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Lauche R, Fathi I, Saddat C, Klose P, Al-Abtah J, Büssing A, Rampp T, Dobos G, Cramer H. Effects of Modified Ramadan Fasting on Mental Well-Being and Biomarkers in Healthy Adult Muslims - A Randomised Controlled Trial. Int J Behav Med 2024:10.1007/s12529-024-10296-0. [PMID: 38777939 DOI: 10.1007/s12529-024-10296-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Ramadan fasting has seen increased attention in research, often with inconsistent findings. This study aims to investigate whether dietary and lifestyle modifications during Ramadan can improve well-being and health in healthy adult Muslims. METHOD A randomised controlled trial with two parallel groups was conducted in an outpatient clinic of a university hospital in Essen, Germany, in 2016. Healthy adult Muslims (n = 114) aged 18-60 years were randomised to a modified fasting group; i.e., they received educational material prompting dietary and lifestyle modifications pre-Ramadan, and a control group who undertook Ramadan fasting as usual. Primary outcome was quality of life (WHO-5 Well-Being Index). Secondary outcomes included sleep quality, spirituality, and mindfulness (all self-report), body weight, body mass index, body fat, waist circumference, hip circumference, blood pressure, and heart rate, as well as blood serum biomarkers. Safety was examined via adverse events. RESULTS The modified fasting group reported significantly higher quality of life (WHO-5) compared to the control after Ramadan (MD 5.9; 95% CI, 0.02-11.8; p < 0.05). Group differences in favour of the modified fasting were also found for satisfaction with health (MD 5.9, 95% CI 0.19-11.67), ease of life (MD 4.1, 95% CI 0.38-7.80) and mindfulness (MD 7.6, 95% CI 2.68-12.52), reductions in weight (MD, - 0.9 kg; 95% CI - 1.39 to - 0.42), BMI (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), hip circumference (MD - 0.3 kg/m2, 95% CI - 0.50 to - 0.15), and diastolic blood pressure (MD - 2.8 mmHg, 95% CI - 5.15 to - 0.43). About 60% of participants reported adverse events, mostly headaches/migraines, dizziness/fatigue, common cold, and gastrointestinal symptoms, with no group differences. One serious non-related adverse event each occurred in both groups. CONCLUSION Pre-Ramadan dietary and lifestyle advice can lead to short-term improvements in mental and physical well-being of adult Muslims observing Ramadan. As such, this study demonstrates the potential benefits of culturally appropriate health interventions in a religious context. TRIAL REGISTRATION ClinicalTrials.gov (Identifier NCT02775175).
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Affiliation(s)
- Romy Lauche
- National Centre for Naturopathic Medicine, Southern Cross University, Military Rd, Lismore, NSW, 2480, Australia.
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany.
| | - Iman Fathi
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Chalil Saddat
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Petra Klose
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Jallal Al-Abtah
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Arndt Büssing
- Institute of Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany
| | - Thomas Rampp
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
- Centre for Complementary and Integrative Medicine, University Hospital Essen, Essen, Germany
| | - Holger Cramer
- National Centre for Naturopathic Medicine, Southern Cross University, Military Rd, Lismore, NSW, 2480, Australia
- Department of Internal and Integrative Medicine, Faculty of Medicine, Evang. Kliniken Essen-Mitte, University of Duisburg-Essen, Essen, Germany
- Institute of General Practice and Interprofessional Care, University Hospital Tübingen, Tübingen, Germany
- Bosch Health Campus, Stuttgart, Germany
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Boobes Y, Afandi B, AlKindi F, Tarakji A, Al Ghamdi SM, Alrukhaimi M, Hassanein M, AlSahow A, Said R, Alsaid J, Alsuwaida AO, Al Obaidli AAK, Alketbi LB, Boubes K, Attallah N, Al Salmi IS, Abdelhamid YM, Bashir NM, Aburahma RMY, Hassan MH, Al-Hakim MR. Consensus recommendations on fasting during Ramadan for patients with kidney disease: review of available evidence and a call for action (RaK Initiative). BMC Nephrol 2024; 25:84. [PMID: 38448807 PMCID: PMC10916266 DOI: 10.1186/s12882-024-03516-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024] Open
Abstract
Ramadan fasting (RF) involves abstaining from food and drink during daylight hours; it is obligatory for all healthy Muslims from the age of puberty. Although sick individuals are exempt from fasting, many will fast anyway. This article explores the impact of RF on individuals with kidney diseases through a comprehensive review of existing literature and consensus recommendations. This study was conducted by a multidisciplinary panel of experts.The recommendations aim to provide a structured approach to assess and manage fasting during Ramadan for patients with kidney diseases, empowering both healthcare providers and patients to make informed decisions while considering their unique circumstances.
