Determinants of body weight changes during Ramadan fasting in India amid COVID-19: A cross-sectional study.

Ramadan intermittent fasting (RIF) presents unique challenges and opportunities for public health and clinical practice, especially in populations with a high prevalence of non-communicable diseases. This study aims to investigate the impact of RIF on weight change among Indian Muslims and explore the associated demographic, dietary, and behavioral factors. A cross-sectional survey was conducted with a sample of Indian Muslim adults who observed RIF. Participants were asked to report their demographic information, family and personal health history, and dietary and lifestyle behaviors before and during Ramadan month. The primary outcome was body weight change, with secondary outcomes including changes in dietary patterns, physical activity, and other health-related lifestyle behaviors. The study found that during Ramadan, nearly half of the participants (48.5%) self-reported a retained initial weight, while a significant fraction (30.9%) self-reported a modest weight reduction between 0.5 to 2.5 kg at the end of Ramadan. Additionally, self-reported eating practices demonstrated moderately altered by about half (48.4%) of the study participants, with 32.2% reporting minor changes and 8.2% indicating substantial changes. An urban residence was associated with a higher likelihood of weight gain, where urban residents showed 3 times the odds of increased weight compared to rural inhabitants. Employment status emerged as a significant determinant for weight fluctuation, influencing both weight gain and loss. During Ramadan, there was a significant rise in snacking frequency, increasing from 21.7% to 32.6% in comparison with pre-Ramadan. The consumption of large quantities of food more frequently grew from 14.9% to 36%, and the incidence of eating despite not being hungry went up from 17.4% to 33.2%. The study demonstrates that RIF is associated with variable changes in body weight among adult Indian Muslims, influenced by urbanization, employment status, and dietary changes. The findings suggest that clinicians should provide tailored advice about body weight regulation during Ramadan and consider integrating community-based health initiatives within religious settings to improve health outcomes.

Body mass index and sleep disturbances: a systematic review and meta-analysis.

Purpose: Overweight and obesity have been common non-communicable diseases in recent years that have far-reaching health effects. This study aimed to study the risk of sleep disturbances based on overweight and obesity using a systematic review and meta-analysis. Views: Three sources of scientific information, namely PubMed, Scopus, and Embase, were selected as scientific databases and searched for articles published in English until May 2021. Also, a manual search on related articles was done. The resulting data required a meta-analysis based on odds ratios, which were extracted and then pooled. The odds ratio was calculated based on the random-effects method. Publication bias and the degree of heterogeneity were studied. Twenty-one longitudinal studies were selected for this meta-analysis. The odds ratio (OR) in this association between body mass index (BMI) ≥ 25 and sleep disturbances was 1.33 and the confidence interval (CI) was between 1.16-1.51. This OR was 1.12 and CI was between 0.98-1.29 in overweight. The OR was 1.24 and CI was between 1.07-1.44 in obesity. The OR was 1.92 and CI was between 0.89-4.15 in men. The OR was 1.47 and CI was between 1.15-1.89 in women. Publication bias and heterogeneity were evident in the meta-analysis. Conclusions: Obesity increases the risk of sleep disturbances in the long term, and both obesity and sleep disturbances have negative effects on health, so it is necessary to develop appropriate interventions to improve obesity.

Prevalence of non-suicidal self-injury, suicidal ideation, suicide attempts, suicide mortality in eating disorders: a systematic review and meta-analysis.

