1Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2Department of Nutrition, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Ramadan is considered as holy month of Muslims worldwide. During this month, most able-bodied Muslim adults refrain from foods, drinks, smoking, and medications from dawn until sunset. In Islamic rules, patients and those for whom fasting may have major health risks are exempted from fasting during Ramadan. There is still no consensus regarding the effects of Ramadan fasting, as a unique opportunity for lifestyle modifications, on cardiovascular risk factors in the Muslim population. The aim of this scientific literature review was to gather comprehensive results with regard to the effects of Ramadan fasting on major cardiovascular risk factors. This literature review focused on the effects of Ramadan fasting on four main factors, including body weight, blood glucose level, blood pressure, and plasma lipoproteins. According to the results, fasting during Ramadan is a good opportunity for patients and healthy subjects for control and prevent from diabetes, hypertension, hyperlipidemia and perhaps body fat mass as major risk factors of cardiovascular diseases, however diabetic patients need to know about physical recommendations for fasting during. However, limitations of the conducted studies should be considered in specific populations while interpreting the results.
Sarraf-Zadegan N, Boshtam M, Rafiei M: Risk factors for coronary artery disease in Isfahan, Iran. Eur J Public Health 1999, 9(1):20–26.
Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, Sabery M, Mohajeri SA, Shalaey N, Moohebati M, Norouzy A. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012;11:69.
Mirzaei B, Rahmani-Nia F, Moghadam MG, Ziyaolhagh SJ, Rezaei A. The effect of ramadan fasting on biochemical and performance parameters in collegiate wrestlers. Iran J Basic Med Sci 2012;15:1215-20.
Akaberi A, Golshan A, Moojdekanloo M, Hashemian M. Does fasting in Ramadan ameliorate Lipid profile? A prospective observational study. Pak J Med Sci. 2014;30(4):708-11.
Klempel MC, Kroeger CM, Bhutani S, Trepanowski JF, Varady KA. Intermittent fasting combined with calorie restriction is effective for weight loss and cardio-protection in obese women. Nutr J. 2012;11:98.
Ramahi I, Seidenberg AB, Kennedy RD, Rees VW. Secondhand smoke emission levels in enclosed public places during Ramadan. Eur J Public Health 2013;23:789-91.
Gellert C, Schöttker B, Brenner H. Smoking and all-cause mortality in older people: Systematic review and meta-analysis. Arch Intern Med 2012;172:837-44.
Norouzy A, Mohajeri SMR, Shakeri S, Yari F, Sabery Karimian M, Philippou E, Varasteh AR, Nematy M. Effect of Ramadan fasting on glycaemic control in patients with Type 2 diabetes. Journal of endocrinological investigation. 2012;35(8):766-71.
Norouzy A, Salehi M, Philippou E, Arabi H, Shiva F, Mehrnoosh S, Mohajeri SM, Mohajeri SA, Motaghedi Larijani A, Nematy M. Effect of fasting in Ramadan on body composition and nutritional intake: a prospective study. Journal of Human Nutrition & Dietetics. J Hum Nutr Diet. 2013;26 Suppl 1:97-104.
International Diabetes Federation. IDF Diabetes Atlas 7th edn http://www.diabetesatlas.org (2016).
White M. Population Approaches to Prevention of Type 2 Diabetes. PLoS Med. 2016;13 (7):e1002080.
Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol. 2014;2(1):56-64.
Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, et al. EPIDIAR study group.Population based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. Diabetes Care. 2004;27:2306–11.
Katibi IA, Akande AA, Bojuwoye BJ, Okesina AB. Blood sugar control among fasting Muslims with type-2 diabetes mellitus in Ilorin. Niger J Med. 2001;10:132–4.
Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan Education and Awareness in Diabetes (READ) program for Muslims with type-2 diabetes who fast during Ramadan. Diabet Med. 2010;27:327–31.
Al-Arouj M, Assaad-Khalil S, Buse J, Fahdil I, Fahmy M, Hafez S, et al. Recommendations for management of diabetes during Ramadan: Update 2010. Diabetes Care 2010;33:1895-902.
Kul S, Savas E, Öztürk ZA, Karadag G. Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J Relig Health. 2014;53:929–42.
Vasan SK, Karol R, Mahendri NV, Arulappan N, Jacob JJ, Thomas N. A prospective assessment of dietary patterns in Muslim subjects with type 2 diabetes who undertake fasting during Ramadan. Indian J Endocrinol Metab 2012;16:552-7.
Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 2012 Jan 3. 125(1):e2-e220.
Chobanian AV, Bakris GL, Black HR et al. Hypertension 2003;42:1206–52.
American Heart Association: Heart Disease and Stroke Statistics: 2010 Update At-A-Glance, Dallas, Texas, 2010, American Heart Association.
Savoia C, Schiffrin E: Vascular inflammation in hypertension and diabetes: molecular mechanisms and therapeutic interventions, Clin Sci (Lond). 2007;112(7):375-84.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365(9455):217-23.
Appel LJ, Sacks FM, Carey VJ et al. JAMA 2005;294:2455–64.
James PA, Oparil S, Carter BL, Cushman WC, et al. Evidence-based guideline for management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311(5): 507-20.
Al-Shafei AI. Ramadan fasting ameliorates arterial pulse pressure and lipid profile, and alleviates oxidative stress in hypertensive patients. Blood Pressure. 2014; 23(3):160-7
Rahman M, Rashid M, Basher S, et al. Improved serum HDL cholesterol profile among Bangladeshi male students during Ramadan fasting. East Mediterr Health J 2004;10:131.
Saleh SA, Elsharouni SA, Cherian B, et al. Effects of Ramadan fasting on waist circumference, blood pressure, lipid profile, and blood sugar on a sample of healthy Kuwaiti men and women. Mal J Nutr 2005;11:143-50.
Phillips NR, Waters D, Havel RJ. Plasma lipoproteins and progression of coronary artery disease evaluated by angiography and clinical events. Circulation. 1993;88(6):2762-70.
Austin MA, Breslow JL, Hennekens CH, Buring JE, Willett WC, Krauss RM. Low density lipoprotein subclass patterns and risk of myocardial infarction. JAMA. 1988;260:1917-1921.
Arca M, Montali A, Valiante S, Campagna F, Pigna G, Paoletti V, et al. Usefulness of atherogenic dyslipidemia for predicting cardiovascular risk in patients with angiographically defined coronary artery disease. Am J Cardiol. 2007;100 (10):1511-1516.
National Cholesterol Education Program (NCEP): Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report, Circulation 106:3143, 2002.
Bo S, Ciccone G, Baldi C, Benini L, Dusio F, Forastiere G, Lucia C, Nuti C, Durazzo M, Cassader M, Gentile L, Pagano G. Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial. J Gen Intern Med. 2007;22(12):1695-703.
Petursson H, Sigurdsson JA, Bengtsson C, Nilsen TI, Getz L. Body configuration as a predictor of mortality: comparison of five anthropometric measures in a 12 year follow-up of the Norwegian HUNT 2 study. PLoS One. 2011;6(10):e26621.
Sadeghirad B, Motaghipisheh S, Kolahdooz F, Zahedi MJ, Haghdoost AA. Islamic fasting and weight loss: a systematic review and meta-analysis. Public Health Nutr. 2014;17(2):396-406.