ArticlePloS one2014
Health impact of fasting in Saudi Arabia during Ramadan: association with disturbed circadian rhythm and metabolic and sleeping patterns.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 74 citations in OpenAlex.
- 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.The journal of nutrition, health & aging · 2024Pooled it
- The Window Matters: A Systematic Review of Time Restricted Eating Strategies in Relation to Cortisol and Melatonin Secretion.Nutrients · 2021Pooled it
- Effects of Ramadan intermittent fasting on leptin and adiponectin: a systematic review and meta-analysis.Hormones (Athens, Greece) · 2021Pooled it
- Trial
- Intermittent fasting and liver disease: Insights from the Ramadan model.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026Article
- Mental Health, Sleep, and Physical Activity Among Young Saudi Women During Ramadan: A Comparative Cohort Study.Nature and science of sleep · 2026Article
- Conceptualizing a Personalized Care Pathway for Parkinson's Disease Using Wearable Sensors in Muslim Patients: The Ramadan Regime.Journal of movement disorders · 2026Article
- Altered Ramadan fasting glycemic profiles of adults with type 1 diabetes reveal strong evidence of underestimated insulin adjustments: a 3-year observational study in Arab settings.Frontiers in endocrinology · 2025Observational
- Effect of 30-day Ramadan fasting on autophagy pathway and metabolic health outcome in healthy individuals.Molecular biology research communications · 2025Article
- Interaction Between Early Meals (Big-Breakfast Diet), Clock Gene mRNA Expression, and Gut Microbiome to Regulate Weight Loss and Glucose Metabolism in Obesity and Type 2 Diabetes.International journal of molecular sciences · 2024Review
- Ramadan Fasting and Short-Term Maximal Physical Performance: Searching for Optimal Timing of the Last Meal "Suhoor" in Female Pre-University Handball Players.European journal of investigation in health, psychology and education · 2023Article
- Review
- Glucagon-Like Peptide-1 (GLP-1) during Ramadan: Narrative Review of the Published Literature.Journal of obesity · 2023Review
- The Health-Promoting Effects and the Mechanism of Intermittent Fasting.Journal of diabetes research · 2023Review
- Ramadan and Diabetes: What About Non-Fasting Patients with Diabetes?Diabetes, metabolic syndrome and obesity : targets and therapy · 2022Article
- Religious Fasting of Muslim Patients After Metabolic and Bariatric Surgery: a Modified Delphi Consensus.Obesity surgery · 2021Article
- Sleep Quality and Performance in Professional Athletes Fasting during the Month of Ramadan.International journal of environmental research and public health · 2021Article
- Time-Restricted Feeding and Aerobic Performance in Elite Runners: Ramadan Fasting as a Model.Frontiers in nutrition · 2021Article
- Ramadan and Diabetes: A Narrative Review and Practice Update.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Review
- Ramadan and Diabetes: A Narrative Review and Practice Update.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020Review
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMuslims go through strict Ramadan fasting from dawn till sunset for one month yearly. These practices are associated with disturbed feeding and sleep patterns. We recently demonstrated that, during Ramadan, circadian cortisol rhythm of Saudis is abolished, exposing these subjects to continuously increased cortisol levels. HYPOTHESIS: Secretory patterns of other hormones and metabolic parameters associated with cortisol, and insulin resistance, might be affected during Ramadan. PROTOCOL: Ramadan practitioners (18 males, 5 females; mean age ±SEM = 23.16±1.2 years) were evaluated before and two weeks into Ramadan. Blood was collected for measurements of endocrine and metabolic parameters at 9 am (±1 hour) and again twelve hours later.
resultsIn Ramadan, glucose concentration was kept within normal range, with a significant increase in the morning. Mean morning concentration of leptin was significantly higher than pre-Ramadan values (p = 0.001), in contrast to that of adiponectin, which was significantly lower (p<0.001). These changes were associated with increased insulin resistance in morning and evening. Concentrations of hsCRP were lower during Ramadan than those during regular living conditions, however, normal circadian fluctuation was abolished (p = 0.49). Even though means of liver enzymes, total bilirubin, total protein and albumin were all decreased during Ramadan, statistically lower means were only noted for GGT, total protein, and albumin (p = 0.018, 0.002 and 0.001 respectively). DISCUSSION: Saudi Ramadan practitioners have altered adipokine patterns, typical of insulin resistance. The noted decreases of hsCRP, liver enzymes, total protein, and albumin, are most likely a result of fasting, while loss of circadian rhythmicity of hsCRP is probably due to loss of circadian cortisol rhythm.
conclusionsModern Ramadan practices in Saudi Arabia, which are associated with evening hypercortisolism, are also characterized by altered adipokines patterns, and an abolished hsCRP circadian rhythm, all likely to increase cardiometabolic risk.
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