Fasting
Ramzan gives the body a natural opportunity to rest, repair and refresh itself, without medicines, supplements or complicated wellness routines. While many people view fasting mainly as a religious duty, science now recognizes its positive effects on metabolism, mental health, healthy ageing and disease prevention.
Fasting is not something modern science invented. It is a process already built into human biology. For centuries, different cultures and faiths have practiced fasting. What research is now confirming is simple: fasting is not only an act of devotion, it is also a powerful biological reset for the body.
Metabolic Autophagy
One of the most important things scientists have learned about fasting is a process called autophagy, which won the Nobel Prize in Medicine in 2016. During fasting, when the body does not receive food for some time, it does not become weak immediately, instead, it starts a natural cleaning process. The body removes damaged cells and unwanted proteins and recycles them for better use.
Research shows that this process may help protect against age-related diseases such as Alzheimer’s, Parkinson’s and even some cancers. Because of this, scientists often describe fasting as a natural “reset button” for the body that may support healthier ageing and longer life.
Liver Health
The liver is the body’s main processing centre. It handles what we eat and drink, including fats, sugars, medicines and harmful substances. Normally, the liver works continuously to manage blood sugar, break down cholesterol and neutralise toxins.
During fasting, the liver changes the way it produces energy. Instead of using glucose from recent meals, it begins to use stored body fat to make energy (a process called ketone production). This shift can support weight control and improve the body’s response to insulin.
Studies also suggest that structured fasting and overall calorie control may help reduce fat buildup in the liver in some people and can improve blood lipid patterns, such as lowering LDL (“bad”) cholesterol and sometimes improving HDL (“good”) cholesterol.
Together, these changes may help lower the risk of type 2 diabetes and heart disease when fasting is done safely and combined with healthy eating. In simple terms, fasting allows the body’s metabolism, including the liver, to work in a more efficient and balanced way.
Intestinal Healing and Microbiome Reset
The gut is often called the body’s “second brain” because it plays a big role not only in digestion but also in immunity and even mood. It contains trillions of helpful bacteria that keep the digestive system balanced. However, irregular eating, too much processed food and constant snacking can disturb this balance, leading to bloating, inflammation and poor digestion.
Fasting gives the gut a much-needed rest period. During this time, the intestine gets a chance to repair itself, and the balance of gut bacteria may improve. Research suggests that fasting and controlled eating patterns can reduce inflammation in the body and support better digestive health.
In simple terms, fasting acts like a natural reset for the digestive system, helping the gut work more smoothly and reducing unnecessary stress on it.
Cognitive Benefits and Mental Clarity
The brain is an energy-intensive organ, consuming about 20% of the body’s total energy. When we fast, the body enters a state of mild stress, which paradoxically benefits the brain. Research shows that fasting increases levels of brain-derived neurotrophic factor (BDNF), a protein essential for learning, memory and neuroplasticity.
Additionally, fasting has been linked to:
Increased production of new neurons (neurogenesis).
Reduction in neuroinflammation, lowering the risk of Alzheimer’s and dementia.
Enhanced focus and cognitive sharpness due to stabilized blood sugar levels and ketone production.
This explains why many people experience heightened mental clarity during fasting, proving that hunger does not weaken the mind—it sharpens it.
Who Can Fast, and Who Should Not?
While fasting has remarkable health benefits, it is not suitable for everyone. Islam itself grants exemptions for those who may suffer adverse effects. Medically, fasting should be approached with caution in the following cases:
Safe to Fast:
Healthy individuals with stable metabolic health.
Individuals with stable chronic diseases (under medical guidance)
Overweight individuals aiming for controlled weight loss.
Those with mild insulin resistance but not on intensive medications.
People with controlled diabetes, monitored closely
Should Avoid or Modify Fasting
Diabetics on high doses of insulin or sulfonylureas (risk of hypoglycemia).
Pregnant and lactating women, as nutritional needs are high.
Patients with severe heart or kidney diseases requiring strict fluid balance.
Those with a history of eating disorders.
Diabetics with uncontrolled sugar levels
Elderly with frailty or chronic diseases
Patients on essential medications requiring frequent intake
Note: With proper medical guidance, even some diabetics and hypertensive patients can fast safely. For individuals with pre-existing conditions, Suhoor (pre-dawn meal) and Iftar (evening meal) should be adjusted under medical supervision.
What to Eat and Avoid During Sehri & Iftar
Fasting during Ramadan is not just about abstaining from food; it’s about nourishing the body with the right nutrients at the right time. In Kashmir, traditional foods like dates, basil seed milk, Phirni, fruits, rice and roti play a significant role in Suhoor (Sehri) and Iftar. However, what we choose to eat directly impacts our energy levels, hydration, and overall health.
