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Islamic Fasting and Health: Difference between revisions
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===Dehydration=== | ===Dehydration=== | ||
One study finds that incidences of dehydration increase during the month of Ramadan | One study finds that incidences of dehydration increase during the month of Ramadan: | ||
{{Quote|| '''PHYSIOLOGICAL FUNCTIONS''' | {{Quote|| '''PHYSIOLOGICAL FUNCTIONS''' | ||
Evidence of hemoconcentration and dehydration has been found during Ramadan (El-Hazmi, Al-Faleh, & Al-Mofleh, 1987; Kayikcioglu et al., 1999; Ramadan et al., 1999; Schmahl & Metzler, 1991; Sweileh et al., 1992). Restricted fluid intake, leading to disturbance in the fluid balance, is likely to cause these conditions. In the initial stages of dehydration, the clinical signs are tachycardia, tiredness and malaise, headaches and nausea. Middle-aged or more elderly persons are usually more prone to the effects of dehydration (Schmahl & Metzler). | Evidence of hemoconcentration and dehydration has been found during Ramadan (El-Hazmi, Al-Faleh, & Al-Mofleh, 1987; Kayikcioglu et al., 1999; Ramadan et al., 1999; Schmahl & Metzler, 1991; Sweileh et al., 1992). Restricted fluid intake, leading to disturbance in the fluid balance, is likely to cause these conditions. In the initial stages of dehydration, the clinical signs are tachycardia, tiredness and malaise, headaches and nausea. Middle-aged or more elderly persons are usually more prone to the effects of dehydration (Schmahl & Metzler). | ||
Dehydration is indicated by the increase of several serum biochemical parameters (El-Hazmi et al., 1987; Ramadan et al., 1999; Schmahl & Metzler, 1991; Sweileh et al., 1992). The increase in uric acid, however, should especially be noted (El-Ati et al, 1995; El-Hazmi et al., 1987; Fedail et al., 1982; Schmahl & Metzler, 1991), because hyperuricemia is one of the known sequelae of prolonged fasting (Murphy & Shipman, 1963). Hyperuricemia is associated with reduction in glomerular filtration rate, decrease in uric acid clearance and alterations in the renal transport of uric acid (Murphy & Shipman). During Ramadan, however, reports show that the increase in uric acid does not excessively deviate from the normal range and studies have not reported clinical gout (El-Hazmi et al., 1987; Fedail et al., 1982). Increased uric acid is, therefore, unlikely to affect healthy individuals.<ref name="Morimoto">Toda, Masahiro, Morimoto, Kanehisa | Dehydration is indicated by the increase of several serum biochemical parameters (El-Hazmi et al., 1987; Ramadan et al., 1999; Schmahl & Metzler, 1991; Sweileh et al., 1992). The increase in uric acid, however, should especially be noted (El-Ati et al, 1995; El-Hazmi et al., 1987; Fedail et al., 1982; Schmahl & Metzler, 1991), because hyperuricemia is one of the known sequelae of prolonged fasting (Murphy & Shipman, 1963). Hyperuricemia is associated with reduction in glomerular filtration rate, decrease in uric acid clearance and alterations in the renal transport of uric acid (Murphy & Shipman). During Ramadan, however, reports show that the increase in uric acid does not excessively deviate from the normal range and studies have not reported clinical gout (El-Hazmi et al., 1987; Fedail et al., 1982). Increased uric acid is, therefore, unlikely to affect healthy individuals.<ref name="Morimoto">Toda, Masahiro, Morimoto, Kanehisa - [http://findarticles.com/p/articles/mi_qa3852/is_200401/ai_n9352292/ Ramadan Fasting - Effect on Healthy Muslims] - Social Behavior and Personality, 2004</ref>}} | ||
===Migraines=== | ===Migraines=== | ||
Migraines are three times more common during Ramadan, affecting an estimated 90 million Muslims: | |||
{{Quote||An estimated 90 million of the world’s 1.57 billion Muslims are likely to suffer from migraine headaches during the dawn-to-dusk fasts during the month of Ramadan – which begins on Wednesday, at the height of summer heat. But Jewish researchers in the US and Israel have suggested how to help prevent the problem. | {{Quote||An estimated 90 million of the world’s 1.57 billion Muslims are likely to suffer from migraine headaches during the dawn-to-dusk fasts during the month of Ramadan – which begins on Wednesday, at the height of summer heat. But Jewish researchers in the US and Israel have suggested how to help prevent the problem. | ||
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===Tachycardia, Severe Headaches, Dizziness, Nausea, Vomiting and Circulatory Collapse=== | ===Tachycardia, Severe Headaches, Dizziness, Nausea, Vomiting and Circulatory Collapse=== | ||
The following study studied [[Turkey|Turkish]] Muslims in [[Germany]] who were involved in heavy and manual work. 'Moderate to severe health disturbances' including severe dehydration were found in such laborers during Ramadan | The following study studied [[Turkey|Turkish]] Muslims in [[Germany]] who were involved in heavy and manual work. 'Moderate to severe health disturbances' including severe dehydration were found in such laborers during Ramadan: | ||
