Fatigue, Sleepiness, Anxiety-Depression Score, Calories And BDNF Serum Level, Quality Of Life Alteration During Holy Ramadhan Month
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Published:
Dec 28, 2022
Keywords:
BDNF, Depression, Fatigue, Ramadhan fasting, Quality of life
Main Article Content
Abstract
Introduction: Ramadhan fasting increases mental and physical health. The study aims to evaluate the effect of Ramadhan fasting on fatigue, sleepiness, depression and anxiety mood, quality of life (QoL), and Brain-derived neurotrophic factor (BDNF) serum level.
Methods: Twenty participants are included in the fasting group (FG), and nineteen participants are included in the non-fasting group (NFG). Fatigue severity scales (FSS), fatigue VAS, Epworth sleepiness scale (ESS), hospital depression and anxiety score (HADS), Beck depression inventory (BDI)-II, Short form 12 (SF-12), and BDNF in both groups were assessed at five-time points: one week before Ramadhan (T1), in the middle of Ramadhan (T2), the last days of Ramadhan (T3), one week after Ramadhan fasting (T4) two weeks after Ramadhan (T5).
Results: We found no significant differences across the time points between FG and NFG groups in all variables (p>0.05). There is a significant correlation between fatigue VAS with BDNF serum levels (r > r table), SF-12 PCS (r>r table) with BDNF, SF-12 MCS (r>r table). There is no correlation between fatigue, depression and anxiety intensity, sleepiness, QoL, BDI-II, and BDNF serum levels with calories, BDI-II, and BDNF of fasting group in Ramadhan (r < r table).
Conclusions: Ramadhan fasting has positive effects on fatigue and mood. Ramadhan fasting does not have a significant effect on sleepiness, physical exercise, and calories consumed. Fatigue VAS and SF-12 PCS can replace the serum BDNF.
Methods: Twenty participants are included in the fasting group (FG), and nineteen participants are included in the non-fasting group (NFG). Fatigue severity scales (FSS), fatigue VAS, Epworth sleepiness scale (ESS), hospital depression and anxiety score (HADS), Beck depression inventory (BDI)-II, Short form 12 (SF-12), and BDNF in both groups were assessed at five-time points: one week before Ramadhan (T1), in the middle of Ramadhan (T2), the last days of Ramadhan (T3), one week after Ramadhan fasting (T4) two weeks after Ramadhan (T5).
Results: We found no significant differences across the time points between FG and NFG groups in all variables (p>0.05). There is a significant correlation between fatigue VAS with BDNF serum levels (r > r table), SF-12 PCS (r>r table) with BDNF, SF-12 MCS (r>r table). There is no correlation between fatigue, depression and anxiety intensity, sleepiness, QoL, BDI-II, and BDNF serum levels with calories, BDI-II, and BDNF of fasting group in Ramadhan (r < r table).
Conclusions: Ramadhan fasting has positive effects on fatigue and mood. Ramadhan fasting does not have a significant effect on sleepiness, physical exercise, and calories consumed. Fatigue VAS and SF-12 PCS can replace the serum BDNF.
Article Details
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References
1. Departemen Agama RI. Al-Quran and its translation. Bandung: CV Dipenogoro; 2008. Available at: https://repository.uin-suska.ac.id/3128 /7/EM.pdf. Accessed June 28th , 2022.
2. Jahromi SR, Sahraian MA, Ashtari F, Ayromlou H, Etemadifar M, Ghaffarpour M, et al. Islamic fasting and multiple sclerosis. BMC Neurol 2014; 14: 56.
3. Azizi F. Islamic fasting and health. Ann Nutr Metab 2010; 56: 273–82.
4. Rouhani MH, Azadbakht L. Is Ramadan fasting related to health outcomes? A review on the related evidence. J Res Med Sci 2014; 19: 987-92.
5. Trepanowski JF & Bloomer RJ. The impact of religious fasting on human health. Nutr J 2010; 9: 57.
6. Tas F, Karabulut S, Ciftci R, Yildiz R, Keskin I, Kilic S, et al. The behavior of Turkish cancer patients in fasting during the holymonth of ramadan. Jpn J Clin Oncol 2014; 44: 705-10.
