Adverse Effects of Islamic Fasting

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Contrary to popular Muslim beliefs, Islamic fasting (Sawm) has numerous adverse effects that have been observed using scientific studies and news sources that are discussed below. As the article will explain using these studies, Islamic fasting has significant harmful affects on health, national economy and productivity, crime rate, safety (higher rate of traffic accidents) and social behavior. Health affects include heat stress, dehydration and nutritional status of lactating women, among others. It must be noted that medical fasting is different from Islamic fasting and can have benefits.

Contents

[edit] What is Islamic fasting?

The salient features of Islamic fasting are:

  • For 30 days every year (during the month of Ramadan), waking up before dawn and eating as much food as possible to prepare for the 12 hour fast
  • Refraining from consuming any food and water from dawn to sunset
  • Breaking the fast at sunset and again eating as much as possible

[edit] Social Behavior

[edit] Irritability

The following study in Morocco found that irritability increased during Ramadan:

Kadri N, Tilane A, El Batal M, Taltit Y, Tahiri SM, Moussaoui D

Abstract

OBJECTIVES: We hypothesized that people in Morocco are more irritable during the month of Ramadan than during the rest of the year. Our objectives were to measure irritability in fasting Muslims during the month of Ramadan, to describe its various modes of expression, and to examine risk factors for this irritability. METHODS AND SUBJECTS: We studied 100 healthy volunteers during the month of Ramadan for two successive years (1994 and 1995). All subjects were male (mean age, 32+/-5.8 years), and 51% of them were smokers. Irritability was assessed over a 6-week period (before, four times during, and after the end of Ramadan). We assessed both subjective (visual analog scale) and objective irritability. We also recorded the consumption of psychostimulants, duration of sleep, and anxiety level as measured by the Hamilton Anxiety Scale. RESULTS: Irritability was significantly higher in smokers than in nonsmokers before the beginning of Ramadan. It was higher in both groups during the Ramadan month. Irritability increased continuously during Ramadan and reached its peak at the end of the month. Consumption of psychostimulants (coffee and tea) and anxiety level followed the same pattern. Smokers and nonsmokers had a similar pattern of irritability over time, but irritability increased more in smokers than in nonsmokers.
Psychosomatic Medicine 2000 Mar-Apr 62:2 280-5 (pdf)
Wael Bakor, 29, marketing manager at a major company in Jeddah, expressed regret at the attitude of employees. “Unfortunately, people become more tense and irritated during Ramadan. One can easily notice the bad moods, the tension and the inability to put up with anyone or anything,” he said.[1]

[edit] Crime Rate

In the past few years, Ramadan — a month usually reserved for pious contemplation and reverence — has been marred by an alarming rise in violent crime, experts have said.

In a study done on the Arab world[2], experts claimed that increases in blood crimes (+1.5%) and theft (+3.5%) were observed during Ramadan.

Director of Jakarta Police’s General Crime Unit, Sr. Comr. Muhammad Iriawan called on Jakarta residents to be alert as crimes tended to increase during the fasting month of Ramadan.

...

Iriawan said crimes such as house break-ins and robberies tend to increase during Ramadan, when the need for extra money was high because of the festivities.
Meanwhile an official of the Jakarta city administration, A Sjarief Mustafa, says that the number of prostitutes caught by his office had increased from 94, before Ramadan, to 264 during it. He also said that the numbers of beggars had increased. He claimed that the incidence of social ills such as begging and prostitution always increased during the "holy month", and said that people from the provinces often used the "momentum" of Ramadan to come to Jakarta and seek money from the Jakarta's residents.

[edit] Effects on Health

In a recent study done on the Arab world, diseases linked to cholesterol and diabetes increased by 27.65% because of overeating.[2] Other health affects include:

[edit] Dehydration

One study finds that the incidences of dehydration rise during the month of Ramadan:

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).

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.

[edit] Other Moderate and Severe Disturbances

The following study studied Turkish Muslims in Germany who were involved in heavy and manual work. 'Moderate to severe health disturbances' including severe dehydration were found in such labourers during Ramadan:

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.
Polish Journal of Occupational Medince 1991 4:3 219-28

Naturally we would expect that this would effect productivity, as is evidenced in a later section on Economical effects.

[edit] 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 change in the body.

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.

Loss of body fat would indicate the use of fat for energy production during Ramadan (Husain, Duncan, Cheah, & Ch'ng, 1987; Ramadan et al., 1999; Sweileh et al., 1992). In addition, researchers have found decreased heart rate and oxygen consumption during Ramadan (Husain et al., 1987; Ramadan et al., 1999; Sweileh et al., 1992). These findings suggest a metabolic adaptation to fasting. It seems that during the Ramadan daylight hours - when no food or water is taken in - to conserve stored energy, the metabolism slows down (Sweileh et al., 1992).

