Katerina Sarri · British Journal Of Nutrition 2004 · prospective controlled cohort study · n=120

Greek Orthodox fasting rituals: a hidden characteristic of the Mediterranean diet of Crete

Cited 119 times in the scientific literature.

Level 3 - non-randomized controlled study

Prospective non-randomized controlled cohort study with parallel control group

OpenAlex W2078215485 · doi:10.1079/bjn20041197 · record verified 2026-08-28

What was done

A 1-year prospective cohort study in Crete compared 60 regular Greek Orthodox Church fasters with 60 non-fasting controls across three fasting periods: Christmas (40 days), Lent (48 days), and Assumption (15 days). Dietary intake was evaluated using 24-hour recalls alongside blood and anthropometric measurements at the beginning and end of each fasting period.

What was found

Compared with controls at the end of fasting periods, fasters had significantly lower intakes of dietary cholesterol, total fat, saturated fatty acids, trans-fatty acids, and protein (all P < 0.001). Fasters decreased daily energy intake by 753 kJ (180 kcal, P < 0.05), whereas controls increased daily energy intake by 573 kJ (137 kcal, P < 0.05). Fasters also showed reduced calcium intake (P < 0.001), but higher intake of dietary fiber (P < 0.001) and folate (P < 0.05) driven by increased fruit and vegetable consumption (P < 0.001). There were no differences in other vitamins or minerals between periods except for vitamin B2.

Why it matters

This study demonstrates that religious fasting rituals are a structural component of the traditional Cretan Mediterranean diet, periodically reducing dietary saturated fats and caloric intake while boosting plant-derived nutrients.

Limits

The study is observational and non-randomized with a modest sample size (n = 120) restricted to a single geographic region (Crete). Dietary assessment relied on 24-hour recalls, which are subject to recall bias, and the abstract does not report the blood or anthropometric outcome data.

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