7. Alabed H, Abuzayan K, Waterhouse J. Changes in subjective and objective measures of performance in ramadan. Int J Sci Res Innov 2013; 7(5): 1174-83.
8. Ovayolu O, Ovayoulu N, Tasan E. Does ramadan fasting affect fatigue in nurses. Holist Nurs Pract 2016; 30: 222-6.
9. Alessio P, Giuliana M, Ruggiero F, Baj G, Florean M, Mascaretti LG, et al. A method for reproducible measurements of serum BDNF: comparison of the performance of six commercial assays. Sci Rep 2015; 5: 17989.
10. Valet M, Stoquart G, Glibert Y, Hakizimana JC, Lejeune T. Is fatigue associated with cardiorespiratory endurance among patients suffering from multiple sclerosis. Ann Phys Rehabil Med 2016; 59: 41.
11. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67(6): 361-70.
12. Wang YP, Gorenstein C. Psychometric properties of the beck depression inventory-II: A comprehensive review. Braz J Psychiatry 2013; 35(4): 416-31.
13. Xiong Y, Zhou XJ, Nisi RA, Martin KR, Karaman MM, Cai K, et al. Brain white matter changes in CPAP-treated obstructive sleep apnea patients with residual sleepiness. J Magn Reson Imaging 2017; 45: 1371-8.
14. Ware JJr, Kosinski M, Keller SD. A 12-item short-form health survey: Construction of scales and preliminary tests of reliability
and validity. Med Care 1996; 34: 220e233.
15. Gejl AK, Enevold C, Bugge A, Andersen MS, Nielsen CH, Andersen LB. Association between serum and plasma brain-derived
neurotrophic factor and influence of storage time and centrifugation strategy. Sci Rep 2019; 9: 9655.
16. Astuti T. Metode food recall. In: Sirajuddin, Surmita & Astuti T. Survey Konsumsi Pangan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018. p. 110.
17. Nugraha B, Ghashang SK, Hamdan I, Hamdan I, Gutenbrunner C. Effect of Ramadan fasting on fatigue, mood, sleepiness, and health-related quality of life of healthy young men in summer time
in Germany: A prospective controlled study. Appetite 2017; 111: 38-45.
18. Faris MAE, Jahrami HA, Alhayki FA, Alkhawaja NA, Ali AM, Aljeeb SH, et al. Effect of diurnal fasting on sleep during ramadan: a systematic review and meta-analysis. Sleep Breath 2020; 24: 771-82.
19. Ware JE, Kosinki M, Keller SD. SF-12: How to score the SF-12 physical and mental health summary scales. 2nd ed. Boston: The Health Institute, NEMC; 1995.
20. Mahgoub AO, Abdekgadir E. The association between health-related quality of life and ramadan fasting in diabetic patients: a survey using a structured D-39 assessment tool. A sudanese cohort. J
Fasting Health 2017; 5: 24-30.
21. Zhang Y, Liu C, Zhao Y, Zhang X, Li B, Cui R. The effects of calorie restriction in depression and potential mechanisms. Curr Neuropharmacol 2015; 13(4): 536-42.
22. Koushali An, Hajiamini Z, Ebadi A, Bayat N. Effect of Ramadan fasting on emotional reactions in nurses. Iran J Nurs Midwifery
Rese 2013; 18: 232-6.
23. Harder-Lauridesn N, Rosenberg A, Benatti FB, Damm JA, Thomsen C, Mortensen EL, et al. Ramadan model of intermittent fasting for 28 d had no major effect on body composition, glucose metabolism, or cognitive function in helathy lean men. Nutrition 2017; 37: 92-103.
24. Kadri N, Tilae A, Batal ME, Taltit Y, Tahiri SM, Moussaoui D. Irritability during the month of Ramadhan. Psychosom Med 2000; 62: 280-5.
25. Radka SF, Holst PA, Fritsche M, Altar CA. Presence of brain-derived neurotrophic factor in brain and human and rat but not
mouse serum detected by a sensitive and specific immunoassay. Brain Res 1996; 709: 122–301.
