In the name of Allah, Most Beneficent, Most Merciful

by Shahid Athar, M.D.
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There are close to 900 million Muslims in the world, including about 8 million in North America. The majority of them observe total fasting (no food or water) between dawn to sunset in the month of Ramadan. They do so not for losing weight or any medical benefit, but for them it is ordained in their Holy Book - Qur'an, which says:

"O you who believe! Fasting is prescribed to you, as it was prescribed for those before you (i.e. Jews & Christians) so that you may (learn) self-restraint." (Qur'an 2:183)

According to Islamic Laws, children below 12, sick patients, travelers, and women who are menstruating or nursing a baby are exempt from fasting. In addition to staying away from food or water for the whole day, they are asked to stay away from sex, smoking or misconduct during the period of fast. In addition, they are encouraged to do more acts of piety i.e. prayer, charity, or reading Qur'an during this month.

Food is needed by the body to provide energy for immediate use by burning up carbohydrates, that is, sugar. Excess of carbohydrates, which cannot be used, is stored up as fat tissue in muscles, and as glycogen in liver for future use. Insulin, a hormone from the pancreas, lowers blood sugar and diverts it to other forms of energy storage, that is, glycogen. To be effective, insulin has to be bound to binding sites could receptor. Obese people lack receptor; therefore, they cannot utilise their insulin. This may lead to glucose intolerance.

When one fasts (or decreases carbohydrate intake drastically), it lowers his blood glucose and insulin level. This causes breakdown of glycogen from liver to provide glucose for energy need and breakdown of fat from adipose tissue to provide for energy needs.

On the basis of human pyshiology described above, semi-starvation (ketogenic diets (1-5) have been devised for effective weight control. These diets provide calculated amount of protein in divided doses with plenty of water, multi-vitamins, etc. These effectively lower weight, blood sugar, but because of their side effects, should be used only under supervision of physicians.

Total fasting reduces or eliminates hunger and causes rapid weight loss. In 1975, Allan Cott in his "Fasting as a way of life" noted that "fasting brings a wholesome physiological rest for the digestive tract and central nervous system and normalises metabolism." It must be pointed out, however, that there are also many adverse effects of total fasting. That includes hypokalemia and cardiac arrythmia associated with low calorie starvation diets used in unsupervised manner.

Studies on Islamic Fasting

Dr. Soliman, from the University Hospital, Amman, Jordan (8) has reported that during the month of Ramadan 1404 AH (June - July, 1984 AD) healthy Muslim volunteers; 42 males and 26 females, ranging in age from 15 - 64 and 16 - 28 years respectively were studied. They were weighed and their blood levels of cortisol, testosterone, Na, K, urea, glucose, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides (TG) and serum osmolality were measured at the beginning and at the end of Ramadan. There was a significant loss of weight in males from a mean of 73.8 + - 6.2 kg to 72.0 + - 7.1 kg (p less than 0.01) and in females from 55.2 + - 4.8 kg to 54.6 + - 4.2 kg (P less than 0.05). Blood glucose levels rose in males from 77.7 + - 23.6 mg/dl to 90.2 mg/dl (P less than 0.05 and in females from 76.0 + - 7 mg/dl to 84.5 + - 1.1 mg/dl (P less than 0.002). All other parameters did not show significant changes.

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