{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:20:33Z","timestamp":1790198433443,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Ramadan fasting (RF) is a form of intermittent fasting that generally improves body composition and related metabolic profiles. Whether RF exacerbates depressive symptomatology in individuals diagnosed with major depressive disorder (MDD) is undetermined. Methods: 100 men, who lived in Bahrain and were between the ages of 18 and 64 years with an established diagnosis of MDD, participated in this 4-week study. Based on preference, participants were assigned to a fasting group (FG, n = 50) and a non-fasting group (NFG, n = 50). The FG engaged in fasting from 03:40 to 18:10 (dawn and dusk timings). Changes in depressive symptoms, body mass, body composition, and components of metabolic syndrome were measured. Results: There were no significant changes in depressive symptoms within the FG vs. NFG after controlling for baseline covariates: mean difference 0.49 (SE = 0.63), p = 0.43. No adverse effects were reported in either group. The FG experienced significant reductions in body mass, 1.87 kg, p = 0.001; body mass index, 0.69 kg\/m2, p = 0.001; body fat, 0.87%, p = 0.001; body surface area, 0.03 m2, p = 0.001; and lean mass, 0.77 kg, p = 0.001. Conclusions: RF did not negatively affect depressive symptoms and improved body composition, suggesting short-term intermittent fasting may be a safe dietary practice for adult males with MDD.<\/jats:p>","DOI":"10.3390\/nu13082718","type":"journal-article","created":{"date-parts":[[2021,8,8]],"date-time":"2021-08-08T21:35:40Z","timestamp":1628458540000},"page":"2718","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Ramadan Fasting Improves Body Composition without Exacerbating Depression in Males with Diagnosed Major Depressive Disorders"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8990-1320","authenticated-orcid":false,"given":"Haitham","family":"Jahrami","sequence":"first","affiliation":[{"name":"Ministry of Health, Manama 410, Bahrain"},{"name":"Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1706-6167","authenticated-orcid":false,"given":"Ahmed S.","family":"BaHammam","sequence":"additional","affiliation":[{"name":"University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, P.O. Box 225503, Riyadh 11324, Saudi Arabia"},{"name":"The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh 11324, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman Ahmed","family":"Haji","sequence":"additional","affiliation":[{"name":"Ministry of Health, Manama 410, Bahrain"},{"name":"Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama 323, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8409-868X","authenticated-orcid":false,"given":"Nicola L.","family":"Bragazzi","sequence":"additional","affiliation":[{"name":"Laboratory for Industrial and Applied Mathematics, Departments and Statistics, York University, Toronto, ON M3J 1P3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihab","family":"Rakha","sequence":"additional","affiliation":[{"name":"Ministry of Health, Manama 410, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Alsabbagh","sequence":"additional","affiliation":[{"name":"Ministry of Health, Manama 410, Bahrain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-3169","authenticated-orcid":false,"given":"Boya","family":"Nugraha","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Hannover Medical School, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan M.","family":"Pasiakos","sequence":"additional","affiliation":[{"name":"Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"196","DOI":"10.4103\/aam.aam_63_17","article-title":"Effect of ramadan fasting on glycemic control and other essential variables in diabetic patients","volume":"17","author":"Bener","year":"2018","journal-title":"Ann. Afr. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/S2215-0366(19)30161-0","article-title":"Considerations for clinicians treating Muslim patients with psychiatric disorders during Ramadan","volume":"6","author":"Furqan","year":"2019","journal-title":"Lancet Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lessan, N., and Ali, T. (2019). Energy Metabolism and Intermittent Fasting: The Ramadan Perspective. Nutrients, 11.","DOI":"10.3390\/nu11051192"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/ajcn\/nqx016","article-title":"The effects of Ramadan fasting on activity and energy expenditure","volume":"107","author":"Lessan","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.4103\/ajm.AJM_76_17","article-title":"Muslim patients in Ramadan: A review for primary care physicians","volume":"7","author":"Abolaban","year":"2017","journal-title":"Avicenna J. Med."},{"key":"ref_6","first-page":"1517","article-title":"Depression Is the Leading Cause of Disability Around the World","volume":"317","author":"Friedrich","year":"2017","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"536","DOI":"10.2174\/1570159X13666150326003852","article-title":"The Effects of Calorie Restriction in Depression and Potential Mechanisms","volume":"13","author":"Zhang","year":"2015","journal-title":"Curr. Neuropharmacol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.2478\/gp-2018-0002","article-title":"A systematic review on the effect of Ramadan on mental health: Minor effects and no harm in general, but increased risk of relapse in schizophrenia and bipolar disorder","volume":"1","author":"Heun","year":"2018","journal-title":"Glob. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.psychres.2012.12.018","article-title":"Fasting in mood disorders: Neurobiology and effectiveness. A review of the literature","volume":"209","author":"Fond","year":"2013","journal-title":"Psychiatry Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"39","DOI":"10.4103\/ijmbs.ijmbs_9_18","article-title":"The year in ramadan fasting research (2017): A narrative review","volume":"10","author":"Beshyah","year":"2018","journal-title":"Ibnosina J. Med. Biomed. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/YIC.0000000000000275","article-title":"Impact of Ramadan fasting on medical and psychiatric health","volume":"34","author":"Chehovich","year":"2019","journal-title":"Int. Clin. Psychopharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2291","DOI":"10.1007\/s00394-020-02216-1","article-title":"A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on body weight in healthy subjects aged 16 years and above","volume":"59","author":"Jahrami","year":"2020","journal-title":"Eur. J. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S000711451900254X","article-title":"Impact of Ramadan Diurnal Intermittent Fasting on Metabolic Syndrome Components in Healthy, Non-Athletic Muslim People Aged Over 15 Years: A Systematic Review and Meta-Analysis","volume":"123","author":"Faris","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"108226","DOI":"10.1016\/j.diabres.2020.108226","article-title":"A systematic review, meta-analysis, and meta-regression of the impact of diurnal intermittent fasting during Ramadan on glucometabolic markers in healthy subjects","volume":"165","author":"Faris","year":"2020","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2273","DOI":"10.1016\/j.numecd.2021.05.002","article-title":"Does four-week consecutive, dawn-to-sunset intermittent fasting during Ramadan affect cardiometabolic risk factors in healthy adults? A systematic review, meta-analysis, and meta-regression","volume":"31","author":"Jahrami","year":"2021","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1017\/S0033291713002778","article-title":"Metabolic syndrome and metabolic abnormalities in patients with major depressive disorder: A meta-analysis of prevalences and moderating variables","volume":"44","author":"Vancampfort","year":"2014","journal-title":"Psychol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1002\/wps.20252","article-title":"Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: A systematic review and meta-analysis","volume":"14","author":"Vancampfort","year":"2015","journal-title":"World Psychiatry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s12160-010-9232-2","article-title":"A randomized controlled trial of behavioral weight loss treatment versus combined weight loss\/depression treatment among women with comorbid obesity and depression","volume":"41","author":"Linde","year":"2011","journal-title":"Ann. Behav. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/cob.12136","article-title":"Attrition and weight loss outcomes for patients with complex obesity, anxiety and depression attending a weight management programme with targeted psychological treatment","volume":"6","author":"McLean","year":"2016","journal-title":"Clin. Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2105\/AJPH.94.3.361","article-title":"Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement","volume":"94","author":"Lyles","year":"2004","journal-title":"Am. J. Public Health"},{"key":"ref_21","unstructured":"World Health, O. (2005). International Classification of Diseases (ICD), World Health Organization."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1080\/02701367.2000.11082794","article-title":"Assessment of physical activity: An international perspective","volume":"71","author":"Booth","year":"2000","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12991-017-0155-1","article-title":"An arabic translation, reliability, and validation of Patient Health Questionnaire in a Saudi sample","volume":"16","author":"AlHadi","year":"2017","journal-title":"Ann. Gen. Psychiatry"},{"key":"ref_25","unstructured":"WHO (2020, January 06). Body mass index\u2014BMI. Available online: https:\/\/www.euro.who.int\/en\/health-topics\/disease-prevention\/nutrition\/a-healthy-lifestyle\/body-mass-index-bmi."},{"key":"ref_26","unstructured":"World Health Organization (2011). Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation, Geneva, Switzerland, 8\u201311 December 2008, World Health Organization."},{"key":"ref_27","unstructured":"Williams, L. (2017). Clinical Handbook for Brunner & Suddarth\u2019s Textbook of Medical-surgical Nursing, Wolters Kluwer Health."