Fasting is a unique moral and spiritual characteristic of Islam. Literally Fasting is defined in Islam to abstain "completely" from foods, drinks, intimate intercourse and smoking, before the break of the dawn till sunset, during the entire month of Ramadan, the ninth month of the Islamic year.

But if we restrict the meaning of the Islamic Fasting to this literal sense, we would be sadly mistaken. It is not just physical hunger and thirst that constitute the Muslim fast, but the nights prior to the beginning of the fast acquire a far more important character and play a central role in the institution of fasting. The Muslims wake up many hours before dawn for individual prayer and the remembrance of God. Also the Holy Quran is recited in every Muslim house much more than in ordinary days. A greater part of the night is thus spent in spiritual exercises which make up so the very essence of fasting.

During the day, apart from restraining from food and water, all is Muslims are particularly exhorted from vain talk, quarrels and fights, or from any such occupation as is below the dignity of a true believer. No indulgence in carnal pleasure is allowed; even husband and wife during the day lead separate lives, except for the formal human relationship common to all people.

“(Fasting) for a fixed number of days; but if any of you is ill, or on a journey, the prescribed number (should be made up) from days later. For those who can do it (with hardship), is a ransom, the feeding of one that is indigent. But he that will give more, of his own free will, it is better for him. And it is better for you that ye fast, if ye only knew.” 2:184

Also, Allah Almighty said while referring to fasting, 

"And when My slaves ask you (O Mohammad) concerning Me, then answer them, I am indeed near (to them by My Knowledge). I respond to the invocations of the supplicant when he calls on Me (without any mediator or intercessor)." [2:186].

Fasting in Islam is a highly developed institution, and needs to be studied in depth. There are two types of injunctions with regards to fasting. One relates to obligatory fasting and the other to optional fasting.

1. Obligatory Fasting

There is one full month in every year in which fasting is prescribed for Muslims all over the world. As the month is a lunar month, so it keeps changing around the year in relation to the solar months. This creates a universal balance for the worshippers. Sometimes the fasting in winter months is easy as far as the days go, in comparison to the long winter nights, while during the summer months the days become long and exacting. As the lunar months keep rotating around the year, so Muslims in all parts of the world have some periods of easy fasting and some of arduous fasting.

2. Optional Fasting

The optional fasting is so well promoted that it becomes a part of the righteous Muslim's way of life. Although a majority of Muslims do not go beyond the month of obligatory fasting, some keep fasts now and then particularly when in trouble. As it is expected that the prayers offered in fasting are more productive, some people keep extra fasts to ward off their problems, but some do it only for the sake of winning Allah's special favors. There no limit to this, except that the founder of Islam strongly discouraged those who had vowed to fast continuously for their whole life. When the Holy Prophet (SAW) came to learn of one such case, he disapproved of the practice and censured the man for attempting to achieve liberation as if by forcing his will upon. He told the person concerned that: 'Just by putting yourself to trouble or discomfort, not only will you be unable to please God, but you may even earn His displeasure.' He pointed out that over emphasis on austerity is likely to make one negligent towards one's wife and children, kith and kin, friends etc.

When Islam introduced this matchless institution, it planted an ever-growing tree of infinite virtue and invaluable products. Here is an explanation of what a Muslim gets by observing Islamic fasting. We may divide benefits of fasting into two types. First is spiritual benefits of fasting and second one is social benefits of fasting.

Abu Hurayrah, may Allah be pleased with him, narrated that Allah’s Apostle, Salla Allahu Alayhi Wasallam, said, what translated means,

“Allah said, ‘All the deeds of the son of Adam are for him: the good deeds will be multiplied ten times to seven hundred time, except fasting, which is for Me and I will reward for it accordingly. He abandons his (sexual) desire, food and drink for Me.’ Verily, there are two joyous and pleasurable moments for the fasting person: one at the time of breaking his fast, and the other is when he will meet his Lord (in the Hereafter). Verily, the unpleasant odor emanating from the mouth of the fasting person is better in the sight of Allah than the scent of musk.” 
[Al-Bukhari & Muslim].

This noble Hadith contains numerous virtues and benefits that can only be attained from fasting. It also indicates the importance of fasting in Islam and its obligation upon all Muslims.

