Role of Ramadan Fasting-Induced Gut Microbiota Restructuration in Cognitive Function: A Scoping Review

Emerging evidence underscores the vital role of the gut–brain axis in neurological health, where gut microbiota and their metabolites significantly influence cognitive and neural functions. This review explores the effects of Ramadan fasting (RF), a culturally and religiously distinctive form of intermittent fasting (IF) on gut microbiota composition and its downstream impact on brain health and cognition. Unlike conventional IF, RF involves prolonged daily abstinence from both food and water, leading to unique metabolic and circadian adaptations. Current findings indicate that RF enhances microbial diversity, increases beneficial bacteria such as Akkermansia muciniphila and Lactobacillus, and modulates metabolites including short-chain fatty acids, bile acids, and tryptophan derivatives. These microbiota-driven changes help regulate neuroinflammation, oxidative stress, synaptic plasticity, and neurotrophic signaling pathways such as brain-derived neurotrophic factor (BDNF) and sirtuin-3 (SIRT3). The review further examines evidence linking Ramadan and other intermittent fasting regimens to neuroprotection in disorders including Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, multiple sclerosis, ischemic stroke, and epilepsy. Fasting-induced gut microbiota modulation appears to enhance cognitive resilience, mitochondrial biogenesis, and intestinal barrier integrity. Despite encouraging preclinical findings, clinical data remain limited and heterogeneous. Future studies should employ well-designed, large-scale longitudinal approaches integrating multi-omics analyses to clarify the mechanistic links between fasting, gut microbiota modulation, and brain function. Overall, Ramadan fasting emerges as a promising non-pharmacological strategy to promote neurological health through targeted regulation of the gut–microbiota–brain axis.