Eating disorders have a wide and profound impact on psychological and general health. The study aims to provide a comprehensive and up-to-date review of non-suicidal self-injury, suicidal ideation, suicide attempts, and suicide mortality in a variety of eating disorders. A systematic search was conducted using four databases from inception until April 2022, limiting the search to English-language. For each of the eligible studies, the prevalence of suicide-related issues in eating disorders was calculated. The prevalence of non-suicidal self-injury, suicide ideation, and suicide attempts was then calculated for each anorexia nervosa and bulimia nervosa. The random-effects method was used for the pool of studies. Fifty-two articles were used for this study and included in the meta-analysis. The prevalence of non-suicidal self-injury is 40% with a confidence interval between 33-46% (I2 97.36%). The prevalence of suicide ideation is 51% with a confidence interval between 41-62% (I2 97.69%). The prevalence of suicide attempts is 22% with a confidence interval between 18-25% (I2 98.48%). The heterogeneity in the studies included in this meta-analysis was high. There is a high prevalence of non-suicidal self-injury, suicidal ideation, and suicide attempts in eating disorders. Thus, comorbidity between eating disorders and suicide issues is an important topic that can provide insights into etiology. Future studies must consider eating disorders along with other types of mental health issues, such as depression, anxiety, sleep problems, and aggression.

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.

Background: Of 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. Methods: This 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. Results: In 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. Conclusion: Increasing 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.

Depression symptoms reducing return to work: a meta-analysis of prospective studies.

Objectives. This study was conducted to estimate the risk of return to work for people who experience symptoms of depression based on the pool of prospective data. Methods. All online articles in PubMed and Scopus which were accessible before November 2019 were searched. The odds ratios of each of the studies were pooled together to obtain an overall odds ratio. The pool of studies was with random effects. The analysis was performed based on the depression symptoms scale, type of disease and duration of follow-up. Two other aspects were examined in the analysis, one being the bias in the publication of studies and the other being the level of heterogeneity that was examined. Results. Thirty-five studies were selected for the meta-analysis. The pooled odds ratio indicates that the odds of return to work in people with depressive symptoms is 31% lower than in those without depressive symptoms. The funnel plot shows that there is asymmetry. The Egger test result was significant (p < 0.001) and there is publication bias. Conclusion. Depression symptoms after sick leave due to physical illness is a risk factor for not returning to work.

Longer working hours and musculoskeletal pain: a meta-analysis.

Objectives. Musculoskeletal pain is the most common health problem in the workplace, and one of the most important risk factors for this pain is longer working hours. This study aimed to investigate the association between long working hours and musculoskeletal pain. Methods. Based on the keywords, two scientific sources - PubMed and Embase - were reviewed. The time limit search included articles that were published until May 2020 and only studies published in English were eligible. The results of the studies were combined based on random effects and pooled odds ratio (OR) reported. The degree of heterogeneity in all analyses was investigated and reported based on χ2 and I2 tests. Publishing bias was also measured using statistical tests. Results. Longer working hours are associated with increased musculoskeletal pain with OR = 1.11 and 95% confidence interval (CI) [1.08, 1.14]. The result was OR = 1.52 and 95% CI [1.14, 2.03] in men and OR = 1.11 and 95% CI [1.00, 1.24] in women. Conclusion. Long working hours are an important and threatening factor for musculoskeletal health. Therefore, this issue should be considered in health policy as well as treatment and prevention.

Sleep quality and sleep-related issues in industrial workers: a global meta-analysis.

Objectives. Sleep-related issues are important health issues. This study aimed to investigate the global prevalence of sleep-related issues in industrial workers. Methods. A syntax of keywords was used to search the PubMed, Web of Science and Scopus databases. The search time was limited to articles published until September 2020, and the search range was in English. Events and samples were extracted for each study to calculate the prevalence. For all subgroups, events and samples were extracted to calculate the results of the subgroups. The random-effects method was used in the analysis. Heterogeneity was examined at the levels of all analyses. Results. Forty-eight articles were included in the analysis as eligible studies. Sleep-related issues have 30% prevalence in the 95% confidence interval (CI) [25, 35%]. The prevalence of sleep-related issues in men was 38%, 95% CI [31, 45%] and in women was 32%, 95% CI [14, 50%]. The prevalence of poor sleep quality, insomnia, sleep duration <7 h, snoring and sleepiness was 36, 22, 37, 29 and 10%, respectively. Conclusions. Sleep-related issues have a high prevalence in industrial workers, and the cause of these differences needs to be addressed and increasing insights provided to prevent and treat sleep disorders.

Digital interventions for smoking abstinence: a systematic review and meta-analysis of randomized control trials.

