Nutritional, sleep, physical activity, and quality-of-life changes during Ramadan fasting: a prospective comparative study

Background Ramadan is the holiest month in the Islamic calendar. Ramadan fasting, which lasts from sunrise to sunset, significantly affects eating habits, physical activity, daytime sleepiness, and quality of life. In this study, body weight, daytime sleepiness (Epworth Sleepiness Scale), physical activity level, dietary intake, and quality of life (SF-36) were assessed in fasting and non-fasting individuals before, during, and after Ramadan. Methods In this prospective longitudinal comparative study of 282 healthy adults, individuals were divided into fasting and non-fasting groups. Data were collected in four phases: 1 week before, in the middle, at the end, and 2 weeks after Ramadan. Results Total energy intake, macronutrient consumption, and body weight decreased during Ramadan and increased again after Ramadan, with these changes being more pronounced in the fasting group. Daytime sleepiness increased and physical activity level decreased in fasting individuals during Ramadan, but both returned toward baseline levels after Ramadan. In terms of quality of life, significant differences between fasting and non-fasting individuals were observed, particularly in physical and emotional role functioning domains ( p  < 0.05). Conclusion This study demonstrated that Ramadan fasting is associated with changes in dietary intake, daytime sleepiness, physical activity, and quality of life. Moreover, similar patterns observed in non-fasting individuals suggest that environmental and lifestyle factors during Ramadan may also play a role.