Professor Muhammad Aziz Rahman
The second most widely practised religion is Islam and there are over 1.7 billion Muslims globally which is about a quarter of the world population. In Australia, Muslims comprise about 2.3% of the population, or around 650,000 people. Practising Muslims observe the holy month of fasting like others globally, which is known as the month of Ramadan. In 2023, this falls between 23 March and 21April. Muslims refrain from eating or drinking from sunrise to sunset.
The term ‘intermittent fasting’ is well known and commonly practised; fasting during Ramadan can be considered a similar practice. However, there are additional features of this special fasting period. Muslims are engaged more in spiritual practice and charity during this month. In fact, it’s considered a month of self-regulation, self-control, self-purification, and self-training for Muslims. They discipline themselves by controlling their lifestyle including food habits and avoiding bad practices such as smoking.
However, many of those practices don’t continue when the month ends, and that’s a missed opportunity. Public Health professionals can consider engaging with Muslim communities for health promotion activities during Ramadan to encourage longer-lasting changes to the health and wellbeing of communities.
Scientific evidence has already explained the health benefits of fasting during Ramadan. These include reduced body weight, decreased blood lipids and sugar, balanced oxidation and anti-oxidation, improved gut microbiome, boosted brain power, improved fatigue, mood, sleepiness, health-related quality of life as well as improved psychological wellbeing. Research findings also indicated taking caution for fasting for a specific group of the population, such as Muslims with diabetes, cardiac disease, gastric ulcers, liver disease, pregnancy or having regular medication multiple times during the daytime.
It’s important to consult with the treating physicians to discuss individual health contexts and any potential risks of fasting so that an informed decision can be taken. In addition, medication schedules, dosage or routes of administration can be altered by physicians or pharmacists, so that patients who want to practice fasting can continue to do so. Similarly, dietary recommendations should also be checked and could be individualised; dietary choices will depend on personal preferences, lifestyle, age, and cultural background.
Muslims are disciplined in many aspects of their lifestyle during the Ramadan fast and Public Health professionals can utilise that opportunity for health promotion. Smokers can’t smoke during the period of fasting, which is quite a prolonged period of 13-14 hours. While it’s quite challenging not to smoke that long for a nicotine-addict smoker at other times, he/she can make it possible during fasting. While that practice of abstinence continues for a month, it’s a golden opportunity for a smoker to reduce smoking, and eventually quit.
Ramadan can be considered a ‘teachable moment’ like hospital admissions work for smokers to consider quitting. But Public Health professionals need to come forward to work with Muslim community leaders and organisations to support smokers to sustain their quitting endeavour. Similarly, fasting controls unnecessary snacking and excessive eating, which is common in many ethnic communities, health promotion initiatives can focus on that lifestyle issue while considering recommendations for food habits.
Sugar-rich food intake is also controlled which is beneficial to health. Lust and desires are also controlled during this month. So people can make an effort to sustain this reduced consumption of sugar-rich food throughout the year.
Muslims develop positive feelings during Ramadan and evidence showed that fasting assisted in reducing anxiety and distress. That experience can be used for further activities on supporting the mental health of Muslim communities.
Gaps in health professionals’ knowledge
Knowledge and research gaps exist on different aspects of fasting during Ramadan, which warrants the attention of Public Health researchers. In a multicultural country like Australia, do our healthcare providers know the recommendations to advise if a patient with a chronic disease wants to fast? Do they know how to modify regular medications so that patients can fast? Is there any practical guideline for healthcare professionals including General Practitioners (GPs), Specialists or nurses?
Are the employers at different workplaces aware of the rituals so that a Muslim employee can have the flexibility to enjoy Iftar – the fast-breaking evening meal – with families? Do we know whether staff face workplace discrimination, affecting the psychological wellbeing of Muslim staff? What about Muslim students who are working clinically in healthcare settings, do we know about their experience?
Do we know whether Muslims delay their regular health screenings or vaccinations due to fasting this month? Have we tried to engage Muslim community leaders or religious leaders in health promotion activities in Australia to examine their effects?
It’s important to have research evidence on such issues, so the findings can guide us in addressing gaps and promoting harmony in the community, and in work settings.
Finally, Ramadan is an additional opportunity to reach out to this minority group in Australia and use some inherent benefits of fasting for behaviour modification in health promotion campaigns by Public Health professionals.
Disclaimer: Do not use any information in this piece to treat or prevent any condition. This information is not a substitute for the advice of a healthcare professional. Consult your general practitioner. We accept no liability for damage, injury or loss due to information provided.
Professor Dr. Muhammad Aziz Rahman (MBBS, MPH, CertGTC, GCHECTL, PhD) is a Research Adviser and Discipline Leader of Public Health, Federation University, Australia. Prof Rahman is also a Board Member and Co-Convenor for the PHAA Health Promotion Special Interest Group, and a Member of the Board of Directors for the Council of Academic Public Health Institutions Australasia (CAPHIA).
Featured image: Naim Benjelloun/Pexels