MEDICAL ASPECTS OF ISLAMIC FASTING

Ramadan tak lama lagi akan muncul.masa begitu cepat berlalu...rasanya baru aje sambut bulan puasa tahun lepas..

Ini adalah satu artikel berkenaan kebaikan berpuasa dari aspek perubatan, dipetik dari Islamic Medicine. bab: 'medical aspect of Islamic fasting' oleh Dr Shahid Athar, MD

“O you who believe! Fasting is prescribed to you, as it was prescribed for those before you (i.e. Jews, & Christians) so that you may (learn) self-restraint.” (2:183)

According to Islamic Laws, children below 12, sick patients, travelers, and women who are menstruating or nursing a baby are exempt from fasting. In addition to staying away from food or water for the whole day, they are asked to stay away from sex, smoking or misconduct during the period of fast. In addition, they are encouraged to do more acts of piety i.e.prayer, charity, or reading Quran during this month.

Food is needed by the body to provide energy for immediate use by burning up carbohydrates, that is, sugar. Excess of carbohydrates which cannot be used is stored up as fat tissue in muscles, and as glycogen in liver for future use. Insulin, a hormone from the pancreas, lowers blood sugar and diverts it to other forms of energy storage, that is, glycogen. To be effective, insulin has to be bound to binding sites could receptor. obese people lack receptor; therefore, they cannot utilize their insulin. This may lead to glucose intolerance.

When one fasts (or decreases carbohydrate intake drastically), it lowers his blood glucose and Insulin level. This causes breakdown of glycogen from liver to provide glucose for energy need and breakdown of fat from adipose tissue to provide for energy needs.

On the basis of human physiology described above, semi-starvation (ketogenic diets) have been devised for effective weight control. These diets provide calculated amount of protein in divided doses with plenty of water, multi-vitamins, etc. These effectively lower weight, blood sugar, but because of their side effects, should be used only under supervision of physicians.

Total fasting reduces or eliminates hunger and causes rapid weight loss. In 1975, Allan Cott in his "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." It must be pointed out, however, that there are also many averse effects of total fasting. That includes hypokalemia and cardiac arrythmia associated with low calorie starvation diets used in unsupervised manner.

Why Islamic Fasting Is Different Than Other Types of Fasting

The Islamic fast, is different from the above "Diet Plans". It has beneficial features of both plans. Its unique medical benefits are due to the following factors :-

1 . As compared to other diet plans, in fasting during Ramadan, there is no malnutrition or inadequate calorie intake since there is no restriction on the type or amount of food intake during Iftaar or Sahar

2. Fasting, in Ramadan is voluntarily undertaken. It is not a prescribed imposition from a physician. In the hypothalamus part of the brain there is a center called "lipostat" which controls the body mass. When severe and rapid weight loss is achieved by starvation diet, the center does not recognize this as normal and, therefore re-programs itself to cause weight gain rapidly once the person goes off the starvation diet. So the only effective way of losing weight is slow, self-controlled, and gradual weight loss by modifying our behavior, and the attitude about eating while eliminating excess food. Ramadan is a month of self-regulation and self-training if terms of food intake thereby causing hopefully, a permanent change in lipostat reading.

3. In Islamic fasting, we are not subjected to a diet of selective food only (i.e. protein only, fruits only etc). 'Sahur' ( breakfast), before dawn is taken and then at sunset fast is broken with something sweet i.e. dates, fruits, juices to warrant any hypoglycemia followed by a regular dinner later on.

4. Additional prayers are prescribed after the dinner, which helps metabolize the food. Using a calorie counter, I counted the amount of calories burnt during extra prayer called Traveeh. It amounted to 200 calories. Islamic prayer called Salat uses all the muscles and joints and can be placed in the category of a mild exercise in terms of caloric out put.

5. Ramadan fasting is actually an exercise in self discipline. For those who are a chain smoker, 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.

6. Psychological effect of Ramadan fasting are also well observed by the description of people who fast. They describe a feeling of inner peace and tranquility. The prophet has advised them "If one slanders you or aggresses against you, tell them I am fasting". Thus personal hostility during the month is minimal. Crime rate in muslim countries fall during this month.