metabolic disorders met the inclusion criteria for this systematic review. Five studies showed a significant increase in BDNF after the intervention, while five studies reported a significant decrease in BDNF levels, and the other six studies showed no significant changes in BDNF levels due to IF regimens. Moreover, five studies examined the RIF protocol, of which, three studies showed a significant reduction, while two showed a significant increase in BDNF levels, along with an improvement in cognitive function after RIF. Conclusions: The current findings suggest that IF has varying effects on BDNF levels and cognitive functions in healthy, overweight/obese individuals and patients with metabolic conditions. However, few human studies have shown that IF increases BDNF levels, with controversial results. In humans, IF has yet to be fully investigated in terms of its long-term effect on BDNF and cognitive functions. Large-scale, well-controlled studies with high-quality data are warranted to elucidate the impact of the IF regimens on BDNF levels and cognitive functions.
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Affiliation(s)
- Refat Alkurd
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 11196, Jordan;
| | - Lana Mahrous
- Department of Health Sciences/Track of Clinical Nutrition, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh 12461, Saudi Arabia;
| | - Falak Zeb
- Nutrition and Food Research Group, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain 15551, United Arab Emirates;
| | - Hamid Alhaj
- Family and Community Medicine and Behavioral Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates;
| | - Husam M. Khraiwesh
- Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University, Salt 19117, Jordan;
| | - MoezAlIslam E. Faris
- Nutrition and Food Research Group, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, United Arab Emirates;
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
- Healthy Aging, Longevity and Sustainability Research Group, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah 27272, United Arab Emirates
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Alasmari AA, Al-Khalifah AS, BaHammam AS, Alshiban NMS, Almnaizel AT, Alodah HS, Alhussain MH. Ramadan fasting model exerts hepatoprotective, anti-obesity, and anti-hyperlipidemic effects in an experimentally-induced nonalcoholic fatty liver in rats. Saudi J Gastroenterol 2024; 30:53-62. [PMID: 38192177 PMCID: PMC10852143 DOI: 10.4103/sjg.sjg_204_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/19/2023] [Accepted: 07/17/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The epidemic of nonalcoholic fatty liver disease (NAFLD) and its metabolic effects present a serious public health concern. We hypothesized that the Ramadan fasting model (RFM), which involves fasting from dawn to dusk for a month, could provide potential therapeutic benefits and mitigate NAFLD. Accordingly, we aimed to validate this hypothesis using obese male rats. METHODS Rats were split into two groups (n = 24 per group), and they were given either a standard (S) or high-fat diet (HFD) for 12 weeks. During the last four weeks of the study period, both S- and HFD-fed rats were subdivided into eight groups to assess the effect of RFM with/without training (T) or glucose administration (G) on the lipid profile, liver enzymes, and liver structure (n = 6/group). RESULTS The HFD+RFM group exhibited a significantly lower final body weight than that in the HFDC group. Serum cholesterol, low-density lipoprotein, and triglyceride levels were significantly lower in the HFD+RFM, HFD+RFM+T, and HFD+RFM+G groups than those in the HFDC group. Compared with the HFDC group, all groups had improved serum high-density lipoprotein levels. Furthermore, HFD groups subjected to RFM had reduced serum levels of aspartate transaminase and alanine transaminase compared with those of the HFD-fed group. Moreover, the liver histology improved in rats subjected to RFM compared with that of HFD-fed rats, which exhibited macro- and micro-fat droplet accumulation. CONCLUSION RFM can induce positive metabolic changes and improve alterations associated with NAFLD, including weight gain, lipid profile, liver enzymes, and hepatic steatosis.
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Affiliation(s)
- Abeer A. Alasmari
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman S. Al-Khalifah
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed S. BaHammam
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Noura M. S. Alshiban
- Experimental Surgery and Animal Lab, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad T. Almnaizel
- Experimental Surgery and Animal Lab, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hesham S. Alodah
- Experimental Surgery and Animal Lab, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, College of Food and Agriculture Sciences, King Saud University, Riyadh, Saudi Arabia
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AbuShihab K, Obaideen K, Alameddine M, Alkurd RAF, Khraiwesh HM, Mohammad Y, Abdelrahim DN, Madkour MI, Faris ME. Reflection on Ramadan Fasting Research Related to Sustainable Development Goal 3 (Good Health and Well-Being): A Bibliometric Analysis. J Relig Health 2023:10.1007/s10943-023-01955-9. [PMID: 38110843 DOI: 10.1007/s10943-023-01955-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 12/20/2023]
Abstract
There is a large body of research on Ramadan intermittent fasting (RIF) and health in Muslim communities, that can offer insights to promote the achievement of Sustainable Development Goal 3 (SDG 3), which encompasses good health and well-being. Based on recent bibliometric evidence, we hypothesized that RIF research is highly relevant to SDG 3, particularly Targets 3.1, 3.2, 3.4, and 3.5. Therefore, this bibliometric study quantified RIF literature supporting SDG 3 and associated targets over the past seven decades and explored themes and trends. All types of research articles were extracted from the Scopus database from inception to March 2022. Microsoft Excel, Biblioshiny, and VOSviewer were used to qualitatively and quantitatively examine RIF research trends supporting SDG 3 and associated targets. We identified 1729 relevant articles. The number of publications notably increased since 1986, with a dramatic increase in 2019-2020. RIF research predominantly supported Target 3.4 (reducing risk for non-communicable diseases), with research hotspots being diabetes, diabetes medications, pregnancy, physiology, metabolic diseases, and obesity and metabolism. This target was also the most commonly supported by dedicated authors and institutions publishing on RIF, whereas other SDG 3 targets were negligibly addressed in comparison. Our comprehensive bibliometric analysis of RIF literature showed growing support for SDG 3 through positive contributions to half of the SDG 3 targets, although Target 3.4 received the most attention. We also identified knowledge gaps that may shape further research directions on RIF and promote the achievement of SDG 3 in Muslim communities.
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Affiliation(s)
- Katia AbuShihab
- Nutrition and Food Research Group, Research Institute of Medical and Health Sciences (RIMHS), Sharjah University, Sharjah, United Arab Emirates
| | - Khaled Obaideen
- Sustainable Engineering Asset Management Research Group, University of Sharjah, Sharjah, United Arab Emirates.
| | - Mohamad Alameddine
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Refat Ahmad Fawzi Alkurd
- Faculty of Pharmacy and Medical Sciences, Department of Nutrition, University of Petra, Amman, Jordan
| | - Husam M Khraiwesh
- Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa' Applied University, Salt, Jordan
| | - Yara Mohammad
- College of Engineering and Information Technology, Ajman University, Ajman, United Arab Emirates
| | - Dana N Abdelrahim
- Health Promotion Research Group, Research Institute of Medical and Health Sciences (RIMHS), Sharjah University, Sharjah, United Arab Emirates
| | - Mohamed I Madkour
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates.
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
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Gallo Afflitto G, Chou TH, Swaminathan SS, Aiello F, Gedde SJ, Nucci C, Porciatti V. Pattern Electroretinogram in Ocular Hypertension, Glaucoma Suspect and Early Manifest Glaucoma Eyes: A Systematic Review and Meta-analysis. Ophthalmol Sci 2023; 3:100322. [PMID: 37334035 PMCID: PMC10272507 DOI: 10.1016/j.xops.2023.100322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 06/20/2023]
Abstract
Topic To provide standardized confidence limits of the transient pattern electroretinogram (tPERG) P50 and N95 and steady state pattern electroretinogram (ssPERG) amplitudes in normal controls as compared to ocular hypertension (OHT), glaucoma suspect (GS), or early manifest glaucoma (EMG) eyes. Clinical Relevance The identification of standardized confidence limits in the context of pattern electroretinogram (PERG) might overcome the high intrinsic variability of the measure, and it might lead to a more intuitive understanding of the results as well as to an easier comparison of data from multiple tests, sites, and operators. Methods The study protocol was prospectively registered on the International Prospective Register of Systematic Reviews (ID: CRD42022370032). A literature search was conducted on PubMed, Web of Science, and Scopus. Studies comparing PERG raw data in normal control eyes as compared to OHT, GS, or EMG were included. The risk of bias was assessed using the National Institute for Health and Clinical Excellence quality assessment tool. The main outcome was the P50, N95, and ssPERG amplitude difference between the control and the study groups' eyes. The standardized mean difference was calculated as a measure of the effect size for the primary outcome. A subanalysis was conducted based on the type of electrodes adopted for the PERG measurements (invasive vs. noninvasive). Results Of the 4580 eligible papers, only 23 were included (1754 eyes). Statistically significant amplitude differences were found in the P50, N95, and ssPERG amplitudes between normal controls and OHT, GS, and EMG eyes. The highest standardized mean difference values were observed in the ssPERG amplitude in all 3 sets of comparison. The subanalysis did not reveal any statistically significant differences between invasive and noninvasive recording strategies. Conclusions The use of standardized values as the main outcome measures in the context of the PERG data analysis is a valid approach, normalizing several confounding factors which have affected the clinical utility of PERG both for individual patients and in clinical trials. Steady state PERG apparently better discriminates diseased eyes compared to tPERG. The adoption of skin-active electrodes is able to adequately discriminate between healthy and diseased statuses. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Gabriele Gallo Afflitto
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Tsung-Han Chou
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Swarup S. Swaminathan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Steven J. Gedde
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Vittorio Porciatti
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
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Abdelrahim DN, El Herrag SE, Khaled MB, Radwan H, Naja F, Alkurd R, Khan MAB, Zeb F, AbuShihab KH, Mahrous L, Obaideen K, Kalam F, Granata Iv F, Madkour M, Faris ME. Changes in energy and macronutrient intakes during Ramadan fasting: a systematic review, meta-analysis, and meta-regression. Nutr Rev 2023:nuad141. [PMID: 37986623 DOI: 10.1093/nutrit/nuad141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
CONTEXT Ramadan fasting (RF) is associated with various physiological and metabolic changes among fasting Muslims. However, it remains unclear whether these effects are attributable to changes in meal timing or changes in dietary energy and macronutrient intakes. Furthermore, the literature on the associations between RF, meal timing, and energy and macronutrient intakes is inconclusive. OBJECTIVES This systematic review aimed to estimate the effect sizes of RF on energy and macronutrient intakes (carbohydrates, protein, fats, dietary fiber, and water) and determine the effect of different moderators on the examined outcomes. DATA SOURCES The Cochrane, CINAHL, EMBASE, EBSCOhost, Google Scholar, PubMed/MEDLINE, ProQuest Medical, Scopus, ScienceDirect, and Web of Science databases were searched from inception to January 31, 2022. DATA EXTRACTION The studies that assessed energy, carbohydrate, protein, fat, fiber, and water intakes pre- and post-fasting were extracted. DATA ANALYSIS Of the 4776 identified studies, 85 relevant studies (n = 4594 participants aged 9-85 y) were selected. The effect sizes for the studied variables were as follows: energy (number of studies [K] = 80, n = 3343 participants; mean difference [MD]: -142.45; 95% confidence interval [CI]: -215.19, -69.71), carbohydrates (K = 75, n = 3111; MD: -23.90; 95% CI: -36.42, -11.38), protein (K = 74, n = 3108; MD: -4.21; 95% CI: -7.34, -1.07), fats (K = 73, n = 3058; MD: -2.03; 95% CI: -5.73, 1.67), fiber (K = 16, n = 1198; MD: 0.47; 95% CI: -1.44, 2.39), and water (K = 17, n = 772; MD: -350.80; 95% CI: -618.09, 83.50). Subgroup analyses showed age significantly moderated the 6 dietary outcomes, and physical activity significantly moderated water intake. There were significant reductions in energy, carbohydrate, and protein intakes during RF. CONCLUSIONS The change in meal timing rather than quantitative dietary intake may explain various physiological and health effects associated with RF.
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Affiliation(s)
- Dana N Abdelrahim
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Salah Eddine El Herrag
- Laboratoire de Nutrition, Pathologie, Agro-biotechnologie & Santé (Lab-NuPABS), Djillali Liabes University, Sidi Bel Abbes, Algeria
- Department of Biology, Faculty of Life and Natural Science, Djillali Liabes University of Sidi Bel Abbes, Sidi Bel Abbes, Algeria
| | - Meghit Boumediene Khaled
- Laboratoire de Nutrition, Pathologie, Agro-biotechnologie & Santé (Lab-NuPABS), Djillali Liabes University, Sidi Bel Abbes, Algeria
- Department of Biology, Faculty of Life and Natural Science, Djillali Liabes University of Sidi Bel Abbes, Sidi Bel Abbes, Algeria
| | - Hadia Radwan
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Refat Alkurd
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, Petra University, Amman, Jordan
| | - Moien A B Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Falak Zeb
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Katia H AbuShihab
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Lana Mahrous
- Department of Health Sciences/Track of Clinical Nutrition, College of Health and Rehabilitation, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Khaled Obaideen
- Sustainable Energy and Power Systems Research Centre, RISE, University of Sharjah, Sharjah, United Arab Emirates
| | - Faiza Kalam
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Frank Granata Iv
- Department of Medical Education, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois, USA
| | - Mohamed Madkour
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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10
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Madkour MI, Islam MT, Tippetts TS, Chowdhury KH, Lesniewski LA, Summers SA, Zeb F, Abdelrahim DN, AlKurd R, Khraiwesh HM, AbuShihab KH, AlBakri A, Obaideen K, Faris ME. Ramadan intermittent fasting is associated with ameliorated inflammatory markers and improved plasma sphingolipids/ceramides in subjects with obesity: lipidomics analysis. Sci Rep 2023; 13:17322. [PMID: 37833312 PMCID: PMC10576029 DOI: 10.1038/s41598-023-43862-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Intermittent fasting (IF) is associated with enormous metabolic alterations that underpin its diverse health effects. Changes in lipid metabolism, particularly ceramides, and other sphingolipids, are among the most notable of these alterations. This study investigated the lipidomic alterations associated with 29-30 days of Ramadan diurnal intermittent fasting (RIF) in metabolically healthy overweight and obese subjects. A prospective cohort of 57 overweight and obese adults (70% males, 38.4 ± 11.2 years), with an age range of 18-58 years was observed prior to and at the conclusion of Ramadan. At both time points, anthropometric, biochemical (lipid profile, glycemic, and inflammatory markers), and dietary intake measurements were taken. Using liquid chromatography-mass spectrometry, a lipidomic analysis of ceramides and other sphingolipids was conducted. Using paired sample t-tests, pre- and post-Ramadan anthropometric, biochemical, and dietary values were compared. RIF was associated with improved levels of lipid profile compartments and inflammatory markers. In addition, RIF was associated with a decrease in plasma sphingosine and sphinganine, which was accompanied by a decrease in sphingosine 1-phosphate and sphinganine 1-phosphate. In addition, RIF was associated with decreased C17, C22, and C24 sphingomyelin, but not C14, C16, C18, C20, and C24:1 sphingomyelin, as well as C20, C22, C24, and C24:1 dihydrosphingomyelin, but not C16 and C18 dihydrosphingomyelin. This study demonstrates that RIF is associated with improvements in plasma sphingosine, sphinganine sphingomyelin, and dihydrosphingomyelin lipid species, as well as improved lipid profile and inflammatory markers, which may confer short-term protection against cardiometabolic problems in patients with overweight/obesity.
