https://doi.org/10.4081/cardio.2024.32
The impact of diurnal fasting during Ramadan on patients with established cardiac disease: a systematic review
Published: June 28, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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During the month of Ramadan, Muslims abstain from eating before dawn until after sunset for a month. This study reviews most recent literature on the effect of Ramadan fasting on the Cardiac patient specifically, excluding any study done on patients with no diagnosis of Cardiac disease to help cardiologists better deal with their patients who would wish to fast during Ramadan. As such, a Medline and Pubmed search was conducted to retrieve studies investigating the effects of fasting during Ramadan specifically on the cardiac patient with regard to incidence of cardiac disease and change in cardiovascular risk parameters. The search was conducted by combining the key word Ramadan fasting with multiple cardiac diseases and cardiovascular risk parameters. Only studies reporting results on patients already diagnosed with a cardiac disease were included. fourteen were included. Most studies have shown, with a few exceptions, that Ramadan fasting has no adverse effects on incidence of cardiovascular disease or the number of hospitalizations due to cardiac disease events. Thus, patients with controlled disease may fast with the consultation and monitoring of their physician.
Cheng CW, Adams GB, Perin L, Wei M, Zhou X, Lam BS, et al. Prolonged fasting reduces IGF-1/PKA to promote hematopoietic-stem-cell-based regeneration and reverse immunosuppression. Cell Stem Cell 2014;146:810-23.
DOI: https://doi.org/10.1016/j.stem.2014.04.014
Cheng CW, Villani V, Buono R, Wei M, Kumar S, Yilmaz OH, et al. Fasting-mimicking diet promotes Ngn3-driven β-cell regeneration to reverse diabetes. Cell 2017;1685:775-88.
DOI: https://doi.org/10.1016/j.cell.2017.01.040
Laviano A, Rossi Fanelli F. Toxicity in chemotherapy: when less is more. New Engl J Med 2012;36624:2319-20.
DOI: https://doi.org/10.1056/NEJMcibr1202395
Lee C, Longo V. Fasting vs dietary restriction in cellular protection and cancer treatment: from model organisms to patients. Oncogene. 2011;3030:3305-16.
DOI: https://doi.org/10.1038/onc.2011.91
Levine ME, Suarez JA, Brandhorst S, Balasubramanian P, Cheng CW, Madia F, et al. Low protein intake is associated with a major reduction in IGF-1, cancer, and overall mortality in the 65 and younger but not older population. Cell Metabol 2014;193:407-17..
DOI: https://doi.org/10.1016/j.cmet.2014.02.006
Raffaghello L, Lee C, Safdie FM, Wei M, Madia F, Bianchi G, et al. Starvation-dependent differential stress resistance protects normal but not cancer cells against high-dose chemotherapy. Proc Natl Acad Sci 2008;10524:8215-20.
DOI: https://doi.org/10.1073/pnas.0708100105
Safdie F, Brandhorst S, Wei M, Wang W, Lee C, Hwang S, et al. Fasting enhances the response of glioma to chemo-and radiotherapy. PloS one 2012;79:e44603.
DOI: https://doi.org/10.1371/journal.pone.0044603
Safdie FM, Dorff T, Quinn D, Fontana L, Wei M, Lee C, et al. Fasting and cancer treatment in humans: A case series report. Aging Albany NY 2009;112:988.
DOI: https://doi.org/10.18632/aging.100114
Di Biase S, Lee C, Brandhorst S, Manes B, Buono R, Cheng CW, et al. Fasting-mimicking diet reduces HO-1 to promote T cell-mediated tumor cytotoxicity. Cancer cell 2016;301:136-46.
DOI: https://doi.org/10.1016/j.ccell.2016.06.005
Brandhorst S, Choi IY, Wei M, Cheng CW, Sedrakyan S, Navarrete G, et al. A periodic diet that mimics fasting promotes multi-system regeneration, enhanced cognitive performance, and healthspan. Cell Metabol 2015;221:86-99.
DOI: https://doi.org/10.1016/j.cmet.2015.05.012
Choi IY, Piccio L, Childress P, Bollman B, Ghosh A, Brandhorst S, et al. A diet mimicking fasting promotes regeneration and reduces autoimmunity and multiple sclerosis symptoms. Cell Rep 2016;1510:2136-46.