Other studies, however, have reported no change in body weight during Ramadan (El-Ati, Beji, & Danguir, 1995; Finch, Day, Razak, Welch, & Rogers 1998; Maislos et al., 1993; Maislos, Abou-Rabiah, Zuili, Iordash, & Shany, 1998). In fact, one study carried out in Saudi Arabia reported a significant increase in body weight during Ramadan (Frost & Pirani, 1987). Such variations may be attributable to local custom and food quality. In short, in Islamic communities - as elsewhere - food habits vary according to geography, culture, and socioeconomic factors (Musaiger, 1993; Rashed, 1992). Ramadan is a special month and the variety of foods generally increases (Karaagaoglu & Yucecan, 2000) so, during this period, richer meals and special treats are not uncommon in households that can afford them.

[edit] Sleep disorders, Daytime Drowsiness and Alertness

Effect of fasting during Ramadan on sleep architecture, daytime sleepiness and sleep pattern:

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.
Ahmed BAHAMMAM/Sleep Disorders Center, Respiratory Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia

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.

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.
Therapie 54:567-72

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:

Daytime alertness, mood, psychomotor performances, and oral temperature during Rramadan 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.
Annals of Nutrition and Metabolism 2000 44:101-7

[edit] Affect on Circadian Patterns

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.[3]

[edit] Lactating women

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. [4]

[edit] Reduced Blood Donation

Blood Transfusion Organization announced that blood donations have dropped by 35 percent since the beginning of the Muslim fasting month of Ramadan (Sept. 25).[5]

The same news source said that "each blood unit can save three lives". This implies that Ramadan also results in loss of life since life-saving blood donations drop by one-third.

[edit] Comments from a Dietitian: Binge eating, headaches and increase in gastric acidity

'Binge eating is a fairly common habit during the Ramadan period, especially as the day is spent without eating or drinking,' says Anjali Dange, Dietitian at Welcare Hospital.

"During the initial days of fasting, you may encounter slight dizziness as well as frequent headaches."

Dr Phadke says that fasting can also increase levels of gastric acidity in the stomach which can cause burning and heaviness, and sometimes a sour taste in the mouth.

[edit] Economical Effects

As some of the above studies established, fasting can cause dehydration, sleep disorders and other harmful affects. Naturally all of this would affect productivity and the national economy. Those living in Muslim majority nations can readily feel the effects of stagnation that accompanies the month of Ramadan. In such places, it is a month that is marked by very low productivity. When the entire population of a country observes fasting during the time they are at work, it is inevitable that they will suffer a significant loss in general productivity. In a survey carried out by Cairo’s Institute of Social Sciences of the Arab World it is found that the productivity of Arab businesses during the month of Ramadan dropped by a staggering 78%:

Ramadan: Productivity of Arab Businesses Drops by 78%

(ANSAmed) - Tunis, September,3

During Ramadan, the productivity of Arab businesses drops by 78%. The essential factors? Fewer work hours, absenteeism, and sick leave. (...) The figures are included in a survey carried out by Cairòs Institute of Social Sciences of the Arab World which was printed today by 'Leaders', a Tunisian website. (ANSAmed)[2]
*

Production in almost all businesses in Morocco drops during the month of Ramadan, analysts say, although consumption increases significantly:

Work hours are shorter during Ramadan, with employees working seven-hour days compared to the regular 8.5-hour days. Some businesses don't open until 10 am, and school timetables change to accommodate the Ramadan calendar.

"The drop in productivity could be due to the disruption of the body clock," said A. Hamdi, who works in an industrial unit. "It is difficult to get used to the work day.

In addition to the women who race home to make iftar, others are sneaking out earlier to avoid traffic jams, which usually start at 4 pm with the end of the normal working day."
Performance in most companies, institutions and government departments around the Arab world is usually at a low during the month of Ramadan, with poor productivity and constant reported absences.

In Bahrain, the work day is reduced to six-hours instead of the normal eight hours:[1]

Alaa Al-Mohammadi, 27, works as a teaching assistant at King Abdul Aziz University, which, during Ramadan, opens between 10 a.m. and 3 p.m. Al-Mohammadi noticed the low level of productivity during the month of Ramadan, especially among students. “On account of the nature of the month when people stay up all night, absenteeism increases among students,” she said.[1]
"Jordanian workers in general are not hard working and in Ramadan, employees frequently are absent or ask for leave, a notable phenomenon that negatively affects the overall economic performance," economist Salameh Darawi told The Jordan Times over the phone Wednesday. Economic analyst Hussam Ayesh said productivity drops by about 50 per cent in the public and private sectors during Ramadan.[6]

[edit] Physical Exhaustion and Incapacitation

Another study takes a look at fasting Muslims who were stricken with lethargy and fatigue due to the behavioral changes that accompany the month long celebration.

