MEDICAL ASPETS OF ISLAMIC FASTING

There are over I billion Muslims in the world, including about 8 million in North America. The majority of them observe total fasting (no food or water) between dawn and sunset during the month of Ramadan. They do so not to lose weight or for any medical benefit, but because it is ordained in the Quran which says, "O you who believe! Fasting is prescribed to you, as it was prescribed for those before you (i.e. Jews and Christians) so that you may (learn) self-restraine" (2:183).

According to Islamic Law, children below twelve, 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 time of the fast. In addition, they are encouraged to do more
acts of piety: prayer, charity, or reading the Quran during this month.

Food is needed by the body to provide energy for immediate use. This is
done by burning up carbohydrates, that is, sugar. Excess of carbohydrates which cannot be used are stored up as fat tissue in the muscles and as glycogen in the 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 called receptors. Obese people lack receptors. Therefore, they cannot utilize their insulin. This may lead to glucose intolerance.

When one fasts (or decreases carbohydrate intake drastically), it lowers one's blood glucose and insulin level. This causes a breakdown of glycogen from the liver to provide glucose for energy needs and break-down of fat from adipose tissue to provide for energy needs. On the basis of human physiology described above, semi-starvation (ketogenic diets) have been devised for effective weight control. These diets provide a calculated amount of protein in divided doses with plenty of water, multivitamins, etc. These effectively lower weight and blood sugar, but because of their side effects, should be used only under the 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, "Fasting brings a wholesome physiological rest for the digestive tract and central nervous system and normalizes metabolism." It must be pointed
out, however, that there are also many adverse effects of total fasting. That includes hypokalemia and cardiac arrhythmia associated with low calorie starvation diets used in unsupervised programs.