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Psycho-Social Behaviour and
Health Benefits of Islamic Fasting
During the Month of Ramadan
Ahmad S, Goel K, Maroof KA, Goel P, Arif M, et al.
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Published by Beacon Books and Media Ltd
Innospace,
Chester Street,
Manchester
M1 5GD,
UK
Copyright: © 2012 Ahmad S, et al.
Ahmad S, Goel K, Maroof KA, Goel P, Arif M, et al. (2012)
Psycho-Social Behaviour and Health Benefits of Islamic Fasting
During the Month of Ramadan. J Community Med Health Educ
2:178. doi:10.4172/2161-0711.1000178
For free distribution
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Contents
Foreword ........................................................................................ 5
Introduction .................................................................................... 6
1.
Psychological effects of fasting .............................................. 8
2.
Produces tranquillity and peace of mind ................................. 9
3.
Social effects of fasting ........................................................ 10
4.
An exercise in self-discipline ............................................... 11
5.
Health Benefits of Ramadan Fasting .................................... 11
6.
Wholesome physiological rest for the Digestive system ....... 13
7.
Effect of Fasting on Body Weight and Blood Cholesterol ..... 14
8.
Diabetes mellitus not adversely affected if controlled sensibly .
............................................................................................ 16
Conclusion ................................................................................... 19
References .................................................................................... 21
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Foreword
A review of research articles on Ramadan fasting
indicates that fasting can serve as an excellent research
model for Psycho-social behaviour and health studies.
The purpose of fasting for Muslims is to learn selfrestraint from indulgence in everyday pleasures, for selfdiscipline, to develop God-consciousness, to develop
self-control, to purify the body, and to empathize with
the poor and hungry. Muslims describe a feeling of inner
peace and tranquillity. This involves restraining anger,
doing good deeds, exercising personal discipline, and
preparing one to serve as a good Muslim and a good
person. One of the greatest advantages of fasting is that
its true observance inculcates in a person a habit of
speaking the truth. Fasting is a powerful therapeutic
process that can help people recover from mild to severe
health conditions.
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Introduction
Ramadan fasting is an Islamic religious fast strictly
observed every year throughout the world during the
month of Islamic calendar for about 30 days. In Islam,
fasting for a month is an obligatory practice during the
holy month of Ramadan, from dawn, until the dusk.
They are advised to be away from foods or water for the
whole day, to stay away from sex, misconduct and also
from consuming medicines, nutritional fluids and
addictions etc.
Ramadan fasting is obligatory for the healthy adult but,
when fasting might significantly affect the health of the
fasting individual or when one is genuinely sick, Islam
exempts him or her from fasting. “God intends every
facility for you; he does not want to put you into
difficulties”. It is ordered in Qur’an that “O you who
believe! Fasting is prescribed to you as it was prescribed
to those before you so that you can learn Taqwa (good
deeds and God-consciousness).” [1].
Healthy adult Muslims should not fear becoming weak
by fasting, but instead it should improve their health and
stamina. In 1994, the first International Congress on
“Health and Ramadan”, held in Casablanca, about 50
research articles presented on the medical ethics of
fasting from the all over the world. It was suggested that
Ramadan fasting would be an ideal recommendation for
the treatment of mild to moderate diseases such as Noninsulin dependent diabetes, essential hypertension,
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weight management, and for rest of the digestive tract
includes lowering blood sugar levels, lowering of
cholesterol and lowering of the lipids profile. It was also
suggested that patients who are suffering from severe
diseases, whether type I diabetes or coronary artery
disease, kidney stones, etc. are exempted from fasting
and should not be allowed to fast [2].
The basic objectives of this month long process are to
mould the behaviour and pattern of life of its
practitioners in such a way that they turn out to be ideal
human beings. In order to achieve this one has to restrain
oneself from listening, speaking, hearing or thinking bad
about others. The impact of this purification process is
expected to last the remaining months, after which the
process is repeated.
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1. Psychological effects of fasting
Psychological effects of Ramadan fasting are also well
observed by the description of people who fast. The
Holy Qur’an is a great source of guidance to humanity
and nothing in it is without the objective of benefits.