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1016\/j.amjcard.2007.07.027","article-title":"Exercise training amount and intensity effects on metabolic syndrome (from Studies of a Targeted Risk Reduction Intervention through Defined Exercise)","volume":"100","author":"Johnson","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1016\/S0140-6736(05)67402-8","article-title":"The metabolic syndrome\u2014A new worldwide definition","volume":"366","author":"Alberti","year":"2005","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1464-5491.2006.01858.x","article-title":"Metabolic syndrome\u2014A new world-wide definition. A consensus statement from the international diabetes federation","volume":"23","author":"Alberti","year":"2006","journal-title":"Diabet. Med."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Cohen, J. (2013). Statistical Power Analysis for the Behavioral Sciences, Academic Press.","DOI":"10.4324\/9780203771587"},{"key":"ref_32","unstructured":"(2020, December 09). R. 4.0.3. Available online: https:\/\/www.R-project.org\/."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2528","DOI":"10.1111\/jcmm.13418","article-title":"Effect of caloric restriction on depression","volume":"22","author":"Manchishi","year":"2018","journal-title":"J. Cell Mol. Med."},{"key":"ref_34","first-page":"232","article-title":"Effect of Ramadan fasting on emotional reactions in nurses","volume":"18","author":"Koushali","year":"2013","journal-title":"Iran. J. Nurs. Midwifery Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"108545","DOI":"10.1016\/j.diabres.2020.108545","article-title":"To explore the association of Ramadan fasting with symptoms of depression, anxiety, and stress in people with diabetes","volume":"172","author":"Yousuf","year":"2021","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3071","DOI":"10.1523\/JNEUROSCI.5584-07.2008","article-title":"Orexin signaling mediates the antidepressant-like effect of calorie restriction","volume":"28","author":"Lutter","year":"2008","journal-title":"J. Neurosci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1073\/pnas.1109237109","article-title":"A role for neuronal cAMP responsive-element binding (CREB)-1 in brain responses to calorie restriction","volume":"109","author":"Fusco","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1006\/bbrc.1995.1189","article-title":"Modulation of endogenous opiate production: Effect of fasting","volume":"207","author":"Molina","year":"1995","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Fernando, H.A., Zibellini, J., Harris, R.A., Seimon, R.V., and Sainsbury, A. (2019). Effect of Ramadan Fasting on Weight and Body Composition in Healthy Non-Athlete Adults: A Systematic Review and Meta-Analysis. Nutrients, 11.","DOI":"10.3390\/nu11020478"},{"key":"ref_40","first-page":"1","article-title":"Prevalence of metabolic syndrome and metabolic abnormalities among patients with depression","volume":"158","author":"Ali","year":"2018","journal-title":"Bahrain Med. Bull."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Nugraha, B., Riat, A., Ghashang, S.K., Eljurnazi, L., and Gutenbrunner, C. (2020). A Prospective Clinical Trial of Prolonged Fasting in Healthy Young Males and Females-Effect on Fatigue, Sleepiness, Mood and Body Composition. Nutrients, 12.","DOI":"10.3390\/nu12082281"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1001\/jamainternmed.2020.4153","article-title":"Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial","volume":"180","author":"Lowe","year":"2020","journal-title":"JAMA Intern. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3837","DOI":"10.1096\/fj.13-230227","article-title":"Effects of high-protein diets on fat-free mass and muscle protein synthesis following weight loss: A randomized controlled trial","volume":"27","author":"Pasiakos","year":"2013","journal-title":"FASEB J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.nut.2017.12.014","article-title":"Time-restricted feeding influences immune responses without compromising muscle performance in older men","volume":"51\u201352","author":"Gasmi","year":"2018","journal-title":"Nutrition"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1053\/j.jrn.2019.06.003","article-title":"Investigating Physical and Nutritional Changes During Prolonged Intermittent Fasting in Hemodialysis Patients: A Prospective Cohort Study","volume":"30","author":"Adanan","year":"2020","journal-title":"J. Ren. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/jhn.12042","article-title":"Effect of fasting in Ramadan on body composition and nutritional intake: A prospective study","volume":"26","author":"Norouzy","year":"2013","journal-title":"J. Hum. Nutr. Diet."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Karras, S.N., Koufakis, T., Adamidou, L., Dimakopoulos, G., Karalazou, P., Thisiadou, K., Makedou, K., and Kotsa, K. (2021). Effects of Christian Orthodox Fasting Versus Time-Restricted Eating on Plasma Irisin Concentrations Among Overweight Metabolically Healthy Individuals. Nutrients, 13.","DOI":"10.1530\/endoabs.73AEP804"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/8\/2718\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:42:06Z","timestamp":1760164926000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/8\/2718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,7]]},"references-count":47,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["nu13082718"],"URL":"https:\/\/doi.org\/10.3390\/nu13082718","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,7]]}}}