OBJECTIVES: Technological advancements have improved patients' health and clinical care through digital interventions. This study investigated the effects of digital interventions on smoking abstinence. METHODS: PubMed, the Cochrane Library, and Scopus were systematically searched from inception until December 2021. Meta-analysis was carried out using a random-effects model. The degree of heterogeneity, quality, and publication bias of the selected studies was further evaluated. RESULTS: A total of 43 randomized control trial studies were eligible for this study. 38,814 participants from 18 countries were included in the analysis. Digital interventions on seven-day point prevalence abstinence (1 month) showed increased smoking abstinence. The odds ratio was 2.02 and confidence interval (CI) was 1.67-2.43; p < 0.001; I2 = 55.1%) . The result for a 30-day point prevalence abstinence (1 month) was 1.63 (CI 1.09-2.46; p = 0.018; I2 = 0%). Digital intervention also had a significant effect on continuous abstinence (odds ratio = 1.68; CI 1.29-2.18; p < 0.001; I2 = 70.1%) and prolonged abstinence (odds ratio = 1.60; CI 1.19-2.15; p = 0.002; I2 = 53.6%). There was evidence of heterogeneity and publication bias. CONCLUSIONS: Digital interventions led to increased smoking abstinence and can be a valuable tool in smoking cessation. Further research is required to evaluate the long-term impact of digital interventions on outcomes related to smoking cessation.

Exercise training and depression and anxiety in musculoskeletal pain patients: a meta-analysis of randomized control trials.

BACKGROUND: Depression and anxiety in patients with musculoskeletal pain harm health and exercise can be effective in improving the condition of these patients. This study was aimed at systematically reviewing and providing a meta-analysis of the effect of exercise training on improving depression and anxiety in patients with musculoskeletal pain. METHODS: The search was done in three databases including PubMed, the Cochrane Library, and Google Scholar up to August 2021. For each of the studies included in the meta-analysis, the mean, standard deviation, and sample size were extracted in the post-test, and the effect size was calculated. Publication bias and heterogeneity were assessed in studies at the end of the analysis. RESULTS: Nineteen randomized control trials were included in the meta-analysis. Exercise training has a positive effect on depression in patients with musculoskeletal pain, so exercise reduces depression and Hedges' g was equal to -0.21, with confidence intervals of -0.40, -0.02. Exercise training has a positive effect on anxiety in patients with musculoskeletal pain, so exercise reduces anxiety and Hedges' g was equal to -0.63, with confidence intervals of -1.08, -0.19. CONCLUSIONS: It was found that exercise training is effective in improving depression and anxiety in patients with musculoskeletal pain and therefore this treatment should be given more attention from clinical specialists.

The effect of exercise on health-related quality of life in persons with musculoskeletal pain: A meta-analysis of randomised control trials.

OBJECTIVES: Exercise has positive effects on musculoskeletal pain. In this project, the impact of exercise was studied on improving health-related quality of life in persons with musculoskeletal pain. METHOD: The study design was a systematic review and meta-analysis. A search was conducted to find original studies in four sources, including PubMed, Web of Science, the Cochrane Library and Scopus, and this search was limited to the original articles published until April 2021, which were in English. For each study, the effect size was calculated. The analysis was based on the random-effects method. RESULT: Twenty-Seven randomised control trial studies were included in the meta-analysis. The total population of participants in the meta-analysis was 1927 persons. Exercise improves health-related quality of life in these persons and the hedges' g was 0.66 (95% CI = 0.38-0.94; I2  = 88.29%). DISCUSSION: Overall, based on the findings, exercise is associated with improving the health-related quality of life of persons with musculoskeletal pain, and therefore the health implications of this finding are beneficial to the general population and professionals.

Global prevalence of anxiety and PTSD in immigrants: a systematic review and meta-analysis.

