The Controversy Over The Health Effects Of Fasting During Ramadan

Pakistani Muslims pray before breaking their fast at a local mosque in Peshawar, Pakistan, Thursday, June 18, 2015. CREDIT: AP PHOTO/MOHAMMAD SAJJAD
Pakistani Muslims pray before breaking their fast at a local mosque in Peshawar, Pakistan, Thursday, June 18, 2015. CREDIT: AP PHOTO/MOHAMMAD SAJJAD

The Islamic holy month of Ramadan commenced this week for 1.6 billion Muslim men and women across the world who will fast during daylight hours, eat small evening meals at community gatherings, and reconnect with the Qur’an — the book they believe reveals the word of God — for 30 days.

Fasting counts among the five pillars of worship for followers of Islam. Followers say the ritual helps them practice patience and increase their physical and mental endurance as they carry on daily obligations on an empty stomach. Doing so, they emphasize, helps them abstain from negative habits and thoughts, recharge spiritually, and stand in solidarity with the less fortunate — an experience they say ultimately brings them closer to God.

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But those who don’t participate have expressed concerns about the health consequences of fasting. Some even attempted to prevent Muslims from observing Ramadan. For instance, officials in China ordered restaurants to stay open during the month-long ritual, and banned civil servants, students, and teachers living in the Xinjiang region — an area with a high concentration of Muslims — from fasting. The United Kingdom placed similar restrictions on students in at least four schools. Officials later reneged, choosing instead to mandate that students get permission from the headmaster to observe Ramadan.

Some medical professionals, like Nour Zibdeh, say dissidents shouldn’t worry. Zibdeh, a dietitian and functional nutritionist of seven years, has found ways to integrate aspects of the month-long fast into her practice that benefit her patients’ health.

“After 10 hours of fasting, the body uses up fat tissue for energy, so this practice is of great benefit to those who have struggled with weight loss,” Zibdeh told ThinkProgress. At her Northern Virginia-based practice, Zibdeh shows her patients — many of whom grapple with weight gain, muscle and joint pain, diarrhea, constipation and other ailments — how to abstain from gluttony and maintain diets high in fruits and vegetables. In 2012, she advised Muslims not to overeat when breaking their fast.

Ramadan, Zibdeh said, reinforces the tenets of her program by limiting when and how much followers eat and forcing them to prepare healthy, home-cooked meals to eat in communal dining environments. Getting that point across to those unfamiliar with Islam, however, means debunking myths about fasting.

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“People think that fasting means starvation, but that doesn’t happen until someone doesn’t eat for four consecutive days,” Zibdeh said. “There are no dangers to fasting if people refuel in the evening hours. Fasting improves brain function and mood, increases vigilance and mental clarity. It also allows the gut to clean chemicals that accumulate. That doesn’t happen often because when we eat, we interfere with that function.”

Research about intermittent fasting’s potential to repair the body and prevent illness supports Zibdeh’s point, showing that when done in tandem with diet change, it spurs weight loss, increases mental wellbeing, and removes toxins in the body. Limiting food intake in this manner also lowers cholesterol levels, as highlighted in a 1997 study that showed a reduction in bad cholesterol and saturated fats during fasts.

Some experts go further in saying that Muslims who participate in Ramadan grow to understand the importance of water, using that to quench their thirst during the breaking of fast at sunset. Night prayers — also known as tarawih — also provide an opportunity for some physical activity. Such changes pose long-term health benefits, the most of significant being the avoidance of diabetes, heart disease, cancer, and other ailments.

In an increasingly quick-pace, stress-inducing society, fasting may also open a window to the past. Last year, a group of researchers wrote in the Proceedings of the National Academy of Sciences journal that the customary three meals per day eating schedule differs from the eating pattern of ancient hunter gatherers. They wrote that indigenous groups ate in accordance of the body’s circadian rhythms — physical, mental, and behavioral changes that follow a 24-hour cycle and respond to natural light and darkness. Disruption to this flow can induce weight gain and slow thinking — similar to what happens to people who experience jetlag.

Followers of Islam also credit the practice of fasting with sharpening their focus and disciplining them, so much so that workplaces and schools have been more accommodating to Ramadan rituals. For example, landscaper Schemsden Rexhepi told the Hartford Courant that he will alter his work schedule for the next month so that he works in the evening instead at the height of the day, when it’s hot. In 2011, a predominately Muslim youth football team in Deerborn, Michigan practiced at night throughout Ramadan — perhaps out of an understanding that students would have broken fast by that time of the day.

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In fact, in recent years, athletes — regardless of whether they follow Islam — have embraced intermittent fasting as part of an effort to maintain their body weight and increase their focus and performance on the field and weight room. In a recent column, certified personal trainer Jason Maxwell argues that 16 hours of fasting followed by an eight-hour eating window pushes athletes to focus less on their hunger, and more on improving their reaction time and increasing strength gains. Full-day fasts, during which athletes abstain from eating for 24 hours, can also help the body in recovering from small injuries and joint pain.

“Muslim sports figures who fast during Ramadan have performed much better. During Ramadan, you only drink water at dawn and the evening to make sure you’re getting the liquids you need,” Rizwan Jaka, the chairman of the board at the All Dulles Area Muslim Society, the third largest mosque in the United States, told ThinkProgress. “When people fast, they go a long time during the day without eating. It’s a cleansing that reduces calorie intake and that of junk food. There’s no time to do mindless snacking. The idea is to not overindulge in food.”

Unbeknownst to many, not all Muslims have to participate in Ramadan. Exemptions exist for children, the physically and mentally ill, women who are menstruating, and expectant and breastfeeding mothers. Muslims on the middle of travel expeditions also don’t have to participate.

Such rules didn’t stop Omar Woodard from taking part in the activities of the Holy Month during his trip to the Congo in 2007 to the bewilderment of natives. Woodard, who’s observing his 20th Ramadan this year, said that it has helped him become worldlier and more cognizant of how much food Americans eat and waste. Such is the case in fast food restaurants, each of which produce an average of 150,000 pounds of food waste annually.

“The amount of food available to us has become so significant that we can be wasteful. During Ramadan, we understand that we need to be more thoughtful of those without,” Woodard, president of the Girard College Foundation, told ThinkProgress. “You’re not usually forced to realize that we eat too much. By shrinking the size of our portions to something much more manageable, we can change our eating habits. There’s no doubt that we lose weight. Fasting is not about starving yourself. That’s why we eat in the morning. It’s a blessed meal that allows you to fast throughout the day.”