Ramadan: Better health through fasting

Don’t overdo it

With the sighting of the crescent moon, the holy month of Ramadan has begun this year, marking the start of a spiritual boot camp in which Muslims fast without any food or water from sunup to sundown. To many, the rigor may seem too tasking, but, as a veteran scientist of clinical nutrition and as a 76-year-old Muslim man who has fasted since I was a boy, growing up in India, I can say that fasting can be a healthy practice not just for God but for you.

Fasting can be healthy for people of all faiths from Christians to Jews, Hindus, Buddhists and others who fast as a part of their spiritual practice. But it’s got to be done right.

Twenty-five years ago in the early 1980s, I started studying the biochemical and physiological impact of “restricted energy intake,” as we call fasting in the business, on the human body, using Ramadan fasting as a model for clinical trials that I ran in the United States and Pakistan. In my hometown of Morgantown, W.V., young Muslim students volunteered to be my guinea pigs, logging their daily meals. In the Middle East and in Lahore, Pakistan, volunteers let me study the effect of fasting on their bodies, analyzing the nutritional component of their diets using food composition tables and computer software.

What I and other researchers have discovered is that fasting has clear spiritual, physical, psychological and social benefits.

There is no doubt, on one level, we are fasting for God. Just like fasting during Lent for Christians and during Yom Kippur for Jews, fasting during Ramadan has a divinely ordained inspiration. The Qur’an (2: 183) tells Muslims, “O you who believe, fasting is prescribed on you as it was prescribed to those before you (that is Jews and Christian and other faiths) so that you may become self-restrained.”

It’s considered “fard,” or required, for healthy Muslim adults to fast. It’s called “sawm” in Arabic, which means “refrain,” and Muslims are expected to refrain from not only food and water but also from sex, smoking, foul talk and harm to others. We are supposed to control our anger, behave kindly, participate in community service, give to charity and generally help others.

The restrictions–both caloric and behaviorally–can be good for us holistically because they serve as a means for disciplining ourselves all-year-around in a world in which we are too often self-absorbed and overindulgent. Fasting serves as a spiritual check, reminding us about issues of poverty and clean water supplies in the world and encouraging us to avoid overeating and wasting food. After all, way too much food ends up in garbage cans.

Restraint from food, water and undesirable behavior makes a person more mentally disciplined and less prone to unhealthy behavior. Researchers in Jordan found a significant reduction of parasuicidal cases during the month of Ramadan. In the United Kingdom, the Ramadan model has been used by various health agencies to reduce cigarette smoking, especially among Africans and Asians.

However, there are choices we can make to be healthier about fasting.

First of all, too many people, ironically, eat too much when they’re not fasting. Scientific studies reveal that some people overeat during Ramadan, a phenomenon that contradicts the essential spirit of Ramadan. Studies indicate that health problems can emerge as a result of eating too much or eating a diet that isn’t balanced. The body has regulatory mechanisms that activate during fasting, and we don’t need to overeat to get our body the nutrients it needs. Scientific studies have shown that there our bodies efficiently utilize the body fat typically available in most of our bodies.

During Ramadan, research has shown that the basal metabolism of fasting subjects slows down. A person can stay healthy and active during Ramadan consuming a diet that is less than the normal amount of calories or food intake but balanced in nutrients.

There is no universal healthy diet for fasting because of global differences in the fasting period, the weather, daily temperature, food availability, lifestyle, cultural habits and other details. But to get the best health and spiritual benefits when fasting, it’s critical to have a diet balanced in protein, essential minerals, vitamins and physiological and protective factors such as dietary fiber and antioxidant compounds.

To start with, it’s important in any faith not to miss the meal you eat before the fast begins. In Islam, it’s said the Prophet Muhammad used to have a light “sahur,” the pre-dawn meal Muslims eat before the fast. For me, a bowl of Raisin Bran has always served the purpose. A cereal high in wheat bran or oatmeal is a great source of dietary fibers including cellulose, hemicelluloses and other non-digestable complex carbohydrates and lignin, which provides bulk and facilitates motality in the digestive tract. As a result, many harmful and toxic compounds are expunged from the body.

Alas, milk, a protein, is a kind of dehydrant. It’s critical to have extra glasses of water to avoid dehydration. Extra water is also needed to flush out urea, protein’s catabolic product, from the body. That’s true of all protein rich foods.

When breaking the fast in any faith, it’s important to consume an easily available energy source in the form of simple sugars such as glucose and fructose that nourishes every living cell, particularly the brain and nerve cells. Dates and juices are good sources of these sugars. Indeed, breaking of fast with several dates is considered “sunnah” in Islam, or a practice of the Prophet Muhammad. Another good choice: a cup of juice without sugar added to bring low blood glucose levels to normal levels. It’s also good advice to have a bowl of vegetable soup. Both juice and soup help maintain water and mineral balance in the body. They also help quenching the thirst quickly.

