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A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on glucometabolic markers in healthy subjects

  • Mo'ez Al-Islam Faris
    Correspondence
    Corresponding author.
    Affiliations
    Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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  • Haitham Jahrami
    Affiliations
    Rehabilitation Services, Periphery Hospitals, Ministry of Health, Manama, Bahrain

    College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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  • Ahmed BaHammam
    Affiliations
    Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, Saudi Arabia

    The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
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  • Zaina Kalaji
    Affiliations
    Department of Clinical Nutrition and Dietetics, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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  • Mohammed Madkour
    Affiliations
    Department of Medical Laboratory Sciences, College of Health Sciences/Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
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  • Mohamed Hassanein
    Affiliations
    Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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      Abstract

      Aim

      Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on glucometabolic markers have yielded conflicting results. We conducted a meta-analysis to estimate the effect size for changes in glucometabolic markers in healthy, non-athletic Muslims during Ramadan, and to assess the effect of variable covariates using meta-regression.

      Methods

      CINAHL, Cochrane, EBSCOhost, EMBASE, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science databases were searched from date of inception to January 2020. The glucometabolic markers analyzed were: fasting glucose (FG), insulin, insulin resistance (HOMA-IR), leptin, and adiponectin.

      Results

      We identified seventy-two studies (3134 participants in total) that were conducted in 22 countries between 1982 and 2020. RDIF-induced effect sizes for the glucometabolic markers were: FG (no. of studies K = 61, number of subjects N = 2743, Hedges' g = −0.102, 95% CI: −0.194, −0.01); serum insulin (K = 16, N = 648, Hedges' g = 0.030 95% CI: −0.165, 0.226); HOMA-IR (K = 10, N = 349, Hedges' g = −0.012, 95% CI: −0.274, 0.250); leptin (K = 13, N = 442, Hedges' g = −0.010, 95% CI: −0.243, 0.223); and adiponectin (K = 11, N = 511, Hedges' g = 0.034, 95% CI: −0.227, 0.296).

      Conclusion

      RDIF imposes no adverse metabolic impacts, and might help in improving some glucometabolic markers in healthy subjects.

      Keywords

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