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Affiliation(s)
- Yousef Boobes
- Seha Kidney Care, Tawam Hospital, Al Ain, UAE.
- Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE.
| | - Bachar Afandi
- Department of Medicine, College of Medicine and Health Science, UAE University, Al Ain, UAE
- Endocrine Division, Tawam Hospital, Al Ain, UAE
| | | | - Ahmad Tarakji
- St. George Medical Center & McMaster University-Waterloo Campus, Kitchener, ON, Canada
| | | | | | - Mohamed Hassanein
- Endocrine Section, Dubai Hospital, Dubai Health, Dubai, UAE
- Mohammed Bin Rashid University of Medicine and Health Science, Dubai, UAE
| | - Ali AlSahow
- Division of Nephrology, Jahra Hospital, Jahra, Kuwait
| | - Riyad Said
- Department of Nephrology and Medicine, Jordan Hospital and Medical Center Ibn Sina University for Medical Sciences, Amman, Jordan
| | - Jafar Alsaid
- Nephrology department, Ochsner Medical Center, New Orleans, LA, USA
| | | | | | - Latifa B Alketbi
- Ambulatory Healthcare Services - Abu Dhabi Healthcare Services, Abu Dhabi, UAE
| | - Khaled Boubes
- Department of Medicine, Ohio State University, Columbus, OH, USA
| | - Nizar Attallah
- Nephrology Associates of Kentuckiana, University of Kentucky, Louisville, USA
| | - Issa S Al Salmi
- Department of Renal Medicine, The Royal Hospital, Muscat, Oman
| | - Yasser M Abdelhamid
- Nephrology Division, Internal Medicine Department -Faculty of Medicine, Cairo University, Cairo, Egypt
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Shahawy S, Raya L, Al Kassab L. Caring for Muslim Patients: A Primer for the Obstetrician Gynecologist. Obstet Gynecol Clin North Am 2024; 51:57-67. [PMID: 38267131 DOI: 10.1016/j.ogc.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Studies show that Muslim American patients experience discrimination and feel uncomfortable seeking appropriate health care for various reasons. Obstetrician-gynecologists should be educated regarding Islamic perspectives on topics such as modesty, sexual health, contraception, abortion, infertility, and fasting during pregnancy. Understanding the barriers Muslim patients face and improving cultural humility will improve the quality of sexual and reproductive care delivered to Muslim patients.
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Affiliation(s)
- Sarrah Shahawy
- Division of Global and Community Health, Department of Obstetrics and Gynecology, Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02115, USA.
| | - Lobna Raya
- Tufts University, 419 Boston Avenue, Medford, MA 02155, USA
| | - Leen Al Kassab
- Department of Obstetrics & Gynecology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA
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4
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Alaeddine C, Schreiber J, Amin MEK. Ramadan fasting intentions among pregnant women in Lebanon. J Egypt Public Health Assoc 2024; 99:1. [PMID: 38228944 DOI: 10.1186/s42506-023-00148-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND According to Islam's teachings, women are religiously exempt from fasting during pregnancy if a woman is concerned about her health or that of the fetus. This study assesses the intentions of pregnant women to fast during Ramadan and evaluates the contribution of items derived from the theory of planned behavior (TPB) in predicting these intentions. METHODS A cross-sectional survey was carried out in Arabic on a convenience sample of 181 pregnant women in Lebanon using a mixture of in-person (46), telephone (31), and online recruitment (104) techniques from February to April 2020. An Exploratory Bayes Tree Analysis was done to examine which TPB items appeared to separate the intention to fast in the best possible way. Then, an ordinal regression was completed followed by a latent class analysis to examine specific classes of participants that could be determined based on the regression results. RESULTS Overall, 58% of participants had the intention to fast all days of Ramadan, 22% had the intention to fast some days and 20% did not intend to fast for any duration. A model was run with perceptions of physical ability, Islam guidance, husband's opinion importance, mother's opinion beliefs, and impact on general health as predictors (R2 = 0.74). A four-cluster model was chosen as the most parsimonious one in interpretation, where classes one and two included the groups of women who intended to fast month-long with differences in predictors. Class three represented the group of women who did not have the intention to fast and the final class represented the group of women who had the intention to fast some days of the month. The women's belief in their physical ability to fast and the opinion of the pregnant women's mothers were very important in deciding the participants' intention to fast. CONCLUSIONS Items derived from TPB constructs helped in producing a model predicting women's intention to fast during Ramadan. Educational messages and interventions related to fasting while pregnant may be delivered by individuals with legitimacy among pregnant women such as those viewed by the target population as powerful motherly figures in their communities.
