Ramadan and the effects of fasting -Moinul Alam

The holy month of Ramadan is knocking at our doors. It is a month of fasting, worship, and spiritual development. Moreover, the Almighty has specially blessed this month for all of us. The first ten days of Ramadan are known as ‘Rahmat’, i.e., when we can seek mercy from Allah. The second ten days are known as ‘Maghfirat’ i.e., when we can seek forgiveness from Allah. The last ten days are for ‘Najat, i.e., when we can seek safety from the fire of hell. This month saw the beginning of the revelation of the holy Quran to Prophet Muhammad (pbuh) in Hijri 610, making this month more special to Allah as well as to the Muslims. Because of the holy Quran’s revelation, Allah has gifted Islam-loving people the night ‘Shab-E-Qadr’, which is more precious than performing rituals in a thousand nights. Muslims are asked to search for the blessed night in the last ten nights of Ramadan.

Fasting is one of the five pillars of Islam. During the month of Ramadan, healthy adult Muslims across the globe fast from sunrise to sunset. During the fasting hours, all sorts of eating and drinking are prohibited. However, several categories of people are exempted from the fast in Ramadan conditionally.

Fasting during the month of Ramadan has many effects on our body and mind. Almost all of these effects are positive. There are certain health issues that may be considered negative for the time being. However, with the proper guidance of the doctor or dietician, these negative effects may easily be converted into positive outcomes.

Ramadan fasting, involving a month of abstinence from food and fluid intake during daylight hours, is practiced by a large part of the world population, depending on the geographical location. For those who are fasting during Ramadan, the days of fasting can vary from 11 to 22 hours. Islamic fasting during Ramadan does not require energy restrictions. However, as the intake of food and fluid becomes less frequent, changes in body weight may occur.

Daylong fasting during Ramadan involves a shift in the pattern of food intake from daytime to the hours of darkness. Fasting is characterized by a coordinated set of metabolic changes designed to spare carbohydrates and increase reliance on fat as a substrate for energy supply. As well as sparing the limited endogenous carbohydrate and increasing the rate of gluconeogenesis from amino acids, glycerol and ketone bodies help maintain the supply of carbohydrate. Many individuals undergo periodic fasts for health, religious, or cultural reasons.

The positive impacts of fasting during Ramadan may be revealed from a study where, after Ramadan fasting, LDL and fasting blood glucose levels decreased in both sexes and also in the entire group compared with levels prior to Ramadan. In females, HDL cholesterol levels were significantly increased. In males, there was a significant decrease in weight, total cholesterol, and TGs. Some studies have reported that Ramadan fasts are associated with significantly lower concentrations of inflammatory markers, which means a decrease in the chances of getting diseases, including infections, auto-immune conditions, and cancer.

For diabetic patients, eating patterns during the month may result in alternating episodes of hyperglycemia and hypoglycemia. Although fasting and postprandial blood sugar were found to be decreased during Ramadan, the risk of hyperglycemia is still present due to overeating during feasting hours commencing with ‘Iftar’. Recent studies have shown that Ramadan fasting practiced by patients with type 2 diabetes for a period of 15–21 days leads to a statistically and clinically significant reduction in hemoglobin A1c (HbA1c) levels of approximately 0.5 points, suggesting that glycemic control is substantially improved during Ramadan fasting in this population.

Interestingly, fasting has been found to cause no negative effects on chronic kidney disease (CKD) patients or those with a transplanted kidney, while its safety has not been confirmed for nephrolithiasis patients. A study on patients with stable chronic obstructive pulmonary disease (COPD) found no effects of Ramadan fasting on the spirometric data of the patients enrolled.

Fasting regimens have the potential to impact modifiable health behaviors and develop a healthy lifestyle. A study in 8 overweight young adults found that increasing the nightly fasting duration to 14 hours resulted in statistically significant decreases in energy intake and weight, as well as improvements in self-reported sleep satisfaction, satiety at bedtime, and energy levels. A decrease in energy intake means less intake of foods with high calories, including fast foods, soft drinks, canned foods, and fried foods, along with an inclination towards a healthy and disciplined life and an affinity for a healthy diet. It will also reduce the chances of getting diseases like diabetes, which is primarily associated with an unhealthy lifestyle and the intake of unhealthy food.

Numerous observational studies have reported that nighttime eating is associated with reduced sleep duration and poor sleep quality, which can lead to insulin resistance and increased risks of obesity, diabetes, cardiovascular disease, and cancer.
Ramadan fasting not only has a positive impact on our health, but it also purifies our mental health. By fasting from dawn to dusk, we are not only securing a grip on our nerves but also realizing the hunger and agony of the poor around us. We can feel the pain of hunger and thirst, thereby becoming more interested in feeding the poor, who starve often.

Fasting also changes our psychology to some extent. During the remaining eleven months of the year, we are not very interested in donating food, money, and clothing to the poor. However, during this blessed month, significant changes take place in our habit of not giving and donating. As any act of charity is multiplied during this blessed month, people are more likely to donate, particularly as part of their ‘Zakat’ during this month.

Ramadan is an opportune time to earn tremendous rewards while supporting the growth and well-being of the Muslim community. Being a Muslim is a lifetime opportunity to write off sins and wrong deeds and seek mercy from our almighty. We should prepare ourselves now to remain physically fit and healthy so that we can fully utilize the opportunities available during this sacred month. Moreover, the good habits developed during this month should be continued during the remaining months of the year.