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Affiliation(s)
- Mohamed Ibrahim Madkour
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | - Md Torikul Islam
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Trevor S Tippetts
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Kamrul H Chowdhury
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Lisa A Lesniewski
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Scott A Summers
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Falak Zeb
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | - Dana N Abdelrahim
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | - Refat AlKurd
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Husam M Khraiwesh
- Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa Applied University, Salt, Jordan
| | - Katia H AbuShihab
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE
| | - Asma AlBakri
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Khaled Obaideen
- Sustainable Energy and Power Systems Research Centre, RISE, University of Sharjah, Sharjah, UAE
| | - MoezAlIslam E Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, UAE.
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, UAE.
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11
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Abdallah H, Khalil M, Farella I, JohnBritto JS, Lanza E, Santoro S, Garruti G, Portincasa P, Di Ciaula A, Bonfrate L. Ramadan intermittent fasting reduces visceral fat and improves gastrointestinal motility. Eur J Clin Invest 2023; 53:e14029. [PMID: 37203871 DOI: 10.1111/eci.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Ramadan is a model of intermittent fasting linked with possible beneficial effects. Scarce information, however, is available about the combined effects of Ramadan intermittent fasting (RIF) on anthropometric and metabolic indices, gastrointestinal symptoms, and motility. METHODS In 21 healthy Muslims, we assessed the impact of RIF on caloric intake, physical activity, gastrointestinal symptoms and motility (gastric/gallbladder emptying by ultrasonography, orocaecal transit time by lactulose breath test), anthropometric indices, subcutaneous and visceral fat thickness (ultrasonography), glucose and lipid homeostasis. RESULTS Mean caloric intake decreased from a median of 2069 kcal (range 1677-2641) before Ramadan to 1798 kcal (1289-3126) during Ramadan and increased again to 2000 kcal (1309-3485) after Ramadan. Although physical activity remained stable before, during, and after RIF, body weight, body mass index and waist circumference decreased in all subjects and in both genders, together with a significant decrease in subcutaneous and visceral fat thickness and insulin resistance. The postprandial gastric emptying speed was significantly faster after than before RIF. Fasting gallbladder volume was about 6% smaller after, than before Ramadan, with a stronger and faster postprandial gallbladder contraction. After RIF, lactulose breath test documented increased microbiota carbohydrate fermentation (postprandial H2 peak), and faster orocaecal transit time. RIF also significantly improved gastric fullness, epigastric pain and heartburn. CONCLUSIONS RIF generates, in healthy subjects, multiple systemic beneficial effects in terms of fat burden, metabolic profile, gastrointestinal motility and symptoms. Further comprehensive studies should assess the potential beneficial effects of RIF in diseased people.
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Affiliation(s)
- Hala Abdallah
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Mohamad Khalil
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Ilaria Farella
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Jerlin Stephy JohnBritto
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Elisa Lanza
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Sergio Santoro
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Gabriella Garruti
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Piero Portincasa
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Agostino Di Ciaula
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Leonilde Bonfrate
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePre-J), Clinica Medica "A. Murri", University of Bari "Aldo Moro" Medical School, Bari, Italy
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12
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Faris ME, Laher I, Khaled MB, Zouhal H. Editorial: The model of Ramadan diurnal intermittent fasting: unraveling the health implications, volume II. Front Nutr 2023; 10:1247771. [PMID: 37680895 PMCID: PMC10482407 DOI: 10.3389/fnut.2023.1247771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023] Open
Affiliation(s)
- MoezAlIslam Ezzat Faris
- Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | | | - Hassane Zouhal
- Department of Science and Techniques of Physical and Sporting Activities (STAPS), University Rennes, M2S (Laboratoire Mouvement, Sport, Santé), Rennes, France
- Institut International des Sciences du Sport (2I2S), Rennes, France
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Abdelrahim DN, Rachida R, Krami AM, Nadia A, Faris ME. Sex as a biological determinant in anthropometric, biochemical, and dietary changes during Ramadan intermittent fasting in healthy people: A systematic review. Diabetes Metab Syndr 2023; 17:102762. [PMID: 37141819 DOI: 10.1016/j.dsx.2023.102762] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/06/2023]
Abstract
AIMS Observing Ramadan intermittent fasting (RIF) is associated with different behavioral, dietary, and health-related outcomes among healthy and unwell people. Sex is a major biological determinant that affects various health outcomes and impacts the effectiveness of dietary and lifestyle modifications. This systematic review aimed to identify differences in health-related outcomes following the practice of RIF by the sex of study participants. METHODS A systematic search was conducted across several databases to qualitatively identify studies focused on dietary, anthropometric, and biochemical outcomes associated with RIF in females and males. RESULTS Of 3870 retrieved studies, sex-based differences were reported in 29 studies that included 3167 healthy people (females n = 1558, 49.2%). Most differences between males and females were reported both before and during RIF. Sex differences were examined for 69 outcomes following RIF and included dietary factors (17 outcomes), anthropometrics (13 outcomes), and biochemical factors (39 outcomes), with the latter including metabolic, hormonal, regulatory, inflammatory, and nutrition-related biochemical markers. CONCLUSIONS Sex-based differences were observed in the examined dietary, anthropometric, and biochemical outcomes associated with the observance of RIF. More attention needs to be directed toward including both sexes in studies focused on the impact of observing RIF and differentiating outcomes based on sex.
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Affiliation(s)
- Dana N Abdelrahim
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Roky Rachida
- Laboratory of Physiopathology, Molecular Genetics & Biotechnology, Faculty of Sciences Ain Chock, Health and Biotechnology Research Centre, Hassan II University of Casa Blanca, Casablanca, Morocco
| | - Al Mahdi Krami
- Laboratory of Physiopathology, Molecular Genetics & Biotechnology, Faculty of Sciences Ain Chock, Health and Biotechnology Research Centre, Hassan II University of Casa Blanca, Casablanca, Morocco
| | - Aadil Nadia
- Laboratory of Physiopathology, Molecular Genetics & Biotechnology, Faculty of Sciences Ain Chock, Health and Biotechnology Research Centre, Hassan II University of Casa Blanca, Casablanca, Morocco
| | - MoezAlIslam Ezzat Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates; University of Sharjah, College of Health Sciences, Department of Clinical Nutrition and Dietetics, United Arab Emirates.
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Sulaiman SK, Tsiga-Ahmed FI, Arora T, Faris ME, Musa MS, Kareem YA, Dayyab FM, Hussein A, Sale S, Javaid SF, Khan MA. Perceived changes in the mental well-being among Nigerians due to Ramadan Intermittent Fasting during the COVID-19 pandemic. Brain Behav 2023; 13:e2990. [PMID: 37060182 PMCID: PMC10175984 DOI: 10.1002/brb3.2990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/09/2023] [Accepted: 03/20/2023] [Indexed: 04/16/2023] Open
Abstract
INTRODUCTION Muslims fast every year during the month of Ramadan from dawn until dusk. This study examined mental well-being and correlating factors among Nigerian adults who observed Ramadan intermittent fasting (RIF). METHODS A validated generalized anxiety disorder-2 and Patient Health Questionnaire-2, the four-item spiritual well-being index, and the Islamic intrinsic religiosity questionnaire were used to collect data about mental well-being (depression, anxiety), spirituality, and intrinsic religiosity through a web-based survey between the May 9, 2021 (27th of Ramadan, 1442) and the June 4, 2021 (29th of Shawwal, 1442). We studied the mental well-being of respondents over a period of 4 weeks before Ramadan (BR) and during the 4 weeks of Ramadan between the April 12, 2021 and the May 12, 2021(DR). Multinomial regression analysis was used to determine the factors associated with depression and anxiety. This research did not receive any grant or funding. RESULTS A total of 770 adult Nigerians who observed RIF study were included in this cross-sectional study. When compared to mental well-being BR, observing RIF by Nigerian adult respondents was associated with a significant improvement in their mental well-being. A higher proportion of respondents felt less depressed DR (61.3% vs. 56.5%. < .001). Interest and pleasure in doing things improved DR than BR (p= 0.007) and respondents felt less nervous and anxious (60.7% vs. 57.1%, respectively; p <.001). Mental well-being was independently associated with sociodemographic characteristics, physical activity, and perceived relationships. CONCLUSIONS This study found significant improvement in mental well-being DR compared to BR despite the ongoing COVID-19 pandemic. The effect of RIF on mental well-being needs further research with multicentric studies among different sets of ethnic populations.
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Affiliation(s)
| | | | - Teresa Arora
- College of Natural & Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Yesir Adeyemi Kareem
- Department of General and Geriatric Psychiatry, Federal Neuropsychiatric Hospital, Maiduguri, Nigeria
| | | | - Aminu Hussein
- Department of Family Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Shehu Sale
- Department of Child Psychiatry, Federal Neuropsychiatric Hospital, Kware, Sokoto, Nigeria
- Department of Psychiatry, Bayero University Kano, Kano, Nigeria
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Moien Ab Khan
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Primary Care, NHS North West London, London, United Kingdom
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15
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Kokkinopoulou A, Rodopaios NE, Koulouri AA, Vasara E, Papadopoulou SK, Skepastianos P, Dermitzakis E, Hassapidou M, Kafatos AG. Impact of Christian Orthodox Church Fasting on Metabolic Syndrome Components in Adults Aged 18-49 Years. Nutrients 2023; 15:nu15071755. [PMID: 37049597 PMCID: PMC10096952 DOI: 10.3390/nu15071755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/30/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE Studies regarding health effects of religious fasting have been increased during the last decade. Our aim was to investigate the effects of Christian Orthodox Church (COC) fasting on metabolic syndrome in young adults. METHODS Participants were 224 men and women, of whom 111 had been following the COC fasting regime and 113 were non-fasters, all aged 18 to 49 years (mean age 29.23 ± 8.78 years). Anthropometric measurements, including the Bioelectrical Impedance Analysis, were performed on individuals, and they also completed food intake questionnaires, and provided blood samples for biochemical analysis. Metabolic syndrome was defined according to criteria of the National Cholesterol Education Program-Adult Treatment Panel III and all variables were checked. RESULTS Fasters did not statistically differ in anthropometric measurements when comparing to non-fasters. Differences were found in terms of biochemical variables, and more specific in HDL cholesterol, LDL cholesterol and total blood cholesterol, and in systemic and diastolic blood pressure, although non statistically significant. Statistically significant differences were only noticed in heart pulses and insulin levels, with fasters having lower heart pulses (69.44 ± 9.84 versus 72.63 ± 10.74) and greater mean values of insulin levels (4.16 ± 4.66 versus 3.12 ± 2.35). When analysis was carried to identify which variables were met for metabolic syndrome, it was found that fasters had statistically significant lower values of blood pressure when compared to non-fasters. In more details mean systolic blood pressure was 121.67 ± 12.21 versus 123.41 ± 11.73 for fasters and non-fasters respectively, and mean diastolic blood pressure was 75.77 ± 8.82 versus 78.27 ± 10.07 for fasters and non-fasters. Furthermore, the mean energy intake was higher in non-fasters (1698.25 ± 515.99 kcals) when compared to fasters (1590.24 ± 404.19 kcals) but not statistically significant different. CONCLUSIONS Young adults aged 18 to 49 years who fast according to the COC fasting regimes do not have different metabolic syndrome prevalence when comparing to non-fasters, but there was a statistically significant difference in the prevalence of elevated blood pressure with fasters having lower values.
