Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Complementary and Integrative Medicine

Editor-in-Chief: Lui, Edmund

Ed. by Ko, Robert / Leung, Kelvin Sze-Yin / Saunders, Paul / Suntres, PH. D., Zacharias

CiteScore 2017: 1.41

SCImago Journal Rank (SJR) 2017: 0.472
Source Normalized Impact per Paper (SNIP) 2017: 0.564

See all formats and pricing
More options …

Decreased anxiety after Dawood fasting in the pre-elderly and elderly

Ika Fidianingsih
  • Corresponding author
  • Department of Histology, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nur Aisyah Jamil
  • Department of Public Health, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Russy Novita Andriani
  • Department of Public Health, Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Wira Muhammad Rindra
Published Online: 2018-10-12 | DOI: https://doi.org/10.1515/jcim-2017-0172



A high prevalence of anxiety in the elderly often leads to decreased quality of life (QOL). A restrictive diet can increase the production of ketone bodies that encourage mood enhancement, neural protection and pain reduction. This study aimed to identify whether Dawood fasting could increase the QOL of the elderly by reducing anxiety.


This research was a quasi-experimental study involving a pretest–post-test control group design. The subjects were pre-elderly and elderly or healthy people aged more than 50, and a consecutive sampling method was employed. The fasting group observed the fast of Dawood, in which they abstained from eating, drinking, or having sexual intercourse from the break of dawn to dusk with the expressed intent to fast every other day. The fast was observed for 22 days (11 fasting days). Anxiety was examined using the Hamilton Rating Scale for Anxiety (HRS-A), while QOL was identified using the Indonesian version of the World Health Organisation Quality of Life (WHOQOL).


A total of 48 respondents participated in this study with 24 respondents observing the fast of Dawood and 24 others not fasting. Results showed that the 22 days of Dawood fast reduced respondents’ complaints about anxiety by 4.37% and was significantly different from the non-fasting group (p=0.001). There was an increase in the QOL of the fasting group (p=0.019), although no significant difference was found when compared to the non-fasting group.


The fast of Dawood reduced anxiety in the pre-elderly and elderly.

Keywords: anxiety; Dawood; elderly; fasting; pre-elderly; quality of life


  • [1]

    Trepanowski JF, Bloomer RJ. The impact of religious fasting on human health. Nutr J. 2010;9:57.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [2]

    Kementrian Kesehatan RI. Gambaran Kesehatan lanjut Usia di Indonesia. Bul Jendela Data dan Inf Kesehat. 2013;Semester I:1–18.Google Scholar

  • [3]

    Donovan AO, Slavich GM, Epel ES, Neylan TC. Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging. Neurosci Biobehav Rev. 2013;37:96–108.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [4]

    National Institute on Aging, National Institutes of Health, US Department of Health and Human Services. Global health and aging. Geneva: World Health Organization, 2011.Google Scholar

  • [5]

    Ferreri F, Lapp LK, Peretti C. Current research on cognitive aspects of anxiety disorders. Curr Opin Psychiatry. 2011;24:49–54.Web of SciencePubMedCrossrefGoogle Scholar

  • [6]

    Porensky EK, Dew MA, Karp JF, Skidmore E, Rollman BL, Shear MK, et al. The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life, and healthcare utilization. Am J Geriart Psychiatry. 2009;17:473–82.CrossrefGoogle Scholar

  • [7]

    Vink D, Aartsen MJ, Comijs HC, Heymans MW, Penninx BW, Stek ML, et al. Onset of anxiety and depression in the aging population: comparison of risk factors in a 9-year prospective study. Am J Geriatr Psychiatry. 2009;17:642–52.Web of ScienceCrossrefGoogle Scholar

  • [8]

    Núñez-Pizarro JL, González-Luna A, Mezones-Holguín E, Blümel JE, Barón G, Bencosme A, et al. Association between anxiety and severe quality-of-life impairment in postmenopausal women: analysis of a multicenter latin american cross-sectional study. Menopause. 2017;24:645–52.Web of SciencePubMedCrossrefGoogle Scholar

  • [9]

    Morrison JH, Brinton RD, Schmidt PJ, Gore AC. Estrogen, menopause, and the aging brain: how basic neuroscience can inform hormone therapy in women. J Neurosci. 2006;26:10332–48.CrossrefPubMedGoogle Scholar

