Summary: In 54 Egyptian adults with metabolic syndrome, adding Islamic intermittent fasting (two days weekly plus mid-lunar-month days) to lifestyle modification produced significantly greater percent improvement in weight, waist circumference, blood pressure, fasting glucose, triglycerides, total cholesterol and HDL than lifestyle modification alone. Absolute end-of-study values did not differ significantly between groups, and no formal adverse-event tally was reported.
PICO Summary
| Element | Detail |
|---|---|
| Population | 54 adults aged 30 to 45 years with metabolic syndrome; single-centre, open-label randomised controlled trial at a university hospital outpatient nutrition clinic in Egypt (Aug 2023 to Feb 2024). |
| Intervention | Islamic intermittent fasting (fasting on Mondays and Thursdays plus the 13th, 14th and 15th of each lunar month) added to lifestyle modification; n=27. |
| Comparison | Lifestyle modification alone; n=27. |
| Outcome | Between-group percent change favoured the fasting arm for weight (p<0.001), waist circumference (p<0.001), systolic BP (p=0.042), diastolic BP (p<0.001), fasting blood glucose (p<0.001), triglycerides (p<0.001), HDL (p<0.001) and total cholesterol (p=0.023). Absolute end-of-study clinical and laboratory values showed no statistically significant between-group difference; both arms improved versus baseline. No 95% confidence intervals, effect sizes, or ARR/NNT were reported, and adverse events were not formally tabulated. |
Islamic intermittent fasting in metabolic syndrome
RCT · metabolic syndrome · 6 months
Adding Islamic intermittent fasting to lifestyle modification produced significantly greater percent improvement in weight and every cardiometabolic marker than lifestyle alone, though absolute end-of-study values did not differ between groups.
Expert Commentary
This trial offers an encouraging but preliminary signal that a culturally familiar fasting pattern can be layered onto standard lifestyle advice. The verdict is cautiously positive: the fasting arm achieved significantly larger percent improvements across every cardiometabolic parameter measured, and the regimen appeared well tolerated. The headline must be read carefully, however. The between-group significance was demonstrated for percent change from baseline, not for absolute end-of-study values, which did not differ significantly between arms; both groups improved, and much of the apparent advantage may reflect the magnitude of within-person change rather than a clear endpoint separation. The single most important limitation is scale and design: 54 participants from one centre, a narrow age band of 30 to 45 years, roughly six months of follow-up, and an unavoidably open-label structure because fasting cannot be blinded, all of which inflate the risk of performance and expectation effects. Registration was retrospective, and no confidence intervals or numbers-needed-to-treat were provided. Can I use this with my patients? Cautiously, for a motivated adult with metabolic syndrome who already observes voluntary Islamic fasting, as a reasonable adjunct to diet and exercise rather than a proven standalone therapy. Larger, longer, multi-centre trials with pre-registered endpoints are needed before firmer recommendations.
References
Nofal HA, Elmor AAR, AbdAllah AM, Zaitoun NA, Andargeery SY, Sharafeddin MA, Hassan RIA, Elhawy LL. 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