Muslims believe that fasting is more than abstaining
from food and drink. Fasting also includes abstaining
from any falsehood in speech and action, abstaining
from any ignorant and indecent speech, and from
arguing, fighting, and having lustful thoughts. Therefore,
fasting strengthens control of impulses and helps
develop good behaviour. This purification of body and
soul harmonizes the inner and outer spheres of an
individual. Muslims aim to improve their body by
reducing food intake and maintaining a healthier
lifestyle. Overindulgence in food is discouraged and
eating only enough to silence the pain of hunger is
encouraged. Muslims believe they should be active,
tending to all their commitments and never falling short
of any duty.
Fasting is believed to help promote chastity and humility
and prevent sin, the outburst of uncontrolled lusts and
desires and farfetched hopes. Fasting also includes
abstaining from any falsehood in speech and action,
abstaining from any ignorant and indecent speech, and
from arguing, fighting, and having lustful thoughts.
Therefore, fasting strengthens control of impulses and
helps to develop good behaviour. During the sacred
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month of Ramadan, believers strive to purify body and
soul and increase their good deeds. This purification of
body and soul harmonizes the inner and outer spheres of
an individual. On a moral level, believers strive to attain
the most virtuous characteristics and apply them to their
daily situations. They try to show compassion,
generosity and mercy to others, exercise patience, and
control their anger. In essence, Muslims are trying to
improve what they believe to be good moral character
and habits.
2. Produces tranquillity and peace of
mind
Muslims do prayer (namaz/salat) five times a day and 20
extra namaz of “Trahveeh” in the night. There is a
beneficial effect of extra prayer. This not only helps with
better utilization of food but also helps in energy output
and it is also beneficial for extra calorie utilization.
Muslims encouraged being doing more acts of piety,
prayers, charity or reading Qur’an. Recitation of the
Qur’an not only produces a tranquillity of heart and
mind, but improves the memory.
Muslims describe a feeling of inner peace and
tranquillity. This involves restraining anger, doing good
deeds, exercising personal discipline, and preparing one
to serve as a good Muslim and a good person. It serves
as a means to sharpen our awareness of God and gives
strengthens and self-control. Besides abstaining from
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food and drinks, fasting involves getting into sublime
states of mind in order to develop positive feelings. In an
investigation in Jordan, a significant reduction of Parasuicidal cases was noted during the month of Ramadan
[3]
.
3. Social effects of fasting
Ramadan fasting encompasses direction to develop
spiritual, moral and social values. It is the message of
equality amongst the individuals of the society. The poor
are given attention and benefit from charity and the
faithful practise of the concept of neighbourhood and
hospitality. Apart from helping to achieve purity of body
and soul through this process of self-purification,
addressing these areas of social significance is bound to
help people shed all those things which are not socially
desirable. The practice of the concept of neighbourhood
is equally important. The neighbourhood concept
ultimately extends to the world and beyond.
Muslims cannot consume alcohol and use smoke in any
form during the month of Ramadan. Those people who
are addicted to such habits, it is the best time for them to
quit these habits, which are spoiling their health and
wasting their money. Since they are restraining
themselves from these habits for one month, they should
continue to do so, for the rest of their life.
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In the United Kingdom, the Ramadan model has been
used by various health departments and organizations to
reduce cigarette smoking among the masses, especially
among Africans and Asians [4].
4. An exercise in self-discipline
Fasting has been made obligatory in order to establish
equality between the rich and the poor; the rich
experience the pangs of hunger and thus fulfil their
obligations with respect to the poor. One of the greatest
advantages of fasting in this month is that its true
observance inculcates in a person a habit of speaking the
truth. Ramadan fasting is actually an exercise in selfdiscipline. For those who are chain smokers, or nibble
food constantly, or drink coffee every hour, it is a good
way to break the habit, hoping that the effect will
continue after the month is over.
Fasting is prescribed by many religions of the world.
Islam specifically outlines one full month of fasting
during the month of Ramadan. It is a physiological,
psychological as well as a spiritual experience. It is
generally accepted that a reward for the self-discipline of
fasting is better health [5].