'' | {{Quote||''The health risks of occupational stress in Islamic industrial workers during the Ramadan fasting period. | ||
Schmahl FW, Metzler B'' | |||
'''Abstract''' | |||
During Ramadan, Moslems are required strictly to avoid fluids and nourishment from dawn to sunset. Heat stress during such abstinence represents a substantial health hazard. In the Federal Republic of Germany (FRG) where numerous Moslems, particularly of Turkish origin, perform heat work and other heavy labour, we observed moderate to severe health disturbances in such labourers during Ramadan, e.g.: '''tachycardia, severe headaches, dizziness, nausea, vomiting and circulatory collapse'''. The '''severe dehydration''' of these workers was demonstrated by substantial increases in their hematocrit, serum protein, urea, creatinine, uric acid and electrolyte imbalance. Because of the evidence of the substantial health hazard to Islamic workers in such situations, we have strongly urged employers to refrain from assigning Islamic workers to heat work or heavy daytime work during Ramadan; we have therefore limited systematic studies of health problems during Ramadan to persons performing only moderate work. Even under these conditions signs of dehydration were found in the 32 labourers monitored. Some of these labourers also had to interrupt their observance of Ramadan due to health problems, e.g.: acute gout due to serum uric acid increase, or circulatory insufficiency. In light of the observed potentially harmful pathophysiological effects, the danger of dehydration of Islamic workers due to heat work during Ramadan should be taken very seriously.<ref> | During Ramadan, Moslems are required strictly to avoid fluids and nourishment from dawn to sunset. Heat stress during such abstinence represents a substantial health hazard. In the Federal Republic of Germany (FRG) where numerous Moslems, particularly of Turkish origin, perform heat work and other heavy labour, we observed moderate to severe health disturbances in such labourers during Ramadan, e.g.: '''tachycardia, severe headaches, dizziness, nausea, vomiting and circulatory collapse'''. The '''severe dehydration''' of these workers was demonstrated by substantial increases in their hematocrit, serum protein, urea, creatinine, uric acid and electrolyte imbalance. Because of the evidence of the substantial health hazard to Islamic workers in such situations, we have strongly urged employers to refrain from assigning Islamic workers to heat work or heavy daytime work during Ramadan; we have therefore limited systematic studies of health problems during Ramadan to persons performing only moderate work. Even under these conditions signs of dehydration were found in the 32 labourers monitored. Some of these labourers also had to interrupt their observance of Ramadan due to health problems, e.g.: acute gout due to serum uric acid increase, or circulatory insufficiency. In light of the observed potentially harmful pathophysiological effects, the danger of dehydration of Islamic workers due to heat work during Ramadan should be taken very seriously.<ref>Polish Journal of Occupational Medicine 1991 4:3 219-28</ref>}} | ||
Naturally we would expect that this would affect productivity, as is evidenced in a later section on | Naturally we would expect that this would affect productivity, as is evidenced in a later section on Economical effects. | ||
===Weight Fluctuation=== | ===Weight Fluctuation=== | ||
The following study takes a look at the significant fluctuations in the weight of individuals that occurs during the month of Ramadan, primarily as a result of the metabolic changes that occur in the body. | The following study takes a look at the significant fluctuations in the weight of individuals that occurs during the month of Ramadan, primarily as a result of the metabolic changes that occur in the body. | ||
{{Quote||Numerous studies have reported significant weight loss during Ramadan (Adlouni, Ghalim, Benslimane, Lecerf, & Saile, 1997; Adlouni et al., 1998; Fedail, Murphy, Salih, Bolton, & Harvey, 1982; Kayikcioglu, Erkin, & Erakgun, 1999; Ramadan, Telahoun, Al-Zaid, & Barac-Nieto, 1999; Schmahl & Metzler, 1991; Sweileh, Schnitzler, Hunter, & Davis, 1992). The declines may result from water loss early in Ramadan and loss of body fat during the later period (Sweileh et al., 1992). In fact, we did find evidence of dehydration. | {{Quote||Numerous studies have reported significant weight loss during Ramadan (Adlouni, Ghalim, Benslimane, Lecerf, & Saile, 1997; Adlouni et al., 1998; Fedail, Murphy, Salih, Bolton, & Harvey, 1982; Kayikcioglu, Erkin, & Erakgun, 1999; Ramadan, Telahoun, Al-Zaid, & Barac-Nieto, 1999; Schmahl & Metzler, 1991; Sweileh, Schnitzler, Hunter, & Davis, 1992). The declines may result from water loss early in Ramadan and loss of body fat during the later period (Sweileh et al., 1992). In fact, we did find evidence of dehydration. | ||
