title: The effect of Ramadan fasting on cardiometabolic risk factors and anthropometrics parameters: A systematic review.
abstract: Fasting during the month of Ramadan is a religious rituals of all healthy adult Muslims. However, there is no clear agreement on the effects of Ramadan fasting on cardiovascular disease. Comorbidities and factors such as age, gender, health status, daily duration of fasting, food intake before and after fasting may impact on a fasting individual's cardiometabolic risk. This review was undertaken to assess the effects of Ramadan fasting on: the incidence of cardiovascular disease during the month of Ramadan; the clinical status of patients with stable cardiac disease; and any alterations in cardiometabolic risk profile.
  
  
  METHODS
  A systematic search was undertaken for studies that investigated the impact of Ramadan fasting on cardiovascular outcomes and risk factors. Electronic databases including MEDLINE, Scopus and Web of Knowledge were searched from 1982 up to 2014. The incidence of acute cardiac illness during Ramadan fasting was similar when compared to non-fasting days. Ramadan fasting is associated with elevations in high-density lipoprotein cholesterol (HDL-c), and reductions in low-density lipoprotein cholesterol (LDL-c) and total cholesterol (T-chol). However, the lipid profile of diabetic patients deteriorated significantly during Ramadan fasting. In addition, Ramadan fasting lowers body weight, body fat percentage and BMI (body mass index). However, the relationship between weight reduction and loss of body fat is not studied. The majority of patients with stable cardiac illness can opt for Ramadan fasting safely. However, the long term effects of Ramadan fasting on cardiovascular outcomes and risk factors remains uncertain, and the apparent discordant effects in individuals with and without diabetes mellitus merits further study.
authors.affiliation: Mohsen Mazidi, PhD. Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Chaoyang, Beijing, China.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Mazidi
authors.affiliation: Peyman Rezaie, MSc. Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Rezaie
authors.affiliation: Owais Chaudhri, PhD. Diabetes and Endocrinology Service, Palmerston North Hospital, Palmerston North, New Zealand.
authors.forename: Owais
authors.initials: O
authors.lastname: Chaudhri
authors.affiliation: Ehsan Karimi, MSc. Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Karimi
authors.affiliation: Ehsan Karimi, MSc. Biochemistry and Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nematy
keywords: Body weight; Body-mass index; Cardiovascular risk; High-density lipoprotein cholesterol; Ramadan fasting