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

TITLE=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

JOURNAL=Frontiers in Nutrition

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1040355

DOI=10.3389/fnut.2023.1040355

ISSN=2296-861X

ABSTRACT=Background: It is estimated that out of the current 2 billion Muslims, around 1.5 billion observe Ramadan intermittent fasting (RIF), distributed over a wide geographical area with versatile cultural, ethnic, social, and economic backgrounds. Sleep is significantly altered during the holy month of Ramadan and is known to have a profound impact on human health. Moreover, sleep is also closely connected to dietary and lifestyle behaviors.  Methods: A cross-sectional study design was conducted using an electronic structured, self-administered questionnaire that was disseminated to Muslim populations across 27 countries. The survey was translated into 13 languages. The questionnaire assessed dietary and lifestyle behaviors as independent variables, with three sleep parameters: quality, duration, and disturbance as the dependent variables. In addition, Structural Equation Modeling (SEM) was performed.   Results: A total of 24,541 adults were enrolled in the study. During Ramadan, SEM analysis revealed that optimum sleep duration (7-9 hours) was significantly associated with frequently practiced physical activity (PA), and frequently consumed plant-based proteins. Smoking was significantly associated with greater sleep disturbance and lower sleep quality reported during Ramadan. Those with frequent consumption of vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent use of food delivery and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding dining in and out in relation to the three sleep parameters. Conclusions: Improving the intake of fruits and vegetables, as well as plant-based food proteins, are important factors that could help improve healthier sleep parameters during the observance of Ramadan fasting. In addition, regular PA, and avoiding smoking are important factors that may contribute to sleep improvement amongst fasting Muslims during Ramadan.