Health benefits and challenges of Ramadan fasting: a narrative review and practical lifestyle model

Ramadan fasting, a yearly religious obligation, is observed by about 1.9 billion Muslims worldwide. Recent studies have associated this practice with potential positive health outcomes, such as reduced risk and improved control of obesity, hypertension and type 2 diabetes. A small-scale human study also demonstrated downregulation of senescence biomarkers (p16INK4A and p21), while an animal study showed upregulation of a longevity gene (TP53) with Ramadan-like fasting. However, most of these health outcomes appear largely circumstantial or are lost shortly after Ramadan. This narrative review synthesises evidence, identifies barriers and proposes an evidence-informed model for healthy Ramadan fasting. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-style search in Google Scholar, Scopus and PubMed/MEDLINE was conducted, and relevant data were extracted from eligible studies. Although some studies associated positive health outcomes with Ramadan fasting, unhealthy diets, sedentary lifestyles, poor sleep habits and inadequate medical supervision seem to prevent people from harnessing these benefits. Adopting a culturally sensitive Ramadan fasting model, the Rejuvenating Ramadan Roadmap, may help mitigate the identified barriers, reduce potential health risks and optimise the practice’s potential positive health outcomes in a sustainable manner.