BACKGROUND: A systematic and meta-analysis of the prevalence of anxiety and posttraumatic stress disorder (PTSD) in immigrants was conducted. METHODS: Based on the keywords, scientific databases were systematically searched to identify articles. The search included the three databases PubMed, Google Scholar and Research Gate until June 2020. The analysis was performed to assess the prevalence of anxiety and PTSD; subgroups were examined based on anxiety disorders. RESULTS: The prevalence of agoraphobia, PTSD, generalized anxiety disorder (GAD), panic disorder, obsessive-compulsive disorder (OCD), social phobia and specific phobia were 4, 25, 9, 4, 3, 5 and 8%, respectively. CONCLUSIONS: Considering the findings of the present study regarding the significant prevalence of anxiety and PTSD in the immigrant population, it is necessary to pay special attention to the mental health of this population.

Prevalence of Suicide in Immigrants/Refugees: A Systematic Review and Meta-Analysis.

OBJECTIVE: In recent years, there has been an increase in immigrant populations worldwide. This study aims to present the global prevalence of suicide between immigrants and refugees as well as to report the prevalence of suicide ideation, suicide mortality, suicide attempts, and plan of suicide. METHOD: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA's) rules were used as a guide in the current research path. PubMed and EMBASE were targeted for the study until December 2019. After collecting the data, the number of events and sample size extracted for each study and also pooled odds ratio and confidence interval (CI) were used to investigate the suicide ratio among immigrants and refugees compared to the native population. RESULTS: Fifty-one studies were included in the meta-analysis to investigate suicide prevalence or suicide odds ratio. The prevalence of suicidal ideation was 16% (CI: 0.12-0.20, I2 = 99.4%), for attempted suicide was 6% (CI: 0.05-0.08, I2 = 98.0%), and for suicide plan prevalence was 4% (CI: 0.00-0.08, I2 = 96.8%). The prevalence of suicidal ideation was 10% (CI: 0.04-0.17, I2 = 0.0%) in men and 17% (CI: 0.10-0.24, I2 = 96.8%) in women. The prevalence of attempted suicide was 1% (CI: 0.01-0.02, I2 = 0.0%) in men and 7% (CI: 0.03-0.10, I2 = 94.4%) in women. The odds ratio of suicide mortality among immigrants was 0.91 (CI: 0.90-0.93, p < 0.001; I2 = 97.6%) and for attempted suicide was 1.15 (CI: 1.10-1.20, p < 0.001; I2 = 92.0%). Begg's test (p = 0.933) (Egger test; p = 0.936) rejected publication bias. CONCLUSION: Given the high prevalence of suicide, especially suicide ideation and suicide attempts in immigrants, increased attention needs to be paid to the mental health of this population.

Prevalence of depression disorder in industrial workers: a meta-analysis.

Objectives. Depression is known to be associated with a variety of occupational factors. The aim of this study was to meta-analyze the prevalence of depressive disorder in industrial workers. Methods. Three databases indexing abstracts of articles were selected and searched until August 2020: PubMed, Web of Science and Scopus. For each study, the sample size and number of depression events were extracted, and after extracting these data, the random effects method was used to assess the prevalence. I2 and χ2 values were used to investigate the heterogeneity. Results. The prevalence of depressive disorder in industrial workers is 21%. The prevalence of depressive disorder in men and women industrial workers is 23 and 28%, respectively. The prevalence of depressive disorder in Asia, Europe and America is equal to 22, 18 and 20%, respectively. The result of the heterogeneity test showed that the heterogeneity is high. Conclusion. The prevalence of depression in industrial workers is higher than in the general population. These differences can be due to the working conditions of industrial workers. Therefore, the work environment and the promotion of occupational health can play an important role in preventing depression.

Unemployment associated with major depression disorder and depressive symptoms: a systematic review and meta-analysis.