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Affiliation(s)
- Anna Kokkinopoulou
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Nikolaos E Rodopaios
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | | | - Eleni Vasara
- Laboratory of Animal Physiology, Department of Zoology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Sousana K Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Petros Skepastianos
- Department of Medical Laboratory Studies, International Hellenic University, 57400 Thessaloniki, Greece
| | - Emmanouil Dermitzakis
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Maria Hassapidou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece
| | - Anthony G Kafatos
- Department of Preventive Medicine and Nutrition Unit, School of Medicine, University of Crete, 71003 Heraklion, Greece
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Khan MAB, BaHammam AS, Amanatullah A, Obaideen K, Arora T, Ali H, Cheikh Ismail L, Abdelrahim DN, Al-Houqani M, Allaham K, Abdalrazeq R, Aloweiwi WS, Mim SS, Mektebi A, Amiri S, Sulaiman SK, Javaid SF, Hawlader MDH, Tsiga-Ahmed FI, Elbarazi I, Manggabarani S, Hunde GA, Chelli S, Sotoudeh M, Faris ME. Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19. Front Nutr 2023; 10:1040355. [PMID: 36969823 PMCID: PMC10030961 DOI: 10.3389/fnut.2023.1040355] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/23/2023] [Indexed: 03/11/2023] Open
Abstract
Background Of around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors. Methods This cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters. Results In total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7-9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters. Conclusion Increasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.
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Affiliation(s)
- Moien A B Khan
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Ahmed S BaHammam
- Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Asma Amanatullah
- Knowledge and Research Support Services Department, University of Management and Technology, Lahore, Pakistan
| | - Khaled Obaideen
- Sustainable Energy and Power Systems Research Centre, RISE, University of Sharjah, Sharjah, United Arab Emirates
| | - Teresa Arora
- Department of Psychology, Zayed University, Abu Dhabi, United Arab Emirates
| | - Habiba Ali
- College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Dana N Abdelrahim
- Sharjah Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohammed Al-Houqani
- Internal Medicine College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Kholoud Allaham
- Department of Neurology, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | | | - Somayea Sultana Mim
- Chattogram International Medical College and Hospital, Chattogram, Bangladesh
| | - Ammar Mektebi
- Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Türkiye
| | - Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sahabi Kabir Sulaiman
- Department of Internal Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | - Syed Fahad Javaid
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | | | - Iffat Elbarazi
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Gamechu Atomsa Hunde
- Faculty of Health Sciences, School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sabrina Chelli
- Royal College of Surgeons in Ireland (Bahrain), Al Muharraq, Bahrain
| | - Mitra Sotoudeh
- Iranshahr University of Medical Sciences, Iranshahr, Iran
| | - MoezAlIslam Ezzat Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Hardiany NS, Remifta Putra MA, Penantian RM, Antarianto RD. Effects of fasting on FOXO3 expression as an anti-aging biomarker in the liver. Heliyon 2023; 9:e13144. [PMID: 36718153 PMCID: PMC9883274 DOI: 10.1016/j.heliyon.2023.e13144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Background Aging is a multifactorial degenerative process that can be modulated by fasting through activation of the Fork-head transcription factor of the O class 3 (FOXO3), which plays an important role in increasing lifespans. However, the effects of different fasting durations on the expression of FOXO3 in the liver has not yet been reported. Objective This study analyzed the effects of different fasting durations on the FOXO3 expression and its pathway by measuring sirtuin1 (SIRT1), insulin-like growth factor-1 (IGF-1), and superoxide dismutase (SOD) activity in the liver. Methods New Zealand white rabbits were used to mimic the effects of fasting on humans. The rabbits were divided into the control, intermittent fasting (IF), and prolonged fasting (PF) groups. Both fasting groups were interspersed with the non-fasting phase for 8 h. This treatment was conducted for 6 days. On Day 7, all the rabbits were sacrificed, and their livers were taken to measure the FOXO3 and SIRT1 mRNA expressions, the IGF-1 protein level, and the SOD activity level. ANOVA, multiple comparison, and Pearson's correlation were performed for statistical analysis. Results The FOXO3 and SIRT1 mRNA expressions were significantly higher in the IF group than in the control group. The FOXO3 expression was also 2.5 times higher in the IF group than in the PF group. There was a positive correlation between the FOXO3 and SIRT1 mRNA expressions. The IGF-1 protein level was significantly lower in the IF and PF groups than in the control group. The SOD-specific activity level was significantly higher in the IF group than in the control and PF groups. Conclusions Intermittent fasting significantly increased the FOXO3 and SIRT1 mRNA expressions and the SOD activity level in the livers of the rabbits and significantly decreased the circulating and hepatic IGF-1. Therefore, intermittent fasting may give a protective intervention effect towards aging.
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Affiliation(s)
- Novi Silvia Hardiany
- Department of Biochemistry & Molecular Biology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia,Corresponding author.
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18
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Al-Jafar R, Wahyuni NS, Belhaj K, Ersi MH, Boroghani Z, Alreshidi A, Alkhalaf Z, Elliott P, Tsilidis KK, Dehghan A. The impact of Ramadan intermittent fasting on anthropometric measurements and body composition: Evidence from LORANS study and a meta-analysis. Front Nutr 2023; 10:1082217. [PMID: 36733380 PMCID: PMC9886683 DOI: 10.3389/fnut.2023.1082217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/02/2023] [Indexed: 01/18/2023] Open
Abstract
Background Although the effect of Ramadan intermittent fasting (RIF) on anthropometry and body composition has been questioned, none of the previous studies tried to explain the reported changes in these parameters. Also, systematic reviews that investigated the topic were limited to healthy individuals or a specific disease group. Methods The London Ramadan Study (LORANS) is an observational study on health effects of RIF. We measured weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR), basal metabolic rate (BMR), fat percentage (FP), free-fat mass (FFM), extremities predicted muscle mass, total body water (TBW), trunk FM, trunk FFM and trunk predicted muscle mass before and immediately after Ramadan. Using mixed-effects regression models, we investigated the effect of RIF with adjustment for potential confounders. We also conducted a meta-analysis of the results of LORANS with other studies that investigated the effect of RIF on anthropometry and body composition. The review protocol is registered with PROSPERO registry (CRD42020186532). Results We recruited 146 participants (Mean ± SD age = 43.3 ± 15 years). Immediately after Ramadan, compared with before Ramadan, the mean difference was-1.6 kg (P<0.01) in weight,-1.95cm (P<0.01) in WC,-2.86cm (P <0.01) in HC, -0.60 kg/m2 (P < 0.01) in BMI and -1.24 kg (P < 0.01) in FM. In the systematic review and meta-analysis, after screening 2,150 titles and abstracts, 66 studies comprising 7,611 participants were included. In the general population, RIF was followed by a reduction of 1.12 Kg in body weight (-1.89- -0.36, I2 = 0), 0.74 kg/m2 reduction in BMI (-0.96- -0.53, I2 = 0), 1.54cm reduction in WC (-2.37- -0.71, I2 = 0) and 1.76cm reduction in HC (-2.69- -0.83, I2 = 0). The effect of fasting on anthropometric and body composition parameters starts to manifest in the second week of Ramadan and starts to diminish 3 weeks after Ramadan. Conclusion RIF is associated with a reduction in body weight, BMI, WC, HC, FM, FP and TBW. Most of these reductions are partially attributed to reduced FM and TBW. The reductions in these parameters appear to reverse after Ramadan.
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Affiliation(s)
- Rami Al-Jafar
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Data Services, Lean Business Services, Riyadh, Saudi Arabia
| | - Nisa Sri Wahyuni
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Karim Belhaj
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Mohammad Hamed Ersi
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Boroghani
- Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Clinical Research Development of Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amer Alreshidi
- Pharmaceutical Care Department, Hail General Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia
| | - Zahra Alkhalaf
- Dammam Medical Complex, Medical and Clinical Affairs, Dammam, Saudi Arabia
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Dementia Research Institute at Imperial College London, London, United Kingdom
- National Institute for Health Research Imperial College Biomedical Research Centre, Imperial College London, London, United Kingdom
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Abbas Dehghan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Dementia Research Institute at Imperial College London, London, United Kingdom
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
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19
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Madkour M, Giddey AD, Soares NC, Semreen MH, Bustanji Y, Zeb F, Halwani R, Faris ME. 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. [PMID: 36698470 PMCID: PMC9868699 DOI: 10.3389/fnut.2022.1008730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction During the holy month of Ramadan, adult healthy Muslims are mandated to abstain from dawn to sunset, with free eating at night hours that may extend up to 12 h. The current work was designed to investigate the metabolomics changes incurred upon the observance of Ramadan diurnal intermittent fasting (RDIF). Methods Twenty-five metabolically healthy participants with overweight and obesity (7 females and 18 males, with a mean age of 39.48 ± 10.0 years) were recruited for the study and were followed before and at the end of RDIF month. Dietary, anthropometric, biochemical, and physical activity assessments were performed before and at the end of the fasting month. The metabolomic assay was performed using liquid chromatography-mass spectrometry for the two-time points. Results and discussion Metabolomics assay revealed a significant reduction in a few metabolites. The analysis revealed that 27 metabolites differed significantly (P < 0.05) between pre-and post-RDIF. Among the differentially abundant metabolites, 23 showed a decrease with fasting, these included several amino acids such as aspartame, tryptophan, phenylalanine, histidine, and other metabolites including valeric acid, and cortisol. On the other hand, only four metabolites showed increased levels after RDIF including traumatic acid, 2-pyrrolidinone, PC[18:1(9Z)/18:1(9Z)], and L-sorbose. The MetaboAnalyst® platform reported that the top enriched metabolic pathways included: (1) histidine metabolism; (2) folate biosynthesis (3) phenylalanine, tyrosine, and tryptophan biosynthesis; (4) aminoacyltRNA biosynthesis; (5) caffeine metabolism; (6) vitamin B6 metabolism; and several other pathways relating to lipid metabolisms such as arachidonic acid metabolism, glycerophospholipid metabolism, and linoleic acid metabolism. In conclusion, RDIF entails significant changes in various metabolic pathways that reflect different dietary and lifestyle behaviors practiced during the fasting month.
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Affiliation(s)
- Mohamed Madkour
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alexander D. Giddey
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Nelson C. Soares
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates,Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates,Department of Human Genetics, National Institute of Health Doutor Ricardo Jorge (INSA), Lisbon, Portugal
| | - Mohammad H. Semreen
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates,Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Yasser Bustanji
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates,School of Pharmacy, Department of Biopharmaceutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan
| | - Falak Zeb
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Rabih Halwani
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates,Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,*Correspondence: MoezAlIslam E. Faris, ,
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20
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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; 32:2714-2729. [PMID: 36333203 DOI: 10.1016/j.numecd.2022.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
AIMS The primary goal of this meta-analysis was to examine the changes in various components of metabolic syndrome (MetS) in healthy adults who observed Ramadan fasting (RF) before Ramadan (T1) and at the end of RF (T2). A secondary goal was to assess the impact of RF on MetS severity in various ethnic and sex groups using the MetS z-score. DATA SYNTHESIS Using PRISMA2020, seven databases were searched for relevant studies published between January 1950 and March 2022. Data extraction involved high-density lipoprotein cholesterol (HDL), triglycerides (TG), fasting blood glucose (FBG), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) for T1 and T2, respectively. The MetS z-score was computed according to international diabetes federation criteria. At T1, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.20 [1.13; 1.27] mmol/L, 1.32 [1.23; 1.42] mmol/L, 4.98 [4.82; 5.15] mmol/L, 87.21 [84.21; 90.21] Cm, 114.22 [101.45; 126.99] mmHg, 76.80 [70.12; 83.47] mmHg, and 89.27 [80.56; 97.98] mmHg, respectively. At T2, the pooled estimates of HDL, TG, FBG, WC, SBP, DBP, and MAP were 1.24 [1.18; 1.31] mmol/L, 1.24 [1.14; 1.34] mmol/L, 4.77 [4.55; 4.99] mmol/L, 85.73 [82.83; 88.64] Cm, 109.48 [97.20; 121.75] mmHg, 74.43 [68.01; 80.85] mmHg, and 86.11 [77.74; 94.48] mmHg, respectively. The MetS z-score showed improvement at T2 for all ethnic groups and both sexes by -0.22 [-0.24; -0.01]. CONCLUSIONS The current meta-analysis suggests that the RF positively impact the MetS components and the overall MetS z-score. PROSPERO REGISTRATION NUMBER ID CRD42022329297 OPEN SCIENCE FRAMEWORK IDENTIFIER: DOI 10.17605/OSF.IO/U9H7T.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia.
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan.
| | | | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India.
| | - Ahmed S BaHammam
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia; Department of Medicine, University Sleep Disorders Center and Pulmonary Service, King Saud University, Riyadh, KSA6, Saudi Arabia.
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21
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Trabelsi K, Ammar A, Boujelbane MA, Puce L, Garbarino S, Scoditti E, Boukhris O, Khanfir S, Clark CCT, Glenn JM, Alhaj OA, Jahrami H, Chtourou H, Bragazzi NL. Religious fasting and its impacts on individual, public, and planetary health: Fasting as a "religious health asset" for a healthier, more equitable, and sustainable society. Front Nutr 2022; 9:1036496. [PMID: 36505246 PMCID: PMC9729557 DOI: 10.3389/fnut.2022.1036496] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Religious fasting is practiced by people of all faiths, including Christianity, Islam, Buddhism, Jainism, as well as Hinduism, Judaism, and Taoism. Individual/clinical, public, global, and planetary health has traditionally been studied as separate entities. Nevertheless, religious fasting, in conjunction with other religious health assets, can provide several opportunities, ranging from the individual to the population, environmental, and planetary levels, by facilitating and supporting societal transformations and changes, such as the adoption of healthier, more equitable, and sustainable lifestyles, therein preserving the Earth's systems and addressing major interconnected, cascading, and compound challenges. In this review, we will summarize the most recent evidence on the effects of religious fasting, particularly Orthodox and Ramadan Islamic fasting, on human and public health. Further, we will explore the potential effects of religious fasting on tackling current environmental issues, with a special focus on nutrition/food restriction and planetary health. Finally, specific recommendations, particularly around dietary intake during the fasting rituals, will be provided to ensure a sustainable healthy planet.
