8/6/2019 Ramadan Health Effects of Fasting the Lancet

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The Lancet, Volume 374, Issue 9690, Page 588, 22 August 2009

doi:10.1016/S0140-6736(09)61506-3

Ramadan: health effects of fastingThe Lancet

Aug 21, 2009, is the start of Ramadan—the ninth month in the Islamic calendar—when, according to Muslims,

the Quran was sent down by Allah to mankind. For this reason, every year Muslims fast from sunrise to sunset

during the 29 or 30 days of Ramadan. The Islamic calendar, being a lunar calendar, is 10 days shorter than the

Gregorian calendar and therefore Ramadan moves forward by 10 days each year. Muslims believe that fastingduring Ramadan improves self-discipline, and increases spirituality, inner peace, and awareness of the hardship

suffered by those who do not have enough food and frequently go hungry without choice. It is not obligatory for

all Muslims—those exempt include children before the age of puberty, and people who are elderly, chronically ill,

or need to take medications regularly. Other individuals who are temporarily exempt include women who are

pregnant or breastfeeding, and people who are travelling long distances or are ill during Ramadan. These

individuals should make up the number of days missed at some other time in the year or during their lifetime.

Headaches (perhaps because of the daytime withdrawal of caffeine and fluids), dehydration, and sleep

deprivation (since long periods are devoted to praying) are a few of the adverse but transient health effects of fasting. Bodyweight might be reduced temporarily, depending on the types of foods that are eaten after the

breaking of the fast at sunset. Vahid Ziaee and colleagues have shown reductions in the concentrations of blood

glucose and HDL, and increases in LDL in healthy individuals during the period of fasting.

Some Muslims taking medications might wish to fast and therefore will not comply with their treatment. Doctors

and pharmacists need to be aware of this possibility and, if possible, offer these patients alternative

treatments—eg, once-daily formulations. Further investigation of the effects of fasting—eg, on metabolic and

endocrine biomarkers with time—might be of interest not only to Muslims but also to individuals for whom

occasional fasting might be of benefit.

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