The effect of Ramadan fasting and physical exercise on fasting blood glucose in productive-age adults: A pilot study
Abstract
Background: Productive-age adults are vulnerable to metabolic disorders due to unhealthy diets, low physical activity, which increase fasting blood glucose levels. Objective: This study aims to analyze the effect of the combination of Ramadan fasting and physical exercise on fasting blood glucose levels in productive-age adults. Methods: A quasi-experimental study with a non-equivalent control group design was conducted on 34 respondents aged 18-25 years with normal or prediabetes fasting blood glucose levels according to the American Diabetes Association classification. Participants underwent a two-week intervention during Ramadan. The intervention group fasted during Ramadan and underwent physical exercise, including walking and soleus push-ups, whereas the control group showed lower adherence to the intervention. Fasting blood glucose levels were measured at the beginning of Ramadan (T₀), the end of Ramadan (T₁), and one month after Ramadan (T₂). Analysis using Two-Way Repeated Measures ANOVA. Results: Fasting glucose levels between the intervention and control groups at T₀, T₁, and T₂ showed no significant differences (p>0.05). Mixed ANOVA results also showed no effect of time (p=0.159), group effect (p=0.855), or interaction between time and group (p=0.269). Conclusion: The combination of Ramadan fasting and physical exercise for two weeks did not result in significant changes in fasting blood glucose levels. However, both groups maintained glycemic homeostasis within the normal range.Downloads
References
World Health Organization. Global report on diabetes 2024. Geneva: WHO; 2024.
International Diabetes Federation. IDF diabetes atlas. 11th ed. Brussels: IDF; 2025.
American Diabetes Association. Classification and diagnosis of diabetes: standards of care in diabetes-2024. Diabetes Care. 2024;47(Suppl 1): S20–42.
International Diabetes Federation. IDF diabetes atlas. 10th ed. Brussels: IDF; 2023.
Aljaloud KS. The role of lifestyle changes to diet, physical activity, and sleep during Ramadan in controlling metabolic syndrome in adults: a scoping review. J Nutr Metab. 2024;2024:1-14.
Bashir M, Al-Homaid A, Boughorbel S, Mokeddem B, Palotti J, Hashim S, et al. Fasting during Ramadan is associated with changes in activity and blood glucose excursion in people with type 2 diabetes on three or more anti-hyperglycemic agents PROFAST-3. Qatar Med J. 2025;2025(3):76.
Kementerian Kesehatan Republik Indonesia. Laporan nasional Riskesdas 2018. Jakarta: Kemenkes RI; 2018.
Lytle LA, dkk. Effect of a lifestyle intervention on cardiometabolic health among emerging adults: a randomized clinical trial. JAMA Netw Open. 2022;5(10): e2231903.
McNeil J, Berry NT, Dollar JM, Shriver LH, Keane SP, Shanahan L, et al. Cross-sectional associations of actigraphy-assessed sleep with dietary outcomes in emerging adults. Eur J Clin Nutr. 2024;78:420-6.
Huang Z, Liu Y, Zhou Y. Sedentary behaviors and health outcomes among young adults: a systematic review of longitudinal studies. Healthcare (Basel). 2022;10(8):1480.
Wu J, Zhang H, Yang L, Shao J, Chen D, Cui N, et al. Sedentary time and the risk of metabolic syndrome: a systematic review and dose-response meta-analysis. Obes Rev. 2022;23(12): e13510.
Rahmawati ND, Andriani H, Wirawan F, et al. Body mass index as a dominant risk factor for metabolic syndrome among Indonesian adults: a 6-year prospective cohort study of non-communicable diseases. BMC Nutr. 2024;10:43.
Badan Pusat Statistik. Rasio ketergantungan dan definisi penduduk usia produktif 15-64 tahun. Jakarta: BPS; 2024.
Badan Pusat Statistik. Struktur penduduk usia produktif Indonesia. Jakarta: BPS; 2020.
LaRose JG, Lanoye A, Brown KL. The transition into young adulthood: a critical period for weight control. Curr Diab Rep. 2017;17(11):114.
Hamilton MT, Hamilton DG, Zderic TW. A potent physiological method to magnify and sustain soleus oxidative metabolism improves glucose and lipid regulation. iScience. 2022;25(9):104869.
Angelyna FD. Pengaruh walking exercise terhadap kadar gula darah (GDP dan G2PP) pada orang dewasa yang mengalami prediabetes: the effect of walking exercise on blood sugar levels (FBS and G2PP) in adults with prediabetes. J Holistics Health Sci. 2025;7(2):342–54.
Permana E, Kamillah S, Wisnusakti K. Pengaruh aktivitas fisik jalan kaki terhadap kadar gula darah pada pasien diabetes melitus di wilayah kerja Puskesmas Cianjur Kota. JNEP. 2021;1(2):36–46.
