The Effects of the Ramadan Month of Fasting on Disease Activity in Patients with Rheumatoid Arthritis
Mohd Shahrir Mohamed SAID, Su Xu VIN, Nashrah Adi AZHAR, Yew JEANS, Muhammad Nur Hafiz ABDULLAH, Sakthiswary RAJALINGHAM, Sazliyana SYAHRUL
Department of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaakob Latif, Kuala Lumpur, Malaysia
Keywords: Diet; disease activity; fasting; Ramadan month; rheumatoid arthritis
Objectives: This study aims to investigate possible effects of Ramadan month of fasting on disease activity in rheumatoid arthritis (RA) patients.
Patients and methods: Between January 2010 and December 2011, 71 patients with RA who were scheduled for follow-up visit before Ramadan month and at two months after Ramadan month were retrospectively analyzed. The fasting cohort (n=39) and non-fasting cohort (n=32) were compared using the Disease Activity score 28 (DAS 28) and the patients' dietary habits both before and during Ramadan month.
Results: In the fasting group, the mean DAS 28 score before Ramadan month was higher than for afterwards, however, this was not statistically significant (p>0.05). Clinical symptoms of morning stiffness and fatigue were found in fewer patients after Ramadan month, however, it was not statistically significant (p>0.05). There was a statistically significant reduction in morning stiffness (p=0.001) and functional class (p=0.011) after Ramadan in the fasting group. The intake of high-calorie foods was not statistically significant (p=0.022) in this group.
Conclusion: Fasting lowers the mean DAS 28 in RA patients. Furthermore, dietary changes do not significantly affect RA disease activity in fasting patients.