1.        Multiplying the rewards for fasting is different than the rest of the acts of worship and good deeds. As for fasting, there is no limit for such multiplication, while in the case of other deeds, each good credit is multiplied from ten to seven hundred times only.

2.        Sincerity while fasting counts more than sincerity while performing other deeds, for Allah said in the Hadith, “He abandons his (sexual) desire, food and drink for Me.”

3.        Allah has chosen fasting to be the acts of worship that He Himself will reward for it, for He said,“Fasting is for Me, and I will reward for it accordingly.”. 

4.        Fasting brings about two great occasions of joy and happiness for the fasting person: one in this life, and that is when he breaks his fast with what Allah has allowed for him of foods and drinks. As for the other, it is in the Hereafter, and that is when he receives the rewards for his fast. This is permissible happiness and joy, just as Allah said, what translated means,

"Say, “In the Bounty of Allah, and in His Mercy (i.e. Islam and the Quran);  therein let them rejoice.”" [10:58].

5.        The odor emanating from the mouth of the fasting person, which is sometimes foul, is more beloved to Allah than the scent of musk. This is because such bad odor is the result of a deed that Allah loves, and He therefore loves the resulting odor as well. This is clear from the portion of the Hadith that reads, “The unpleasant odor emanating from the mouth of a fasting person is better in the sight of Allah than the scent of musk.”

6.        Among the benefits of fasting is that Allah has designated one of the gates of Paradise solely for those who frequently fast. The Prophet Salla Allahu Alayhi Wasallam said, what translated means,

“There is a gate in Paradise called Ar-Rayyan, and those who frequently fast will enter through it on the Day of Resurrection, and none except them shall enter through it. It will be said, ‘Where are those who used to fast?’ They will stand up, and none except them will enter through it. Upon entry, that gate will be closed and no one else will enter through it.”
[Al-Bukhari].

7.        Fasting is a shield and protection from harmful desires and from the heat of Hell, as an authentic Hadith affirms.

8.        The supplication of the fasting person is accepted. The Messenger of Allah, Salla Allahu Alayhi Wasallam, said, what translated means,

“The fasting person has at the time of breaking his fast a Du’aa’ that is not rejected.” 
[Ibn Majah & Al-’Hakim].

Also, Allah Almighty said while referring to fasting, 

"And when My slaves ask you (O Mohammad) concerning Me, then answer them, I am indeed near (to them by My Knowledge). I respond to the invocations of the supplicant when he calls on Me (without any mediator or intercessor)." [2:186]. 

9.         Another benefit of fasting is that It teaches man the principle of sincere Love: because when he observes Fasting he does it out of deep love for God. And the man who loves God truly is a man who really knows what love is.

10.       It.indoctrinates man in patience and selflessness, as through fasting, he feels the pains of deprivation but he endures them patiently.  The Prophet Salla Allahu Alayhi Wasallam said, what translated means,

“Fasting is one half of patience.” 
[At-Tirmithi & Ibn Majah].

1. Fasting has numerous health benefits, just as the Prophet Salla Allahu Alayhi     Wasallam stated, 
   
        “Fast and you shall attain good health.” 
         [Ibn As-Sunni & Abu Na’eem].

This is because fasting protects the internal and external body parts and aids the person in avoiding harmful foods.

Fasting has numerous other virtues and benefits, but we only mention a few to drive home the point to the reader.

1. It teaches man the principle of sincere Love: because when he observes Fasting he does it out of deep love for God. And the man who loves God truly is a man who really knows what love is.
2. It equips man with a creative sense of hope and an optimistic outlook on life; because when he fasts he is hoping to please God and is seeking His Grace.
3. It imbues in man the genuine virtue of effective devotion, honest dedication and closeness to God; because when he fasts he does so for God and for His sake alone.
4. It cultivates in man a vigilant and sound conscience; because the fasting person keeps his fast in secret as well as in public. In fasting, especially, there is no mundane authority to check man's behavior or compel him to observe fasting. He keeps it to please God and satisfy his own conscience by being faithful in secret and in public. There is no better way to cultivate sound conscience in man.
5. It indoctrinates man in patience and selflessness, as through fasting, he feels the pains of deprivation but he endures them patiently.
6. It is an effective lesson in applied moderation and willpower.
7. Fasting also provides man with a transparent soul, a clear mind and a light body.
8. It shows man a new way of wise savings and sound budgeting.
9. It enables man to master the art of Mature Adaptability. We can easily understand the point once we realize that fasting makes man change the entire course of his daily life.
10. It grounds man in discipline and healthy survival.
11. It originates in man the real spirit of social belonging, unity and brotherhood, of equality before God as well as before the law.
12. It is a Godly prescription for self-reassurance and self-control.