5. Health Benefits of Ramadan Fasting
Ramadan fasting can be good for one’s health and
personal development. Muslims do not fast because of
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medical benefits which are of a secondary nature, but the
health benefits of fasting are important issues. Islamic
law is very clear about the exemption from fasting for
the children below the age of 12 years, sick, travelling,
elderly, the women who are menstruating, breastfeeding
and pregnant, and those unable to understand the
purpose of fasting during Ramadan. They are allowed to
restrain from fasting for one day to onwards depending
on the conditions of their illness. Young children and
those with unsound mental faculties are completely
exempted from fasting and also exempted from
compensating for the lost fasting days for as long as they
remain in these states [6,7].
Ramadan focused patient education should focus on preRamadan evaluation, risk stratification, and reminder
about the generous religious exemptions available for
deserving individuals. Those who are medically fit to
fast need to be educated about the importance of
balanced nutritious diet, moderate physical exercise,
adherence to the advised drugs and medications, selfmonitoring of their glycemic status, early recognition of
dangerous situations, and the necessary remedial
measures.
Review of available medical literature indicates that
fasting in Ramadan is safe and probably beneficial with
proper education and good management for the majority
of persons suffering from diabetes. Healthy stable and
well informed type-1 diabetes are also able to fast safely
[8]
.
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6. Wholesome physiological rest for the
Digestive system
Fasting is obligatory for all healthy adult Muslims during
Ramadan. The study conducted by Iraki et al. suggested
that during Ramadan fasting increased gastric acidity is
often noticed, exhibiting itself with symptoms such as a
burning feeling and heaviness in the stomach and a sour
mouth [9].
The body immediate need at the times of Iftar is to get
easily available energy sources in form of glucose for
every living cell, particularly the brain and nerve system.
A balance diet improves blood cholesterol, reduces
gastric acidity, prevents constipation and other digestive
problems and contributes to an active and healthy life
style.
Total fasting reduces or eliminates excess hunger and
rapid weight loss. A study conducted by Sulimani
suggested that health problems can emerge as a result of
an excess food intake, foods that make the diet
unbalanced and insufficient sleep [10].
In 1975, Cott [11], in his book Fasting as a Way of life
noted that “fasting brings a wholesome physiological
rest for the digestive tract and central nervous system
and normalizes metabolism.”
The findings of Ramadan fasting among Muslims and
similar limited energy intake situations among nonMuslims suggest that a high-fat diet around 36 percent of
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energy through fat, which includes poly-unsaturated fat,
may be beneficial in preventing elevation of blood
cholesterol or uric acid level and better retention of
protein in the body [12].
7. Effect of Fasting on Body Weight and
Blood Cholesterol
One of the major problems that contribute to conflicting
results on the effect of quantity or quality of dietary fat
on blood cholesterol level is a failure to examine the
effect of dietary fat in relation to body weight or changes
in body weight. There is an increase in blood cholesterol
levels with increasing or decreasing weight from normal
weight levels.
A study from Jordan showed that in 60 healthy Muslim
volunteers, that body weight decreased significantly at
the end of fasting, while there was no effect on cortisol,
testosterone, electrolytes, cholesterol or triglycerides. In
this study blood glucose increased slightly. Athar et al.
[13] from Iran continued these findings showing that in
the first half of Ramadan, there was a decrease in body
weight. However, it became steady during the second
half. He also showed that serum glucose decreased in the
first ten days but slightly increased at the end and
reached the pre-Ramadan level [13]. It has also been
reported that overweight persons lose more weight than
normal or underweight subjects. In normal non-diabetic
individuals, an average weight loss of 1.7-3.8 kg has
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been reported in different studies, the loss being greater
in overweight persons [14].
Hallak and Nomani [14] noted increased blood cholesterol
level with weight loss during the fasting month of
Ramadan in their study [15].
In one study that was over-represented by females, no
change in body weight was seen [16].
Pregnant and lactating women need for energy and
nutrients are more critical than the needs of men. There
is a possibility of health complications to the pregnant
and lactating women and the fetus or the lactating
mothers, if energy and nutrients requirement are not met
during the Ramadan fasting [17].
Nomani et al. revealed that among non-Muslim
American female subjects there was increase in blood
cholesterol level with lowering of the body mass-index
below 18.5 [18].
Maislos et al. suggested that when no significant
difference was noticed in blood cholesterol levels, before
and after fasting period, there was no significant
difference in body weight as well, during Ramadan. A
slight increase/decrease in the total cholesterol levels, an
increase in HDL-cholesterol, but no appreciable effects
on triglycerides and LDL-cholesterol levels were
observed [19].
