Summary: In 54 adults aged 30 to 45 with metabolic syndrome, adding intermittent Islamic fasting (two weekly sunnah fasts plus three mid-lunar-month days) to lifestyle modification was compared with lifestyle modification alone in a single-centre randomized controlled trial. Both arms improved after the intervention, and absolute endpoint parameters did not differ significantly between groups; however, the fasting arm showed significantly greater percent-change improvements in weight, waist circumference, blood pressure, fasting glucose, lipids and HDL (most p<0.001). Effect sizes and confidence intervals were not reported in the abstract.
PICO Summary
| Element | Detail |
|---|---|
| Population | 54 adults aged 30 to 45 with metabolic syndrome; single-centre clinical nutrition outpatient clinic, Egypt; recruited August 2023 to February 2024. |
| Intervention | Intermittent Islamic fasting plus lifestyle modification (n=27). Fasting comprised two days weekly (Monday and Thursday) plus the 13th, 14th and 15th of each lunar month, alongside diet and physical-activity advice. |
| Comparison | Lifestyle modification alone (n=27), comprising the same diet and physical-activity recommendations without prescribed fasting. |
| Outcome | No significant between-group difference was seen in absolute clinical or laboratory endpoints, and both arms improved. Between-group differences in percent change favoured the fasting arm for weight (p<0.001), waist circumference (p<0.001), systolic blood pressure (p=0.042), diastolic blood pressure (p<0.001), fasting blood glucose (p<0.001), triglycerides (p<0.001), HDL (p<0.001) and total cholesterol (p=0.023). Effect estimates, 95% CIs and ARR/NNT were not reported in the abstract. |
Islamic fasting in metabolic syndrome
RCT · metabolic syndrome · 6 months
Fasting added to lifestyle gave significantly larger percent-change improvements in weight and metabolic markers, but absolute endpoints did not differ between arms and the trial was small and open-label.
Expert Commentary
This single-centre randomized trial offers an early signal that structured intermittent Islamic fasting, layered onto standard lifestyle advice, may amplify metabolic improvement in adults with metabolic syndrome. The verdict, however, must stay cautious. The headline benefits are expressed as between-group differences in percent change, while absolute endpoint values did not differ significantly between arms and both groups improved, so much of the gain reflects shared lifestyle modification rather than fasting alone. The dominant limitation is statistical fragility: with only 27 patients per arm and no reported effect sizes, confidence intervals or adjustment for multiple comparisons, the cluster of very low p-values should be read as hypothesis-generating, not definitive. The open-label design, in which neither participants nor assessors could be blinded to a behavioural intervention, further inflates the risk of performance and reporting bias, and self-reported adherence to a faith-based fast is difficult to verify. Generalisability is narrow given the single Egyptian centre and the 30-to-45 age band. Can I use this with my patients? Not yet as a prescribed therapy, though it offers reassurance for a motivated Muslim patient already practising sunnah fasting who also commits to diet and activity changes. Larger, adequately powered, multi-centre trials reporting absolute effects and adherence data are needed before firmer recommendations can be made.
References
Nofal HA, Elmor AAR, AbdAllah AM, Zaitoun NA, Andargeery SY, Sharafeddin MA, et al. Effect of intermittent Islamic fasting in management of metabolic syndrome: a randomized control trial. BMC Public Health. 2025;25(1):2476. doi:10.1186/s12889-025-23493-7