Sex as a Biological Factor in the Changes in Disease Patients During Ramadan Intermittent Fasting: A Systematic Review

Abstract

BackgroundDuring 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 BodyThe 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.ConclusionCurrently, 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.

Effect of Calorie Restriction and Intermittent Fasting Regimens on Brain-Derived Neurotrophic Factor Levels and Cognitive Function in Humans: A Systematic Review

“…In one clinical trial, sex was found to be one of the biological determinants that shaped the effect of fasting on circulating BDNF levels. Such a difference was also a mirror for the differences in the effect of observing RIF on the two sexes in healthy and disease conditions, as revealed by previous reviews [71,72].…”

Review of the Literature on Ramadan Fasting and Health in 2022

“…Several studies investigated the pathophysiological mechanisms of the impact of RF on some aspects of health 4 5 6 7 8 and nutritional changes including body composition and energy metabolism. 9 10 11 12 13…”

“…Additionally, a systematic review also evaluated the effect of sex on epilepsy and headache frequency during RF. 8 Six studies on headaches looked at the sex difference. Most of these studies reported that in the baseline condition, the headache was more frequent in women and that RF was a triggering factor for headaches.…”

“…The effects of sex in six disease outcomes of patients who observed RF were evaluated in a systematic review of observational and relevant clinical studies. 8 Eighteen studies reported sex-based differences for variables such as BMI, blood glucose, the frequency of hypoglycemia, renal colic, mortality, thrombosis, and gastrointestinal diseases in patients observing RF. Most differences between men and women were reported in the baseline before and during Ramadan.…”

Reklamasi Iman dalam Puasa Ramadhan

“…Puasa terbukti 'aman' bagi pasien dengan beberapa kondisi kronis, seperti diabetes melitus, dan penyakit kardiovaskular (Akhtar et al, 2022). puasa Ramadan bermanfaat bagi kesehatan penderita diabetes, penyakit ginjal, jantung, saluran cerna, sakit kepala, dan epilepsi (Roky et al, 2022).…”