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Affiliation(s)
- Chaza Alaeddine
- Faculty of Pharmacy, Beirut Arab University, Beirut, Lebanon
| | - Jim Schreiber
- School of Nursing, Duquesne University, Pittsburgh, USA
| | - Mohamed E K Amin
- Faculty of Pharmacy, Alamein International University, El Alamein, Egypt.
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AbuShihab K, Obaideen K, Alameddine M, Alkurd RAF, Khraiwesh HM, Mohammad Y, Abdelrahim DN, Madkour MI, Faris ME. Reflection on Ramadan Fasting Research Related to Sustainable Development Goal 3 (Good Health and Well-Being): A Bibliometric Analysis. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01955-9. [PMID: 38110843 DOI: 10.1007/s10943-023-01955-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 12/20/2023]
Abstract
There is a large body of research on Ramadan intermittent fasting (RIF) and health in Muslim communities, that can offer insights to promote the achievement of Sustainable Development Goal 3 (SDG 3), which encompasses good health and well-being. Based on recent bibliometric evidence, we hypothesized that RIF research is highly relevant to SDG 3, particularly Targets 3.1, 3.2, 3.4, and 3.5. Therefore, this bibliometric study quantified RIF literature supporting SDG 3 and associated targets over the past seven decades and explored themes and trends. All types of research articles were extracted from the Scopus database from inception to March 2022. Microsoft Excel, Biblioshiny, and VOSviewer were used to qualitatively and quantitatively examine RIF research trends supporting SDG 3 and associated targets. We identified 1729 relevant articles. The number of publications notably increased since 1986, with a dramatic increase in 2019-2020. RIF research predominantly supported Target 3.4 (reducing risk for non-communicable diseases), with research hotspots being diabetes, diabetes medications, pregnancy, physiology, metabolic diseases, and obesity and metabolism. This target was also the most commonly supported by dedicated authors and institutions publishing on RIF, whereas other SDG 3 targets were negligibly addressed in comparison. Our comprehensive bibliometric analysis of RIF literature showed growing support for SDG 3 through positive contributions to half of the SDG 3 targets, although Target 3.4 received the most attention. We also identified knowledge gaps that may shape further research directions on RIF and promote the achievement of SDG 3 in Muslim communities.
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Affiliation(s)
- Katia AbuShihab
- Nutrition and Food Research Group, Research Institute of Medical and Health Sciences (RIMHS), Sharjah University, Sharjah, United Arab Emirates
| | - Khaled Obaideen
- Sustainable Engineering Asset Management Research Group, University of Sharjah, Sharjah, United Arab Emirates.
| | - Mohamad Alameddine
- Department of Health Service Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
| | - Refat Ahmad Fawzi Alkurd
- Faculty of Pharmacy and Medical Sciences, Department of Nutrition, University of Petra, Amman, Jordan
| | - Husam M Khraiwesh
- Department of Nutrition and Food Processing, Faculty of Agricultural Technology, Al-Balqa' Applied University, Salt, Jordan
| | - Yara Mohammad
- College of Engineering and Information Technology, Ajman University, Ajman, United Arab Emirates
| | - Dana N Abdelrahim
- Health Promotion Research Group, Research Institute of Medical and Health Sciences (RIMHS), Sharjah University, Sharjah, United Arab Emirates
| | - Mohamed I Madkour
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Department of Medical Laboratory Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - MoezAlIslam E Faris
- Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates.
