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Clinical Management of Intermittent Fasting in Patients with Diabetes Mellitus

Energy Metabolism and Intermittent Fasting: The Ramadan Perspective

Imperial College London Diabetes Center (ICLDC), Abu Dhabi 48338, UAE
Author to whom correspondence should be addressed.
Nutrients 2019, 11(5), 1192;
Received: 18 April 2019 / Revised: 6 May 2019 / Accepted: 9 May 2019 / Published: 27 May 2019
(This article belongs to the Special Issue Health Effects of Intermittent Fasting: How Broad are the Benefits?)
Intermittent fasting (IF) has been gaining popularity as a means of losing weight. The Ramadan fast (RF) is a form of IF practiced by millions of adult Muslims globally for a whole lunar month every year. It entails a major shift from normal eating patterns to exclusive nocturnal eating. RF is a state of intermittent liver glycogen depletion and repletion. The earlier (morning) part of the fasting day is marked by dominance of carbohydrate as the main fuel, but lipid becomes more important towards the afternoon and as the time for breaking the fast at sunset (iftar) gets closer. The practice of observing Ramadan fasting is accompanied by changes in sleeping and activity patterns, as well as circadian rhythms of hormones including cortisol, insulin, leptin, ghrelin, growth hormone, prolactin, sex hormones, and adiponectin. Few studies have investigated energy expenditure in the context of RF including resting metabolic rate (RMR) and total energy expenditure (TEE) and found no significant changes with RF. Changes in activity and sleeping patterns however do occur and are different from non-Ramadan days. Weight changes in the context of Ramadan fast are variable and typically modest with wise inter-individual variation. As well as its direct relevance to many religious observers, understanding intermittent fasting may have implications on weight loss strategies with even broader potential implications. This review examines current knowledge on different aspects of energy balance in RF, as a common model to learn from and also map out strategies for healthier outcomes in such settings. View Full-Text
Keywords: fast; intermittent; Ramadan; energy expenditure; weight fast; intermittent; Ramadan; energy expenditure; weight
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MDPI and ACS Style

Lessan, N.; Ali, T. Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients 2019, 11, 1192.

AMA Style

Lessan N, Ali T. Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients. 2019; 11(5):1192.

Chicago/Turabian Style

Lessan, Nader, and Tomader Ali. 2019. "Energy Metabolism and Intermittent Fasting: The Ramadan Perspective" Nutrients 11, no. 5: 1192.

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