By Dr. Asna Urooj. Chairperson, Department of Studies in Food Science and Nutrition, University of Mysore

Healthy adult Muslims all over the world, observe fasting during Ramadan, the ninth month in the Islamic calendar. They do so not to lose weight or any medical benefit but as it is ordained in Quran which says, “O you who believe! Fasting is prescribed to you, as it was prescribed for those before you (that is, Jews, and Christians) so that you may (learn) self-restraint.” (2:183)

Who are exempt  from fasting?

According to Islamic laws, children below the age of 12, patients, travellers, and women who are menstruating or nursing a baby are exempt.

Fasting involves a total abstinence from food and fluid consumption from dawn to dusk and also stay away from sex, smoking or misconduct. Special prayers ‘Tarawih’ are offered at night. It signifies sacrifice, giving, piousness, self-training and empathy with the impoverished. Indeed, the essence is spiritual nonetheless; the holy month offers several benefits for both mind and the body. [The Holy Month of Ramadan (Ramzan) commenced on May 7 (Tuesday) and fasting also began the same day]

During the ongoing month of Ramadan, eating patterns change. Individuals consume two relatively large meals, one before the dawn (Sehri) and the other right after the sunset (Iftar). The alteration in circadian rhythm is also of significance. People are more active after sunset and in the night and they may also become sleep-deprived.

In a narration of Abu Nuaim, Prophet Mohammad (PBUH) said, “soomo wa tsahhoo”, which can be translated to mean, “Fast and be healthy.”

 Even science has proven that Ramadan is a month full of blessings. The International Congress on “Health and Ramadan” held in Casablanca in 1994, covered 50 studies on medical ethics of Ramadan and noted various improvements in the health conditions of those who fast. The conclusions of these presentations were that Ramadan fasting had beneficial effects on health especially on blood glucose, blood pressure, lipid profile and weight. No serious adverse effects were noted.

If any negative effects were seen at all, it was in those who over-indulge in food at Iftar or do not sleep well at night. One should be aware fasting will be dangerous to your health such as in Type 1 Diabetics, you are not recommended to fast as your medical condition may worsen. For those who can fast, read on to learn about some of the incredible health benefits of fasting on our overall well-being. The impact of fasting on health is the most commonly researched religious fasting worldwide.

What does Science say?

Fighting cancer: The duration of fasting ranges from 8 hours to 14 hours around the world and this starvation is ideal for the autophagy process known as ‘Self Eating’ in Greek. Japanese Nobel Peace Prize winner scientist, Yoshinori Ohsumi has suggested that fasting during Ramadan can make your body fight cancer. He emphasises that the ideal time for autophagy to fight cancer cells is 8-14 hours of starvation for approx 25-28 days annually. It is amazing that even in the state of worship the Almighty protects us from deadly cancer and many others which are yet to be discovered.

Body weight and composition: Changes in eating habits may lead to a reduction in frequency of food and beverage intake which in turn lead to a decline in energy intake, loss of body weight and a state of dehydration. The latter is reflected in body weight reduction and changes in biochemical parameters related to body water status. The reduction of body weight has been reported but the connection between weight loss and body fat reduction is not investigated.

Fasting and GI system: Healthy individuals might experience minor Gastrointestinal (GI) symptoms but no serious complications have been reported. However, those suffering from digestive disorders including peptic ulcer must seek medical advice as Ramadan fasting seems to increase peptic ulcer complications (peptic ulcer perforation and bleeding) and have a deteriorating effect on patients with chronic peptic ulcer diseases on drug therapy.

Blood lipid profile: Studies report reductions in bad “LDL” cholesterol, triglyceride and increases in good “HDL” levels thereby protecting your heart from cardiovascular disease.

Diabetes: Fasting lowers blood glucose and insulin level, causing breakdown of glycogen from liver to provide glucose for energy need and breakdown of fat from adipose tissue to provide for energy needs. Diabetes controlled by diet alone can fast and hopefully with weight reduction, their diabetes may even be improved. Diabetics who are on oral hypoglycaemic drugs along with the diet must be cautious. They should consult their physician regarding the drug time and dosage and preferably take the drug with Iftar in the evening. Diabetics on insulin should fast under close medical supervision and make suitable changes in the insulin dose.

One must consult a nutritionist to select the right food ingredients particularly sources of carbohydrates, proteins and fats to provide the ‘lente’ effect (sustained release of nutrients).

They must avoid or minimise desserts/ sweet snacks common in Ramadan and monitor their blood sugar before breakfast and after ending their fast. If blood sugar is below 70mg/dl, one may feel dizzy, trembling, palpitations, sweaty and feel tired/ fatigued. If these symptoms are present they may have to break the fast and take fruit juice/ glucose drink/ tender coconut water and after 10-15 minutes have a snack/ small meal. Never ignore the warnings of hypoglycaemia.

Hypertension: Fasting during Ramadan results in lowering of blood pressure in hypertensive subjects with controlled and mild hypertension with prompt medication.

Pregnancy: Fasting in well-nourished pregnant woman has no adverse effect on the offspring. However, the Prophet (PBUH) said pregnant and nursing women need not fast as the Almighty Allah doesn’t want even a small foetus, to suffer.

In my own opinion, during the first and third trimester, women should not fast. If in the second trimester (4-6 months) of pregnancy, women may fast provided that (1) Her own health is good, and (2) It is done with the permission of her obstetrician and under close supervision. The possible damage to the foetus may not be from malnutrition provided the Iftar and Sehri are adequate, but from dehydration, from prolonged (10-14-hour) abstinence from water.

Scientific studies reveal Ramadan fasting has health protective effects. However people with diabetes, hypertension, CVD and chronic diseases  must consult their physician and dietician to fast.

Other benefits

Addictions can come in all shapes and forms and Ramadan provides an excellent opportunity to ditch them. Because Ramadan teaches self-restraint for most of the day, we may realise that forgoing our addiction all together may not be as hard as we think.

Fasting provides tranquillity of the heart and mind. By practicing generosity, charity (Zakat), gathering around the iftar table, praying and self-control by practicing good manners.

Healthy tips

• Whole grain cereals (wheat, rice, ragi), low-fat milk, lean meat, fish (steamed), egg white, dal, legumes, peas, Khichdi

• Small servings of fresh fruits such as watermelon, papaya, orange, musambi, grapes, pineapple and vegetable salads

• Curds with a pinch of Elaichi powder (cardamom) taken after dawn meal will  prevent from feeling thirsty 

• Avoid consuming high-fat foods, bakery products and deep-fried foods like samosa, pakodas, bajji etc. Eat in moderate amount

• Avoid overeating in Sehri as it may cause indigestion and postprandial hyperglycemias. Eat just before sunrise and not at midnight

• Avoid consuming carbonated beverages like sodas and colas after breaking fast

Fasting has different impacts on different individuals. These variations highly depend on daily nutritional habits and the season that Ramadan occurs. However, there is no fear possibility of malnutrition or inadequate calorie intake since there is no restriction on the type or amount of food intake during Iftaar or Sehri.