At the onset of Ramadan Muslims all over the world start fasting from dawn to dusk daily for 30 days as ordained in the Quran.
"O you who believe! Fasting is prescribed to you as it was prescribed to those before you so that you can learn Taqwa." (Quran 2:183)
The Arabic word Taqwa is translated in many ways, including God-consciousness, God-fearing, piety, and self-restraining. Thus, we are asked to fast daily for one month from dawn to dusk and avoid food, water, intimate relations, and other sins during that period.
But why do we need to fast? In our human experience, we know that temptations and ways of the world tend to spoil our purity and austerity. Think of the act of eating. If we indulge in thinking about food all of the time, snack and nibble the whole day, and overindulge when we sit for a meal, we surely will head toward obesity. The same can be said of doing anything excessively – arguing, obsession with sex, seeking entertainment, etc.
Now when one is fasting, these obsessions are minimized. When one looks at mouth-watering food, s/he cannot even taste it. S/he has to give up snacking and nibbling, caffeinated pick-me-ups, and smoking. Sexual passions have to be curtailed. And if provoked to fight, the suggested response is to say, "I am fasting and I cannot respond to your provocation." Reaching this point of self-restraint is to achieve Taqwa, God-consciousness or nearness to God.
Medical Benefits of Ramadan
Ramadan is a month of self-regulation and self-training. Muslims fast in accordance with our religious requirements, but there are medical benefits as well. Generally, fasting has been used by patients for weight management, to rest the digestive tract, and for lowering lipids. There can be adverse effects of both total fasting and crash diets.
Islamic fasting is different from these diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The calorie intake of Muslims during Ramadan is typically at or slightly below the nutritional requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician. And there is hope that this training will last beyond the end of Ramadan.
The difference between Ramadan and total fasting is the timing of the food; during Ramadan, we take an early pre-dawn breakfast and do not eat until dusk. The fast is from both food and liquid intake. Abstinence from water for eight to 10 hours is not necessarily bad for health. In fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism. It has even been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.
The physiological effect of fasting includes lowering of blood sugar, lowering of cholesterol, and lowering of the systolic blood pressure. In fact, Ramadan fasting could be an ideal recommendation for the treatment of mild to moderate, stable, non-insulin diabetes, obesity, and essential hypertension.
More than 25 years ago, the first International Congress on Health and Ramadan, held in Casablanca, Morocco, entered 50 extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted, not one finding suggested that fasting worsened any patients' health or their baseline medical condition. Additional studies have confirmed these findings. It is important to note that patients who are suffering from severe diseases, such as Type I diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not be allowed to fast.
Ramadan Has Psychological Benefits, Too
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 in areas of the world where Muslims are living in large numbers, the crime rate decreases.
This psychological improvement could be related to better stabilization of blood glucose while fasting; hypoglycemia after eating can aggravate behavior changes. There is a spiritual beneficial effect of extra prayer at night. This not only helps with better utilization of food, but also helps in energy output. It has been calculated that there are 10 extra calories output for each unit of the prayer. This would particularly be connected to the extra prayers that are performed during the last 10 nights of Ramadan, when the believer is seeking the night of power, when worship during this night is said to be worth a thousand months.
It is important to emphasize that Muslims are not performing prayers for exercise, but a mild movement of the joints with extra calorie utilization can be a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but it has also been shown to improve memory.
Fasting is a special act of worship which is ultimately between the believer and the Creator Himself, as no one else knows for sure if this person is actually fasting. In a hadith of the Prophet Muhammad, peace and blessings be upon him, Allah says, "Fasting is for Me and I only will reward it." In another hadith, the Prophet reminds us, "If one does not give up falsehoods in words and actions, Allah has no need of him giving up food and drink."
Shahid Athar, M.D., was an internationally respected medical practitioner, professor, author, and leader in the field of Internal Medicine and Endocrinology. He was born in Patna, India, completed his medical residency in Chicago, and practiced at the St. Vincent Hospital in Indianapolis. He was the president of the Islamic Medical Association of North America from 2001-2002 and was a frequent speaker on medical ethics, Islam, and spirituality. He engaged in various interfaith activities and received top honors for his community service. He died in 2018 but his influence lives on.