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Affiliation(s)
- Khaled Trabelsi
- Research Laboratory: Education, Motricity, Sport and Health, Sfax, Tunisia
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany
- UFR SESS-STAPS, Paris-East Créteil University, LIRTES (EA 7313), Créteil, France
| | - Mohamed Ali Boujelbane
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Egeria Scoditti
- National Research Council, Institute of Clinical Physiology, Lecce, Italy
| | - Omar Boukhris
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Saber Khanfir
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Cain C. T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom
| | - Jordan M. Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, United States
| | - Omar A. Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Sciences, University of Petra, Amman, Jordan
| | - Haitham Jahrami
- Department of Psychiatry, Ministry of Health, Manama, Bahrain
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Hamdi Chtourou
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Sulaiman SK, Tsiga-Ahmed FI, Faris ME, Musa MS, Akpan UAO, Umar AM, Abubakar SM, Allaham KK, Alyammahi T, Abdbuljalil MA, Javaid SF, Khan MAB. 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; 19:14340. [PMID: 36361226 PMCID: PMC9653919 DOI: 10.3390/ijerph192114340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
The Islamic month of Ramadan is marked by fasting, when Muslims refrain from eating and drinking from dawn to sunset, which has an impact on their dietary habits. The study aimed to assess Nigerian Muslims' dietary modifications during Ramadan and their related changes in body weight and health status. A web-based cross-sectional study was conducted among Nigerian adult Muslims. The survey assessed sociodemographic, dietary habits, eating behaviors, food choices, perceived weight changes, and health status. The logistic regression model was used to assess the predictors of weight change and perceived health status. There were 770 participants, 62.9% of whom were women, ranging in age from 18 to 60 years with a mean age of 27.7 ± 6.4 years. Fruits, palm dates, homemade foods, milk products, and vegetables were more frequently consumed. There were fewer energy drinks, pastries, salty snacks, and carbonated or sugared drinks consumed during Ramadan than before. Over half (54.6%, 95% CI: 51.0-58.9%) of the respondents lost weight during Ramadan, 37.0% (95% CI: 17.4-38.6%) maintained their weight and 8.4% (95% CI: 6.6-10.6%) gained weight during the month. Nearly all (97.3%, 95% CI: 95.8-98.3%) reported having good health during Ramadan, and 2.7% (95% CI: 1.7-4.1%) reported having a poorer health state during Ramadan. There was a significant weight loss and healthy dietary change associated with Ramadan fasting in Nigeria. Public health measures must be in place to impart such positive health behaviors so that such healthy habits continue throughout the year.
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Affiliation(s)
- Sahabi Kabir Sulaiman
- Department of Internal Medicine, Yobe State University Teaching Hospital, Damaturu P.M.B 1047, Nigeria
| | - Fatimah Isma’il Tsiga-Ahmed
- Department of Community Medicine, Bayero University Kano/Aminu Kano Teaching Hospital, Kano P.M.B 3452, Nigeria
| | - MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates
| | - Muhammad Sale Musa
- Department of Internal Medicine, Yobe State University Teaching Hospital, Damaturu P.M.B 1047, Nigeria
| | - Udoyen Abasi-okot Akpan
- Department of Medicine, National Pirogov Memorial Medical University, 21018 Vinnytsia, Ukraine
| | | | - Salisu Maiwada Abubakar
- Department of Biochemistry and Africa Centre of Excellence for Population Health and Policy, Bayero University, Kano P.M.B. 3011, Nigeria
| | - Kholoud K. Allaham
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Taif Alyammahi
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Munther A. Abdbuljalil
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Syed Fahad Javaid
- Health and Wellness Research Group, Department of Psychiatry and Behavioral Sciences, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
| | - Moien AB Khan
- Health and Wellness Research Group, Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain P.O. Box 15551, United Arab Emirates
- Primary Care, NHS North West London, London TW3 3EB, UK
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23
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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; 22:1649. [PMID: 36042437 PMCID: PMC9427176 DOI: 10.1186/s12889-022-13953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/02/2022] [Indexed: 11/12/2022] Open
Abstract
Severe procedures were undertaken globally because of the COVID-19 pandemic to overcome the spread of the disease and to prevent catastrophic results affecting the health care system including social distancing, lockdowns, and quarantines. Despite the widely known health benefits of Ramadan fasting, there was a general concern regarding the lifestyle of people during Ramadan 2020 that accompanied the period of COVID-19 pandemic and the home confinement applied. The main objective for the current cross-sectional investigation was to investigate the influence of Covid-19 lockdown during Ramadan fasting on weight change on 481 participants in Saudi Arabia. Identifying the contributing risk factors to weight gain were also addressed. Around 42% of the participants had gained weight and around 38% of the participants had lost weight. Physical activity level was shown to be considered as a protective factor against weight gain (OR = 1.03 with P = 0.008), while increasing the number of meals and not adapting healthy cooking methods can both be considered as contributing factors to weight gain (OR = 1.03 with P = 0.009, and OR = 1.03 with P = 0.004, respectively). Assessing these changes during Ramadan of COVID-19 quarantine provided valuable perspective on the health and wellbeing of Saudi Arabia citizens. These findings should be considered in future studies to explore the persistence of Covid-19 related weight status and habit change.
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Affiliation(s)
- Mai A Khatib
- Dietitian and Assistant professor at the Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80215, Jeddah, 21589, Saudi Arabia.
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Kord Varkaneh H, Salehi Sahlabadi A, Găman MA, Rajabnia M, Sedanur Macit-Çelebi M, Santos HO, Hekmatdoost A. Effects of the 5:2 intermittent fasting diet on non-alcoholic fatty liver disease: A randomized controlled trial. Front Nutr 2022; 9:948655. [PMID: 35958257 PMCID: PMC9360602 DOI: 10.3389/fnut.2022.948655] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background and aims Dietary regimens are crucial in the management of non-alcoholic fatty liver disease (NAFLD). The effects of intermittent fasting (IF) have gained attention in this regard, but further research is warranted. Thus, we aimed to ascertain the overall effects of the 5:2 IF diet (5 days a week of normal food intake and 2 consecutive fasting days) in patients with NAFLD compared to a control group (usual diet). Methods and results A 12-week randomized controlled trial was performed to evaluate the effects of the 5:2 IF diet on anthropometric indices, body composition, liver indices, serum lipids, glucose metabolism, and inflammatory markers in patients with NAFLD. The IF group (n = 21) decreased body weight (86.65 ± 12.57–82.94 ± 11.60 kg), body mass index (30.42 ± 2.27–29.13 ± 1.95 kg/m2), waist circumference (103.52 ± 6.42–100.52 ± 5.64 cm), fat mass (26.64 ± 5.43–23.85 ± 5.85 kg), fibrosis (6.97 ± 1.94–5.58 ± 1.07 kPa), steatosis scores/CAP (313.09 ± 25.45–289.95 ± 22.36 dB/m), alanine aminotransferase (41.42 ± 20.98–28.38 ± 15.21 U/L), aspartate aminotransferase (34.19 ± 10.88–25.95 ± 7.26 U/L), triglycerides (171.23 ± 39.88–128.04 ± 34.88 mg/dl), high-sensitivity C-reactive protein (2.95 ± 0.62 −2.40 ± 0.64 mg/L), and cytokeratin-18 (1.32 ± 0.06–1.19 ± 0.05 ng/ml) values compared to the baseline and the end of the control group (n = 23)—p ≤ 0.05 were considered as significant. However, the intervention did not change the levels of high-density lipoprotein cholesterol, total cholesterol, low-density lipoprotein cholesterol, fasting blood sugar, insulin, HOMA-IR, and total antioxidant capacity. Conclusion Adhering to the 5:2 IF diet can reduce weight loss and related parameters (fat mass and anthropometric indicators of obesity), as well as hepatic steatosis, liver enzymes, triglycerides, and inflammatory biomarkers in patients with NAFLD.
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Affiliation(s)
- Hamed Kord Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ammar Salehi Sahlabadi
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Mohsen Rajabnia
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Science, Tehran, Iran
| | | | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlândia, Brazil
| | - Azita Hekmatdoost
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sunardi D, Chandra DN, Medise BE, Friska D, Manikam NRM, Lestari W, Insani PNC, Ayusari AA, Mayasari D, Saftarina F, Sari DK, Ulvie YNS. Assessment of water consumption during Ramadan intermittent fasting: Result from Indonesian cross-sectional study. Front Nutr 2022; 9:922544. [PMID: 35958263 PMCID: PMC9358207 DOI: 10.3389/fnut.2022.922544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/04/2022] [Indexed: 11/22/2022] Open
Abstract
During Ramadan fasting, people are likely to consume water and beverages lower than recommended intake due to the limited time. However, it is necessary to achieve the recommended daily water intake to maintain the hydration status, as well as productivity during fasting. Unfortunately, there is a lack of data on drinking patterns during Ramadan. This study aims to investigate water and beverage intake and drinking patterns to help achieve water requirements during Ramadan among Indonesian adults. This is a cross-sectional study conducted during the Ramadan period from April to May 2021 (Ramadan 1442 Hijri). We used a self-administered questionnaire on drinking habits during Ramadan and utilized a 7-day fluid record (Liq.In 7) to assess water and beverage intake among participants who were managed through online procedure. There were 380 participants from five universities across Indonesia who completed the questionnaire accordingly and then analyzed it. The result shows that total water and beverage intake during Ramadan among participants was below the recommendation [1,670 (1,326–2,034) ml/day]. Among the type of beverages, water is the highest level of consumption [1,262 (983–1,666) ml/day] then followed by sugar-sweetened beverages [200 (91–350) ml/day]. We found a significant difference in water and beverages consumption between time of iftar [474 (375–590) ml/day], nighttime [574 (414–810) ml/day], and suhoor [560 (423–711) ml/day]. From this study, we found that during Ramadan the most common drinking pattern is 2-4-2, but a drinking pattern of 4-2-2 glasses (sequence of four glasses at iftar, two glasses at nighttime, two glasses at suhoor) had a significantly higher chance to adhere with the recommendation of fluid intake compared to other patterns. Therefore, based on this research on water and beverage intake, it is necessary and important to make improvements among Indonesian adults during Ramadan, and the drinking pattern of 4-2-2 glasses may help to achieve the recommended daily water consumption.
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Affiliation(s)
- Diana Sunardi
- Department of Nutrition, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dian Novita Chandra
- Department of Nutrition, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Bernie Endyarni Medise
- Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Department of Child Health, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dewi Friska
- Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.,Occupational Medicine, Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Nurul Ratna Mutu Manikam
- Department of Nutrition, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Wiji Lestari
- Department of Nutrition, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Indonesian Hydration Working Group, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | | | - Diana Mayasari
- Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia
| | - Fitria Saftarina
- Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia
| | | | - Yuliana Noor Setiawati Ulvie
- Department of Nutrition, Faculty of Nursing and Health Science, Universitas Muhammadiyah Semarang, Semarang, Indonesia
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Madkour MI, Hassan RE, Sherif NM, Awadallah S, Abdelrahim DN, Jahrami HA, Abu Shihab K, Faris ME. Haptoglobin polymorphism modulates cardiometabolic impacts of four consecutive weeks, dawn to sunset Ramadan intermittent fasting among subjects with overweight/obesity. Diabetes Res Clin Pract 2022; 190:110024. [PMID: 35905889 DOI: 10.1016/j.diabres.2022.110024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/11/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022]
Abstract
AIMS Haptoglobin (Hp) is a multifaceted marker of inflammation, and mediates the interplay between obesity, inflammation, and cardiometabolic dysfunction. However, the role of the Hp phenotype in modulating intermittent fasting (IF)-induced cardiometabolic changes remains to be elucidated. METHODS Hp phenotype was determined for the study subjects. Cardiometabolic markers were assessed before and at the end of four consecutive weeks, dawn to sunset IF. RESULTS A total of 114 subjects (75 males and 39 females, 38.7 ± 11.7 years, body mass index (BMI) of 30.41 ± 5.09 kg/m2) were recruited. Hp2-2 (n = 55, 48.2 %) and Hp2-1 (n = 53, 46.5 %) were the predominant phenotypes. Significant reductions were observed in serum Hp, IL-6, TNF-α, triglycerides (TG), total cholesterol (TC), LDL, BMI, and fat mass (FM), while a significant elevation was observed in serum CD163, HDL, and IL-10 at the end of the IF month for the whole population. Based on the Hp polymorphism, significant decreases in Hp, BMI, FM, TG, LDL, and TNF-α, with significant increases in HDL and CD163 levels were observed among subjects with Hp2-2 and Hp2-1 phenotypes. A more pronounced reduction in FM was reported in subjects with Hp2-2 in comparison with Hp2-1. CONCLUSION Hp gene polymorphism modulates IF-induced changes in cardiometabolic markers. CLINICAL TRIAL REGISTRATION NUMBER ISRCTN18205186; https://trialsearch.who.int/?TrialID=ISRCTN18205186.
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Affiliation(s)
- Mohamed I Madkour
- Department of Medical Laboratory Sciences, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Rasha E Hassan
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Naglaa M Sherif
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt
| | - Samir Awadallah
- Department of Medical Laboratories, College of Allied Medical Sciences, Zarqa University, Zarqa, Jordan
| | - Dana N Abdelrahim
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates; Department of Clinical Nutrition and Dietetics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Haitham A Jahrami
- Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
| | - Katia Abu Shihab
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates.