Objectives. This study investigated the association between unemployment and depressive symptoms and major depression disorder worldwide using a systematic review and meta-analysis. Methods. Search time was limited to all articles published in English until December 2020. In the association between unemployment and depression, first, the results of qualified studies were extracted and, then, the results of each study were pooled with each other using the random effects method. Results. The prevalence of depression in the unemployed is 21%, 95% confidence interval (CI) [18, 24%]. This prevalence for depression symptoms is 24%, 95% CI [20, 28%] and for major depressive disorder is 16%, 95% CI [9-24%]. The association between unemployment and depressive symptoms was odds ratio (OR) 2.06, 95% CI [1.85, 2.30] and the association for major depressive disorder was OR 1.88, 95% CI [1.57, 2.25]. The association between unemployment and depression in men was OR 2.27, 95% CI [1.76, 2.93] and in women was OR 1.62, 95% CI [1.40, 1.87]. Conclusions. What is clear from the present study is that unemployment can lead to a higher prevalence of depressive symptoms and major depressive disorder, thereby undermining the mental health of the unemployed.

Smoking and alcohol use in unemployed populations: a systematic review and meta-analysis.

Unemployment is an economic and social phenomenon that has economic, social, personal, and health consequences. This study aimed to investigate the relationship between unemployment and alcohol use and smoking as a systematic review and meta-analysis.The two databases PubMed and Scopus were selected for the search and using a set of keywords, these two sources of scientific information were searched from 2004 to June 2021 and 1996 until June 2021, respectively. To meta-analyze the relationship between unemployment and smoking and alcohol use, odds ratio and confidence interval were calculated for this relationship. The meta-analysis was performed based on a random-effects. Subgroups were also performed for men and women. Heterogeneity in studies as well as publication bias were also examined.A total of 52 cross-sectional and cohort studies were included in the meta-analysis. In the relationship between unemployment and alcohol use, the odds ratio was 1.25 and the confidence interval was between 1.12 and 1.41. In the relationship between unemployment and smoking, the odds ratio was 1.43 and the confidence interval was between 1.13 and 1.81.According to the results, it can be said that unemployment increases the likelihood of alcohol use and smoking. Therefore, policymakers must pay more attention to the health consequences of economic problems, especially unemployment.

Effect of exercise training on improving sleep disturbances: a systematic review and meta-analysis of randomized control trials.

OBJECTIVES: Exercise training has beneficial effects on various aspects of health. This study aimed to investigate the effect of exercise training on the improvement of sleep disturbances using systematic review and meta-analysis of randomized control trials. METHOD: Four indexes of scientific information including PubMed, Web of Science, Scopus, and the Cochrane library were selected and all manuscripts of these sources were searched in English until January 2021. The studies were screened and finally, the studies were entered into meta-analysis and the Standardized Mean Difference (SMD) was calculated, and the analyzes were performed based on the random effects method. Publication bias and heterogeneity were examined in all analyzes. RESULT: A total of 32 studies were included in the meta-analysis. Meta-analysis showed that exercise training is effective in improving sleep quality (SMD = -0.85 and confidence interval (CI) was -1.16-0.54; P < 0.001). Exercise training improving insomnia (SMD = -0.87 and CI was -1.68-0.06; P = 0.036). Exercise training improves sleepiness (SMD = -0.38 and CI was -0.68-0.07; P = 0.016), obstructive sleep apnea (SMD = -0.40 and CI was -0.67-0.14; P = 0.003) and restless legs syndrome (SMD = -1.02 and CI was -1.56-0.49; P < 0.001). DISCUSSION: Exercise training has beneficial effects on a variety of sleep disturbances and therefore it can be said that providing the necessary conditions for exercise training can play a major role in promoting health, especially since this type of intervention is a non-pharmacological intervention.

Depression symptoms and risk of sick leave: a systematic review and meta-analysis.

OBJECTIVES: Depression symptoms are one of the most common psychiatric disorders and affect all aspects of life. The impact of depression symptoms on sick leave in the working population is a major issue that requires a more comprehensive examination. METHODS: This systematic review used the PRISMA method to identify eligible studies (n = 15). Subsequently, the association between depression symptoms and sick leave was examined and several important subgroup analyses were performed. RESULTS: Depression symptoms were associated with sick leave, with an overall risk ratio (RR) of 1.52 [95% confidence interval (95% CI) 1.34-1.73]. In men, the result displayed RR 2.19 (95% CI 1.17-4.09) and in women, the result showed RR 1.54 (95% CI 1.35-1.76). Additional subgroup analyses that account for methodological differences across studies based on the method of assessing depression symptoms and sick leave showed that this association was consistent. CONCLUSION: Depression symptoms are associated with sick leave. Given that sick leave can have an economic and social burden, more attention to depression symptoms is necessary.

