The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting ("Ramadan Fasting") on Hidradenitis Suppurativa: Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study

Giovanni Damiani, Naim Mahroum, Paolo Daniele Maria Pigatto, Alessia Pacifico, Piergiorgio Malagoli, Danica Tiodorovic, Rosalynn Rz Conic, Howard Amital, Nicola Luigi Bragazzi, Abdulla Watad, Mohammad Adawi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6%) and 31 females (56.4%), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The "Severity of International Hidradenitis Suppurativa Severity Score System" (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of -0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the "Autoinflammatory Disease Damage Index" (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.

Original languageEnglish
JournalNutrients
Volume11
Issue number8
DOIs
Publication statusPublished - Aug 1 2019

Fingerprint

Hidradenitis Suppurativa
fasting
Fasting
Safety
quality of life
Biological Products
regression analysis
weight loss
Sample Size
antibiotics
Weight Loss
Multivariate Analysis
phenotype
sampling
Regression Analysis
Quality of Life
duration
Anti-Bacterial Agents
Phenotype
Therapeutics

Keywords

  • circadian rhythms
  • dietary intervention
  • hidradenitis suppurativa
  • human biological clock
  • intermittent fasting

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting ("Ramadan Fasting") on Hidradenitis Suppurativa : Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study. / Damiani, Giovanni; Mahroum, Naim; Pigatto, Paolo Daniele Maria; Pacifico, Alessia; Malagoli, Piergiorgio; Tiodorovic, Danica; Conic, Rosalynn Rz; Amital, Howard; Bragazzi, Nicola Luigi; Watad, Abdulla; Adawi, Mohammad.

In: Nutrients, Vol. 11, No. 8, 01.08.2019.

Research output: Contribution to journalArticle

Damiani, Giovanni ; Mahroum, Naim ; Pigatto, Paolo Daniele Maria ; Pacifico, Alessia ; Malagoli, Piergiorgio ; Tiodorovic, Danica ; Conic, Rosalynn Rz ; Amital, Howard ; Bragazzi, Nicola Luigi ; Watad, Abdulla ; Adawi, Mohammad. / The Safety and Impact of a Model of Intermittent, Time-Restricted Circadian Fasting ("Ramadan Fasting") on Hidradenitis Suppurativa : Insights from a Multicenter, Observational, Cross-Over, Pilot, Exploratory Study. In: Nutrients. 2019 ; Vol. 11, No. 8.
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abstract = "Hidradenitis suppurativa (HS) is a chronic-relapsing and debilitating disease, which affects the components of the folliculopilosebaceous unit and severely impacts on the perceived health-related quality of life. Among the possible treatments, dietary interventions, such as fasting, have been described to positively impact on HS. However, nothing is known about the effects of circadian, intermittent fasting, such as the Ramadan fasting. A sample of 55 HS patients (24 males (43.6{\%}) and 31 females (56.4{\%}), mean age 39.65 ± 8.39 years, average disease duration 14.31 ± 7.03 years) was recruited in the present study. The {"}Severity of International Hidradenitis Suppurativa Severity Score System{"} (IHS4) decreased significantly from 11.00 ± 5.88 (before Ramadan) to 10.15 ± 6.45 (after Ramadan), with a mean difference of -0.85 ± 0.83 (p < 0.0001). At the univariate analyses, the improvement was associated with HS phenotype (with a prominent improvement among those with ectopic type), treatment (with the improvement being higher in patients receiving topical and systemic antibiotics compared to those treated with biologics), the {"}Autoinflammatory Disease Damage Index{"} (ADDI), and Hurley scores. At the multivariate regression analysis, only the Hurley score (regression coefficient = 0.70, p = 0.0003) was found to be an independent predictor of change in the IHS4 score after fasting. The improvement in the IHS4 score was not, however, associated with weight loss. In conclusion, the Ramadan fasting proved to be safe and effective in HS patients. Considering the small sample size and the exploratory nature of the present investigation, further studies in the field are warranted, especially longitudinal, prospective and randomized ones.",
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AU - Mahroum, Naim

AU - Pigatto, Paolo Daniele Maria

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AU - Conic, Rosalynn Rz

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