The Rufaida Project: Researching the Impact of Ramadan Fasting on the Gut and Vaginal Microbiome

Condition(s) studied

Study summary

The body's systems are deeply connected, but they are often studied separately. A recent large-scale citizen-science project on women's health, called Isala, discovered a group of gut-related bacteria present in the vaginal microbiome. This finding supports the idea that gut and vaginal bacteria interact closely, a connection known as the gut-vagina axis. However, it remains unclear whether changes in gut bacteria influence the vaginal microbiome.

This discovery led to an exploration of how diet affects both the gut and vaginal microbiomes. In the gut, bacteria rely on carbohydrates from food, while in the vagina, bacteria feed on glycogen, a sugar stored in the vaginal lining. This glycogen is broken down into smaller sugars, which beneficial Lactobacillus bacteria use for fermentation. Since starch is a major source of these sugars, researchers suspect that a starch-rich diet may support Lactobacillus growth, which in turn promotes vaginal health.

To test this hypothesis, the Rufaida Project was launched. Ramadan is characterised by a fasting period of approximately one month during which participants abstain from eating between sunrise and sunset. Ramadan provides a unique opportunity to study how fasting affects the microbiome under controlled conditions.

In this study, 50 Muslim women will be asked to provide vaginal and stool samples at eight predetermined time points-before, during, and after Ramadan. These samples will be analysed using 16S rRNA amplicon sequencing to determine bacterial composition. Comparative analysis will be conducted between samples across different time points and anatomical sites. The objective is to understand how fasting and dietary changes influence the gut and vaginal microbiomes, and whether gut bacteria play a role in shaping vaginal health. Additionally, participants will complete weekly health questionnaires. An additional study group of up to 300 Muslim women will complete weekly questionnaires without providing biological samples.

This research could improve understanding of the links between diet, gut health, and vaginal health, potentially leading to new strategies for enhancing women's well-being through nutrition.

Eligibility

Primary outcome measure(s)

• Characterizing the gut and vaginal microbiome in relation to dietary components and meal frequency during ramadan using 16S rRNA sequencing — up to 4 years
  To investigate the potential influence of dietary components and meal frequency on the gut and vaginal microbiome, vaginal and stool samples will be collected from participants before, during, and after a period of intermittent fasting (Ramadan). Bacterial community composition will be determined using 16S rRNA amplicon sequencing by Illumina MiSeq analysis. Bioinformatic tools will be employed to assess taxonomic profiles across different time points and anatomical sites. Particular attention will be given to correlations between gut- and vaginal-associated microbial taxa, with the aim of identifying bacterial signatures potentially shaped by dietary changes and fasting patterns. The analysis will further explore whether specific gut microbiota are associated with the presence or modulation of vaginal microbial communities, with a focus on health-promoting taxa such as Lactobacillus species.

Trial sites (1)

More University Hospital, Antwerp trials in Belgium

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