Allah - beginning with the name of - the Most Gracious Merciful, the Most Merciful.
Sallallahu alan-Nabiyyil Sallallahu alaihi wasallam Salatan- wasalamanalaika Ya Rasoolallah.
Assalaamualycum Wa Rehamtullahe Wa Barkathu.
Medical Benefits of Ramadan
Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.
Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one's entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.
The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.
The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on "Health and Ramadan", held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients' health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.
There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, "If one slanders you or aggresses against you, say I am fasting.'" This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.
There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in output. There are 10 extra calories output for each rikat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.
Ramadan Health Guidelines
This article provides useful advice on how to avoid some common problems encountered in Ramadhan. If followed, it would enable one to fast comfortably and enjoy fully the spiritual benefits of Ramadhan.
During the holy month of Ramadhan, our diet should not differ very much from our normal diet and should be as simple as possible. The diet should be such that we maintain our normal weight, neither losing nor gaining. However, if one is over-weight, Ramadhan is an ideal time to normalize one's weight.
In view of the long hours of fasting, we should consume slow digesting foods including fibre containing-foods rather than fast-digesting foods. Slow digesting foods last up to 8 hours, while fast-digesting foods last for only 3 to 4 hours.
- Slow-digesting foods are foods that contain grains and seeds like barley, wheat, oats, millet, semolina, beans, lentils, whole meal flour, unpolished rice, etc. (called complex carbohydrates).
- Fast-burning foods are foods that contain sugar, white flour, etc. (called refined carbohydrates).
- Fibre-containing foods are bran-containing foods, whole wheat, grains and seeds, vegetables like green beans, peas, sem (papry), marrow, mealies, spinach, and other herbs like methie, the leaves of beetroot (iron-rich), fruit with skin, dried fruit especially dried apricots, figs and prunes, almonds, etc.
The foods eaten should be well-balanced, containing foods from each food group, i.e. fruits, vegetables, meat/chicken/fish, bread/cereals and dairy products. Fried foods are unhealthy and should be limited. They cause indigestion, heart-burn, and weight problems.
Fried and fatty foods.
Foods containing too much sugar.
Over-eating especially at sehri.
Too much tea at sehri. Tea makes you pass more urine taking with it valuable mineral salts that your body would need during the day.
Smoking cigarettes. If you cannot give up smoking, cut down gradually starting a few weeks before Ramadhan. Smoking is unhealthy and one should stop completely.
Complex carbohydrates at sehri so that the food lasts longer making you less hungry.
Haleem (mixed meat & lentil soup) is an excellent source of protein and is a slow-burning food.
Dates are excellent source of sugar, fibre, carbohydrates, potassium and magnesium.
Almonds are rich in protein and fibre with less fat.
Bananas are a good source of potassium, magnesium and carbohydrates.
As much water or fruit juices as possible between iftar and bedtime so that your body may adjust fluid levels in time.
Constipation can cause piles (hemorrhoids), fissures (painful cracks in anal canal) and indigestion with a bloated feeling.
Causes: Too much refined foods, too little water and not enough fibre in the diet.
Remedy: Avoid excessive refined foods, increase water intake, use bran in baking, brown flour when making roti (flower bread).
INDIGESTION AND WIND
Causes: Over-eating. Too much fried and fatty foods, spicy foods, and foods that produce wind e.g. eggs, cabbage, lentils, carbonated drinks like Cola also produce gas.
Remedy: Do not over-eat, drink fruit juices or better still drink water. Avoid fried foods, add ajmor to wind-producing foods.
LETHARGY ('low blood pressure')
Excessive sweating, weakness, tiredness, lack of energy, dizziness, especially on getting up from sitting position, pale appearance and feeling faint are symptoms associated with "low blood pressure". This tends to occur towards the afternoon.
Causes: Too little fluid intake, decreased salt intake.
Remedy: Keep cool, increase fluid and salt intake.
Caution: Low blood pressure should be confirmed by taking a blood pressure reading when symptoms are present. Persons with high blood pressure may need their [Banned Word Used] adjusted during Ramadhan. They should consult their doctor.
Causes: Caffeine and tobacco-withdrawal, doing too much in one day, lack of sleep, hunger usually occur as the day goes by and worsens at the end of the day. When associated with "low blood pressure", the headache can be quite severe and can also cause nausea before Iftar.
Remedy: Cut down caffeine and tobacco slowly starting a week or two before Ramadhan. Herbal and caffeine-free teas may be substituted. Reorganise your schedule during the Ramadan so as to have adequate sleep.
LOW BLOOD SUGAR
Weakness, dizziness, tiredness, poor concentration, perspiring easily, feeling shaky (tremor), unable to perform physical activities, headache, palpitations are symptoms of low blood sugar.
Causes in non-diabetics: Having too much sugar i.e. refined carbohydrates especially at suhur (sehri). The body produces too much insulin causing the blood glucose to drop.
Remedy: Eat something at sehri and limit sugar-containing foods and drinks.
Caution: Diabetics may need to adjust their [Banned Word Used] in Ramadan, consult your doctor.
Causes: Inadequate intake of calcium, magnesium and potassium foods.
Remedy: Eat foods rich in the above minerals e.g. vegetables, fruit, dairy products, meat and dates.
Caution: Those on high blood pressure [Banned Word Used] and with kidney stone problems should consult their doctor.
PEPTIC ULCERS, HEART BURN, GASTRITIS AND HIATUS HERNIA
Increased acid levels in the empty stomach in Ramadhan aggravate the above conditions. It presents as a burning feeling in the stomach area under the ribs and can extend up to the throat. Spicy foods, coffee, and Cola drinks worsen these conditions.
Medications are available to control acid levels in the stomach. People with proven peptic ulcers and hiatus hernia should consult their doctor well before Ramadhan.
Kidney stones may occur in people who have less liquids to drink. Therefore, it is essential to drink extra liquids so as to prevent stone formation.
Causes: During Ramadhan, when extra salah are performed the pressure on the knee joints increases. In the elderly and those with arthritis this may result in pain, stiffness, swelling and discomfort.
Remedy: Lose weight so that the knees do not have to carry any extra load. Exercise the lower limbs before Ramadhan so that they can be prepared for the additional strain. Being physically fit allows greater fulfilment, thus enabling one to be able to perform salah with ease.
Dr. Farouk Haffejee
Islamic Medical Association of South Africa – Durban