Now, someone may be tempted to raise the objection: If this is the case with the Islamic institution of fasting, and if this is the picture of Islam in this aspect, why are the Muslims not living in a utopia? To such an objection we can only say that Muslims have lived in and enjoyed a utopia in a certain epoch of their history. The realization of that utopia was a phenomenon of a unique achievement in the history of man. We say unique, because no religion or social system other than Islam has ever been able to realize its ideals in reality.

Fasting and Health  (Article by Shahid Athar M.D)

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran.  The medical benefits of fasting are as a result of fasting.  Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids.  There are many adverse effects of total fasting as well as so-called crash diets.  Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake.  The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan.  If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one's entire life.  Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets.  Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk.  Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration.  The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

Compensation of missed Fasts The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure.  In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension.  In 1994 the first International Congress on "Health and Ramadan", held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting.  While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients' health or baseline medical condition.  On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well.  There is a peace and tranquility for those who fast during the month of Ramadan.  Personal hostility is at a minimum, and the crime rate decreases.  This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

Recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory.  Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision.  Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

DIABETES MELLITUS AND RAMADAN FASTING

Diabetes mellitus affects people of all faiths. Muslims are no exception. Many diabetic Muslims have a desire to fast during the month of Ramadan, although if they cannot for health reasons, they have a valid exemption. The dilemma for physicians and Muslim scholars is whether or not Muslim diabetic patients (1) should be allowed to fast if they decide to; (2) can fast safely; (3) can be helped to fast if they decide to; (4 ) can have their disease monitored at home; and (5) are going to derive any benefit or harm to their health. Fasting during Ramadan by a Muslim diabetic patient is neither his right nor Islamic obligation, but only a privilege to be allowed by his physician, at the patient's request, knowing all the dangers and assuming full responsibility in dietary compliance and glucose monitoring, with good communication between the physician and the patient .

PSYCHOLOGICAL STATE OF DIABETES DURING RAMADAN

Diabetes mellitus itself adversely affects patients' psychological states by changes in glucose metabolism, blood and CSF osmolality, needs for discipline and compliance, fear of long term complications and threat of hypoglycemic attacks and the possibility of dehydration and coma.

On the other hand, fasting during Ramadan has a tranquilizing effect on the mind, producing inner peace and decrease in anger and hostility. Fasting Muslims realize that manifestations of anger may take away the blessings of fasting or even nullify them.

Diabetics know that stress increases the blood glucose by increasing the catecholamine level and any tool to lower the stress ; ie., biofeedback or relaxation improves diabetic control. Thus, Islamic fasting during Ramadan should have a potentially beneficial effect with regard to diabetic control.

CRITERIA ALLOWING DIABETICS TO FAST DURING RAMADAN

(1) The age limit of 20 has no Quranic basis. The actual physical development and tolerance which can proceed the physiological age is the criteria here, not the age. If a male diabetic has the physical built and ability of fasting, he should be instructed to fast if he can do it without difficulty or compromising his heatlh as explained in the rest of the article.

(2) The ban on fasting of pregnant females or nursing mothers is not Quranic or called for. Pregnant and or nursing mothers have to assess their own tolerance and ability of fasting. Those who are healthy enough, having mild Diabetes should be able to fast.

(3)  In case of body weight normal or above ideal body weight, Again. These are general suggestions, not Quranic rules. We should not use the scale to decide when to fast or not. A healthy slightly under weight person has no excuse not to fast, if he/she can. He/she can check with his/her physician if he/she is questioning his/her ability to fast.

(4) In case of absence of infection, co-existing unstable medical conditions, i.e, coronary artery disease, severe hypertension (B/P 200/120), kidney stones, COPD or emphysema, Again these are generalization that is not necessarily correct. Some COPD or emphysema patients, mild infections, mild coronary artery disease etc, may be able to fast without difficulty or compromising their well being. If in any doubt ask your good submitter (Muslim) doctor.