| Summary: | Background: Ramadan fasting (RF) is a form of intermittent fasting that generally improves body composition and related metabolic profiles. Whether RF exacerbates depressive symptomatology in individuals diagnosed with major depressive disorder (MDD) is undetermined. Methods: 100 men, who lived in Bahrain and were between the ages of 18 and 64 years with an established diagnosis of MDD, participated in this 4-week study. Based on preference, participants were assigned to a fasting group (FG, <i>n</i> = 50) and a non-fasting group (NFG, <i>n</i> = 50). The FG engaged in fasting from 03:40 to 18:10 (dawn and dusk timings). Changes in depressive symptoms, body mass, body composition, and components of metabolic syndrome were measured. Results: There were no significant changes in depressive symptoms within the FG vs. NFG after controlling for baseline covariates: mean difference 0.49 (SE = 0.63), <i>p</i> = 0.43. No adverse effects were reported in either group. The FG experienced significant reductions in body mass, 1.87 kg, <i>p</i> = 0.001; body mass index, 0.69 kg/m<sup>2</sup>, <i>p</i> = 0.001; body fat, 0.87%, <i>p</i> = 0.001; body surface area, 0.03 m<sup>2</sup>, <i>p</i> = 0.001; and lean mass, 0.77 kg, <i>p</i> = 0.001. Conclusions: RF did not negatively affect depressive symptoms and improved body composition, suggesting short-term intermittent fasting may be a safe dietary practice for adult males with MDD.
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