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Other studies show Ramadan fasting induces a marked
increase in high-density lipoprotein cholesterol and
decrease in low-density lipoprotein cholesterol [20].
Its observance involves abstinence from eating and
drinking from dawn until sunset during the entire holy
month. The effects of Ramadan fasting on body
physiology as well as on the different biochemical,
hematological, and metabolic parameters are reviewed.
Metabolic changes, when present, are mild and
reversible. The effects of fasting on diabetes mellitus,
treatment with non-steroidal anti-inflammatory agents,
and anticoagulation therapy are discussed [21].
8. Diabetes mellitus not adversely
affected if controlled sensibly
In normal individuals, there is a slight fall in average
blood glucose levels in the first few days of Ramadan
fasting followed by normalization by about the 20th day,
and a relatively slight increase subsequently, but all
these variations are well within the normal physiological
range [21].
In properly educated, well-informed and motivated
persons with diabetes, under good medical supervision,
no significant aberrations in their blood glucose values
were reported during Ramadan fasting. However, some
of the diabetics who fasted during Ramadan experienced
variations in their blood glucose values depending upon
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the type, composition, and quantity of food consumed,
regularity in medicine taking, alterations in daily
physical activities or occasional binge eating after the
breaking of the fast [22].
In diabetics who fasted during Ramadan, some reports
have shown no change, or a decrease, or even a slight
increase in body weights perhaps due to the variations in
the life style changes practiced by these persons
especially in regard to quality and quantity of food
intake and the level of physical activities [23].
In another study, HbA1c, serum fructosamine level,
insulin, and C-peptide levels did not show any
significant changes during or soon after Ramadan fasting
[24]
.
In well-informed and motivated diabetics, total daily
caloric intake showed a slight decrease during the
Ramadan fasting [25].
Possible major metabolic risks associated with Ramadan
fasting for people with uncontrolled diabetes include
hypoglycemia, hyperglycemia with or without the risk of
impending ketosis, dehydration, and thrombosis [26].
Hyperglycemia can occur in persons who are negligent
about their medications and indulge in over-eating in the
hours after or before the stipulated fasting period.
Normally, the plasma glucose level fluctuates in a very
narrow range. In the prandial state the plasma glucose
level rises which is promptly sensed by the pancreas and
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results in an increase in insulin secretion, suppression of
glucagon secretion, a decrease in hepatic glucose output,
and an increase in the peripheral glucose utilization and
its storage. In diabetics, there is a loss of the first phase
insulin secretion and an increase in the pro insulin and
split proinsulin levels resulting in an increase in free
fatty acids and triglyceride levels. Glucagon levels
remain high and the hepatic glucose output is also not
suppressed appropriately. All these result in postprandial hyperglycemia. Even isolated post-prandial
hyperglycemia is known to increase the risk of fatal
cardiovascular disease.
Checking blood glucose through finger prick does not
invalidate fasting state. So patients are encouraged to
check blood glucose periodically. If blood sugar levels
are low and patient experiencing signs/symptoms of
hypoglycemia, it is advisable that the fast is broken
immediately.
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Conclusion
Fasting in the month of Ramadan is ordained on the
Muslim believers. Ramadan fasting has not only been
spiritually beneficial but it has physical, psychological,
social and health benefits.
Ramadan is a month of self regulation, process of self
purification, truthfulness and self trainings with the hope
that this training will last beyond the end of Ramadan.
One advantage of fasting is that the poor are given
attention and benefits from charity and the faithful
practice of the concept of neighbourhood and hospitality.
The physiological effect of fasting includes lowering 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. Fasting is powerful therapeutic
processes that can help people recover from mild to
severe health conditions. Our body has a self healing
power, in order to activate this power, the stomach must
be kept empty, if Ramadan fasting is done properly it
can help to recover from most diseases. If persons take
care about their dietary patterns, avoid addictions, speak
the truth, practice the concept of neighbourhood and
hospitality and give charity as prescribed, do regular
prayers, they will not only become an ideal human
beings, but will certainly be also entitled for God’s
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blessing and protection which all of us so desperately
need.
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al. (1997) Ramadan diet restrictions modify the circadian
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