Abstract
Fasting during the month of Ramadan is a religious rituals of all healthy adult Muslims. However, there is no clear agreement on the effects of Ramadan fasting on cardiovascular disease. Comorbidities and factors such as age, gender, health status, daily duration of fasting, food intake before and after fasting may impact on a fasting individual’s cardiometabolic risk. This review was undertaken to assess the effects of Ramadan fasting on: the incidence of cardiovascular disease during the month of Ramadan; the clinical status of patients with stable cardiac disease; and any alterations in cardiometabolic risk profile.Methods:A systematic search was undertaken for studies that investigated the impact of Ramadan fasting on cardiovascular outcomes and risk factors. Electronic databases including MEDLINE, Scopus and Web of Knowledge were searched from 1982 up to 2014. The incidence of acute cardiac illness during Ramadan fasting was similar when compared to non-fasting days. Ramadan fasting is associated with elevations in high-density lipoprotein cholesterol (HDL-c), and reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol). However, the lipid profile of diabetic patients deteriorated significantly during Ramadan fasting. In addition, Ramadan fasting lowers body weight, body fat percentage and BMI (body mass index). However, the relationship between weight reduction and loss of body fat is not studied. The majority of patients with stable cardiac illness can opt for Ramadan fasting safely. However, the long term effects of Ramadan fasting on cardiovascular outcomes and risk factors remains uncertain, and the apparent discordant effects in individuals with and without diabetes mellitus merits further study.
Highlights
There are approximately 1.6 billion Muslims worldwide
A comprehensive search strategy was developed for original articles published in peer-reviewed journals, using terms related to the impact of Ramadan fasting on cardiovascular outcomes, risk factors and body composition
The identified studies were reviewed and articles were included in the analysis if they reported the effects of Ramadan fasting on cardiovascular outcomes, such as myocardial infarction, cardiac revascularization, heart failure or stroke, or on cardiometabolic risk factors such as body mass index (BMI), blood pressure (BP) or lipid profiles
Summary
There are approximately 1.6 billion Muslims worldwide. The ninth lunar month, is the holiest month in the Islamic calendar. During this month, millions of Muslims fast from dawn to sunset each day.[1] Studies of fasting commonly distinguish between caloric restriction (CR), alternate-day fasting (ADF), and dietary restriction (DR). Ramadan fasting is considered similar to ADF because both incorporate alternating feast periods and fast periods.[2]. Areas of the world with large Muslim populations, such as the Middle East and South Asia, bear a heavy
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