  • [10]

    Olatunji BO, Cisler JM, Tolin DF. Quality of life in the anxiety disorders: a meta-analytic review. Clin Psychol Rev. 2007;27:572–81.PubMedCrossrefGoogle Scholar

  • [11]

    Wikananda G. Hubungan kualitas hidup dan faktor resiko pada usia lanjut di wilayah kerja puskesmas tampaksiring i kabupaten gianyar bali 2015. Intisari Sains Medis. 2017;8:1–12.Google Scholar

  • [12]

    Patinan S, Esmaeilpour-Bandboni M, Mansour-Ghanaei R, Atrkar-Roshan Z. The relationship between chronic diseases and quality of life of elderly residing in nursing homes across guilan. Jundishapur J Chronic Dis Care. 2017;6:e57872.Google Scholar

  • [13]

    Shobeiri F, Jenabi E, Hazavehei SM, Roshanaei G. Quality of life in postmenopausal women in Iran: a population-based study. J Menopausal Med. 2016;22:31–38.CrossrefPubMedGoogle Scholar

  • [14]

    Van Malderen L, Mets T, Gorus E. Interventions to enhance the quality of life of older people in residential long-term care: systematic review. Ageing Res Rev. 2013;12:141–50.Web of SciencePubMedCrossrefGoogle Scholar

  • [15]

    Lutter M, Krishnan V, Russo SJ, Jung S, McClung CA, Nestler EJ. Orexin signaling mediates the antidepressant-like effect of calorie restriction. J Neurosci. 2008;28:3071–75.Web of SciencePubMedCrossrefGoogle Scholar

  • [16]

    Fond G, Macgregor A, Leboyer M, Michalsen A. Fasting in mood disorders: neurobiology and effectiveness. Rev Lit Psychiatry Res. 2013;209:253–58.CrossrefGoogle Scholar

  • [17]

    Furuncuoglu Y, Karaca E, Aras S, Yonem A. Metabolic, biochemical, and psychiatric alteratios in healthy subjects during Ramadan. Pak J Nutr. 2007;6:209–11.CrossrefGoogle Scholar

  • [18]

    Amin A, Sailesh KS, Mishra S, Reddy UK, Sriram N, Mukkadan JK. Effects of fasting during Ramadan month on depression, anxiety and stress and cognition. Int J Med Res Rev. 2016;4:771–74.Google Scholar

  • [19]

    Koushali AN, Hajiamini Z, Ebadi A, Bayat N, Khamseh F. Effect of Ramadan fasting on emotional reactions in nurses. Iran J Nurs Midwifery Res. 2013;18:232–36.PubMedGoogle Scholar

  • [20]

    Teng NI, Shahar S, Manaf ZA, Das SK, Taha CS, Ngah WZ. Efficacy of fasting calorie restriction on quality of life among aging men. Physiol Behav. 2011;104:1059–64.Web of ScienceCrossrefPubMedGoogle Scholar

  • [21]

    Saiyad S, Saiyad M, Patel U, Verma A. Effect of Ramadan fasting on anthropological and physiological parameters. NHL J Med Sci. 2014;3:59–62.Google Scholar

  • [22]

    Ajabnoor GM, Bahijri S, Borai A, Abdulkhaliq AA, Al-Aama JY, Chrousos GP. Health impact of fasting in Saudi Arabia during Ramadan: association with disturbed circadian rhythm and metabolic and sleeping patterns. PLoS One. 2014;9:e96500.CrossrefWeb of ScienceGoogle Scholar

  • [23]

    Bahammam AS, Nashwan S, Hammad O, Sharif MM, Pandi-Perumal SR. Objective assessment of drowsiness and reaction time during intermittent Ramadan fasting in young men: a case-crossover study. Behav Brain Funct. 2013;9:32.Web of ScienceCrossrefGoogle Scholar

  • [24]

    Lenze EJ, Mantella RC, Shi P, Goate AM, Nowotny P, Butters MA, et al. Elevated cortisol in older adults with generalized anxiety disorder is reduced by treatment: a placebo-controlled evaluation of escitalopram. Am J Geriatr Psychiatry. 2011;19:482–90.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [25]

    Zangeneh F, Abedinia N, Naghizadeh MM, Yazdi RS, Madani T. The effect of Ramadan fasting on hypothalamic pituitary ovarian (HPO) axis in women with polycystic ovary syndrome. Women Health Bull. 2014;1:e18962.Google Scholar