DOI: https://doi.org/10.1016/j.celrep.2016.05.009
Parrella E, Maxim T, Maialetti F, Zhang L, Wan J, Wei M, et al. Protein restriction cycles reduce IGF‐1 and phosphorylated Tau, and improve behavioral performance in an Alzheimer's disease mouse model. Aging Cell 2013;122:257-68.
DOI: https://doi.org/10.1111/acel.12049
Al Suwaidi J, Bener A, Suliman A, Hajar R, Salam A, Numan M, et al. A population based study of Ramadan fasting and acute coronary syndromes. Heart 2004;906:695-6.
DOI: https://doi.org/10.1136/hrt.2003.012526
Talib S, van de Poll SW. Brugada syndrome diagnosed after Ramadan. Lancet 2013;3829886:100.
DOI: https://doi.org/10.1016/S0140-6736(13)60810-7
Siegel AJ, Bhatti NA, Wasfy JH. Reprising Ramadan-related angina pectoris: a potential strategy for risk reduction. Am J Case Rep 2016;17:841-4.
DOI: https://doi.org/10.12659/AJCR.900133
Al Suwaidi J, Bener A, Hajar HA, Numan MT. Does hospitalization for congestive heart failure occur more frequently in Ramadan: a population-based study 1991-2001. Int J Cardiol 2004;962:217-21.
DOI: https://doi.org/10.1016/j.ijcard.2003.06.018
Al Suwaidi J, Zubaid M, Al-Mahmeed WA, Al-Rashdan I, Amin H, Bener A, et al. Impact of fasting in Ramadan in patients with cardiac disease. Saudi Med J 2005;2610:1579-83
Bener A, Hamad A, Fares A, Al-Sayed HM, Al-Suwaidi J. Is there any effect of Ramadan fasting on stroke incidence? Singapore Med J 2006;475:404-8.
Chamsi-Pasha H, Ahmed WH. The effect of fasting in Ramadan on patients with heart disease. Saudi Med J 2004;251:47-51.
Çomoğlu S, Temizhan A, Peşinci E, Tandoğan İ, Özbakir Ş. Effects of Ramadan fasting on stroke. Turk J Med Sci 2003;334:237-41.
El-Mitwalli A, Zaher AA, El Menshawi E. Circadian rhythm of stroke onset during the month of Ramadan. Acta Neurol Scandin 2010;1222:97-101.
DOI: https://doi.org/10.1111/j.1600-0404.2009.01265.x
Salam AM, AlBinali HA, Salim I, Singh R, Asaad N, Al-Qahtani A, et al. Impact of religious fasting on the burden of atrial fibrillation: a population-based study. Int J Cardiol 2013 Oct 03;1683:3042-3. PubMed PMID: 23642825. English. doi: 10.1016/j.ijcard.2013.04.131
DOI: https://doi.org/10.1016/j.ijcard.2013.04.131
Salam AM, Sulaiman K, Alsheikh-Ali AA, Singh R, Asaad N, Al-Qahtani A, et al. Acute heart failure presentations and outcomes during the fasting month of Ramadan: an observational report from seven middle eastern countries. Curr Med Res Opin 2017:1-9.
DOI: https://doi.org/10.1080/03007995.2017.1376629
Mousavi M, Mirkarimi S, Rahmani G, Hosseinzadeh E, Salahi N. Ramadan fast in patients with coronary artery disease. Iranian Red Cresc Med J 2014;1612.
DOI: https://doi.org/10.5812/ircmj.7887
Yousefi B, Faghfoori Z, Samadi N, Karami H, Ahmadi Y, Badalzadeh R, et al. The effects of Ramadan fasting on endothelial function in patients with cardiovascular diseases. Eur J Clin Nutr 2014;687:835-9.
DOI: https://doi.org/10.1038/ejcn.2014.61
Khafaji HA, Bener A, Osman M, Al Merri A, Al Suwaidi J. The impact of diurnal fasting during Ramadan on the lipid profile, hs-CRP, and serum leptin in stable cardiac patients. Vascular Health Risk Manag 2012;8:7-14. 4
DOI: https://doi.org/10.2147/VHRM.S22894
Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J 2012;11:69.
DOI: https://doi.org/10.1186/1475-2891-11-69
Al-Shafei AI. Ramadan fasting ameliorates arterial pulse pressure and lipid profile, and alleviates oxidative stress in hypertensive patients. Blood Press 2014;233:160-7.
