title: Effects of prolonged fasting on fatigue and quality of life in patients with multiple sclerosis.
abstract: Fasting is one of the recommended worships of several great religions in the world. During the month of Ramadan, circadian rhythm and pattern of eating changes result in physiological, biochemical and hormonal changes in the body. Many Muslims with medical conditions ask their physicians about the feasibility and safety of fasting during Ramadan. In this study, we aim to assess the effect of Ramadan fasting on the quality of life and fatigue in multiple sclerosis (MS) patients. Relapsing-remitting MS (RRMS) patients according to McDonald's criteria who had mild disability (EDSS score ≤3) were included in this study. Fatigue and quality of life were were assessed using the validated Persian versions of modified fatigue impact scale (MFIS) and multiple sclerosis quality of life-54 (MSQOL-54) questionnaires, respectively. 218 patients (150 females and 68 males) were enrolled in our study. There was no statistically significant difference between the mean total score of MSIF before and after fasting (25.50 ± 13.81 versus 26.94 ± 16.65; p = 0.58). The mean physical health and mental health composites of quality of life increased significantly after fasting (p = 0.008 and p = 0.003 respectively). Despite the observed lack of favorable effects on fatigue, our results showed increased quality of life of MS patients once Ramadan has ended. Whether this is specifically related to Ramadan-related fasting deserves further testing in appropriately designed larger prospective clinical studies.
authors.affiliation: Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Etemadifar
authors.affiliation: Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Sayahi
authors.affiliation: Division of Neurology, Department of Medicine, Amiri Hospital, Kuwait City, Kuwait.
authors.forename: Raed
authors.initials: R
authors.lastname: Alroughani
authors.affiliation: Department of Neurology, Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.|Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Nafiseh
authors.initials: N
authors.lastname: Toghianifar
authors.affiliation: Department of Epidemiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Akbari
authors.affiliation: Isfahan Research Committee of Multiple Sclerosis, Isfahan University of Medical Sciences, Isfahan, Iran. zahranasr1@yahoo.com.|Medical Students' Research Center, Isfahan University of Medical Sciences, Isfahan MS Society No. 2, Behesht Building, Bozorgmehr Ave., Isfahan, 81588-44799, Iran. zahranasr1@yahoo.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Nasr
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004185:Disability Evaluation; D005215:Fasting; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Fasting; Fatigue; Islam; Multiple sclerosis; Quality of life