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Faris ME, Laher I, Khaled MB, Mindikoglu AL, Zouhal H. Editorial: The model of Ramadan diurnal intermittent fasting: Unraveling the health implications - volume I. Front Nutr 2022; 9:971610. [PMID: 35928837 PMCID: PMC9344887 DOI: 10.3389/fnut.2022.971610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- MoezAlIslam Ezzat Faris
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: MoezAlIslam Ezzat Faris ;
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | | | - Ayse L. Mindikoglu
- Section of Gastroenterology and Hepatology, Margaret M. and Albert B. Alkek Department of Medicine and Division of Abdominal Transplantation, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Hassane Zouhal
- Department of Science and Techniques of Physical and Sporting Activities (STAPS), University Rennes, M2S (Laboratoire Mouvement, Sport, Santé) – EA 1274, F-35000 Rennes, and Institut International des Sciences du Sport (2I2S), Rennes, France
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Dehghanbanadaki H, Aazami H, Hosseinkhani S, Razi F, Bandarian F, Larijani B. Bibliometric overview of Ramadan fasting studies during 2010-2021. Diabetes Metab Syndr 2022; 16:102531. [PMID: 35717895 DOI: 10.1016/j.dsx.2022.102531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS To quantify the bibliometric parameters of Ramadan fasting literature from 2010 to 2021. MATERIALS AND METHODS Scopus was searched for all articles related to Ramadan fasting or Islamic fasting from the beginning of 2010 to the end of 2021. Only original articles and reviews were included and their bibliometric and scientometric parameters were determined using Excel, Graph Pad Prism, VOSviewer, and Sci2 tool software. RESULTS Finally 1276 articles, including 1109 original articles and 167 reviews, were included. These articles had 14263 citations and an H-index of 48. Based on the number of publications, top institute, top journal, top country, and top authors were University of Sfax (n = 48 articles), Diabetes Research and Clinical Practice (n = 69), the United States (n = 144), and Chtourou H & Hassanein M (n = 38), respectively. Also, Diabetes Research and Clinical Practice had a strong bibliographic coupling with other journals. The recent bursting words were adrenal insufficiency and COVID-19. The most co-occurred topics were the effect of Ramadan fasting on diabetic patients, pregnant women, and glycemic state and body composition of diabetic patients. CONCLUSION This study provided a comprehensive bibliometric overview of Ramadan fasting literature from 2010 to 2021. The temporal change in the number of publications and other analyses on the literature of 2019, 2020 and 2021 showed that substantial increasing publications with new emerging subjects had become of interest to many researchers during the last three years.
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Affiliation(s)
- Hojat Dehghanbanadaki
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Aazami
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Scientometrics Department, FarIdea Company, Tehran, Iran
| | - Shaghayegh Hosseinkhani
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Razi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bandarian
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Roky R, Aadil N, Krami AM, Benaji B, Errabih I, Abdelrahim DN, Faris ME. Sex as a Biological Factor in the Changes in Disease Patients During Ramadan Intermittent Fasting: A Systematic Review. Front Nutr 2022; 9:908674. [PMID: 35845800 PMCID: PMC9284209 DOI: 10.3389/fnut.2022.908674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background During Ramadan, many patients with diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy choose to fast even against their doctor's advice. The impact of this intermittent fasting on health and disease could be different in men and women. The aim of this study was to determine the effect of sex as a factor in diseases outcomes of patients who opt to fast during Ramadan. Main Body The articles included in this study reported data on six diseases: diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy. A systematic search was performed on PubMed and Scopus for observational and clinical studies mentioning Ramadan, diabetes, renal, cardiovascular, gastrointestinal diseases, headaches, and epilepsy in both men and women. Data was extracted by two independent reviewers using a standardized data-collection form. From 381 original articles, 38 studies were selected, including 25,023 patients of which 44.4% were women. Sex-based differences were reported by 18 studies for several variables such as body mass index, blood glucose, the frequency of hypoglycemia, renal colic, mortality, thrombosis, and gastrointestinal diseases in patients fasting during Ramadan. Most of the differences between men and women were reported both in the baseline period before Ramadan and during Ramadan. Indeed, during the period outside Ramadan, the frequency of renal colic, cardiovascular, gastrointestinal diseases, were higher in men; while body mass index, Thrombosis, and headache were higher in women. In the remaining 21 studies, it was reported that the sex factor was not associated with the effect of Ramadan fasting in the frequency and other outcomes of these diseases. Conclusion Currently, small attention is paid to sex as a determinant factor in patients while fasting during Ramadan. There appeared to be differences in the frequency and incidence of diseases in men and women during Ramadan. Closer attention to sex differences regarding the frequency and the progression of the diseases during fasting may help to improve patient care, especially to benefit those patients willing to fast during Ramadan.
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Affiliation(s)
- Rachida Roky
- Department of Biology, Laboratory of Physiopathology, Molecular Genetics & Biotechnology, Faculty of Sciences Ain Chock, Health and Biotechnology Research Centre, Hassan II University of Casablanca, Casablanca, Morocco
| | - Nadia Aadil
- Department of Biology, Laboratory of Microbiology, Pharmacology, Toxicology, Biotechnology and Environment Faculty of Sciences Ain Chock, Hassan II University of Casablanca, Casablanca, Morocco
| | - Al Mehdi Krami
- Department of Biology, Laboratory of Physiopathology, Molecular Genetics & Biotechnology, Faculty of Sciences Ain Chock, Health and Biotechnology Research Centre, Hassan II University of Casablanca, Casablanca, Morocco
| | - Brahim Benaji
- Health Technologies Engineering Department, Research Group in Biomedical Engineering and Pharmaceutical Sciences, ENSAM, Mohammed V University, Agdal, Morocco
| | - Ikram Errabih
- Gastroenterology Department, Ibn Sina Hospital, Mohammed V University, Agdal, Morocco
| | - Dana N. Abdelrahim
- Department of Clinical Nutrition and Dietetics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam Ezzat Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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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; 61:595-607. [PMID: 35730413 DOI: 10.1080/03670244.2022.2089878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study aimed to evaluate the effect of diurnal Ramadan fasting on cardiometabolic risk factors (blood glucose, lipid profile, inflammatory cytokines) and sleep quality in healthy Turkish adults. This prospective observational study was conducted with a total of 32 individuals (12 males, 20 females) who were aged between 19-32 years and fasted for 25 or more continuous days in Ankara, Turkey between 1 Ramadan 1442 and 30 Ramadan 1442. Individuals applied fasting for 16 hours in the spring season. Blood samples were taken after at least 8 hours of fasting, anthropometric measurements were taken and sleep quality was assessed using The Pittsburgh Sleep Quality Index (PSQI) at the beginning and the end of Ramadan. There was a significant decrease in body mass index (BMI), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels during Ramadan fasting (p < .005). There were no changes in lipid profiles and sleep quality. There was a significant increase in fasting blood glucose levels (p < .05); however, this change is within normal limits. There was also a significant relationship between BMI and CRP, IL-6, and TNF-α levels (p < .05). The diurnal Ramadan fasting did not affect lipid profiles and sleep quality in healthy Turkish subjects. However, decreased BMI and inflammatory cytokine levels were observed at the end of Ramadan fasting. More studies are needed to clarify the role of Ramadan fasting in healthy populations.
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Affiliation(s)
- Özge Mengi Çelik
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Trakya University, Edirne, Turkey
| | - Tevfik Koçak
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
| | - Eda Köksal
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
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Kammoun N, Hidouri S, Ghram A, Ammar A, Masmoudi L, Driss T, Knechtle B, Weiss K, Hammouda O, Chlif M. Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males. Am J Mens Health 2022; 16:15579883221103418. [PMID: 35723054 PMCID: PMC9344188 DOI: 10.1177/15579883221103418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effect of a walking football (WF) program during Ramadan fasting (RF) on heart rate variability (HRV) indices, body composition, and physical fitness in middle-aged males. Thirty-one healthy sedentary men were randomized to WF (n = 18) and control (n = 13) groups. Both groups participated in RF. The WF group were involved in a training program (small-sided games) of three sessions a week during RF. The time and frequency domains of HRV, body composition, handgrip, lumbar strength, Modified Agility Test (MAT), and 6-minute walk test (6MWT) were measured before Ramadan (BR), during Ramadan (DR), and after Ramadan (AR). We reported that RF has significantly altered some parameters of HRV DR; the mean HR decreased while the mean RR, LF, and HF increased. WF had a significant effect on HRV and mean HR DR compared with BR and AR decreased while mean RR, HF and LF increased. DR, body mass decreased in both groups, while body mass index (BMI) decreased and lean mass increased only in WF group. Lower body mass and BMI levels were reported AR only in WF group. Physical capacity improved AR, compared with BR, only in the WF group with longer distance in 6MWT, shorter time(s) in MAT, and higher lumbar strength levels. We conclude that RF increases parasympathetic system activity. WF practice during RF is safe and might improve body composition, physical fitness, autonomic cardiac function, and physical fitness in middle-aged males.
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Affiliation(s)
- Noureddine Kammoun
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sami Hidouri
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Amine Ghram
- Healthy Living for Pandemic Event Protection (Hl-Pivot) Network, Chicago, IL, USA.,Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Achraf Ammar
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France.,Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Liwa Masmoudi
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Tarak Driss
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Katja Weiss
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
| | - Omar Hammouda
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.,Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Mehdi Chlif
- EA 3300 "APS and Motor Patterns: Adaptations-Rehabilitation," Sport Science Department, Picardie Jules Verne University, Amiens, France.,Tunisian Research Laboratory Sports Performance Optimization, National Center of Medicine and Science in Sports (NCMSS), Tunis, Tunisia
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Negm M, Bahaa A, Farrag A, Lithy RM, Badary HA, Essam M, Kamel S, Sakr M, Abd El Aaty W, Shamkh M, Basiony A, Dawoud I, Shehab H. 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; 22:203. [PMID: 35462542 PMCID: PMC9036734 DOI: 10.1186/s12876-022-02272-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background Intermittent fasting (IF) during the month of Ramadan is part of the religious rituals of Muslims. The effect of intermittent fasting on disease activity in inflammatory bowel diseases (IBD) is still unknown. This is the first study to assess the effect of IF during Ramadan on inflammatory markers in patients diagnosed with IBD. The effects on clinical disease activity, quality of life, and levels of depression were also assessed. Methods Patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) who intended to observe Ramadan fasting were recruited. The following were assessed immediately before and at the end of Ramadan: Serum CRP and stool calprotectin, partial Mayo score, Harvey Bradshaw index (HBI), Simple IBD questionnaire (SIBDQ), and Hamilton depression scale questionnaire. Results 80 patients diagnosed with IBD were recruited (60 UC, 20 CD). Serum CRP and stool calprotectin did not show a significant change before vs after fasting (median CRP 0.53 vs 0.50, P value = 0.27, Calprotectin 163 vs 218 respectively, P value = 0.62). The partial Mayo score showed a significant rise after fasting (median 1 before vs 1 after fasting, mean: 1.79 vs 2.33 respectively, P value = 0.02). Harvey-Bradshaw index did not show a significant change after fasting (median 4 vs 5, P value = 0.4). Multiple linear regression revealed that older age and a higher baseline calprotectin were associated with a higher change in Mayo score after fasting (P value = 0.02 and P value = 0.01, respectively). No significant change was detected in SIBDQ or Hamilton depression scale scores. Conclusions In patients diagnosed with UC, IF during Ramadan was associated with worsening of clinical parameters, the effect was more pronounced in older patients and those with higher baseline calprotectin levels. However, IF during Ramadan was not associated with an adverse effect on objective inflammatory markers (CRP and calprotectin).
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Akbari HA, Yoosefi M, Pourabbas M, Weiss K, Knechtle B, Vancini RL, Trakada G, Ben Saad H, Lavie CJ, Ghram A. Association of Ramadan Participation with Psychological Parameters: A Cross-Sectional Study during the COVID-19 Pandemic in Iran. J Clin Med 2022; 11:jcm11092346. [PMID: 35566470 PMCID: PMC9103718 DOI: 10.3390/jcm11092346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023] Open
Abstract
COVID-19 restrictions are associated with poor physical-activity (PA). Less is known about the relationship between the combination of these restrictions with Ramadan intermittent fasting (RIF), PA, mental health, and sleep-quality. The present study aimed to evaluate whether COVID-19 restrictions and RIF during the fourth wave of the COVID-19 pandemic in Iran are associated with poor PA, anxiety, well-being, and sleep-quality outcomes. A total of 510 individuals participated in an online questionnaire that was disseminated to adults (≥18 years) residing in Iran from 13 May 2021 to 16 May 2021 (~3 days), just after the end of Ramadan 2021. PA behavior (Godin-Shephard Leisure-Time Exercise Questionnaire), anxiety (General Anxiety Disorder-7), well-being (Mental Health Continuum-Short Form), and sleep-quality (Pittsburgh Sleep Quality Index). Of 510 individuals included in the study (331 female (64.9%); mean ± SD, 31 ± 12 years), 172 (33.7%) reported less PA during the Ramadan 2021. PA was associated with better well-being and sleep-quality outcomes. Regardless of PA, participants who fasted for all of Ramadan had less anxiety and better well-being outcomes than those who fasted part of Ramadan or did not fast at all. However, the fasting part of Ramadan decreased the sleep-quality of active participants. The Ramadan 2021 was associated with poor PA, well-being, and sleep-quality of Iranians. However, PA was associated with better well-being and sleep-quality outcomes, and those who fasted all Ramadan had better anxiety and well-being outcomes. Therefore, PA during Ramadan might be an essential and scalable mental health resilience builder during COVID-19 restrictions which should be encouraged.