DOI: https://doi.org/10.3109/08037051.2013.836808
Salahuddin M, Sayed Ashfak A, Syed S, Badaam K. Effect of Ramadan fasting on body weight, BP and biochemical parameters in middle aged hypertensive subjects: an observational trial. JCDR 2014;83:16.
Topacoglu H, Karcioglu O, Yuruktumen A, Kiran S, Cimrin A, Ozucelik D, et al. Impact of Ramadan on demographics and frequencies of disease‐related visits in the emergency department. Int J Clin Pract 2005;598:900-5.
DOI: https://doi.org/10.1111/j.1742-1241.2005.00460.x
Bursztyn M, Mekler J, Wachtel N, Ben-Ishay D. Siesta and ambulatory blood pressure monitoring Comparability of the afternoon nap and night sleep. Am J Hypertension 1994;73:217-21.
DOI: https://doi.org/10.1093/ajh/7.3.217
Chamsi-Pasha H, Ahmed WH, Al-Shaibi KF. The cardiac patient during Ramadan and Hajj. J Saudi Heart Assoc 2014;264:212-5.
DOI: https://doi.org/10.1016/j.jsha.2014.04.002
Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Curr Med Res Opin 2013;294:343-54.
DOI: https://doi.org/10.1185/03007995.2013.774270
Adlouni A, Ghalim N, Saı̈le R, Hda N, Parra HJ, Benslimane A. Beneficial effect on serum apo AI, apo B and Lp AI levels of Ramadan fasting. Clin Chim Acta 1998;2712:179-89.
DOI: https://doi.org/10.1016/S0009-8981(97)00245-3
Aksungar FB, Eren A, Ure S, Teskin O, Ates G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann Nutr Metab 2005;492:77-82.
DOI: https://doi.org/10.1159/000084739
Aksungar FB, Topkaya AE, Akyildiz M. Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Ann Nutr Metabol 2007;511:88-95.
DOI: https://doi.org/10.1159/000100954
Akaberi A, Golshan A, Moojdekanloo M, Hashemian M. Does fasting in Ramadan ameliorate Lipid profile? A prospective observational study. Pakistan J Med Sci 2014;304:708.
Barkia A, Mohamed K, Smaoui M, Zouari N, Hammami M, Nasri M. Change of diet, plasma lipids, lipoproteins, and fatty acids during Ramadan: a controversial association of the considered Ramadan model with atherosclerosis risk. J Health Popul Nutr 2011;295:486.
DOI: https://doi.org/10.3329/jhpn.v29i5.8902
Niewada M, Członkowska A. Prevention of ischemic stroke in clinical practice: a role of internists and general practitioners. Polskie Archiwum Medycyny Wewnętrznej 2014;12410:540-8.
DOI: https://doi.org/10.20452/pamw.2464
Al-Arouj M, Assaad-Khalil S, Buse J, Fahdil I, Fahmy M, Hafez S, et al. Recommendations for management of diabetes during Ramadan. Diabetes Care 2010;338:1895-902.
DOI: https://doi.org/10.2337/dc10-0896
Salti I, Bénard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, et al. A population-based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries. Diabetes Care 2004;2710:2306-11.
DOI: https://doi.org/10.2337/diacare.27.10.2306
Bravis V, Hui E, Salih S, Mehar S, Hassanein M, Devendra D. Ramadan Education and Awareness in Diabetes READ programme for Muslims with type 2 diabetes who fast during Ramadan. Diabet Med 2010;273:327-31.
DOI: https://doi.org/10.1111/j.1464-5491.2010.02948.x
Ibrahim M, Abu Al Magd M, Annabi FA, Assaad-Khalil S, Ba-Essa EM, Fahdil I, et al. Recommendations for management of diabetes during Ramadan: update 2015. BMJ Open Diabetes Res Care 2015;31.
DOI: https://doi.org/10.1136/bmjdrc-2015-000108
How to Cite
Refaat, M. M., El Jamal, N., El-Rayess, H. M., Gebran, A., & Salam, A. M. (2024). The impact of diurnal fasting during Ramadan on patients with established cardiac disease: a systematic review. Global Cardiology, 2(2). https://doi.org/10.4081/cardio.2024.32
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