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===Sleep Disorders, Daytime Drowsiness, Alertness and Cognition=== | ===Sleep Disorders, Daytime Drowsiness, Alertness and Cognition=== | ||
Effects of fasting on sleep architecture, daytime sleepiness and sleep patterns: | |||
{{Quote||'''Abstract:''' Fasting during Ramadan is distinct from regular voluntary or experimental fasting. This project was conducted to objectively assess the effect of Ramadan fasting on sleep architecture, daytime sleepiness and the circadian cycle of melatonin level. Eight healthy volunteers reported to the Sleep Disorders Center on four occasions for polysomnography and multiple sleep latency tests: 1) an initial visit for adaptation; 2) 2 weeks before Ramadan (BL); and 3,4) during the first and third weeks of Ramadan (R1, R3). Salivary melatonin level was measured using radioimmunoassay. Sleep latency at night was significantly shorter and the amount of rapid eye movement sleep was significantly less, at R3 compared to BL. There was no difference in multiple sleep latency test data between BL and Ramadan. Although melatonin level kept the same circadian pattern at BL, R1 and R3, it had a flatter slope and a significantly lower peak at midnight (00:00) at R1 and R3. This study showed a significant reduction in sleep latency and rapid eye movement sleep during the third week of Ramadan fasting. Otherwise, there was no significant effect of Ramadan on sleep architecture and assessment revealed no increase in daytime sleepiness. Although melatonin level had the same circadian pattern during Ramadan, the level of the hormone dropped significantly from baseline. The results of the scientific studies can lead us to conclude that fasting severely alters an individual's circadian rhythm. As a result, the unfavorable side-effects such as lethargy and a lack of motivation, will unfortunately contribute to a society's lack of productivity.<ref>Ahmed BAHAMMAM/Sleep Disorders Center, Respiratory Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia</ref>}} | {{Quote||'''Abstract:''' | ||
Fasting during Ramadan is distinct from regular voluntary or experimental fasting. This project was conducted to objectively assess the effect of Ramadan fasting on sleep architecture, daytime sleepiness and the circadian cycle of melatonin level. Eight healthy volunteers reported to the Sleep Disorders Center on four occasions for polysomnography and multiple sleep latency tests: 1) an initial visit for adaptation; 2) 2 weeks before Ramadan (BL); and 3,4) during the first and third weeks of Ramadan (R1, R3). Salivary melatonin level was measured using radioimmunoassay. Sleep latency at night was significantly shorter and the amount of rapid eye movement sleep was significantly less, at R3 compared to BL. There was no difference in multiple sleep latency test data between BL and Ramadan. Although melatonin level kept the same circadian pattern at BL, R1 and R3, it had a flatter slope and a significantly lower peak at midnight (00:00) at R1 and R3. This study showed a significant reduction in sleep latency and rapid eye movement sleep during the third week of Ramadan fasting. Otherwise, there was no significant effect of Ramadan on sleep architecture and assessment revealed no increase in daytime sleepiness. Although melatonin level had the same circadian pattern during Ramadan, the level of the hormone dropped significantly from baseline. The results of the scientific studies can lead us to conclude that fasting severely alters an individual's circadian rhythm. As a result, the unfavorable side-effects such as lethargy and a lack of motivation, will unfortunately contribute to a society's lack of productivity.<ref>Ahmed BAHAMMAM/Sleep Disorders Center, Respiratory Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia</ref>}} | |||
Naturally, a fast would indicate that individuals are ingesting less food. But the following two studies reveal that the decrease in the number of meals that are eaten directly disturbs normal sleep habits and thereby increases daytime drowsiness. | Naturally, a fast would indicate that individuals are ingesting less food. But the following two studies reveal that the decrease in the number of meals that are eaten directly disturbs normal sleep habits and thereby increases daytime drowsiness. | ||
''Taoudi Benchekroun M, Roky R, Toufiq J, Benaji B, Hakkou F, | {{Quote|| ''Epidemiological study: chronotype and daytime sleepiness before and during Ramadan. | ||
Taoudi Benchekroun M, Roky R, Toufiq J, Benaji B, Hakkou F'' | |||
'''Abstract''' | |||
