International conference champions health benefits of intermittent fasting and Ramadan

International experts have lent intermittent fasting and Ramadan fasting their support, saying going without food even for short periods can help alleviate the adverse impact of a host of health problems.

During an international conference convened by the University of Sharjah's College of Health Sciences, the experts reiterated the health benefits of fasting, presenting research with' promising evidence that fasting can lower the risk of diabetes, help people lose weight, extend lifespan, and prevent metabolic diseases from aggravating.

Scientists from the U.S., France, Lebanon, Oman, Tunisia, Saudi Arabia, Egypt, China, the U.K., Malaysia, Kuwait, Qatar, Jordan, Turkey, Pakistan, and the United Arab Emirates attended the gathering dubbed "The International Conference on Fasting."

The two-day conference took place just a few days before the world's nearly two billion Muslims were preparing to take part in this year's Ramadan, the Islamic holy month during which they do not eat or drink from dawn to sunset.

There is a plethora of research on intermittent fasting in which fasters leave long gaps between their daily meals. The hours per day Muslims fast differ in different places based on the latitude of each location and the Earth's orbit around the sun.

Most of the world's Muslims are said to observe Ramadan, the most important month of the Islamic calendar.

University of Sharjah's Professor of Clinical Nutrition MoezAlIslam Ezzat Faris estimated that 1.6 billion Muslims honor Ramadan every year. However, most fasting science publications originate outside the Muslim world, he said.

"Most fasting-related publications come from North America or Europe, and are the least in the Muslim, Arab countries," Prof. Faris said, adding scientific papers dwelling on fasting have garnered more than 26,000 citations, with Ramadan publications seeing 9% growth annually.

Dr. Elie Akl, Professor of Medicine at the American University of Beirut, called for further collaboration among fasting scientists in the Middle East whom he said churned out 20% of fasting literature every year.

The scientists at the conference said fasting was turning into a science and a topic of research interest to academics.

The conference's keynote speaker Harvard Medical School's Professor Osama Hamdy spoke of the dawn of a new epoch of fasting science. "We are at the beginning of a whole era of science, and the science of fasting will be one big subject of research in the future.

"Years of age (are) added and (it) delays years of health aging. Dietary restriction in general has been shown for years and years to improve many problems such as Metabolic syndrome, Diabetes, Cancer, and so on."

Prof. Hamdy gave an account of the different types of intermittent fasting, notably time-restricted eating, alternate-day fasting, the 5:2 fasting approach, and Ramadan. He accredited intermittent fasting in general with an array of health benefits.

He unveiled to a packed conference room the findings of fasting research as reported by the Diabetes Remission Outcome Program (DROP). "This is the beginning of a whole era of treating diabetes in a very early stage by just nutrition and exercise."

He said the program pursued a two-tier approach with a 12-week intervention period in which participants adhered to an 800-1000 calorie diet. "We give them diabetes-specific formula—people fast for 16 hours in time-restricted eating, then break the fast with a shake, and have dinner with 600-800 calories."

Following the intervention phase, the participants transitioned to a nine-month maintenance phase, gradually returning to a 1,500–1,800 caloric diet. "People lost around 8% of their body weight during intervention. Their A1C (blood sugar test) went down from 6.4 to 6.1 on no medication. This means remission."

Even a year later, the participants remained in remission, with an improved quality of life. "This is the beginning of a whole era of treating diabetes in a very early stage by just nutrition and exercise," Prof. Hamdy said.

However, the scientists showed that Ramadan intermittent fasting may have an adverse impact if fasters overeat when breaking their fast.

For instance, King Saud University's Professor of Pulmonary and Sleep Medicine, Ahmed BaHammam, warned Ramadan fasters against binging.

For many, Ramadan is a time of feasting. In the oil-rich Gulf states, for example, Iftar, the evening meal with which Muslims break their fast after the sun has gone down, is something like a lavish banquet in which sugary diets dominate.

"Ramadan fasting's effects don't just affect the lifestyle. It is also the meal timing, the circadian rhythm, and interaction with insulin. This research journey has been eye-opening and humbling. It shows how science can help us understand both tradition and health," said Prof. BaHammam.

Fasting was not found to be beneficial to everyone leaving a long gap between meals, compressing meals into shorter periods, or observing longer periods like Ramadan.

Prof. Mohamed Hassanein of Dubai Health Authority said diabetic Muslims needed special consultancy and care if they opted to observe Ramadan.

"We have at least 150 million Muslims estimated to have type 2 diabetes. Ramadan needs planning. And the best of course is for any clinician or for any person with diabetes to go to the health care person for a proper assessment before Ramadan."

Prof. Hassanein introduced a new app he and his colleague have developed to estimate the risk factors diabetics may encounter if they decide to fast during Ramadan.

Called the DAR Academy app, the application calculates the potential risks when people with diabetes feed it with personal health data like glycemic control, nature of the job, fasting hours, level of frailty, and social circumstances.

However, Prof. Hassanein said Muslims generally were averse to medical advice not to fast during Ramadan no matter the risks; they would only adhere to instructions supplied by their imam, or clergyman. "The patient will listen to the imam and not to the doctor."

Prof. Hassanein advised Muslim diabetics to consult their doctors so that they can tell them what exercise they need to do, monitor their blood glucose levels, and adjust their medication timing and dosage.