What to Eat at Sehri
Complex Carbohydrates – Whole wheat roti, brown/white rice, oats (for slow energy release).
Healthy Fats – Nuts, seeds and a drizzle of olive oil to keep you full longer.
Proteins – Eggs, yogurt, lean meats (chicken, fish) for muscle preservation.
Hydration – Water, herbal tea
What to Avoid:
Salty Foods – Pickles, processed foods (increase thirst).
Sugary Cereals & White Bread – Cause sugar spikes and crashes.
Caffeinated Drinks – Tea, coffee (cause dehydration and frequent urination).
What to Eat at Iftar
Dates & Water – A natural energy booster and hydrator
Basil seed & milk
Fruits & Fiber – Apples, pears, and bananas to sustain energy.
Soups & Light Starters – Lentil soup, bone broth to restore electrolytes.
Proteins & Vegetables – Grilled fish, lean meats, legumes, and greens for muscle repair.
Traditional Delights in Moderation – Phirni (using almond milk and sugar substitutes).
Healthy Fats – Olive oil, nuts, and seeds for sustained energy.
What to Avoid:
Deep-Fried Snacks – Pakoras, samosas, fried meats (cause bloating and sluggishness).
Sugary Desserts & Drinks – Traditional sweets (increase sugar spikes and fatigue).
Overeating – Leads to discomfort and slows metabolism.
Essential Tips for a Healthy Ramadan
Prioritize Hydration – Drink ample water between Iftar and Suhoor to prevent dehydration.
Balanced Nutrition – Include protein, fiber, and healthy fats in every meal for sustained energy.
Smart Cooking Choices – Opt for grilled, baked, or steamed dishes instead of fried foods.
Monitor Blood Sugar – Regular checks are essential, especially for diabetics on medication.
Portion Control – Stick to recommended serving sizes to avoid overeating and discomfort.
Calorie Awareness – More oil, larger servings, or extra ingredients can significantly increase calorie intake.
Eat Mindfully – Avoid overeating to prevent bloating and sluggishness.
Stay Active – Engage in light post-Iftar walks or gentle stretching for better digestion.
Prioritize Sleep – Quality rest is crucial for metabolism, digestion, and overall well-being.
Limit Caffeine – Excess tea or coffee can lead to dehydration and disrupt sleep.
Listen to Your Body – If you feel weak, dizzy, or unwell, seek medical advice immediately.
A mindful approach to fasting ensures not just spiritual fulfillment but also optimal health and vitality throughout Ramadan.
Precautions for Diabetics During Fasting & When to Break the Fast
Precautions Before and During Fasting
Consult Your Doctor – Get medical clearance before fasting, especially if on insulin or multiple medications.
Monitor Blood Sugar Regularly – Check levels before Suhoor, mid-day, before Iftar, and two hours after Iftar.
Stay Hydrated – Drink plenty of water between Iftar and Suhoor to prevent dehydration and blood sugar fluctuations.
Choose Suhoor Wisely – Opt for complex carbs (oats, whole wheat), healthy fats (nuts, avocados), and proteins (eggs, yogurt) to maintain stable sugar levels.
Avoid Sugary & Processed Foods – They cause rapid spikes and crashes in blood sugar levels.
Be Cautious with Physical Activity – Light walking is fine, but intense exercise may lead to hypoglycemia.
Adjust Medication if Needed – Work with your doctor to modify insulin or oral diabetes medications to prevent extreme highs or lows.
When to Break the Fast Immediately
Diabetics should break their fast if they experience:
Severe Hypoglycemia (Low Blood Sugar) – If blood sugar drops below 70 mg/dL (3.9 mmol/L), break the fast immediately with dates, juice or glucose tablets.
Hyperglycemia (High Blood Sugar) – If blood sugar exceeds 300 mg/dL (16.7 mmol/L), fasting should be stopped to prevent complications.
Dehydration Symptoms – Excessive thirst, dry mouth, dizziness, or dark urine indicate dehydration, requiring immediate rehydration.
Severe Weakness or Confusion – Any signs of fainting, disorientation, or heart palpitations signal the need to break the fast and seek medical help.
Fasting with diabetes requires careful planning and monitoring. Prioritize health over obligation, as Islam allows exemptions for medical conditions.