Few epidemiological data have been reported on the relation between Ramadan fasting, life habits (meal frequency, sleep habits) and daytime sleepiness during Ramadan. This paper presents the results of a detailed study of the chronotype and daytime sleepiness before and during Ramadan. It was conducted on a sample of 264 subjects aged between 20 and 30 years. Results have revealed a significant decrease in the meal frequency during Ramadan compared with the control period. Before Ramadan, the majority of subjects woke up between 6 and 7 a.m. and went to sleep between 10 and 11 p.m. however, during Ramadan fasting, they woke up after 8 a.m. and preferred to go to sleep later (after midnight). Chronotype as evaluated by the Horne and Ostberg scale was changed significantly during Ramadan: an increase of the evening type and a decrease in the morning type of subjects was observed. Daytime sleepiness as evaluated by the Epworth Sleepiness Scale was significantly increased.<ref>Therapie 54:567-72</ref>}} | |||
The following study studies the effect that fasting has on the alertness of an individual. Evidently, the change in sleep patterns causes a decrease in oral temperature and alertness: | |||
'' | {{Quote||''Daytime alertness, mood, psychomotor performances, and oral temperature during Ramadan intermittent fasting. Roky R, Iraki L, HajKhlifa R, Lakhdar Ghazal N, Hakkou F'' | ||
'''Abstract''' | |||
During the month of Ramadan, Moslems abstain from drinking and eating daily between sunrise and sunset. This change of meals schedule is accompanied with changes in sleep habit, which may affect diurnal alertness. This study examined the effect of Ramadan intermittent fasting on the diurnal alertness and oral temperature in 10 healthy young subjects. The cognitive task battery including movement reaction time (MRT), critical flicker fusion (CFF) and visual analogue scale, was administered at 6 different times of the day: 09.00, 11.00, 13.00, 16.00, 20.00 and 23.00 h on the 6th, 15th, and 28th days of Ramadan. The baseline day was scheduled one week before Ramadan, and the recovery day 18 days after this month. Oral temperature was measured prior to each test session and at 00.00 h. During Ramadan oral temperature decreased at 09.00, 11.00, 13.00, 16.00 and 20.00 h and increased at 23.00 and 00.00 h. Subjective alertness decreased at 09.00 and 16.00 h and increased at 23.00 h. Mood decreased at 16.00 h. MRT was increased at the beginning of Ramadan (R6) and CFF was not changed. These results showed that daytime oral temperature, subjective alertness and mood were decreased during Ramadan intermittent fasting.<ref>Annals of Nutrition and Metabolism 2000 44:101-7</ref>}} | |||
===Cognition=== | ===Cognition=== | ||
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===Affect on Circadian Patterns=== | ===Affect on Circadian Patterns=== | ||
{{Quote||This change of meal schedule is accompanied with changes in sleep habits, such as delayed and shortened sleep periods, which may affect endocrine and neuroendocrine circadian patterns. Several cardiovascular parameters (i.e., heart rate, blood pressure, vascular tone, and coagulation-fibrinolysis) show circadian pattern. Several studies reported that autonomic activity and melatonin rhtyhmicity may be responsible for circadian patterns of cardiovascular parameters. '''Changes of sleep habit in Ramadan affects autonomic activity and melatonin rhtyhmicity'''. The other negative effects may be that, during fasting patients with cardiovascular disease cannot consume medications, such as anti-ischemic, anti-platelet, anti-hypertensive drugs, and drugs of heart failure on time. Some patients may get admitted to the hospital with cardiovascular symptoms owing to failure of therapy.<ref>"Does Ramadan modify the Circadian Patterns?" - Journal of Postgraduate Medicine, March 2006, Vol. 52 Issue 1 [https://tspace.library.utoronto.ca/bitstream/1807/6924/1/jp06011.pdf pdf]</ref>}} | |||
{{Quote||This change of meal schedule is accompanied with changes in sleep habits, such as delayed and shortened sleep periods, which may affect endocrine and neuroendocrine circadian patterns. Several cardiovascular parameters (i.e., heart rate, blood pressure, vascular tone, and coagulation-fibrinolysis) show circadian pattern. Several studies reported that autonomic activity and melatonin rhtyhmicity may be responsible for circadian patterns of cardiovascular parameters. '''Changes of sleep habit in Ramadan affects autonomic activity and melatonin rhtyhmicity'''. The other negative effects may be that, during fasting patients with cardiovascular disease cannot consume medications, such as anti-ischemic, anti-platelet, anti-hypertensive drugs, and drugs of heart failure on time. Some patients may get admitted to the hospital with cardiovascular symptoms owing to failure of therapy.<ref>"Does Ramadan modify the Circadian Patterns?" | |||
===Lactating women=== | ===Lactating women=== | ||
In a | In a certain study, the nutritional status of lactating women was affected by Ramadan fasting. All of the nutrient intakes (except vitamins A, E and C) decreased during Ramadan. The study said that it would seem prudent to excuse lactating women from fasting during Ramadan.<ref>"The effect of Ramadan on maternal nutrition and composition of breast milk." Pg. 278-283, vol. 48 - Nutrition and Dietetics; Food Engineering, Hacettepe University, Ankara, Turkey</ref> | ||
===Pregnancies=== | ===Pregnancies=== | ||