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
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Ong AKW, Yee AL, Fong AJH, Arasoo VJT, Ramadas A. Effects of Ramadan fasting on fetal health: A systematic review. Aust N Z J Obstet Gynaecol 2023; 63:625-637. [PMID: 37283305 DOI: 10.1111/ajo.13706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Ramadan fasting (RF) is mandatory for all healthy Muslims in the ninth month of the Islamic calendar. Although pregnant women are exempt from fasting, many make the decision to practise it. Concerns that fasting during pregnancy harms the fetus remain, as there are no firm recommendations regarding its safety. OBJECTIVES To provide a systematic review on the effects of RF on fetal health. SEARCH STRATEGY We conducted a literature search for peer-reviewed articles through Ovid MEDLINE, PubMed, SCOPUS, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) until 31 December 2021. SELECTION CRITERIA All case-control and observational cohort studies that reported on fetal outcomes of pregnant women who underwent RF for at least one day during pregnancy are included. DATA COLLECTION AND ANALYSIS Two researchers independently reviewed the eligibility of all studies. A third researcher resolved any conflict between researchers. Findings are extracted from eligible papers and presented as narratives. MAIN RESULTS Fourteen articles are included based on eligibility criteria, with a total sample size of 2889. Studies demonstrate negative associations between RF and neonatal weight, amniotic fluid index, preterm birth and growth parameters mainly during the second and third trimesters. However, the evidence is not strongly supported. CONCLUSION There is limited data to elucidate the relationship between RF and fetal health, hence the need for more studies to provide a better understanding.
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Affiliation(s)
- Andrew Khai Weyn Ong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Anne Li Yee
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Adrian Jing Hong Fong
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | | | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Mulcahy MC, El Habbal N, Snyder D, Redd JR, Sun H, Gregg BE, Bridges D. Gestational Early-Time Restricted Feeding Results in Sex-Specific Glucose Intolerance in Adult Male Mice. J Obes 2023; 2023:6666613. [PMID: 37808966 PMCID: PMC10558268 DOI: 10.1155/2023/6666613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
The timing of food intake is a novel dietary component that impacts health. Time-restricted feeding (TRF), a form of intermittent fasting, manipulates food timing. The timing of eating may be an important factor to consider during critical periods, such as pregnancy. Nutrition during pregnancy, too, can have a lasting impact on offspring health. The timing of food intake has not been thoroughly investigated in models of pregnancy, despite evidence that interest in the practice exists. Therefore, using a mouse model, we tested body composition and glycemic health of gestational early TRF (eTRF) in male and female offspring from weaning to adulthood on a chow diet and after a high-fat, high-sucrose (HFHS) diet challenge. Body composition was similar between groups in both sexes from weaning to adulthood, with minor increases in food intake in eTRF females and slightly improved glucose tolerance in males while on a chow diet. However, after 10 weeks of HFHS, male eTRF offspring developed glucose intolerance. Further studies should assess the susceptibility of males, and apparent resilience of females, to gestational eTRF and assess mechanisms underlying these changes in adult males.
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Affiliation(s)
- Molly C. Mulcahy
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
| | - Noura El Habbal
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
| | - Detrick Snyder
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
| | - JeAnna R. Redd
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
| | - Haijing Sun
- Michigan Medicine, Department of Pediatrics, Division of Diabetes, Endocrinology and Metabolism, Ann Arbor, MI, USA
| | - Brigid E. Gregg
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
- Michigan Medicine, Department of Pediatrics, Division of Diabetes, Endocrinology and Metabolism, Ann Arbor, MI, USA
| | - Dave Bridges
- University of Michigan School of Public Health, Department of Nutritional Sciences, Ann Arbor, MI, USA
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Denizli R, Sakcak B, Farisoğulları N, Erdinç AS, Kara Ö, Tanacan A, Şahın D. Effect of Ramadan Fasting in Turkey Upon Fetal Well-being and Perinatal Outcomes During the Last-Trimester of Pregnancy. JOURNAL OF RELIGION AND HEALTH 2023; 62:879-887. [PMID: 36689062 DOI: 10.1007/s10943-023-01744-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Ramadan, a one-month period in which eating and drinking are prohibited from sunrise to sunset, is considered sacred by Muslims. According to Islamic rules, fasting is obligatory for adults and healthy people, but patients and travelers are exempted from this rule. It is not clear whether pregnant women can fast during Ramadan. This cross-sectional case-control study included low-risk pregnant women at 32-37 weeks of gestation in Turkey. We examined healthy women in the last period of their pregnancy and found similar perinatal outcomes between the fasting and nonfasting participants. In the evaluation of fetal well-being, a decrease in the number of accelerations in the non-stress test (NST) and the need to repeat the test were found to be statistically significantly higher in fasting pregnant women. We consider that this may prolong the evaluation period and increase unnecessary hospitalizations due to nonreactive NST results. More randomized controlled trials are needed to conclude that fasting during pregnancy is safe.
