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A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above

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Abstract

Purpose

Studies on the effect of Ramadan diurnal intermittent fasting (RDIF) on body weight have yielded conflicting results. Therefore, we conducted a systematic review and meta-analysis to estimate the effect size of body weight changes in healthy, non-athletic Muslims practicing Ramadan fasting, and to assess the effect of covariates such as age, sex, fasting time duration, season, and country, using subgroup analysis, and meta-regression. Covariate adjustments were performed to explain the variability of weight change in response to Ramadan fasting.

Methods

CINAHL, Cochrane, EBSCOhost, EMBASE, Google Scholar, ProQuest Medical, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science databases were searched from date of inception in 1950 to the end of August 2019.

Results

Eighty-five studies, conducted in 25 countries during 1982–2019, were identified. RDIF yielded a significant, but small reduction in body weight (K = 85, number of subjects, N = 4176 (aged 16–80 years), Hedges’ g =− 0.360, 95% confidence interval (CI) − 0.405 to − 0.315, I2 = 45.6%), this effect size translates into difference in means of − 1.022 kg (95% CI − 1.164 kg to − 0.880 kg). Regression analysis for moderator covariates revealed that fasting time (min/day) is a significant (P < 0.05) moderator for weight change at the end of Ramadan, while age and sex are not. Variable effects for the season and country were found.

Conclusion

RDIF may confer a significant small reduction in body weight in non-athletic healthy people aged 16 years and above, directly associated with fasting time and variably correlated with the season, and country.

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Authors and Affiliations

  1. Rehabilitation Services, Periphery Hospitals, Ministry of Health, Manama, Bahrain

    Haitham A. Jahrami

  2. College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain

    Haitham A. Jahrami

  3. Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute for Medical and Health Sciences (RIMHS), University of Sharjah, P.O.Box 27272, Sharjah, United Arab Emirates

    Joud Alsibai & Mo’ez Al-Islam E. Faris

  4. Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, UK

    Cain C. T. Clark

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  4. Mo’ez Al-Islam E. Faris
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MF and HJ contributed to the conception and design of the work. MF and HJ participated in researching and collecting articles. MF and JS participated in the article reviews and data extraction. HJ performed all data analyses. MF and HJ contributed to drafting the manuscript, and CC contributed to critically revising the manuscript and provided intellectual contributions to strengthen the manuscript. All authors were involved in writing the paper and approved the final version for publication.

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Jahrami, H.A., Alsibai, J., Clark, C.C.T. et al. A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above. Eur J Nutr 59, 2291–2316 (2020). https://doi.org/10.1007/s00394-020-02216-1

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