the effect of ramadan fasting alone or in conjunction with physical activity on hematological factors and insulin resistance in adult muslims: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to evaluate the effects of ramadan fasting, either alone or combined with physical exercise, on blood hematological factors and insulin resistance in adult muslims. six electronic databases (web of science, embase (ovid), cochrane library, pubmed/medline, and scopus) and google scholar were searched to identify relevant studies. we employed random-effects models to estimate the weighted mean difference (wmd) with 95% confidence intervals (cis). the limitations of this study include the following: only english-language articles were considered, and there was variability in the types of fasting observed during ramadan, measurement conditions, fasting duration, and ambient temperature. a total of twenty-three studies were included in the analysis. the meta-analysis indicated that fasting combined with exercise reduced homa-ir and white blood cell count. while no significant differences were observed between the fasting-only group and the fasting-plus-exercise group regarding insulin levels, fasting blood glucose, red blood cell count, hemoglobin, hematocrit, and platelet count, the group that combined fasting with exercise demonstrated a more favorable effect on these variables compared to the fasting-only group. our findings suggest that fasting combined with exercise reduced homa-ir and white blood cell count in adult muslims. furthermore, this combined approach did not alter insulin, fasting blood glucose, red blood cells, hemoglobin, hematocrit, or platelet levels. regular physical activity during ramadan can shed light on the impact of fasting on metabolic health. consistent physical activity combined with a balanced diet appears to be an effective strategy for improving insulin resistance and hematological indices during ramadan. this approach has the potential to enhance metabolic health and overall well-being.