Fasting is a practice that has been used for centuries in many religions such as Christianity and Islam as a form of sacrifice, self-discipline and gratitude. Ramadan ended earlier this month. It is a time when Muslims around the world fast from sunrise to sunset every day for one full month.
In our home country of Egypt during Ramadan, at sunset, the time of breaking the fast, you see people giving food to less fortunate people on the streets, including those on duty such as traffic wardens and police officers. They will come out with boxes of food from their cars and give it to anyone who needs it. At the time of breaking the fast, you hear a sound signal of a canon going through the streets and the local mosques announcing prayer and this signals to everyone that it is time to eat.
Families across the world gather around the table and eat together, which in itself creates a sense of celebration and joy. Children will all have a new colourful lantern called a “fanoos” which also signifies how Ramadan is a celebration.
Lived in Ireland for the past 20 years means it has been challenging carrying out Ramadan in a western environment, especially when you are so far away from your family and the overall atmosphere of Ramadan is missing.
However, Ireland has become vastly multinational in recent times and the awareness about Ramadan and its practice has increased.
It is no longer as challenging as it was and, if anything, our friends and family here in Ireland only make it easier with their support and understanding. On several occasions some of our Irish friends have even fasted with us for support for a day and then they join us for breaking the fast and we eat together. That has been incredible.
Over the years, it has been difficult to complete Ramadan while working full days especially when sunset is so late during the summer months, and keeping your focus is something we have struggled with in the past. However, we have learned that it’s what we eat that determines our energy levels and levels of focus.
Often, we have been fortunate to work with organisations that take our fasting into consideration and help to accommodate us as much as possible, for example, allowing us to go home early as we aren’t taking a lunch break or allowing us to work half-days, and so on.
Now that we work for ourselves as pharmacists, it has become much easier to split the time between us so it’s not too long a shift for one person.
In terms of food choices and what we have found really beneficial is making a superfood-packed smoothie and having it before going to bed. It includes chia seeds, almond or coconut milk, nut butter, matcha powder, spinach, wheatgrass and a variety of different fruits and nuts and generally anything else we find lying around. It is amazing how much energy we get from this smoothie and how long it stays in our system.
As well as the fact that it’s part of our religion and despite the difficulty to complete fasting sometimes, especially since we work as full-time pharmacists and our concentration is vital for our jobs, we feel a great sense of achievement and personal satisfaction when we’ve completed a day.
There’s no doubt also that we generally feel more energised and have a greater sense of wellbeing, both mentally and physically, while fasting.
Besides its religious uses, in recent times there has been a major spotlight on the health benefits of fasting, especially intermittent fasting. As pharmacists and diet counsellors who also fast as part of our religion, we are interested to learn about why more and more people are integrating fasting into their lives and not just for religious purposes.
Body responses
Periods of deprivation of food facilitate change around a range of different immunological and metabolic responses in the body. Studies suggest that restricting the time period in which you eat could have profound effects on your health including blood sugar balance, digestion, sleep and weight loss.
Studies on mice suggest that changes in feeding schedule can have a massive influence on weight and metabolism. Mice that ate the same amount of food and calories throughout 24 hours compared with those whose eating time was restricted, put on more weight. So the calories eaten were the same, yet it led to a significant difference in weight.
The researchers concluded that periods of regularly fasting for 12-16 hours a day might have a dramatic impact on body weight. What was particularly interesting was the results were the same regardless of the type of diet they ate, even when they ate a high-fat, high-sugar diet.
Intermittent fasting means alternating between a period of fasting and non-fasting. There are many different takes and suggested protocols on intermittent fasting and how to follow it. For example, overnight fasting, which is the most straight forward way to implement fasting into the diet, suggests taking that window when a person sleeps and is not eating anyway and adding several more hours of fasting to it, either in the morning or before they sleep, so that in total they are fasting for at least 10-12 hours per day.
This is enough to achieve all the positive effects fasting can have on the body without it being too difficult, since the majority of it is carried out while you sleep.
The 5:2 diet is another method of intermittent fasting that has been in the spotlight lately which involves fasting for two days per week or consuming very few calories on those days and eating normally for the other five days of the week.
Valter Longo, professor of gerontology and biological sciences at the USC Davis School of Gerontology and the USC Dornsife College of Letters, Arts and Sciences in California, in the US, carried out a study on mice and how fasting can weaken cancer and concluded that "the combination of fasting cycles plus chemotherapy was either more or much more effective than chemo alone".
What we have also found particularly interesting is, traditionally, we break our fast with a few dates soaked in milk and a large glass of water. This has been the way we’ve always done it and it’s been passed down from generation to generation.
When we skip doing this, we have generally found that when we break our fast we tend to eat everything in sight. We end up overeating and have to contend with a subsequent food coma on the couch afterwards.
It turns out that studies have shown that when you break your fast with something sweet such as dates, it re-adjusts your insulin levels back to normal which prevents you from over-eating. The large glass of water also helps hydrate you straight away as it’s generally more thirst than hunger that we feel while fasting.
Introducing fasting
There is no one correct way to introduce fasting into someone’s life and it is not something that we all necessarily have to do. Some people cannot fast for health reasons – pregnant and lactating women, children and the elderly, or people with type 1 diabetes – and anyone on medication or suffering from any medical conditions should consult their doctor before starting any form of fast.
However, the extensive research and studies being carried out on the benefits it has on the body, particularly in certain disease states, as well as its power to support the immune system, is promising and ongoing, so we will surely learn more in the near future.
Perhaps this traditional religious form of sacrifice that has been around for centuries may become a vital medical tool in future.
Sally El-Banna, MPharm, MPSI, and Ola El-Garawany, BSc (Pharm), MPSI, are qualified pharmacists (Trinity College Dublin) and diet counsellors (Institute of Health Sciences).