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Affiliation(s)
- Ramazan Denizli
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey.
| | - Bedri Sakcak
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Nihat Farisoğulları
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Ayşe Seval Erdinç
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Atakan Tanacan
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
| | - Dilek Şahın
- Department of Obstetrics and Gynecology, Ministry of Health, Ankara City Hospital, Ankara, 06800, Turkey
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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In utero Ramadan exposure and child nutrition. J Dev Orig Health Dis 2023; 14:96-109. [PMID: 35796235 DOI: 10.1017/s204017442200037x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In this study, we empirically analyse whether in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. The data for the analyses come from a retrospective assessment of 759,799 children from 103 Demographic and Health Surveys (DHS) across 56 countries during 2003-2020. Considering the month-long Ramadan exposure as a natural experiment, we implement an intent-to-treat framework, comparing stunting and underweight among children aged 0-5 years who were exposed to Ramadan fasting at any time in utero with those who were not exposed. Our findings do not show significant evidence to conclude that in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. On the contrary, except for stunting in Muslim children who had in utero exposure to Ramadan fasting during the first months of pregnancy, we find no significant association between in utero exposure to Ramadan fasting and child stunting and underweight. Our main results are robust to multiple robustness checks.
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Magalhães M, Ojeda A, Mechlowitz K, Brittain K, Daniel J, Roba KT, Hassen JY, Manary MJ, Gebreyes WA, Havelaar AH, McKune SL. Socioecological predictors of breastfeeding practices in rural eastern Ethiopia. Int Breastfeed J 2022; 17:93. [PMID: 36578078 PMCID: PMC9795740 DOI: 10.1186/s13006-022-00531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Estimates by the World Health Organization indicate that over 800,000 global neonatal deaths each year are attributed to deviations from recommended best practices in infant feeding. Identifying factors promoting ideal breastfeeding practices may facilitate efforts to decrease neonatal and infant death rates and progress towards achieving the Sustainable Development Goals set for 2030. Though numerous studies have identified the benefits of breastfeeding in reducing the risk of childhood undernutrition, infection and illness, and mortality in low- and middle-income countries, no studies have explored predictors of breastfeeding practices in rural eastern Ethiopia, where undernutrition is widespread. The aim of this study is to examine predictors of infant feeding practices in Haramaya, Ethiopia, using a multi-level conceptual framework. METHODS This study uses data collected from household questionnaires during the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project among 102 households in the Haramaya woreda, Eastern Hararghe Zone, Eastern Ethiopia, and investigates factors influencing breastfeeding practices: early initiation, prelacteal feeding, and untimely complementary feeding. RESULTS Nearly half (47.9%) of infants in this study were non-exclusively breastfed (n = 96). Generalized liner mixed effects models of breastfeeding practices revealed that prelacteal feeding may be a common practice in the region (43.9%, n = 98) and characterized by gender differences (p = .03). No factors evaluated were statistically significantly predictive of early initiation and untimely complementary feeding (82% and 14%, respectively). Severely food insecure mothers had more than 72% lower odds of early breastfeeding initiation, and participants who self-reported as being illiterate had 1.53 times greater odds of untimely complementary feeding (95% CI, [0.30,7.69]) followed by male children having 1.45 greater odds of being untimely complementary fed compared to female (95% CI,[0.40,5.37]). CONCLUSIONS This study found high rates of prelacteal feeding and low prevalence of exclusive breastfeeding, with girls more likely to be exclusively breastfed. While no predictors evaluated in this multi-level framework were associated with prevalence of early initiation or complementary feeding, rates may be clinically meaningful in a region burdened by undernutrition. Findings raise questions about gendered breastfeeding norms, the under-examined role of khat consumption on infant feeding, and the complex factors that affect breastfeeding practices in this region. This information may be used to guide future research questions and inform intervention strategies.