Parental divorce and offspring smoking and alcohol use: a systematic review and meta-analysis of observational studies.

OBJECTIVE: This study was conducted to investigate the relationship between parental divorce and smoking and alcohol consumption in offspring, which is based on a systematic review method and ultimately meta-analysis. Method: In a systematic search, three databases were selected. The manuscripts were searched based on the keywords and the time limit for the search was published manuscripts in English until November 2020. For the relationship between parental divorce and smoking/alcohol use in offspring, one main analysis, and four analyses based on sex, study design, adjusted level, and continents were performed. Result: Forty-three studies were synthesized from the collection of manuscripts. The odds of smoking in offspring whose parents were separated was 1.45 (CI 1.37-1.54) and this odds in men was equal to 1.38 (CI 1.11-1.71; Z = 2.91; p = 0.004; I2 = 81.5%) and in women, 1.78 (CI 1.51-2.10; Z = 6.88; p < 0.001; I2 = 69.6%). The odds of alcohol use in offspring whose parents were separated was 1.43 (CI 1.15-1.77) and this odds in men was equal to 1.69 (CI 1.16-2.47; Z = 2.73; p = 0.006; I2 = 99.6%) and in women 1.79 (CI 1.07-2.99). Discussion: The findings of the present study can be used in health-related policies, prevention, and clinical interventions. This study was a subject with limitations, also.

Prevalence of current and former smoking in industrial workers worldwide: a systematic review and meta-analysis.

OBJECTIVES: One of the health problems in recent decades is the prevalence of smoking in the world. In this study, the global prevalence of smoking in industrial workers was investigated using meta-analysis. METHOD: The method of the present study was a systematic review and meta-analysis. Three scientific sources, PubMed, Web of Science, and Scopus, were selected for the search, and these databases were searched until September 2020. Random effects method was used for the analysis and then the analysis was performed for the type of smoking (Current, Former), gender, and continent. Heterogeneity was examined in all analyses. RESULT: A total of 88 studies were included in the meta-analysis. The prevalence of smoking in industrial workers was 41% also the confidence interval was 35-48%. The prevalence of current smoking in industrial workers was 39% also the confidence interval was 29-48%. The prevalence of former smoking in industrial workers was 18% also the confidence interval was 13-22%. I2 heterogeneity test was 99.9%. DISCUSSION: From the findings of the present study, it can be seen that industrial workers are more exposed to smoking compared to the general population, and this can put their health at greater risk.

The prevalence of depression symptoms after smoking cessation: a systematic review and meta-analysis.

Objectives: Smoking cessation can have positive effects on people's health, especially mental health. This study aimed to address the prevalence of depression in the smoking cessation population. Methods: In the present meta-analysis study, PRISMA protocol was used. Two databases, PubMed and Scopus, were selected. Articles in these two databases in English were targeted and the search was limited to July 2020. First, the results related to the prevalence of depression were calculated. The results were pooled. Results: Forty-nine articles with different designs were eligible for meta-analysis. The prevalence of depression in the smoking cessation population was 18% and the confidence interval was 14-22%. The highest depression prevalence was in Asia and Europe, followed by America. The prevalence of major depression in the smoking cessation population was 15% and the prevalence of depressive symptoms was 17%. The smoking cessation population had a lower odds of depression than current smokers (OR= 0.63 CI = 0.54-0.75; I2 83.9%). There was little evidence for publication bias. Discussion: The status of depression in the smoking cessation population is different from that of nonsmokers and current smokers. Therefore, in terms of health policy and encouraging people to smoking cessation, the issue of its positive effects on mental health should be emphasized.