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21 April 2023Fasting or sawn during the month of Ramadan is one of the five pillars of the Muslim religion. It consists of not eating or drinking (not even water) from sunrise to sunset. This implies that the intake of liquids and food is exclusively at night. Therefore, it can be considered a form of intermittent fasting.
How long does the fast last? Is not fixed. Ramadan is celebrated in the ninth month of the Islamic calendar and, as it is a lunar calendar, the date of Ramadan celebration changes every year. In Spain, the fasting period can be about 10 hours if Ramadan is in winter and about 15 hours when it takes place in summer.
This year it started on March 23 and will end on April 21. And it is obligatory for all Muslims except for children, the elderly, pregnant and lactating women, sick people and people who have to make long journeys.
Fasting for 16 hours improves body composition
Ramadan is one of the most studied forms of intermittent fasting. We are talking about a pattern of food intake that alternates periods of fasting, without eating food or with a significant reduction in calories, with periods of unrestricted food intake. The most common form of intermittent fasting is to fast for 16 hours and eat in an 8-hour interval. Which is just what is done during Ramadan.
Over the past four decades, numerous studies have been conducted on the health effects of Ramadan fasting. Research shows that, as in other fasting situations, there is an improvement in body composition after Ramadan. This consists of a decrease in weight, body fat percentage and body mass index. And it is greater in overweight or obese individuals.
Body changes are mainly due to two reasons. On the one hand, the restriction in caloric intake, since we go from a pattern of 3-4 meals a day to one of 2 meals at night. And on the other hand, the adaptation of the metabolism, which causes more fats to be burned to obtain the energy necessary for the functioning of the body.
In addition, as in other intermittent fasting situations, there is also a decrease in total cholesterol and LDL cholesterol levels, fasting blood glucose, blood pressure and an increase in insulin sensitivity. All of these adaptations to fasting are considered metabolically beneficial.
Depression and anxiety decrease
The effects of fasting during Ramadan on mental health have been less analyzed. Several studies have measured the levels of depression, anxiety and mental stress of participants before and after the month of Ramadan, both in individuals with mental health problems and in healthy people.
It has been proven that after Ramadan these levels are lower in sick people and do not change in healthy subjects. It follows that Ramadan can have positive effects on individuals with depression, stress and anxiety.
But why? It seems to have to do with the fact that, during the Ramadan fast, due to changes in eating schedules, changes occur in the day/night circadian rhythms. They mainly affect the release of hormones such as leptin and ghrelin, which regulate satiety and appetite, but also participate in the regulation of our emotional state. That would justify the beneficial effects of Ramadan fasting on mental health.
However, these studies have an important limitation, since Ramadan involves many other lifestyle changes. Diet is modified but also the duration of sleep and its schedules, exposure to light, exercise levels and patterns of social relationships. All of these elements can affect people's moods.
Risk of dehydration and hypoglycemia
Fasting in Ramadan is generally considered safe, especially for people without health problems. However, it may have some risks. The most common is dehydration, especially in hot climates and when Ramadan takes place in summer. That dehydration can temporarily reduce physical and cognitive performance. However, it is rare for episodes of extreme dehydration to occur, since adequate levels of fluids are usually consumed after breaking the fast.
Especially in the first days of Ramadan, episodes of headaches as well as possible hypoglycemia can occur, especially in people with diabetes.
Other problems related to Ramadan are the difficulty in following pharmacological treatments, since meal times are altered. And also the reduction in the number of hours of sleep, since they go to bed later to break the fast at the end of the day (Iftar) and get up earlier to eat the first meal (Suhoor).
It is important to note that all these changes and effects on health are temporary and disappear around two weeks after the end of the fast.
During Ramadan, fewer calories are consumed but more sugars
There is no doubt that Ramadan affects dietary habits. Due to the diversity of cultures and dietary patterns that exist in different countries that practice Ramadan, it is difficult to reach clear conclusions. Despite everything, studies show three clear patterns that are different from those of the rest of the year.
Firstly, the shifting of meal times to the evening. Suhoor, considered as breakfast, provides 30-40% of the calories for the day and Iftar consumes 60-70% of the remaining calories. Sometimes, a soup is served between these two meals, in order to try to follow a pattern of 3 meals a day.
Secondly, there is an intake of traditional dishes, typical of Arab culture, and many of them are only consumed during Ramadan. Finally, meals are eaten as a family.
A study carried out a decade ago shows that four major dietary patterns are followed during Ramadan:
- One similar to the Western diet rich in fast food, salty snacks, nuts, potatoes, fish, chicken, chocolates and juices.
- The second would be a pattern high in cholesterol and with a high consumption of sugary and salty junk food, with a lot of pickles and sweets.
- The third would be a diet similar to the Mediterranean, with abundant vegetables, olive oil, dairy products, fresh and dried fruits, dates, red meat, tea and coffee.
- Finally, there would be the typical Ramadan diet in which you eat halim (wheat, barley, meat and sometimes lentil stew), soups, legumes, porridges (with oats, seeds, nuts and dried fruits mixed with yogurt, milk or water ), dates, whole grain, sugary drinks and Arabic sweets.
This diversity of dietary patterns makes it difficult to know how the dietary modifications of Ramadan affect the intakes of macronutrients (carbohydrates, fats and proteins) and micronutrients (vitamins and minerals). Although the research carried out in this regard shows divergent data, it seems clear that, although no significant nutritional deficit occurs, there is a lower calorie intake, a higher consumption of sugars and fiber.
In short, everything indicates that fasting in Ramadan is good for our metabolic health and has few harmful effects. In addition, its physiological and nutritional effects end when the month of fasting ends.
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Source: The Conversation. Authorship:
Francisco Manuel Martin Bermudo
Professor of Nutrition and Bromatology, Pablo de Olavide University