26. Acheson A, Conover JC, Fandl JP, DeChiara TM, Russell M, Thadani A, et al. A BDNF autocrine loop in adult sensory neurons prevents cell death. Nature 1995; 374: 450–3.
27. Kishi T, Yoshimura R, Ikuta T, Iwata N. Brain-derived neurotrophic factor and major depressive disorder: evidence from meta-analyses. Front Psychiatry 2018; 8: 308.
28. Saligan LN, Lukkahatai N, Holder G, Walitt B, Machado-Vieira R. Lower brain-derived neurotrophic factors level associated with worsening fatigue in prostate cancer patients during repeated stress from radiatic therapy. World J Biol Psychiatry 2016; 17: 608-14.
29. Araya AV, Orellana X, Espinoza J. Evaluation of the effect of caloric restriction on serum BDNF in overweight and obese subjects: preliminary evidences. Endocrine 2008; 33: 300-4.
30. Khaled MB, Belbraouet S. Ramadan fasting diet entailed a lipid metabolic disorder among type 2 diabetic obese women. Am J Appl Sci 2009; 6(3): 471-7.
31. Mafauzy M, Mohammed WB, Anum MY, Zulkifli A, Ruhani AH. A study of the fasting diabetic patients during the month of ramadan. Med J Malaysia 1990; 45: 14-7.
32. Bakhotmah, Balkess Abed. The puzzle of self-reported weight gain in a month of fasting (ramadan) among a cohort of Saudi families in Jeddah Western Saudi Arabia. Nutr J 2011; 10: 84.
2. Jahromi SR, Sahraian MA, Ashtari F, Ayromlou H, Etemadifar M, Ghaffarpour M, et al. Islamic fasting and multiple sclerosis. BMC Neurol 2014; 14: 56.
3. Azizi F. Islamic fasting and health. Ann Nutr Metab 2010; 56: 273–82.
4. Rouhani MH, Azadbakht L. Is Ramadan fasting related to health outcomes? A review on the related evidence. J Res Med Sci 2014; 19: 987-92.
5. Trepanowski JF & Bloomer RJ. The impact of religious fasting on human health. Nutr J 2010; 9: 57.
6. Tas F, Karabulut S, Ciftci R, Yildiz R, Keskin I, Kilic S, et al. The behavior of Turkish cancer patients in fasting during the holymonth of ramadan. Jpn J Clin Oncol 2014; 44: 705-10.
7. Alabed H, Abuzayan K, Waterhouse J. Changes in subjective and objective measures of performance in ramadan. Int J Sci Res Innov 2013; 7(5): 1174-83.
8. Ovayolu O, Ovayoulu N, Tasan E. Does ramadan fasting affect fatigue in nurses. Holist Nurs Pract 2016; 30: 222-6.
9. Alessio P, Giuliana M, Ruggiero F, Baj G, Florean M, Mascaretti LG, et al. A method for reproducible measurements of serum BDNF: comparison of the performance of six commercial assays. Sci Rep 2015; 5: 17989.
10. Valet M, Stoquart G, Glibert Y, Hakizimana JC, Lejeune T. Is fatigue associated with cardiorespiratory endurance among patients suffering from multiple sclerosis. Ann Phys Rehabil Med 2016; 59: 41.
11. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67(6): 361-70.
12. Wang YP, Gorenstein C. Psychometric properties of the beck depression inventory-II: A comprehensive review. Braz J Psychiatry 2013; 35(4): 416-31.
13. Xiong Y, Zhou XJ, Nisi RA, Martin KR, Karaman MM, Cai K, et al. Brain white matter changes in CPAP-treated obstructive sleep apnea patients with residual sleepiness. J Magn Reson Imaging 2017; 45: 1371-8.
14. Ware JJr, Kosinski M, Keller SD. A 12-item short-form health survey: Construction of scales and preliminary tests of reliability
and validity. Med Care 1996; 34: 220e233.