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Affiliation(s)
- Hesam Addin Akbari
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Mohammad Yoosefi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Maryam Pourabbas
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
| | - Katja Weiss
- Medbase St. Gallen Am Vadianplatz, 9100 St. Gallen, Switzerland; (K.W.); (B.K.)
| | - Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, 9100 St. Gallen, Switzerland; (K.W.); (B.K.)
- Institute of Primary Care, University of Zurich, 8091 Zurich, Switzerland
| | - Rodrigo Luiz Vancini
- Center for Physical Education and Sports, Federal University of Espírito Santo, Vitória 29075-910, Brazil;
| | - Georgia Trakada
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, 115 28 Athens, Greece;
| | - Helmi Ben Saad
- Research Laboratory “Heart Failure, LR12SP09”, Faculty of Medicine of Sousse, Hospital Farhat HACHED of Sousse, University of Sousse, Sousse 4054, Tunisia;
| | - Carl J. Lavie
- Healthy Living for Pandemic Event Protection (HL—PIVOT) Network, Chicago, IL 60612, USA;
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA 70121, USA
| | - Amine Ghram
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran 1415563117, Iran; (H.A.A.); (M.Y.); (M.P.)
- Healthy Living for Pandemic Event Protection (HL—PIVOT) Network, Chicago, IL 60612, USA;
- Correspondence:
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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. [PMID: 35454343 DOI: 10.3390/medicina58040503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/22/2022] [Accepted: 03/28/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Dietary modification is the principal approach to the management of hyperlipidemia in adults. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key regulator of plasma cholesterol and a target for novel lipid-lowering pharmacotherapies. This study aimed to explore how circulating levels of PCSK9 changed during Ramadan intermittent fasting in metabolically healthy obese subjects. Materials and Methods: This cross-sectional study used convenience sampling to recruit 55 overweight and obese participants (22 females and 33 males) who observed Ramadan fasting. Body weight and composition, glucoregulatory factors, serum PCSK9 concentration, dietary intake, and physical activity were assessed 1 week before and at the end of Ramadan fasting. Results: The median (interquartile range) age was 35 (22) years, and body mass index was 30.2 (5.4). We found significant (p < 0.05) increases in serum levels of PCSK9, serum insulin, insulin resistance, and leptin at the end of Ramadan compared with pre-fasting levels. Significant (p < 0.05) reductions in body weight, waist circumference, systolic and diastolic blood pressure, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and adiponectin were also observed at the end of Ramadan. Conclusions: Observing Ramadan fasting was associated with increased PCSK9 levels in metabolically healthy obese subjects. The complex relationships between PCSK9 and insulin resistance and dysregulation of adipokine secretion in relation to dietary and lifestyle modifications during Ramadan warrant further research.
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Alnasser A, Almutairi M. Considering intermittent fasting among Saudis: insights into practices. BMC Public Health 2022; 22:592. [PMID: 35346130 PMCID: PMC8959076 DOI: 10.1186/s12889-022-12908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/03/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There is a dearth of studies on intermittent fasting in Saudi Arabia outside of Ramadan. The aim of this research was to study and describe the practice of intermittent fasting outside of Ramadan among Saudi people. METHODS A web-based survey that focused on intermittent fasting practices-specifically the use of intermittent fasting applications, goal setting, and the effects of fasting on an individual's state of health-was administered, collected, and analyzed. RESULTS The study revealed that 58% (298/514) of the respondents practiced intermittent fasting for a duration of less than 3 months. The most-practiced pattern of intermittent fasting was a 16/8 fasting pattern (43.8%, 225/514). About 88.3% (454/514) of those who followed intermittent fasting drank fluids while fasting. Additionally, the amount of weight loss after intermittent fasting was less than 2.2 kg for 35% (180/514) of the participants. The primary goal of intermittent fasting for 44.9% (231/514) of the respondents was to lose weight. The majority of the participants (84.6%, 435/514) did not use any fasting applications. CONCLUSION The results of the current research on intermittent fasting outside of Ramadan are preliminary and inconclusive. The findings of the present study advance the idea that for some Saudis, the practice of intermittent fasting does not necessarily begin and end with Ramadan; this finding may present a strategic opportunity for Saudi health professionals who are focused on the obesity epidemic and other public health issues in Saudi Arabia. This study sought to help start a discussion on this topic and fill the knowledge gap.
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Affiliation(s)
- Aroub Alnasser
- Food Science and Nutrition Department, College of Food and Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh, 11495, Saudi Arabia.
| | - Mashael Almutairi
- Food Science and Nutrition Department, College of Food and Agriculture Sciences, King Saud University, P.O. Box 22452, Riyadh, 11495, Saudi Arabia
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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. [PMID: 35372458 PMCID: PMC8968860 DOI: 10.3389/fnut.2021.741811] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/20/2021] [Indexed: 01/13/2023] Open
Abstract
Aim and BackgroundA growing body of evidence supports the impact of intermittent fasting (IF) on normalizing body weight and that the interaction between body genes and environmental factors shapes human susceptibility to developing obesity. FTO gene is one of these genes with metabolic effects related to energy metabolism and body fat deposition. This research examined the changes in FTO gene expression upon Ramadan intermittent fasting (RIF) in a group of metabolically healthy subjects with overweight and obesity.MethodsSixty-three (63) subjects were recruited, of which 57 (17 males and 40 females, mean age 38.4 ± 11.2 years) subjects with overweight and obesity (BMI = 29.89 ± 5.02 kg/m2were recruited and monitored before and at the end of Ramadan month), and 6 healthy subjects with normal BMI (21.4 ± 2.20 kg/m2) recruited only to standardize the reference for normal levels of FTO gene expression. In the two-time points, anthropometric, biochemical, and dietary assessments were undertaken, and FTO gene expression tests were performed using RNA extracted from the whole blood sample.ResultsIn contrast to normal BMI subjects, the relative gene expressions in overweight/obese were significantly decreased at the end of Ramadan (−32.30%, 95% CI–0.052 −0.981) in comparison with the pre-fasting state. Significant reductions were found in body weight, BMI, fat mass, body fat percent, hip circumference, LDL, IL-6, TNF-α (P<0.001), and in waist circumference (P<0.05), whilst HDL and IL-10 significantly increased (P<0.001) at the end of Ramadan in comparison with the pre-fasting levels. Binary logistic regression analysis for genetic expressions showed no significant association between high-energy intake, waist circumference, or obesity and FTO gene expression.ConclusionsRIF is associated with the downregulation of the FTO gene expression in subjects with obesity, and this may explain, at least in part, its favorable metabolic effects. Hence, RIF presumably may entail a protective impact against body weight gain and its adverse metabolic-related derangements in subjects with obesity.
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Affiliation(s)
- Mohamed I. Madkour
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Lara J. Bou Malhab
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Wael M. Abdel-Rahman
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Dana N. Abdelrahim
- Department of Clinical Nutrition and Dietetics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Maha Saber-Ayad
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Maha Saber-Ayad
| | - MoezAlIslam E. Faris
- Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Nutrition and Dietetics, University of Sharjah, Sharjah, United Arab Emirates
- MoezAlIslam E. Faris
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Junker A, Wang J, Gouspillou G, Ehinger JK, Elmér E, Sjövall F, Fisher-Wellman KH, Neufer PD, Molina AJA, Ferrucci L, Picard M. Human studies of mitochondrial biology demonstrate an overall lack of binary sex differences: A multivariate meta-analysis. FASEB J 2022; 36:e22146. [PMID: 35073429 PMCID: PMC9885138 DOI: 10.1096/fj.202101628r] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023]
Abstract
Mitochondria are maternally inherited organelles that play critical tissue-specific roles, including hormone synthesis and energy production, that influence human development, health, and aging. However, whether mitochondria from women and men exhibit consistent biological differences remains unclear, representing a major gap in knowledge. This meta-analysis systematically examined four domains and six subdomains of mitochondrial biology (total 39 measures), including mitochondrial content, respiratory capacity, reactive oxygen species (ROS) production, morphometry, and mitochondrial DNA copy number. Standardized effect sizes (Hedge's g) of sex differences were computed for each measure using data in 2258 participants (51.5% women) from 50 studies. Only two measures demonstrated aggregate binary sex differences: higher mitochondrial content in women's WAT and isolated leukocyte subpopulations (g = 0.20, χ2 p = .01), and higher ROS production in men's skeletal muscle (g = 0.49, χ2 p < .0001). Sex differences showed weak to no correlation with age or BMI. Studies with small sample sizes tended to overestimate effect sizes (r = -.17, p < .001), and sex differences varied by tissue examined. Our findings point to a wide variability of findings in the literature concerning possible binary sex differences in mitochondrial biology. Studies specifically designed to capture sex- and gender-related differences in mitochondrial biology are needed, including detailed considerations of physical activity and sex hormones.
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Affiliation(s)
- Alex Junker
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Jennifer Wang
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Gilles Gouspillou
- Département des Sciences de l’Activité Physique, Faculté des Sciences, Université du Québec à Montréal (UQAM), Montreal, Québec, Canada
| | - Johannes K. Ehinger
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden,Otorhinolaryngology Head and Neck Surgery, Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Fredrik Sjövall
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kelsey H. Fisher-Wellman
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, USA,Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - P. Darrell Neufer
- East Carolina Diabetes and Obesity Institute, East Carolina University, Greenville, North Carolina, USA,Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Anthony J. A. Molina
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Martin Picard
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA,Department of Neurology, H. Houston Merritt Center, Columbia University Translational Neuroscience Initiative, Columbia University Irving Medical Center, New York, New York, USA,NewYork State Psychiatric Institute, New York, New York, USA
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Almulhem M, Thayakaran R, Hanif S, Gooden T, Thomas N, Hazlehurst J, Tahrani AA, Hanif W, Nirantharakumar K. 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:e0262530. [PMID: 35025960 PMCID: PMC8757987 DOI: 10.1371/journal.pone.0262530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 12/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background The effect of fasting on immunity is unclear. Prolonged fasting is thought to increase the risk of infection due to dehydration. This study describes antibiotic prescribing patterns before, during, and after Ramadan in a primary care setting within the Pakistani and Bangladeshi populations in the UK, most of whom are Muslims, compared to those who do not observe Ramadan. Method Retrospective controlled interrupted time series analysis of electronic health record data from primary care practices. The study consists of two groups: Pakistanis/Bangladeshis and white populations. For each group, we constructed a series of aggregated, daily prescription data from 2007 to 2017 for the 30 days preceding, during, and after Ramadan, respectively. Findings Controlling for the rate in the white population, there was no evidence of increased antibiotic prescription in the Pakistani/Bangladeshi population during Ramadan, as compared to before Ramadan (IRR: 0.994; 95% CI: 0.988–1.001, p = 0.082) or after Ramadan (IRR: 1.006; 95% CI: 0.999–1.013, p = 0.082). Interpretation In this large, population-based study, we did not find any evidence to suggest that fasting was associated with an increased susceptibility to infection.
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Affiliation(s)
- Munerah Almulhem
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Rasiah Thayakaran
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Shahjehan Hanif
- Life and Medical Sciences, University College London, London, United Kingdom
| | - Tiffany Gooden
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Neil Thomas
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Jonathan Hazlehurst
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Abd A. Tahrani
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, United Kingdom
| | - Wasim Hanif
- Diabetes Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- * E-mail: (KN); (WH)
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- * E-mail: (KN); (WH)
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Trabelsi K, Ammar A, Glenn JM, Boukhris O, Khacharem A, Bouaziz B, Zmijewski P, Lanteri P, Garbarino S, Clark CCT, Chamari K, Bragazzi NL, Hill D, Chtourou H. Does observance of Ramadan affect sleep in athletes and physically active individuals? A systematic review and meta-analysis. J Sleep Res 2021; 31:e13503. [PMID: 34693577 DOI: 10.1111/jsr.13503] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 09/09/2021] [Accepted: 09/30/2021] [Indexed: 01/03/2023]
Abstract
The purpose of this systematic review and meta-analysis is to provide an accurate description of the effect of Ramadan observance on sleep duration, sleep quality, daily nap duration, and daytime sleepiness in athletes and physically active individuals. Five electronic databases (PubMed, Web of Science, Scopus, Wiley, and Taylor and Francis) were used to search for relevant studies conducted with athletes or physically active individuals during Ramadan, published in any language, and available before May 23, 2021. Studies that included assessments of sleep quantity and/or quality, and/or daytime sleepiness, and/or daily naps in athletes and physically active individuals were included. The methodological quality of the studies was assessed using "QualSyst". Of the 18 papers included in this study (298 participants in total), 14 were of strong quality, two were moderate, and the remaining two were rated as weak. Individuals who continued to train during Ramadan experienced a decrease in sleep duration (number of studies, K = 17, number of participants, N = 289, g = -0.766, 95% confidence interval [CI] -1.199 to -0.333, p = 0.001). Additionally, the global score of the Pittsburgh Sleep Quality Index increased from 4.053 (K = 5, N = 65, 95% CI 3.071-5.034) pre-Ramadan, to 5.346 (95% CI 4.362-6.333) during Ramadan, indicating a decrease in sleep quality. The duration of daytime naps increased during compared to pre-Ramadan (K = 2, N = 31, g = 1.020, 95% CI 0.595-1.445, p = 0.000), whereas Epworth Sleepiness Scale scores remained unchanged during versus pre-Ramadan (K = 3, N = 31, g = 0.190, 95% CI -0.139-0.519, p = 0.257). In conclusion, individuals who continued to train during Ramadan experienced a decrease in sleep duration, impairment of sleep quality, and increase in daytime nap duration, with no change in daytime sleepiness levels.
