Ramadan is the ninth month in the Islamic calendar. The word Ramadan meant “great heat” as this occurred in the pre-Islamic solar calendar. Fasting in this month is one of the Five Pillars of Islam.
We read in the Qur’an: ....Ramadhan is the (month) in which was sent down the Qur'an, as a guide to mankind, also clear (Signs) for guidance and judgment (Between right and wrong). So every one of you who is present (at his home) during that month should spend it in fasting, but if any one is ill, or on a journey, the prescribed period (Should be made up) by days later. Allah intends every facility for you; He does not want to put to difficulties. (He wants you) to complete the prescribed period, and to glorify Him in that He has guided you; and perchance ye shall be grateful.. (Al-Quran-Surah Baqara, 2: 185)
One can ask what are the benefits of fasting?
People have fast for health reasons. Scientists have studied the effects of fasting on the body and found that the intake of food increases the body’s metabolism. After fasting, metabolism can become as much as 22 per cent lower than the normal rate. But research also has shown that after long periods of fasting, the body tends to adjust itself by lowering the rate of metabolism itself. After fasting, a person should gradually resume eating.
In some studies performed on fasting Muslims and Muslimah, it was observed that there was a slight loss of weight both in the males and the females. Their blood glucose levels increased significantly. Other parameters such as blood levels of cortisol, testosterone, Na, K, urea, total cholesterol, HDL (high density lipoprotein), LDL (low density lipoprotein), TG (triglycerides) and serum osmolality did not show notable variations.
Another study performed about a decade ago in Iran showed that sporadic restraint from food and drink for about 17 hours a day for 30 days does not alter male reproductive hormones, HPTA (hypothalamic-pituitary-thyroid axis) or peripheral metabolism of thyroid hormones. Any changes noticed return to normal four weeks after fasting.
A recent study on “Increased fat oxidation during Ramadan fasting in healthy women: an adaptive mechanism for body-weight maintenance” was performed by Drs. Jalila El Ati, et al, published in the Am. J. Clin. Nutri. August 1995. In this study possible effects of Ramadan fasting on anthropometric and metabolic variables were investigated in healthy Tunisian Muslim women. Total daily energy intake remained unchanged whereas the qualitative components of nutrients were markedly affected. Neither body weight nor body composition were influenced by Ramadan fasting. Results also indicate the concomitant decrease of plasma insulin concentrations with respiratory and energy expenditure during Ramadan.
Fat oxidation was increased and carbohydrate oxidation was decreased during the light span of the nycthemeron. In non-Muslim countries such as the United States the physicians particularly the Family Physicians and Internists should be aware of changes of glucose and bilirubin during the month of Ramadan.
Rheumatic Disease
Fasting may enhance mucosa derived B lymphocyte cell responsiveness while having no effect on B cell responsiveness in both rheumatoid arthritis patients and healthy volunteers. After a three-day, water-only fast, 7 rheumatoid arthritis patients and 17 healthy volunteers received influenza virus vaccine either orally or by injection. One week later blood samples were analyzed for B lymphocyte response. B lymphocyte response was enhanced in the group receiving the vaccine orally in both arthritis patients and volunteers. The response to injected vaccine was unchanged in both groups.
Longevity studies on laboratory animals have shown that restriction of caloric intake increases longevity, slows the rate of functional decline, and reduces incidence of age-related disease in a variety of species. The mechanism of action of caloric restriction remains unknown; however, data suggest that cellular functions are altered in such a way that destructive by-products of metabolism are reduced, and defense or repair systems are enhanced by this nutritional manipulation. Animal and human studies suggest potential benefits of dietary modification, exercise, antioxidants, hormones, and deprenyl.
Effect on Lactating Mothers
The effects of fasting and increased blood insulin and glucose on milk volume and composition were studied with glucose clamp methodology in exclusively and partially breast-feeding women (producing no more than 200 ml milk per day). There was no effect on milk volume, milk glucose concentration, total fat content or lactose secretion rate. It is concluded that human milk production is isolated from the homeostatic mechanisms that regulate glucose metabolism in the rest of the body, in part because the lactose synthetase system has a Km for glucose lower than the concentration available in the Golgi compartment.
Short-term fasting in normal women
In a study which investigated the effects of a short-term fast (72 hours) on female reproductive hormone secretion and menstrual function, it was concluded that in spite of profound metabolic changes, a 72-hour fast during the follicular phase does not affect the menstrual cycle of normal cycling women.
Fasting and healing
Studies are being conducted to treat serious illnesses like osteo-or rheumatoid arthritis or asthma utilizing fasting for a short duration of a few days to medically supervised water (only fasts of 30 days) to help the body heal itself. It has been known that both children and animals refuse to eat when sick as a natural response. The severely sick have no appetite, but they take the food only at the urging of the family members.
The severely sick feel no hunger because food in severe sickness intervenes with natural response. The body is always trying to heal itself. When the patient is resting and consuming water only, the body heals itself and fasting acts as a facilitating process. One can get rid of coffee, cigarettes salty or sugary foods, which are addictive, through fasting, as fasting can help clear the taste buds and healthful foods start to taste better again. However insulin-dependent diabetics should not fast because of ketosis in patients with insulin-dependent diabetes, who cannot break down the ketones and use them as fuel. Healthy people use the ketones (by-products of fat metabolism) to maintain energy. (To conserve the glycogen stores, glucose becomes restricted to the central nervous system, mainly the brain. Instead of taking the glucose from the brain, the body begins breaking down the fatty acids in adipose (fatty) tissue). People with non-insulin-dependent diabetes (the majority of people who have diabetes) can improve their health through fasting.
Fasting helps cardiovascular disease, arthritis, asthma, non-insulin-dependent diabetes, ulcers, and digestive disorders, lupus, skin problems (including cysts, tumors and kidney stones). Even quitting smoking and obesity respond favourably to fasting.
Hence fasting during the month of Ramadan does not cause any adverse medical effects, on the other hand may have some beneficial effects on weight and lipid metabolism.
