Effect of Islamic Fasting on the Severity of Rheumatoid Arthritis

Introduction: Rheumatoid arthritis (RA) is a chronic, inflammatory, peripheral polyarthritis associated with unclear etiology. RA often leads to joint deformity and cartilage destruction in the patients. The present study aimed to assess the effect of Islamic fasting on the severity of RA. Methods: This observational study was conducted on 28 patients with RA, who were randomly divided into two groups. The study was initiated two weeks before Ramadan and continued until one month after Ramadan in 2015. One group followed Islamic fasting during Ramadan, and the other group did not fast. The study groups were visited twice; the first visit was before Ramadan, and the second visit was after Ramadan. Data were recorded on the number of tender and swollen joints, disease activity score (DAS-28), visual analog scale (VAS) of the patients, VAS of the physicians, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results: The mean number of the tender joints decreased from 1.36±1.94 to 0.42±0.85 (P=0.02), and the mean number of the swollen joints decreased from 0.79±1.05 to 0.07±0.26 in the fasting group (P=0.02). In addition, DAS-28 and VAS of the physicians reduced significantly in the fasting group only, while the VAS score of the patients showed no significant reduction in the study groups. The mean DAS-28 decreased from 2.74±1.06 to 2.18±0.64 in the fasting group (P=0.003). Moreover, the mean DAS-28 decreased from 2.71±0.8 to 2.27±1.01 in the non-fasting group (P=0.24). Conclusion: According to the results, Islamic fasting during the holy month of Ramadan could effectively decrease the severity of RA. However, further evidence is required to recommend this dietary intervention for patients with RA.