Ramadan fasting benefits BP regardless of weight, other factors


21 October 2021

2 minutes to read

Source / Disclosures

Disclosures: The authors do not report any relevant financial disclosures.

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Fasting during the month of Ramadan may have beneficial effects on BP independent of changes in weight, body fat and total body water, according to the results of an observational study.

The study, published in the Journal of the American Heart Association, sought to determine the health effects of the radical lifestyle change that millions of people undergo during Ramadan. The publication consisted of a systematic review of several previously conducted studies, as well as a longitudinal study independently conducted by researchers in London.

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“Although hundreds of millions of Muslims practice Ramadan fasting around the world, the effect of this ritual on health is not sufficiently studied. Rami Al Jafar, MSPH, lecturer and doctoral student in epidemiology and biostatistics at Imperial College London, and colleagues have written. “Blood pressure could be strongly affected by such changes in food intake and timing, physical activity and sleep patterns, including in people with hypertension. Studies on the effect of Ramadan fasting on blood pressure, however, are inconclusive. “

LORANS study

The London Ramadan Study (LORANS) assessed the systolic and diastolic BP of 85 participants from April 25 to June 16, 2019, before and immediately after Ramadan. The average age of the participants was 46 years and 53% were men. The fasting time was 15.5 hours per day, and BP was calculated three times at 30-second intervals on each of the two visits (before and after Ramadan), with the researchers averaging the three measurements. The researchers measured the fat percentage / mass, fat free mass, and total body water for each participant and asked participants to complete questionnaires to determine basic lifestyle choices.

LORANS results revealed that systolic BP after Ramadan fasting was 7.29 mm Hg lower (95% CI, –4.74 to –9.84) and diastolic BP was 3.42 lower. mm Hg (95% CI, –1.73 to –5.09).

Systematic review

The researchers then conducted a systematic review and meta-analysis of 32 additional studies from around the world to investigate the effects of Ramadan on systolic and diastolic BP outside of London. Among the cohort of 3,213 participants, 23.3% were in good health, 55.5% had type 2 diabetes, 3.5% had hypertension, and 19.1% had chronic kidney disease.

“Although there have been previous reviews on this topic, each of them has targeted studies on healthy individuals or on a specific group of diseases,” wrote Al-Jafar and his colleagues. “Our meta-analysis covered studies of healthy and unhealthy individuals and included a subgroup analysis. We included our own study (LORANS) in which we recruited a multicultural community sample.

Among participants in the systematic review, systolic BP was 3.19 mm Hg lower (95% CI, –4.43 to –1.96; I2 = 48%) and diastolic BP of 2.26 mm Hg (95% CI, -3.19 to -1.34; I2 = 66%) after Ramadan.

The body undergoes a metabolic change that begins between 8 and 12 hours of fasting, when the body switches from glucose to ketones for energy, resulting in a drop in insulin that lowers BP, the researchers wrote.

According to the study, lower BP was observed mainly in the healthy, hypertensive and diabetic groups, but not in patients with chronic kidney disease.

“Ramadan fasting appears to have a beneficial effect on BP regardless of weight, total body water and body fat,” wrote Al-Jafar and his colleagues. “Our review supports the recommendations of the Communities in Action organization (supported by the National Health Service) and the Saudi government, which describe fasting in Ramadan as a safe religious practice when it comes to blood pressure.”

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