Table 1: Areas that merit further research.

Areas of interest

Current knowledge and future directions

Dates and obesity

‘Ajwa’ (a variety of Saudi dates) has been demonstrated to have antioxidant, anti-inflammatory and cardioprotective properties in animal models [74]. However, there are limited on its effect in humans. It has been postulated that leptin resistance is probably involved in the pathogenesis of obesity, and the effects of Ajwa dates on weight maintenance/loss can be investigated.

Black seeds and obesity

A recent trial showed that the consumption of black seeds and turmeric improved metabolic parameters in patients with metabolic syndrome [75]. Further research over longer periods should be conducted to investigate the effect of black seeds on body weight.

Dietary regimens that alter gut microbiota

Gut microbiota plays an important role in weight maintenance [76]. Previous researches suggest that honey [77] and yogurt [78] help in maintaining healthy gut flora and promote weight stability. Another study suggests that dates alter gut microbiota and prevent colorectal cancer [79]. Further randomized controlled trials are however recommended to investigate this finding.

Systematic reviews on the benefits of Ramadan fasting, fasting and weight maintenance, as well as the effect of Thursday and Monday fasting

Fasting and weight gain/loss are major areas of interest for researchers [80]. Randomized controlled trials/meta analyses should be conducted to explore the long-term effects of different fasting regimens in obese patients.

The association between Ramadan fasting and sleep patterns

It has been suggested the sleep-wake cycle is altered during Ramadan [81]. In addition, it is known that eating patterns in Ramadan have implications on body metabolism and biochemical markers and fasting causes an increase in the levels of high-density lipoprotein [81]. Randomized controlled trials should be conducted to explore the effects of fasting on health, including its effect on glucose homeostasis, insulin metabolism, and blood pressure [81].

Breastfeeding

Findings from a meta-analysis suggest that breastfeeding is a significant protective factor against obesity in children [48]. Nevertheless, more research has to be conducted to investigate the association between breastfeeding and obesity.