Islamic fasting and multiple sclerosis

Abstract

BackgroundMonth-long daytime Ramadan fasting pose s major challenges to multiple sclerosis (MS) patients in Muslim countries. Physicians should have practical knowledge on the implications of fasting on MS. We present a summary of database searches (Cochrane Database of Systematic Reviews, PubMed) and a mini-symposium on Ramadan fasting and MS. In this symposium, we aimed to review the effect of fasting on MS and suggest practical guidelines on management.DiscussionIn general, fasting is possible for most stable patients. Appropriate amendment of drug regimens, careful monitoring of symptoms, as well as providing patients with available evidence on fasting and MS are important parts of management. Evidence from experimental studies suggests that calorie restriction before disease induction reduces inflammation and subsequent demyelination and attenuates disease severity. Fasting does not appear to have unfavorable effects on disease course in patients with mild disability (Expanded Disability Status Scale (EDSS) score ≤3). Most experts believed that during fasting (especially in summer), some MS symptoms (fatigue, fatigue perception, dizziness, spasticity, cognitive problems, weakness, vision, balance, gait) might worsen but return to normal levels during feasting. There was a general consensus that fasting is not safe for patients: on high doses of anti-convulsants, anti-spastics, and corticosteroids; with coagulopathy or active disease; during attacks; with EDSS score ≥7.SummaryThese data suggest that MS patients should have tailored care. Fasting in MS patients is a challenge that is directly associated with the spiritual belief of the patient.

Does Ramadan Fasting Affect Fatigue in Nurses?

“…5,25,29,30 In addition to these problems, Ramadan fasting is emphasized to cause lifestyle changes, stress, 31,32 and particularly fatigue. 4,33 Fatigue is a complex phenomenon characterized by a subjective feeling of tiredness, both physical and mental, that can be experienced by nurses in the workplace. In today's physically demanding and safety-sensitive industries, including health care, fatigue requires attention because it affects job productivity and occupational health 34 and can ultimately adversely affect the patient safety.…”

“…2,7 Travellers, menstruating, pregnant, or breastfeeding women, children as well as the sick, elderly, and disabled people are exempt from fasting. 4,7,8 Muslims believe that the fasting during Ramadan improves self-discipline and increases spirituality, inner peace, and awareness of the hardship suffered by those who do not have enough food and frequently go hungry without choice. 9 Therefore, it is a religious obligation for all healthy adult Muslims to fast during Ramadan.…”

“…[1][2][3] Fasting during the holy month of Ramadan is considered to be 1 of the 5 pillars of Islam. 4,5 During Ramadan, Muslims are forbidden from eating, drinking, smoking, sexual activity, and taking medications (orally or parenterally) each day-approximately 11 to 20 hours (from break of dawn until sunset), for 28 to 30 days (number of days in Ramadan in which people fast) depending on the geographic location and season. 2,4,6 Two main meals are eaten during the month of Ramadan: one before dawn (Sahur) and the other at sunset (Iftar).…”

Effects of Walking Football During Ramadan Fasting on Heart Rate Variability and Physical Fitness in Healthy Middle-Aged Males

“…Healthy Muslims fast from dawn to dusk (12–20 hr/day, depending on the season and the geographical region). Observers refrain from eating food, drinking liquids, and other physical needs such as smoking and sexual intercourse ( Ghram et al, 2021 ; Jahromi et al, 2014 ). Ramadan fasting (RF) as intermittent fasting is mandatory for all healthy adult Muslims ( Akbari et al., 2022 ; Lessan & Ali, 2019 ).…”

Fatigue, Sleepiness, Anxiety-Depression Score, Calories And BDNF Serum Level, Quality Of Life Alteration During Holy Ramadhan Month

“…1 Fasting during the month of Ramadhan is one of the five main pillars of Islam. 2 Surah Al-Baqarah:187 Correspondent:…”