The model of Ramadan diurnal intermittent fasting: unraveling the health implications, volume III

MoezAlIslam Ezzat Faris ^1* Khaled Boumediene ² Hamdi Chtourou ³ Faiza Kalam ^4,5 Dana N. Abdelrahim ⁶ Ahmed S BaHammam ⁷

• ¹ Applied Science Private University, Amman, Jordan
• ² Faculté des Sciences de la Nature et de la Vie, Univeristé Djillali Liabes Sidi Bel Abbès, Sidi Bel Abbes, Algeria
• ³ High Institute of Sport and Physical Education of Sfax, Sfax, Sfax, Tunisia
• ⁴ Ohio State University, Newark, Newark, Ohio, United States
• ⁵ The Ohio State University, Columbus, Ohio, United States
• ⁶ University of Sharjah, Sharjah, United Arab Emirates
• ⁷ King Saud University, Riyadh, Riyadh, Saudi Arabia

This theme issue encompasses a diverse range of studies examining various aspects of RIF, thereby further solidifying its importance in the health sciences. The included articles collectively enhance our understanding of the effects of fasting on various health parameters without being confined to metabolic benefits alone. The thirteen studies in this Research Topic provide comprehensive insights into the diverse health implications of RIF. Conducted by 82 authors from 15 countries, these studies examine the RIF's effects on metabolic health (validating risk assessment tools for diabetic patients, assessing benefits for NAFLD, metabolic profile, and blood pressure), hormonal adaptations (in pre-and post-menopausal women) and effect of calorie restriction and intermittent fasting, including RIF, on PCOS. Effect on physical performance (timing of resistance training, impact on bioenergetic pathways during exercise), molecular mechanisms (gene expression related to inflammation and oxidative stress, influence of haptoglobin polymorphism), nutritional interventions (benefits of Ramadan-specific nutrition education), physiological adaptations (changes in body water compartments), gut microbiome alterations (shifts in bacterial composition and correlations with dietary components), as well as the changes in inflammatory markers and mental health parameters. Furthermore, the effect of combining exercise and fasting on animal models of osteoporosis was examined. Together, these studies highlight the potential of RIF to improve metabolic health, including inflammatory markers and body composition, while emphasizing that these benefits result from a combination of fasting and dietary and lifestyle habits during non-fasting hours. One critical area explored is the role of RIF in managing chronic diseases. Research examining the application of RIF in diabetes risk assessment highlights the need for personalized medical guidance for individuals with type 2 diabetes who fast. Similarly, findings on cardiovascular risk markers highlight the potential of RIF in modulating lipid profiles and blood pressure, reinforcing its relevance in cardiometabolic health strategies (Madkour, Malhab, et al., 2022). Another emerging theme is the interaction between fasting and physical performance. Studies investigating resistance training and exercise timing during Ramadan provide valuable insights into optimizing muscle function and hormonal balance in athletes and active individuals. The debate over training in the fasting versus fed state remains ongoing, and contributions to this issue offer evidence-based recommendations for maintaining strength and performance during fasting periods (Drummond, Soares et al., 2023;Triki, Zouhal et al., 2023;Triki, Ben Abderrahman, et al., 2024). Furthermore, this volume expands on the relationship between fasting and the gut microbiome, an area of increasing scientific interest. The gut microbiota plays a pivotal role in maintaining metabolic health, regulating immune function, and controlling inflammation. Research in this issue suggests that RIF induces shifts in microbial composition, with potential implications for long-term gut health (Saglam, Colak, et al., 2023). These findings highlight the need for further investigations into dietary modifications during RIF to optimize gut microbiome adaptations and overall health benefits.While the studies in this Research Topic offer significant advancements in understanding RIF, several key areas require further investigation. Future research should prioritize:1. Longitudinal Studies on RIF: Most existing research focuses on the short-term effects of fasting. Long-term follow-up studies are needed to evaluate whether RIFinduced metabolic adaptations persist beyond Ramadan and contribute to long-term health benefits or risks. Ramadan intermittent fasting serves as a valuable model for understanding the broader implications of intermittent fasting on human health. This Research Topic presents compelling evidence that RIF extends beyond religious observance and represents a structured dietary intervention with diverse physiological benefits. The insights gained from these studies pave the way for refining fasting strategies to optimize health outcomes in various populations. As interest in IF continues to grow, future research should strive to bridge existing knowledge gaps, ensuring that fasting recommendations are evidencebased, personalized, and accessible to those seeking to harness its health-promoting potential.