Precautions for Hypertensive Patients During Fasting
Fasting can be safe for individuals with hypertension, but proper precautions must be taken to prevent complications. Here’s what hypertensive patients should keep in mind during Ramadan:
Monitor Blood Pressure Regularly – Keep track of BP levels before Suhoor, midday, and after Iftar to ensure stability.
Stay Hydrated – Drink plenty of water between Iftar and Suhoor to prevent dehydration, which can spike blood pressure.
Limit Salt Intake – Avoid salty foods (pickles, processed snacks, canned items) as they can raise blood pressure.
Choose Heart-Healthy Foods – Consume whole grains, lean proteins, fresh fruits, and vegetables to maintain stable BP.
Avoid Caffeinated Drinks – Excess tea and coffee can dehydrate the body and increase blood pressure fluctuations.
Take Prescribed Medications – Do not skip BP medications; consult a doctor about adjusting doses for fasting.
Avoid Heavy or Fried Foods – Oily and fried foods can contribute to weight gain and higher BP levels.
Engage in Light Physical Activity – Post-Iftar walks or gentle stretching can improve circulation and heart health.
When Should a Hypertensive Patient Break the Fast?
Fasting should be stopped immediately if any of the following occur:
Severe Headache, Dizziness, or Blurred Vision – Signs of dangerously high or low BP.
BP Exceeds 180/110 mmHg – A hypertensive emergency that requires immediate medical attention.
Chest Pain or Shortness of Breath – May indicate a cardiac issue and should not be ignored.
Severe Weakness or Fainting – A sign of low BP or dehydration that needs urgent hydration and rest.
Diabetes and Ramadan: Practical Guidelines (IDF-DAR 2021)
These guidelines were jointly developed and compiled by International Diabetes Federation (IDF) and Diabetes & Ramadan (DAR) International Alliance. They were prepared by an international panel of endocrinologists, diabetologists, primary care physicians and public health experts, with contributions from Islamic scholars to ensure medical and religious alignment.
This document provides evidence-based, real-world guidance to help healthcare professionals and people with diabetes fast safely during Ramadan. It was developed because many patients fast despite medical exemptions.
Why Special Guidance is Needed
Ramadan fasting changes meal timing, sleep patterns, and metabolism. People with diabetes face risks such as: Hypoglycaemia; Hyperglycaemia; Dehydration; Diabetic ketoacidosis.
Despite exemptions, a large proportion of diabetics still fast.
Risk Stratification (Core Concept)
The guidelines emphasize pre-Ramadan risk assessment, classifying patients into:
Low Risk: People who can usually fast safely with basic precautions.
Examples: Well-controlled Type 2 diabetes; On diet alone or low-risk medicines (e.g., metformin); No recent hypoglycaemia; Otherwise medically stable
Moderate Risk: People who may fast with caution and close medical supervision.
Examples: Type 2 diabetes with moderate control; On medicines that can sometimes cause low sugar; Elderly but otherwise stable; Presence of mild complications
They require: dose adjustment, education, and regular glucose monitoring.
High / Very High Risk
People who are strongly advised NOT to fast because of significant danger.
Examples:
Type 1 diabetes
History of severe hypoglycaemia
Poorly controlled diabetes
Advanced kidney or heart disease
Frail elderly
Pregnant women with diabetes
Recent hospitalization for diabetes complications
For this group, fasting can lead to serious harm.
Pre-Ramadan Assessment (Very Important)
Patients planning to fast should have a medical review before Ramadan to: Assess risk; Adjust medications; Educate about warning signs; Plan nutrition and hydration.
Structured education has been shown to reduce hypoglycaemia events.
Nutrition Guidance
At Suhoor: Prefer complex carbohydrates; Include protein and healthy fats; Maintain hydration
At Iftar: Avoid excessive sugary and fatty foods; Control portions; Rehydrate adequately. Overeating at Iftar is highlighted as a common clinical problem and should be avoided.
Medication Adjustment Principles
The book strongly emphasizes individualized therapy: No one-size-fits-all regimen; Dose and timing must be modified; Choice of drugs should consider hypoglycaemia risk; Insulin regimens often need adjustment
Glucose Monitoring
Patients who fast should: Monitor blood glucose regularly; Understand that testing does NOT break the fast (medico-religious consensus); Be trained to recognize danger signs
When to Break the Fast
Patients must break the fast if: Blood glucose becomes too low or too high; Severe symptoms occur; Dehydration develops
Education on this point is repeatedly stressed in the guideline.
Special Focus: Elderly
The guideline notes that older adults: Have higher complication risk; More often require hospital care; Need closer monitoring and individualized decisions
Note: The information provided is for general awareness only. Always consult your doctor for individual medical advice and personalised guidance.