Some behavioural Changes observed among fasting subjects, their nutritional habits and energy expenditure in Ramadan. Karaaðaoðlu N, Yücecan S

Abstract

This study was conducted in five provinces and food consumption, physical activity types and duration for 3 consecutive days were recorded in the questionnaire together with some general characteristics of 750 (320 males, 430 females) adults who were on fast during Ramadan at time of interview. One hundred and eighty-seven subjects had some type of health problems, among whom 60.4% were using drugs, and 31.6% were on diets; however, during Ramadan 9.7 and 18.8% of the subjects dropped taking drugs and did not regularly keep on diets, respectively. During the fasting time, from dawn to sunset, 34.3% of the subjects developed some behavioural disturbances, such as feeling tired and being unwilling to work. Although the meal consumed at dawn consisted of foods that were usually eaten at breakfast, the meal consumed at sunset consisted of a great variety of foods. Calcium intake was the most insufficiently consumed nutrient. It was observed that the daily energy intakes were less than the expenditures both in males and females. Further research should be done on the effects of fasting in health and disease.
International Journal of Food Science and Nutrition 2000 Mar 51:125-34

In September 2009, Stephen Constantine, Head coach of Sudan partly blamed his side’s loss to the Black Stars to the fasting of most of his players. [7] In Italy, both a prominent coach and a team owner in the top Serie A league linked the rigors of Ramadan's sunrise-to-sunset fasting to Muslim players' poor performance on the pitch. [8]

An increase in road traffic accidents in the U.A.E. during Ramadan was reported. [9].

[edit] Comments from Muslims and former Muslims

Dr. Muhammad Alabdooni, the chairman of the Dutch Moroccan Physicians Association, maintains there is no scientific proof that Islamic fasting is physiologically beneficial. [10]

An employee at a construction material company, who preferred anonymity, said: "Everything is slow in Ramadan and I myself tend to delay work. The only fast thing I see in Ramadan is lunatic drivers speeding to get home for iftar."[6]
In Ramzan the working hours are nine to one. That’s it. And in these four hours work is the last thing on the workers’ mind. Go to any government office during these four hours and you will encounter a grouchy, lazy and sick-of-life person with bad breath (apparently even brushing your teeth in the morning is not kosher if you are fasting). No matter how urgent your work, leave the place and come back after two and a half months in the third week of Muharram. This man is in no mood to do anything. He’d rather go home and watch an Indian movie till he breaks fast.
I couldn't concentrate in school. I had nasty heart burn all morning, because we'd wake up at an ungodly hour to gorge! [...] There are many women in my life and some of them are extremely old with various medical conditions. They all feel compelled to fast. It drives me insane!

[edit] Conclusion

Intermittent and prolonged fasting is generally not conducive to a healthy lifestyle. Depriving the body of water and essential nutrients by dividing and postponing meals to irregular intervals does nothing to limit consumption. Infact it causes a host of health, performance and mood disorders. Fasting is not normally prescribed for the well being of human beings. Instead, it is commonly understood that eating healthy, smaller-portioned meals, interspersed throughout the day is far better in maintaining a well-balanced diet and far more forgiving on a person's metabolism. Any claims that prolonged and intermittent fasting contributes to the well-being of an individual's health are misleading, based on the scientific studies that prove otherwise. If the Islamic argument in favor of fasting is that “we fast because God commanded us to do so," then it is obvious that God is not a nutritionist or a dietician because the negatives definitely outweigh the positives.

So the question to the Muslim world is: keeping in mind the above adverse affects of fasting observed in studies, what benefit does the Muslim world get for 1 billion people staying hungry throughout the day for one full month every year? Did Allah actually want Muslims to suffer physically, economically and socially for one month every year? Also, if fasting is beneficial as Muslims claim, why do Muslims not fast the entire year instead of just one month?

[edit] References

  1. ↑ 1.0 1.1 1.2 Productivity and Self-Discipline in Ramadan
  2. ↑ 2.0 2.1 2.2 See Google cache of the original article: Ramadan: Productivity of Arab Businesses Drops by 78%, which has now been taken down. The existence of the article can be verified by Google search results which show multiple other websites quoting the same news article at the time of publication.
  3. ↑ "Does Ramadan modify the Circadian Patterns?" - J Postgrad Med March 2006 Vol 52 Issue 1 pdf
  4. ↑ "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
  5. ↑ Iran-Daily.com (pdf) - October 1, 2006
  6. ↑ 6.0 6.1 Productivity suffers during holy month (backup link)
  7. ↑ "Fasting affected my players" – Sudan coach
  8. ↑ Soccer Star Benched for Fasting During Ramadan
  9. ↑ Bener, A., Absood, G. H., Achan, N. V., & Sankaran-Kutty, M. (1992). Road traffic injuries in Al-Ain City, United Arab Emirates. The Journal of the Royal Society of Health, 112, 273-276.
  10. ↑ Is fasting during Ramadan good for your health?

[edit] External Links

[edit] Scientific Studies

[edit] See also

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