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Affiliation(s)
- Khaled Trabelsi
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia.,High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Achraf Ammar
- Institute of Sport Science, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.,Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
| | - Jordan M Glenn
- Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
| | - Omar Boukhris
- Research Unit, "Physical Activity, Sport and Health", UR18JS01, National Observatory of Sport, Tunis, Tunisia
| | - Aimen Khacharem
- LIRTES (EA 7313), UFR SESS-STAPS, Paris-East Créteil University, Créteil, France
| | - Bassem Bouaziz
- Higher Institute of Computer Science and Multimedia of Sfax, University of Sfax, Sfax, Tunisia
| | - Piotr Zmijewski
- Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Paola Lanteri
- Neurophysiopathology Unit, Foundation IRCCS Carlo Besta Neurological Institute, Milan, Italy
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, UK
| | - Karim Chamari
- ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Laboratory "Sport Performance Optimization", (CNMSS); ISSEP Ksar-Said, Manouba University, Manouba, Tunisia
| | - Nicola L Bragazzi
- Department of Health Sciences (DISSAL), Postgraduate School of Public Health, University of Genoa, Genoa, Italy.,Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON, Canada
| | - David Hill
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas, USA
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.,Research Unit, "Physical Activity, Sport and Health", UR18JS01, National Observatory of Sport, Tunis, Tunisia
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Al‐Jafar R, Zografou Themeli M, Zaman S, Akbar S, Lhoste V, Khamliche A, Elliott P, Tsilidis KK, Dehghan A. Effect of Religious Fasting in Ramadan on Blood Pressure: Results From LORANS (London Ramadan Study) and a Meta-Analysis. J Am Heart Assoc 2021; 10:e021560. [PMID: 34619991 PMCID: PMC8751902 DOI: 10.1161/jaha.120.021560] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022]
Abstract
Background Ramadan fasting is practiced by hundreds of millions every year. This ritual practice changes diet and lifestyle dramatically; thus, the effect of Ramadan fasting on blood pressure must be determined. Methods and Results LORANS (London Ramadan Study) is an observational study, systematic review, and meta-analysis. In LORANS, we measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 85 participants before and right after Ramadan. In the systematic review, studies were retrieved from PubMed, Embase, and Scopus from inception to March 3, 2020. We meta-analyzed the effect from these studies and unpublished data from LORANS. We included observational studies that measured SBP and/or DBP before Ramadan and during the last 2 weeks of Ramadan or the first 2 weeks of the month after. Data appraisal and extraction were conducted by at least 2 reviewers in parallel. We pooled SBP and DBP using a random-effects model. The systematic review is registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42019159477). In LORANS, 85 participants were recruited; mean age was 45.6±15.9 years, and 52.9% (n=45) of participants were men. SBP and DBP after Ramadan fasting were lower by 7.29 mm Hg (-4.74 to -9.84) and 3.42 mm Hg (-1.73 to -5.09), even after adjustment for potential confounders. We identified 2778 studies of which 33 with 3213 participants were included. SBP and DBP after/before Ramadan were lower by 3.19 mm Hg (-4.43 to -1.96, I2=48%) and 2.26 mm Hg (-3.19 to -1.34, I2=66%), respectively. In subgroup analyses, lower blood pressures were observed in the groups who are healthy or have hypertension or diabetes but not in patients with chronic kidney disease. Conclusions Our study suggests beneficial effects of Ramadan fasting on blood pressure independent of changes in weight, total body water, and fat mass and supports recommendations for some governmental guidelines that describe Ramadan fasting as a safe religious practice with respect to blood pressure.
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Affiliation(s)
- Rami Al‐Jafar
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
| | | | - Sadia Zaman
- School of MedicineImperial College LondonLondonUnited Kingdom
| | - Sharmin Akbar
- Department of ChemistryImperial College LondonLondonUnited Kingdom
| | - Victor Lhoste
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
| | - Ahlam Khamliche
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
| | - Paul Elliott
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
- Dementia Research Institute at Imperial College LondonLondonUnited Kingdom
- National Institute for Health Research Imperial College Biomedical Research CentreImperial College LondonLondonUnited Kingdom
| | - Konstantinos K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
- Department of Hygiene and EpidemiologyUniversity of Ioannina School of MedicineIoanninaGreece
| | - Abbas Dehghan
- Department of Epidemiology and BiostatisticsSchool of Public HealthImperial College LondonLondonUnited Kingdom
- Dementia Research Institute at Imperial College LondonLondonUnited Kingdom
- MRC‐PHE Centre for Environment and Health, School of Public HealthImperial College LondonLondonUnited Kingdom
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Jahrami H, BaHammam AS, Haji EA, Bragazzi NL, Rakha I, Alsabbagh A, Nugraha B, Pasiakos SM. Ramadan Fasting Improves Body Composition without Exacerbating Depression in Males with Diagnosed Major Depressive Disorders. Nutrients 2021; 13:nu13082718. [PMID: 34444878 PMCID: PMC8398343 DOI: 10.3390/nu13082718] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Ramadan fasting (RF) is a form of intermittent fasting that generally improves body composition and related metabolic profiles. Whether RF exacerbates depressive symptomatology in individuals diagnosed with major depressive disorder (MDD) is undetermined. Methods: 100 men, who lived in Bahrain and were between the ages of 18 and 64 years with an established diagnosis of MDD, participated in this 4-week study. Based on preference, participants were assigned to a fasting group (FG, n = 50) and a non-fasting group (NFG, n = 50). The FG engaged in fasting from 03:40 to 18:10 (dawn and dusk timings). Changes in depressive symptoms, body mass, body composition, and components of metabolic syndrome were measured. Results: There were no significant changes in depressive symptoms within the FG vs. NFG after controlling for baseline covariates: mean difference 0.49 (SE = 0.63), p = 0.43. No adverse effects were reported in either group. The FG experienced significant reductions in body mass, 1.87 kg, p = 0.001; body mass index, 0.69 kg/m2, p = 0.001; body fat, 0.87%, p = 0.001; body surface area, 0.03 m2, p = 0.001; and lean mass, 0.77 kg, p = 0.001. Conclusions: RF did not negatively affect depressive symptoms and improved body composition, suggesting short-term intermittent fasting may be a safe dietary practice for adult males with MDD.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Manama 410, Bahrain; (E.A.H.); (I.R.); (A.A.)
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
- Correspondence: (H.J.); (N.L.B.)
| | - Ahmed S. BaHammam
- University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, P.O. Box 225503, Riyadh 11324, Saudi Arabia;
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh 11324, Saudi Arabia
| | - Eman Ahmed Haji
- Ministry of Health, Manama 410, Bahrain; (E.A.H.); (I.R.); (A.A.)
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain
| | - Nicola L. Bragazzi
- Laboratory for Industrial and Applied Mathematics, Departments and Statistics, York University, Toronto, ON M3J 1P3, Canada
- Correspondence: (H.J.); (N.L.B.)
| | - Ihab Rakha
- Ministry of Health, Manama 410, Bahrain; (E.A.H.); (I.R.); (A.A.)
| | - Amani Alsabbagh
- Ministry of Health, Manama 410, Bahrain; (E.A.H.); (I.R.); (A.A.)
| | - Boya Nugraha
- Department of Rehabilitation Medicine, Hannover Medical School, 30625 Hannover, Germany;
| | - Stefan M. Pasiakos
- Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA;
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Faris M, Jahrami H, Abdelrahim D, Bragazzi N, BaHammam A. The effects of Ramadan intermittent fasting on liver function in healthy adults: A systematic review, meta-analysis, and meta-regression. Diabetes Res Clin Pract 2021; 178:108951. [PMID: 34273453 DOI: 10.1016/j.diabres.2021.108951] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 07/03/2021] [Accepted: 07/12/2021] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Growing evidence is suggestive that intermittent fasting likely to improve liver function; however, still the evidences are controversial to draw a definitive conclusion. Therefore, we conducted a systematic review and meta-analysis to estimate the effect size for changes in liver function tests (LFT) in healthy people practicing Ramadan diurnal intermittent fasting (RDIF), and to examine the impact of different covariates using subgroup analysis and meta-regression. METHODS Scientific databases were searched from date of inception in 1950 to the end of July 2020. The liver function tests searched and analyzed were aspartate transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), bilirubin (BLU), L-lactate dehydrogenase (LDH) and prothrombin time (PT). RESULTS Twenty studies (601 adult participants in total, aged 18-57 years) conducted in 10 countries between 1987 and 2020 were identified. RDIF-induced effect sizes for the LFT expressed as standardized mean difference (SMD) [95% confidence interval] were: AST (no. of studies K = 16, number of subjects N = 502, SMD = -0.257 [-0.381, -0.133], I2 = 42%); ALT (K = 16, N = 502, SMD = -0.105 [-0.282, 0.07], I2 = 71%); GGT (K = 2, N = 46, SMD = -0.533 [-0.842, -0.224], I2 = 0%); ALP (K = 10, N = 312, SMD = -0.318 [-0.432, -0.204], I2 = 0.0%); BLU (K = 10, N = 325, SMD = -0.264 [-0.520, -0.007], I2 = 70.1%); LDH (K = 5, N = 145, SMD = -0.041 [-0.380, 0.298], I2 = 72%); PT (K = 2, N = 74, SMD = -0.027 [-0.732, 0.678], I2 = 87%). CONCLUSION RDIF induces significant but small (AST, ALP, BLU) to medium (GGT) positive changes on LFT, and may confer a transient, short-term protection against fatty liver disease in healthy subjects.
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Affiliation(s)
- MoezAlIslam Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates.
| | - Haitham Jahrami
- Rehabilitation Services, Periphery Hospitals, Ministry of Health, Manama, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Dana Abdelrahim
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan
| | - Nicola Bragazzi
- Department of Mathematics and Statistics, Laboratory of Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
| | - Ahmed BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
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Koppold-Liebscher DA, Klatte C, Demmrich S, Schwarz J, Kandil FI, Steckhan N, Ring R, Kessler CS, Jeitler M, Koller B, Ananthasubramaniam B, Eisenmann C, Mähler A, Boschmann M, Kramer A, Michalsen A. Effects of Daytime Dry Fasting on Hydration, Glucose Metabolism and Circadian Phase: A Prospective Exploratory Cohort Study in Bahá'í Volunteers. Front Nutr 2021; 8:662310. [PMID: 34395487 PMCID: PMC8358295 DOI: 10.3389/fnut.2021.662310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Religiously motivated Bahá'í fasting (BF) is a form of intermittent dry fasting celebrated by abstaining from food and drinks during daylight hours every year in March for 19 consecutive days. Aim: To test the safety and effects of BF on hydration, metabolism, and the circadian clock. Methods: Thirty-four healthy Bahá'í volunteers (15 women) participated in this prospective, exploratory cohort study. Laboratory examinations were carried out in four study visits: before fasting (V0), in the third week of fasting (V1) as well as 3 weeks (V3) and 3 months (V4) after fasting. Data collection included blood and urine samples, anthropometric measurements and bioelectrical impedance analysis. At V0 and V1, 24- and 12-hour urine and serum osmolality were measured. At V0–V2, alterations in the circadian clock phase were monitored in 16 participants. Our study was augmented by an additional survey with 144 healthy Bahá'í volunteers filling out questionnaires and with subgroups attending metabolic measurements (n = 11) and qualitative interviews (n = 13), the results of which will be published separately. Results: Exploratory data analysis revealed that serum osmolality (n = 34, p < 0.001) and 24-hour urine osmolality (n = 34, p = 0.003) decreased during daytime fasting but remained largely within the physiological range and returned to pre-fasting levels during night hours. BMI (body mass index), total body fat mass, and resting metabolic rate decreased during fasting (n = 34, p < 0.001), while body cell mass and body water appeared unchanged. The circadian phase estimated by transcript biomarkers of blood monocytes advanced by 1.1 h (n = 16, p < 0.005) during fasting and returned to pre-fasting values 3 weeks after fasting. Most observed changes were not detectable anymore 3 months after fasting. Conclusions: Results indicate that BF (Bahá'í fasting) is safe, has no negative effects on hydration, can improve fat metabolism and can cause transient phase shifts of circadian rhythms. Trial Registration:https://www.clinicaltrials.gov/, identifier: NCT03443739.
