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. 2023 Mar 8:10:1040355.
doi: 10.3389/fnut.2023.1040355. eCollection 2023.

Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19

Moien A B Khan  1 , Ahmed S BaHammam  2 , Asma Amanatullah  3 , Khaled Obaideen  4 , Teresa Arora  5 , Habiba Ali  1 , Leila Cheikh Ismail  6 , Dana N Abdelrahim  7 , Mohammed Al-Houqani  8 , Kholoud Allaham  9 , Rand Abdalrazeq  10 , Wahid Sharif Aloweiwi  11 , Somayea Sultana Mim  12 , Ammar Mektebi  13 , Sohrab Amiri  14 , Sahabi Kabir Sulaiman  15 , Syed Fahad Javaid  16 , Mohammad Delwer Hossain Hawlader  17 , Fatimah Isma'il Tsiga-Ahmed  18 , Iffat Elbarazi  19 , Saskiyanto Manggabarani  20 , Gamechu Atomsa Hunde  21 , Sabrina Chelli  22 , Mitra Sotoudeh  23 , MoezAlIslam Ezzat Faris  6 ; Ramadan Intermittent Fasting Collaborators
Collaborators, Affiliations

Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19

Moien A B Khan et al. Front Nutr. .

Abstract

Background: Of around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors.

Methods: This cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters.

Results: In total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7-9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters.

Conclusion: Increasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF.

Keywords: Ramadan; diet; fasting; intermittent fasting; lifestyle and behavior; sleep.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Worldmap showing the number of participants using color density for the 27 participating countries.
FIGURE 2
FIGURE 2
Sociodemographic characteristics of the 24,500 study participants.
FIGURE 3
FIGURE 3
Structural equation modeling (SEM) for the relationships between sleep components and the dietary and lifestyle behaviors during Ramadan fasting month among the 24,500 study participants.
See this image and copyright information in PMC

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