Frontiers in Nutrition (Mar 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,
  • Ahmed S. BaHammam,
  • Asma Amanatullah,
  • Khaled Obaideen,
  • Teresa Arora,
  • Habiba Ali,
  • Leila Cheikh Ismail,
  • Dana N. Abdelrahim,
  • Mohammed Al-Houqani,
  • Kholoud Allaham,
  • Rand Abdalrazeq,
  • Wahid Sharif Aloweiwi,
  • Somayea Sultana Mim,
  • Ammar Mektebi,
  • Sohrab Amiri,
  • Sahabi Kabir Sulaiman,
  • Syed Fahad Javaid,
  • Mohammad Delwer Hossain Hawlader,
  • Fatimah Isma’il Tsiga-Ahmed,
  • Iffat Elbarazi,
  • Saskiyanto Manggabarani,
  • Gamechu Atomsa Hunde,
  • Sabrina Chelli,
  • Mitra Sotoudeh,
  • MoezAlIslam Ezzat Faris,
  • Ramadan Intermittent Fasting Collaborators,
  • Abasi-Okot Akpan Udoyen,
  • Abdelrhman Muwafaq Janem,
  • Abdullah Taha Zayed,
  • Adriana Johny Skafi,
  • Ahmed Ashraf Elmoghazy,
  • Ahmed Daniyal Nawaz,
  • Ahmed Juma AlKaabi,
  • Sabri Amalin Najiha Binti Mohd,
  • Amir Human-Hoveidaeiv,
  • Amir N Attia,
  • Ammar Mektebi,
  • Amna Mohammed Al Zadjali,
  • Anis Riahi,
  • Anto Jamma Hadi,
  • Ashish Ramesh Dubey,
  • Ayesha Iqbal,
  • ali Bachar Jalal El,
  • Bakri Yahia Roumi Jamal,
  • Baraa Moujahed Hajjar,
  • Chika Chizitelu Madekwe,
  • Cicih Bhakti Purnamasari,
  • Cicih Bhakti Purnamasari,
  • Dawlah Qasem Murshed Ahmed Saeed,
  • Dhaval Maunishkumar Shah,
  • Dima Ibrahim,
  • Diyae Khadri,
  • Eman Younis Al-Fahdi,
  • Fatema Al Mazrouei,
  • Fatema Al Mazrouei,
  • Fatema Muneer Radhi,
  • Fatema Yusuf Aljanabi,
  • Fatima Al sheriff Al Zaabi,
  • Fatima Al sheriff Al Zaabi,
  • Fatima Alzhra Mohamed Hanifa,
  • Fatma Mustafa Ridha,
  • Fayaz Ahmad Momand,
  • Fayeza Hasan,
  • Filopater Mar Gerges,
  • Firmansyah Firmansyah Firmansyah,
  • Frederick Putra Wijaya,
  • Hassan B Nagy,
  • Hussam Kiwan,
  • Ibrahim Khaled Salah El Din,
  • Israa Hasan Hasan,
  • Jehad Firas Samhouri,
  • Kamil Sannah,
  • Lamisa Rahman,
  • M Munir,
  • Malik Bendak,
  • Maram sirelkhatim elsayed,
  • Marwa Mohammed morgom,
  • Maya Shahadeh Alassadi,
  • Meryem Gounni,
  • Moath Ahmed Aldafas,
  • Mohammad Mahmoud Jarrah,
  • Mohammad Shahrour,
  • Mohammad Elyas Wardak,
  • Mohammad Pourfridoni,
  • Mohammad Zulqurnain Haider,
  • Mohammed Chakir,
  • Mohammed Al-Rsheed mostafa Omar Abueissa,
  • Mohannad Abdalfdeeel Almahie Shaban,
  • Mohannad Abdalfdeel Almahie Shaban,
  • Monzir Musa Hamdan Mohammed,
  • Mosab Salah elmahi Ahmed,
  • Muhammad Daniyal Khan,
  • Muhammad Sameh Amer,
  • Muttahid Shah,
  • Nadirah Ghenimi Ghenimi,
  • Nailah Mahmood,
  • Nermeen Mohammed Afifi,
  • Noran Omar Mahmood,
  • Noura Ahmad Kanjo,
  • Rahaf Ziad Abughosh,
  • Ramy Rafaat Yassa,
  • Rani Rahmasari Tanuwijaya M Gizi,
  • Reza Heidari-Soureshjani,
  • Romana Riyaz,
  • Rutab Tareen,
  • Sajjad Ahmed Khan,
  • Sana Kalim Qureshi,
  • Sara Mohammed Ahmed Musleh Al Badani,
  • Sara Nazmy Ataallah,
  • Saud Mohammed Alwatban,
  • Saud Mohammed Alwatban,
  • Saud Mohammed Alwatban,
  • Sayed Mustafa Kamal,
  • Shams Ul Haq Noori,
  • Somto Judith Okafor,
  • Tadjadit Lydia,
  • Tariq Ali Al Habsi,
  • Tejaswini Ashok,
  • Tujuba Diribsa Benti,
  • Waseem N Ahmed,
  • Yazan William Giacaman,
  • Yesiru Adeyemi Kareem,
  • Zainab Sadeq AlRabeea

DOI
https://doi.org/10.3389/fnut.2023.1040355
Journal volume & issue
Vol. 10

Abstract

Read online

BackgroundOf 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.MethodsThis 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.ResultsIn 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.ConclusionIncreasing 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.

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