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Affiliation(s)
- Marina Magalhães
- grid.15276.370000 0004 1936 8091Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, USA ,grid.168010.e0000000419368956Present address: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA USA
| | - Amanda Ojeda
- grid.15276.370000 0004 1936 8091Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Department of Microbiology and Cell Science, University of Florida, Gainesville, USA
| | - Karah Mechlowitz
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Kaitlin Brittain
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Jenna Daniel
- grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Kedir Teji Roba
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Jemal Yousuf Hassen
- grid.192267.90000 0001 0108 7468Department of Rural Development and Agricultural Extension, College of Agriculture and Environmental Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Mark J. Manary
- grid.4367.60000 0001 2355 7002Department of Pediatrics, School of Medicine, Washington University, St. Louis, USA
| | - Wondwossen A. Gebreyes
- grid.261331.40000 0001 2285 7943Global One Health Initiative, The Ohio State University, Columbus, USA
| | - Arie H. Havelaar
- grid.15276.370000 0004 1936 8091Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Institute for Sustainable Food Systems, University of Florida, Gainesville, USA
| | - Sarah L. McKune
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA ,grid.15276.370000 0004 1936 8091Center for African Studies, University of Florida, Gainesville, USA
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Hassan-Beck R, Hafidh K, Badi A, Doukman K, Karmo M, Mir R, Beshyah SA. Ramadan Fasting in Health and Disease in 2021: A Narrative Review. IBNOSINA JOURNAL OF MEDICINE AND BIOMEDICAL SCIENCES 2022. [DOI: 10.1055/s-0042-1757473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Introduction: The literature on the health aspects of Ramadan fasting (RF) is widely spread in many journals.
Materials and Methods: This is a narrative review of data obtained from the PubMed database (National Library of Medicine, Bethesda, Maryland, United States). We used the search term “Ramadan fasting,” and relevant records were examined. The publications are narrated thematically.
Results: The publications spanned fundamental, clinical, professional, cultural, and advocacy facets. The publications crossed conventional disciplinary lines and geographical locations and appeared in journals with different access systems. The contents are presented under the themes that emerged depending on the retrieved literature. This year basic coverage included changes in physiology and nutrition during Ramadan. However, the clinical issues included a wide range of topics. These included the impact of RF on nonalcoholic fatty liver disease and adjustments needed in endocrine replacement therapy for hypothyroidism and adrenal insufficiency. Coverage also included chronic kidney disease. The impact on maternal health, fetal well-being, and long-term effects of RF exposures were addressed in several studies. Studies in cardiovascular medicine focused on blood pressure and cardiovascular risk factors. Sports medicine and athletes' well-being received somewhat prominent coverage. The impact on renal function, particularly in patients with chronic kidney disease, was investigated by a few authors. Several groups addressed the eyes' structure and function, neurological conditions, especially headache disorders, and hematological and oncological conditions. Finally, the impact of RF on several aspects of mental health and well-being was addressed by various groups.
Conclusions: Health aspects of RF received a sustained academic interest with a broad spectrum in 2021. This narration provides an overview of the year's scholarly health-related literature on various aspects of health and disease. It should help researchers and clinicians catch up quickly with the health concerns during Ramadan.