Too often, at least in Muslim homes, folks break the fast with sherbets and sweets. That’s the worst way to break a fast, according to many scientific studies, because they represent a high intake of sugar in form of sucrose.

For the later dinner meal, it’s essential to consume variety of foods with balance and moderation. Just because we haven’t eaten all day, we shouldn’t forget the “food pyramid” that represents the A, B, C’s of a healthy diet. That means including a vegetable salad with dinner.

Cultural preferences aside, it’s best to avoid spicy foods because it promotes acidity in the stomach and digestive tract problems.

It’s wise to eat fruit at the end of meals, such as apples, oranges, peaches, pears or whatever fruit might be in season. Fruits provide dietary fiber that facilitates the prevention of constipation, stomach acidity and other digestive health issues. What’s more, fruits and vegetables are good sources of certain nutrients such as vitamin C and vitamin A. They also provide antioxidants, flavonoids and protective phytochemicals. Fresh fruits and vegetable are good sources of water, too. They contain between 92 per cent to 97 per cent water. Between breaking fast and starting a new day’s fast, it’s critical that we consume plenty of water.

To follow the spirit of Ramadan and other fasting traditions, discipline, control and behavioral change are critical. One of the things that should go: smoking. Smoking isn’t allowed during the Muslim fast, and that’s a good thing. Smoking negatively affects the utilization of various vitamins, metabolites and enzyme systems in the body and promotes the production of free radicals (atoms, molecules and ions with unpaired electrons), a major factor in cancer. Smoking is also a risk factor for many other health problems.

Further, it’s best to avoid caffeine drinks such as Coke, coffee or tea. Caffeine is a diuretic. But it’s best to be gradual with the reduction. A sudden decrease in caffeine and nicotine, coupled with hunger and dehydration, can prompt headaches, mood swings, irritability and, even sometimes, road rage. The American Psychosomatic Society indicated that caffeine and nicotine use increases the occurrence of irritability during fasting, but the end of Ramadan the irritability drops.

It’s important to remember to brush your teeth–a habit that can fall by the wayside with the new eating and sleeping schedule.

Typically, people who are normal weight or overweight people shouldn’t gain weight. For overweight people, Ramadan is an excellent opportunity to lose weight. Underweight or marginally normal weight people shouldn’t use this time to lose weight, but a couple of pounds of body weight loss isn’t harmful. That may be due to dehydration or the somewhat reduced calorie intake.. This small body weight loss is easily regained after Ramadan.

If we eat properly a balanced diet when we fast, we will maintain our body weight, maintain our energy level and perform our daily work normally. Just like during the rest of the year, it’s critical to eat a good balanced diet while fasting.

Fasting isn’t the time to ditch exercise. It’s important that everyone engage in some kind of light exercise, such as stretching or walking. “Taraweeha,” a special Ramadan prayer that lasts for up to an hour, can have the benefit of “ibada,” or prayer, as well as light exercise. It’s important to follow good time management practices for prayer and other religious activities, as well as sleep, studies, job and exercise, to maintain a balanced life even when fasting.

Finally, it’s important to remember that fasting doesn’t mean being a martyr to good health. In Islam, Muslims don’t have to fast if they’re pregnant, traveling, breast feeding, elderly or ill. In those cases, they can feed the poor instead, perhaps making up the fasts later. People with diabetes, peptic ulcers, kidney stones, hypertension and other health problems must consult their physician on the question of whether to fast; and then if they do fast, what is the best diet for them.

Increasingly, scientists are starting to recognize the benefits of reduced energy intake on weight. A study released earlier this year at the European Congress on Obesity concluded that increased energy intake was the most significant cause of the rise in obesity in the United States since the 1970s. The issue of restricted energy intake continues to have wide consequences in the United States, where the Centers for Disease Control is reporting an alarming increase in obesity rates. Appropriately, the office of the U.S. Surgeon General is developing public education campaigns about the health risks of being overweight.

In a way, Ramadan is like an annual continuing education workshop on how becoming a better citizen of the world. It’s said that the Prophet Muhammad told his followers, “He who does not desist from obscene language and acting obscenely (during the period of fasting), Allah has no need that he didn’t eat or drink.”

Another time, it’s said the Prophet declared, “Fasting is not only from food and drink, fasting is to refrain from obscene (acts). If someone verbally abuses you or acts ignorantly toward you, say (to them), ‘I am fasting; I am fasting.’”

(Photo: Hamed Saber)

Zafar Nomani is a professor emeritus of human nutrition and foods at West Virginia University. He received the King Hassan II Award at the first International Conference on Scientific and Medical Research on Ramadan, held in Casablanca, Morocco. This article was previously published in the Washington Post’s On Faith and is reprinted here with permission.


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