15. Gejl AK, Enevold C, Bugge A, Andersen MS, Nielsen CH, Andersen LB. Association between serum and plasma brain-derived
neurotrophic factor and influence of storage time and centrifugation strategy. Sci Rep 2019; 9: 9655.
16. Astuti T. Metode food recall. In: Sirajuddin, Surmita & Astuti T. Survey Konsumsi Pangan. Jakarta: Kementerian Kesehatan Republik Indonesia; 2018. p. 110.
17. Nugraha B, Ghashang SK, Hamdan I, Hamdan I, Gutenbrunner C. Effect of Ramadan fasting on fatigue, mood, sleepiness, and health-related quality of life of healthy young men in summer time
in Germany: A prospective controlled study. Appetite 2017; 111: 38-45.
18. Faris MAE, Jahrami HA, Alhayki FA, Alkhawaja NA, Ali AM, Aljeeb SH, et al. Effect of diurnal fasting on sleep during ramadan: a systematic review and meta-analysis. Sleep Breath 2020; 24: 771-82.
19. Ware JE, Kosinki M, Keller SD. SF-12: How to score the SF-12 physical and mental health summary scales. 2nd ed. Boston: The Health Institute, NEMC; 1995.
20. Mahgoub AO, Abdekgadir E. The association between health-related quality of life and ramadan fasting in diabetic patients: a survey using a structured D-39 assessment tool. A sudanese cohort. J
Fasting Health 2017; 5: 24-30.
21. Zhang Y, Liu C, Zhao Y, Zhang X, Li B, Cui R. The effects of calorie restriction in depression and potential mechanisms. Curr Neuropharmacol 2015; 13(4): 536-42.
22. Koushali An, Hajiamini Z, Ebadi A, Bayat N. Effect of Ramadan fasting on emotional reactions in nurses. Iran J Nurs Midwifery
Rese 2013; 18: 232-6.
23. Harder-Lauridesn N, Rosenberg A, Benatti FB, Damm JA, Thomsen C, Mortensen EL, et al. Ramadan model of intermittent fasting for 28 d had no major effect on body composition, glucose metabolism, or cognitive function in helathy lean men. Nutrition 2017; 37: 92-103.
24. Kadri N, Tilae A, Batal ME, Taltit Y, Tahiri SM, Moussaoui D. Irritability during the month of Ramadhan. Psychosom Med 2000; 62: 280-5.
25. Radka SF, Holst PA, Fritsche M, Altar CA. Presence of brain-derived neurotrophic factor in brain and human and rat but not
mouse serum detected by a sensitive and specific immunoassay. Brain Res 1996; 709: 122–301.
26. Acheson A, Conover JC, Fandl JP, DeChiara TM, Russell M, Thadani A, et al. A BDNF autocrine loop in adult sensory neurons prevents cell death. Nature 1995; 374: 450–3.
27. Kishi T, Yoshimura R, Ikuta T, Iwata N. Brain-derived neurotrophic factor and major depressive disorder: evidence from meta-analyses. Front Psychiatry 2018; 8: 308.
28. Saligan LN, Lukkahatai N, Holder G, Walitt B, Machado-Vieira R. Lower brain-derived neurotrophic factors level associated with worsening fatigue in prostate cancer patients during repeated stress from radiatic therapy. World J Biol Psychiatry 2016; 17: 608-14.
29. Araya AV, Orellana X, Espinoza J. Evaluation of the effect of caloric restriction on serum BDNF in overweight and obese subjects: preliminary evidences. Endocrine 2008; 33: 300-4.
30. Khaled MB, Belbraouet S. Ramadan fasting diet entailed a lipid metabolic disorder among type 2 diabetic obese women. Am J Appl Sci 2009; 6(3): 471-7.
31. Mafauzy M, Mohammed WB, Anum MY, Zulkifli A, Ruhani AH. A study of the fasting diabetic patients during the month of ramadan. Med J Malaysia 1990; 45: 14-7.
32. Bakhotmah, Balkess Abed. The puzzle of self-reported weight gain in a month of fasting (ramadan) among a cohort of Saudi families in Jeddah Western Saudi Arabia. Nutr J 2011; 10: 84.