Zhang H, Guo Y, Hua G, Guo C, Gong S, Li M, Yang Y. Exercise training modalities in prediabetes: a systematic review and network meta-analysis. Front Endocrinol. 2024;15:1308959.
Elek D, Toth M, Sonkodi B, Acs P, Kovacs GL, Tardi P, et al. The efficacy of soleus push-up in individuals with prediabetes: a pilot study. Sports. 2025;13(3):81.
Zhang L, Cheng X, Yang Y, Li X, Yuan Y. Optimal exercise dose and modality for glycemic control in prediabetes: a systematic review and network meta-analysis. Front Endocrinol. 2025;16:1560676.
Alogaiel DM, Alsuwaylihi A, Alotaibi MS, Macdonald IA, Lobo DN. Effects of Ramadan intermittent fasting on hormones regulating appetite in healthy individuals: a systematic review and meta-analysis. Clin Nutr. 2025;44(3):512–524.
Elmajnoun HK, Faris ME, Abdelrahim DN, Haris PI, Abu-Median AB. Effects of Ramadan fasting on glycaemic control among patients with type 2 diabetes: systematic review and meta-analysis of observational studies. Diabetes Ther. 2023;14(3):479-96.
Swan-Abu Salih A, et al. Ramadan fasting and glycemic control in patients with type 2 diabetes. Prim Care Diabetes. 2025. doi: 10.1016/j.pcd.2025.01.002.
Ali T, Lessan N. Chrononutrition in the context of Ramadan: Potential implications. Diabetes Metab Res Rev. 2024;40(2): e3728.
Hejazi K, Toghdari A, Rahimzadeh MM, Fakhrealali M. The effect of Ramadan fasting alone or combined with physical activity on insulin resistance. J Nutr Metab. 2025;2025:1-12.
Lauche R, Saddat C, Fathi I, Klose P, Rampp T, Al-Abtah J, et al. Effects of a modified Ramadan fasting on physical and mental health in healthy adult Muslims: a randomized controlled trial. In: American Public Health Association Annual Meeting & Expo; 2017 Nov 4-8; United States.
Ranganathan P, Pramesh CS, Buyse M. Common pitfalls in statistical analysis: intention-to-treat versus per-protocol analysis. Perspect Clin Res. 2016;7(3):144-6.
Tripepi G, Chesaye M, Dekker FW, Zoccali C. Intention to treat and per protocol analysis in clinical and epidemiological research. Nephrol Dial Transplant. 2020;35(8):1299-302.
World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020.
Lessan N, Ali T. Energy metabolism and intermittent fasting: the Ramadan perspective. Nutrients. 2019;11(5):1192.
Syeda UA, Battillo D, Visaria A, Malin SK. The importance of exercise for glycemic control in type 2 diabetes. Am J Med Open. 2023;9:100031.
Stockman MC, Thomas D, Burke J, Apovian CM. Effects of intermittent fasting on glucose homeostasis and lipid profiles: a pilot study. Curr Obes Rep. 2018;7(2):172-185.
Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG, et al. Flipping the metabolic switch: understanding and applying the health benefits of fasting. Obesity. 2018;26(2):254-268.
Ganesan K, Habboush Y, Sultan A. Intermittent fasting: the choice for a healthier lifestyle. Cureus. 2018;10(7): e2947.
Pavlou V, Cienfuegos S, Lin S, Gabel K, Varady KA. Effect of time-restricted eating versus usual care on fasting glucose and insulin sensitivity: a randomized controlled trial. Nutrients. 2023;15(18):4021.
Yuan X, Wang J, Yang S, Gao M, Cao L, Li X, et al. Effect of intermittent fasting diet on glucose and lipid metabolism and insulin resistance in patients with impaired glucose tolerance: a systematic review and meta-analysis. TouchREV Endocrinol. 2023;19(1):44-51.
RezkAllah SS, Takla MK. Effects of different dosages of interval training on glycemic control in people with prediabetes: a randomized controlled trial. Diabetes Spectr. 2019;32(2):125-31.
Faris MA, Kacimi S, Al-Kurd RA, Fararjeh MA, Bustanji YK, Mohammad MK, et al. Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects. Nutr Res. 2012;32(12):947-955.
Horne BD, Muhlestein JB, Anderson JL. Health effects of intermittent fasting: hormesis or harm? A systematic review. Am J Clin Nutr. 2015;102(2):464-470.
World Health Organization Regional Office for the Western Pacific, International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia; 2000.
Lee J, Yoon KH. β-cell recovery revisited: Is prediabetes remission driven by insulin sensitivity or β-cell function? J Diabetes Investig. 2026;17(5):716-718.
Submitted
Copyright (c) 2026 Nur Islamiyah, St. Masithah, Fitri Wahyuni, Selvia
This work is licensed under a Creative Commons Attribution 4.0 International License.
World Nutrition Journal provides immediate open access to its content under the Creative Commons Attribution License (CC BY 4.0). This permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