  • [26]

    El-Migdadi F, El-Akawi Z, Abudheese R, Bashir N. Plasma levels of adrenocorticotropic hormone and cortisol in people living in an environment below sea level (Jordan valley) during fasting in the month of Ramadan. Horm Res. 2002;58:279–82.Google Scholar

  • [27]

    Bahijri S, Borai A, Ajabnoor G, Abdul Khaliq A, AlQassas I, Al-Shehri D, et al. Relative metabolic stability, but disrupted circadian cortisol secretion during the fasting month of Ramadan. PLoS One. 2013;8:e60917.CrossrefWeb of ScienceGoogle Scholar

  • [28]

    Kandhalu P. Effects of cortisol on physical and psychological aspects of the body and effective ways by which one can reduce stress. Berkeley Sci J. 2013;18:14–16.Google Scholar

  • [29]

    Lee DY, Kim E, Choi MH. Technical and clinical aspects of cortisol as a biochemical marker of chronic stress. BMB Rep. 2015;48:209–16.Web of ScienceCrossrefPubMedGoogle Scholar

  • [30]

    Lahdimawan A, Handono K, Indra MR, Prawiro SR. Effect of Ramadan fasting on endorphin and endocannabinoid level in serum, PBMC and macrophage. Int J Pharm Sci Invent. 2013;2:46–54.Google Scholar

  • [31]

    Mousavi SA, Rezaei M, Baghni SA, Seifi M. Effect of fasting on mental health in the general population of Kermanshah, Iran. J Fasting Heal. 2014;2:65–70.Google Scholar

  • [32]

    Sulandari S, Wijayanti M, Sari RD. Religious activity: an alternative to achieve happiness in later life. J Educ Soc Sci. 2017;6:55–64.Google Scholar

  • [33]

    Shiah YJ, Chang F, Chiang SK, Lin IM, Tam WC. Religion and health: anxiety, religiosity, meaning of life and mental health. J Relig Health. 2015;54:35–45.CrossrefWeb of SciencePubMedGoogle Scholar

  • [34]

    Aghamohammadi Kalkhoran M, Karimollahi M. Religiousness and preoperative anxiety: correlational study. Ann Gen Psychiatry. 2007;6:1–5.CrossrefGoogle Scholar

  • [35]

    Nugraha B, Ghashang SK, Hamdan I, Gutenbrunner C. Effect of Ramadan fasting on fatigue, mood, sleepiness, and health-related quality of life of healthy young men in summer time in Germany: a prospective controlled study. Appetite. 2017;111:38–45.Web of ScienceCrossrefGoogle Scholar

  • [36]

    Martin CK, Bhapkar M, Pittas AG, Pieper CF, Das SK, Williamson DA, et al. Effect of calorie restriction on mood, quality of life, sleep, and sexual function in healthy nonobese adults: the CALERIE 2 randomized clinical trial. JAMA Intern Med. 2016;176:743–52.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [37]

    Etemadifar M, Sayahi F, Alroughani R, Toghianifar N, Akbari M, Nasr Z. Effects of prolonged fasting on fatigue and quality of life in patients with multiple sclerosis. Neurol Sci. 2016;37:929–33.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [38]

    Mahjoub AO, Abdelgadir E. The association between health-related quality of life and Ramadan fasting in diabetic patients: a survey using a structured D-39 assessment tool. Middle East Cohort J Fasting Heal. 2017;5:24–30.Google Scholar

  • [39]

    Altuntas YE, Gezen FC, Sahoniz T, Kement M, Aydin H, Sahin F, et al. Ramadan fasting in patients with a stoma: a prospective study of quality of life and nutritional status. Ostomy Wound Manage. 2013;59:26–32.PubMedGoogle Scholar

About the article

Received: 2017-12-07

Accepted: 2018-06-11

Published Online: 2018-10-12

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: We would like to thank the Directorate of Research and Community Services of Universitas Islam Indonesia (DPPM UII) for funding this research.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Complementary and Integrative Medicine, Volume 16, Issue 1, 20170172, ISSN (Online) 1553-3840, DOI: https://doi.org/10.1515/jcim-2017-0172.

Export Citation

© 2019 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Comments (0)

Please log in or register to comment.
Log in