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Affiliation(s)
- Reem Hassan-Beck
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Khadija Hafidh
- Department of Diabetes and Endocrinology, Rashid Hospital, Dubai, United Arab Emirates
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
| | - Amal Badi
- Department of Obstetrics and Gynecology, Koster Clinic, Dubai, United Arab Emirates
| | - Khaled Doukman
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Abu Dhabi Sports Council, Abu Dhabi, United Arab Emirates
| | - Mazn Karmo
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
| | - Ruqqia Mir
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
- Department of Neurology, Abu Dhabi Stemm Cell Center, Abu Dhabi, United Arab Emirates
| | - Salem A. Beshyah
- Department of Medicine, Dubai Medical College for Girls, Dubai, United Arab Emirates
- Department of Medicine, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Medicine, Yas Clinic Khalifa City, Abu Dhabi, United Arab Emirates
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The association of social and food preparation location context with the quality of meals and snacks consumed by young adults: findings from the MYMeals wearable camera study. Eur J Nutr 2022; 61:3407-3422. [PMID: 35523897 PMCID: PMC9464156 DOI: 10.1007/s00394-022-02891-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/07/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE This study examined the association of social contexts and food preparation location with the quality of meals and snacks (predominately from the five food groups (FFG) versus discretionary foods) in a sample of young Australian adults (18-30 years old) using wearable camera technology. METHODS A sub-sample from the cross-sectional MYMeals study wore a wearable camera that captured images every 30 s for three consecutive days. Eating episodes from 133 participants (55% female) were classified across 4 domains: food quality (observed proportion of FFG and discretionary items), preparation location, social interaction, and screen use. Socio-economic status (SES) was assigned using residential postcode and gender self-reported. Associations of contexts and demographic factors with food quality stratified by meal type were determined using mixed binary logistic regression models. RESULTS Of the 1840 eating episodes identified, 1775 were included in analysis (n = 8 preparation location and n = 57 food components that could not be identified were excluded). Food prepared at home was more likely to be from the FFG at lunch (OR = 4.8 95% CI 2.7-8.6), dinner (OR = 14.8 95% CI 7.6-28.6), and snacks (OR = 3.2 95% CI 2.2-4.8). Participants from higher SES areas were more likely to consume breakfasts (OR = 3.2 95% CI 1.4-7.4) and lunches (OR = 1.9 95% CI 1.0-3.7) predominately from the FFG. Females were more likely to consume lunches (OR = 2.0 95% CI 1.1-3.8) that was largely from the FFG. Social interaction and screen use were not associated with meal or snack quality. CONCLUSION Wearable cameras have verified the importance of addressing meals and snacks prepared outside of home as an important contributor of discretionary food.
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Mahanani MR, Abderbwih E, Wendt AS, Deckert A, Antia K, Horstick O, Dambach P, Kohler S, Winkler V. Long-Term Outcomes of in Utero Ramadan Exposure: A Systematic Literature Review. Nutrients 2021; 13:nu13124511. [PMID: 34960063 PMCID: PMC8704584 DOI: 10.3390/nu13124511] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/15/2021] [Indexed: 11/21/2022] Open
Abstract
Health outcomes of in utero Ramadan exposure have been reported in a systematic literature review; however, the available literature on long-term effects were not fully covered. Our study aims to specifically review the long-term outcomes of in utero Ramadan exposure. We searched for original research articles analyzing any long-term outcome of in utero Ramadan exposure, excluding maternal and perinatal outcomes. Sixteen studies from 8304 non-duplicate search results were included. Most studies suggest negative consequences from in utero Ramadan exposure on health, as well as on economic outcomes later in adulthood. Higher under-five mortality rate, higher mortality under three months, and under one year, shorter stature, lower body mass index, increased incidence of vision, hearing and learning disabilities, lower mathematics, writing and reading scores, as well as a lower probability to own a home were associated with Ramadan exposure during conception or the first trimester of pregnancy. Furthermore, age and sex seem to play a pivotal role on the association. Existing studies suggest that in utero Ramadan exposure may adversely impact long-term health and economic well-being. However, evidence is limited. Meanwhile, increasing awareness of the potential risks of Ramadan fasting during pregnancy should be raised among pregnant women and clinicians and other antenatal care workers should promote better maternal healthcare.
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Affiliation(s)
- Melani R. Mahanani
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Eman Abderbwih
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Amanda S. Wendt
- Potsdam Institute for Climate Impact Research, Member of the Leibniz Association, P.O. Box 601203, 14412 Potsdam, Germany;
| | - Andreas Deckert
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Peter Dambach
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Stefan Kohler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (M.R.M.); (E.A.); (A.D.); (K.A.); (O.H.); (P.D.); (S.K.)
- Correspondence: ; Tel.: +49-6221-56-5031
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