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Affiliation(s)
- Daniela A Koppold-Liebscher
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Caroline Klatte
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Demmrich
- Department of Sociology, Cluster of Excellence Religion and Politics, University of Münster, Münster, Germany
| | - Julia Schwarz
- Department of Oecotrophology, Hochschule Niederrhein, University of Applied Science, Mönchengladbach, Germany
| | - Farid I Kandil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Campus Benjamin Franklin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Nico Steckhan
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Connected Healthcare, Hasso Plattner Institute, University of Potsdam, Potsdam, Germany
| | - Raphaela Ring
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Barbara Koller
- Laboratory of Chronobiology, Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | | | - Anja Mähler
- Experimental and Clinical Research Center-a Joint Cooperation Between Charité-Universitätsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Boschmann
- Experimental and Clinical Research Center-a Joint Cooperation Between Charité-Universitätsmedizin Berlin and Max Delbrueck Center for Molecular Medicine, Berlin, Germany
| | - Achim Kramer
- Laboratory of Chronobiology, Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
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Jahrami HA, Faris ME, I Janahi A, I Janahi M, Abdelrahim DN, Madkour MI, Sater MS, Hassan AB, Bahammam AS. Does four-week consecutive, dawn-to-sunset intermittent fasting during Ramadan affect cardiometabolic risk factors in healthy adults? A systematic review, meta-analysis, and meta-regression. Nutr Metab Cardiovasc Dis 2021; 31:2273-2301. [PMID: 34167865 DOI: 10.1016/j.numecd.2021.05.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/07/2021] [Accepted: 05/10/2021] [Indexed: 02/07/2023]
Abstract
AIMS This study aimed to evaluate the effects of Ramadan diurnal intermittent fasting (RDIF; 29-30 days) on cardiometabolic risk factors (CMRF) in healthy adults, and examine the effect of various cofactors on the outcomes using sub-group meta-regression. DATA SYNTHESIS We conducted a systematic review and meta-analysis to measure the effect sizes of changes in CMRF in healthy adult Muslims observing RDIF. Ten scientific databases (EBSCOhost, CINAHL, Cochrane, EMBASE, PubMed/MEDLINE, Scopus, Google Scholar, ProQuest Medical, ScienceDirect, and Web of Science) were searched from the date of inception (1950) to the end of November 2020. The CMRF searched and analyzed were total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), diastolic blood pressure (DBP), and heart rate (HR). We identified 91 studies (4431 adults aged 18-85 years) conducted between 1982 and 2020 in 23 countries distributed over four continents. RDIF-induced effect sizes for CMRF were: TC (no. of studies K = 77, number of subjects N = 3705, Hedge's g = -0.092, 95% confidence interval (CI): -0.168, 0.016); TG (K = 74, N = 3591, Hedge's g = -0.127, 95% CI: -0.203, 0.051); HDL-C (K = 68, N = 3528, Hedge's g = 0.138, 95% CI: 0.051, 0.224); LDL-C (K = 65, N = 3354, Hedge's g = -0.115, 95% CI: -0.197, -0.034); VLDL-C (K = 13, N = 648, Hedge's g = -0.252, 95% CI: -0.431, 0.073), DBP (K = 32, N = 1716, Hedge's g = -0.255, 95% CI: -0.363, 0.147), and HR (K = 12, N = 674, Hedge's g = -0.082, 95% CI: -0.300, 0.136). Meta-regression revealed that the age of fasting people was a significant moderator of changes in both HDL-C (P = 0.02) and VLDL-C (P = 0.01). Male sex was the only significant moderator of changes in LDL-C (P = 0.055). Fasting time duration was the only significant moderator of HDL-C (P = 0.001) at the end of Ramadan. CONCLUSIONS RDIF positively impacts CMRF, which may confer short-term transient protection against cardiovascular disease among healthy people.
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Affiliation(s)
- Haitham A Jahrami
- Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates.
| | - Abdulrahman I Janahi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mohamed I Janahi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Dana N Abdelrahim
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Mohamed I Madkour
- Department of Medical Laboratory Sciences, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Mai S Sater
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Adla B Hassan
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed S Bahammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
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Su J, Wang Y, Zhang X, Ma M, Xie Z, Pan Q, Ma Z, Peppelenbosch MP. Remodeling of the gut microbiome during Ramadan-associated intermittent fasting. Am J Clin Nutr 2021; 113:1332-1342. [PMID: 33842951 PMCID: PMC8106760 DOI: 10.1093/ajcn/nqaa388] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Intermittent fasting is a popular dietary intervention with perceived relatively easy compliance and is linked to various health benefits, including weight loss and improvement in blood glucose concentrations. The mechanistic explanations underlying the beneficial effects of intermittent fasting remain largely obscure but may involve alterations in the gut microbiota. OBJECTIVES We sought to establish the effects of 1 mo of intermittent fasting on the gut microbiome. METHODS We took advantage of intermittent fasting being voluntarily observed during the Islamic faith-associated Ramadan and sampled feces and blood, as well as collected longitudinal physiologic data in 2 cohorts, sampled in 2 different years. The fecal microbiome was determined by 16S sequencing. Results were contrasted to age- and body weight-matched controls and correlated to physiologic parameters (e.g., body mass and calorie intake). RESULTS We observed that Ramadan-associated intermittent fasting increased microbiome diversity and was specifically associated with upregulation of the Clostridiales order-derived Lachnospiraceae [no fasting 24.6 ± 13.67 compared with fasting 39.7 ± 15.9 in relative abundance (%); linear discriminant analysis = 4.9, P < 0.001 by linear discriminant analysis coupled with effect size measurements] and Ruminococcaceae [no fasting 13.4 ± 6.9 compared with fasting 23.2 ± 12.9 in relative abundance (%); linear discriminant analysis = 4.7, P < 0.001 by linear discriminant analysis coupled with effect size measurements] bacterial families. Microbiome composition returned to baseline upon cessation of intermittent feeding. Furthermore, changes in Lachnospiraceae concentrations mirrored intermittent fasting-provoked changes in physiologic parameters. CONCLUSIONS Intermittent fasting provokes substantial remodeling of the gut microbiome. The intermittent fasting-provoked upregulation of butyric acid-producing Lachnospiraceae provides an obvious possible mechanistic explanation for health effects associated with intermittent fasting.
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Affiliation(s)
- Junhong Su
- Department of Gastroenterology and Hepatology, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, China
| | - Yueying Wang
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Xiaofang Zhang
- Department of Basic Medicine, Medical School, Kunming University of Science and Technology, Kunming, China
| | - Mingfu Ma
- The Fifth People's Hospital of Qinghai (Qinghai Tumor Hospital), Xining, China
| | - Zhenrong Xie
- The Medical Biobank, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Zhongren Ma
- China-Malaysia National Joint Laboratory, Biomedical Research Center, Northwest Minzu University, Lanzhou, China
| | - Maikel P Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC—University Medical Center Rotterdam, Rotterdam, The Netherlands
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Arbour MW, Stec M, Walker KC, Wika JC. Clinical Implications for Women of a Low-Carbohydrate or Ketogenic Diet With Intermittent Fasting. Nurs Womens Health 2021; 25:139-51. [PMID: 33838849 DOI: 10.1016/j.nwh.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/08/2020] [Accepted: 11/01/2020] [Indexed: 12/27/2022]
Abstract
Obesity in the United States is pervasive and associated with morbidity, mortality, and increased health care costs. For women, obesity may affect stages of life including early menarche, fertility, pregnancy, and menopause as a result of hormonal imbalances and insulin resistance. The insulin-carbohydrate model of obesity has been proposed as an explanation for growing obesity rates and can be used to target weight loss strategies by increasing insulin sensitivity. Together, low-carbohydrate dietary patterns along with intermittent fasting may help individuals with insulin resistance not only lose weight but also increase their insulin sensitivity. The purpose of this article is to review the epidemiology and physiology of obesity and the indicators for health while outlining strategies for nurses and other clinicians to use when counseling women who are following a low-carbohydrate or ketogenic diet with intermittent fasting for weight management.
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Abdelrahim D, Faris ME, Hassanein M, Shakir AZ, Yusuf AM, Almeneessier AS, BaHammam AS. Impact of Ramadan Diurnal Intermittent Fasting on Hypoglycemic Events in Patients With Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials and Observational Studies. Front Endocrinol (Lausanne) 2021; 12:624423. [PMID: 33763029 PMCID: PMC7984365 DOI: 10.3389/fendo.2021.624423] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/11/2021] [Indexed: 01/14/2023] Open
Abstract
Ramadan is the 9th month of the lunar calendar during which Muslims abstain from food and drink between dawn and sunset for 30 consecutive days. Ramadan fasting is observed by all healthy Muslim adults, as well many Muslims with type 2 diabetes (T2DM). Hypoglycemic events (HE) are a serious complication associated with diabetes management and are associated with increased cardiovascular disease risk. Conflicting results have been reported concerning the incidence of HE among people with T2DM observing Ramadan fasting. This review summarizes available scientific evidence on the occurrence of HE and the effects of different moderators on the incidence of HE among patients with T2DM during Ramadan. We conducted a systematic review of available observational studies and randomized controlled trials (RCTs) for patients with T2DM who fasted during Ramadan, with HE as the primary outcome. Ten databases were searched for relevant studies from inception until October 31, 2020. In total, 68 studies (35 RCTs and 33 observational studies) met the inclusion criteria. Non-sulfonylureas hypoglycemic medications showed superior effects in lowering the incidence of HE over sulfonylureas hypoglycemic medications. Variable moderators were associated with experiencing HE during Ramadan in both observational studies and RCTs, including sex, geographical location, body anthropometric indicators, season, dietary behaviors, fasting duration, time since diagnosis, and pre-fasting education. This comprehensive systematic review covered the largest number of observational and clinical studies investigating the impact of Ramadan on HE among patients with T2DM. The study highlights the significance of different moderators that influence the effect of Ramadan fasting on HE, including dietary behaviors, fasting time duration, sex, season, country, pre-fasting education, age, and time since diagnosis. The study also highlighted the impact of different hypoglycemic medications on HE and noted the superiority of non-sulfonylureas over sulfonylureas hypoglycemic medications in lowering the risk for hypoglycemia in people with T2DM during Ramadan fasting.
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Affiliation(s)
- Dana Abdelrahim
- Department of Nutrition and Food Technology, Faculty of Agriculture, The University of Jordan, Amman, Jordan
| | - MoezAlIslam E. Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- *Correspondence: Ahmed S. BaHammam, ; MoezAlIslam E. Faris, ;
| | - Mohamed Hassanein
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Ayman Z. Shakir
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Ayesha M. Yusuf
- Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | | | - Ahmed S. BaHammam
- Department of Medicine, College of Medicine, The University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia
- *Correspondence: Ahmed S. BaHammam, ; MoezAlIslam E. Faris, ;
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Xiao Q, Bauer C, Layne T, Playdon M. The association between overnight fasting and body mass index in older adults: the interaction between duration and timing. Int J Obes (Lond) 2021; 45:555-64. [PMID: 33214704 DOI: 10.1038/s41366-020-00715-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/14/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Circadian rhythms play an important role in the regulation of eating and fasting, and mistimed dietary intakes may be detrimental to metabolic health. Extended overnight fasting has been proposed as a strategy to better align the eating-fasting cycle with the internal circadian clock, and both observational and experimental studies have linked longer overnight fasting with lower body weight. However, it remains unclear if the timing of overnight fasting modifies the relationship between fasting duration and weight outcomes. METHODS The current study included 495 men and 499 women age 50-74 years. Dietary intake over 12 months was assessed by 24-h dietary recalls every two months, and body-mass index was measured at the beginning, middle and end of the study. Logistic regression was used to estimate the relationship between overnight fasting duration and the likelihood of being overweight or obesity adjusted for multiple confounders, and assessed whether the relationship was modified by the timing of overnight fasting, measured as the midpoint of the fasting period. RESULTS Among participants with early overnight fasting (midpoint < 02:19 am), a longer fasting duration was associated with lower odds of overweight and obesity; while among those with late fasting (≥02:19 am), longer fasting was associated with higher odds of overweight and obesity. Specifically, when compared to the shortest quintile of overnight fasting duration, the longest quintile was associated with a 53% reduction in the odds of overweight and obesity in the early fasting group (OR = 0.47, 95% CI = 0.23, 0.97), but a 2.36-fold increase in the late fasting group (OR = 3.36, 95% CI = 1.48, 7.62). Additionally adjusting for dietary intakes during morning and late evening periods did not affect the observed associations. CONCLUSIONS Longer overnight fasting was associated with a reduced likelihood of being overweight or obese, but only among those with an early timing of fasting.
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Soliman S, Faris ME, Ratemi Z, Halwani R. Switching Host Metabolism as an Approach to Dampen SARS-CoV-2 Infection. Ann Nutr Metab 2020; 76:297-303. [PMID: 32950986 PMCID: PMC7573915 DOI: 10.1159/000510508] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/26/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND COVID-19 pandemic, a global threat, adversely affects all daily lives, altered governmental plans around the world, and urges the development of therapeutics and prophylactics to avoid the expansion of the viral infection. With the recent gradual opening after long lockdown, several recommendations have been placed, with dietary modification as one of the most important approaches that have been appraised. SUMMARY Here, we are reviewing how changing the host metabolism, particularly changing the host metabolic state from the carbohydrate-dependent glycolytic state to a fat-dependent ketogenic state, may affect viral replication. Furthermore, the impact of intermittent fasting (IF) in triggering metabolic switch along with the impact of supplementation with medium-chain triglycerides (MCTs) such as lauric acid in repressing the envelope formation and viral replication is also addressed. The amalgamation of IF and a ketogenic diet rich in MCTs is thought to work as a prophylactic measure for normal people and adjunct therapy for infected persons. Key Message: A diet regimen of ketogenic breakfast along with supplementation with two doses of lauric acid-rich MCTs at breakfast and lunch times, followed by 8-12-h IF and a dinner rich with fruits and vegetables, could be a potential prophylactic strategy and adjuvant therapy to combat SARS-CoV-2 infections.
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Affiliation(s)
- Sameh Soliman
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,
| | - Zakaria Ratemi
- Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada
| | - Rabih Halwani
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Abstract
Meta-analysis is an important statistical tool, and it is often used to solve clinical problems. However inevitably when conducting a meta-analysis, the included studies often have heterogeneity. This paper suggests the inclusion of relevant background data or contextual variables into the model. The contextual variables are those variables not explicitly measured in the studies included in a meta-analysis; thus, these must be very well-described and justified as parameters for analyses.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Kingdom of Bahrain; College of Medicine and Medial Sciences, Arabian Gulf University, Manama P.O Box 26671, Bahrain
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