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NAME : Fatimahtul Zahrah binti Kamarudin
NICK NAME : Timah
ADDRESS : Senai, Johor
COURSE : engineering and computer science
FAVOURITE QUOTE : when you’re tired, learn to rest not quit.

EMAIL : fatimahtulzahrah141@gmail.com
NO. PHONE : 0198843137

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my first picture of sunset in CFS IIUM.

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Quranic Reflection No. 475. Āyat 58:11 - Spending time in seeking knowledge

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يَرْفَعِ اللَّهُ الَّذِينَ آمَنُوا مِنْكُمْ وَالَّذِينَ أُوتُوا الْعِلْمَ دَرَجَاتٍ
Yarfa'i-llāhul-ladhīna āmanū minkum walladhīna ūtul-'ilma darajāt
Allah will raise in rank those of you who have faith and those who have been given knowledge.
(Sūrat al-Mujādilah, No 58, Āyat 11)

In verses 9 - 11 of this sūra, Almighty Allah 'azza wajall talks about certain rules for social interaction among believers. Then in the above phrase He talks about the reward for those who obey those rules. Obedience requires faith in Allah subhānahu wata'ālā and knowledge and awareness of His wishes. The word 'darajāt' refers to ranks or different statuses. The word is plural and indefinite, implying a sort of limitless ranks in closeness to Allah and in the rewards they would receive.

This verse tells us that human beings ascend in ranks through two qualities - faith and knowledge. Sincere faith in Allah (swt) is the foundation of all the virtues of a believer, it is the root from which stem beautiful thoughts and actions. Knowledge is an outstanding quality of the believer. Its great merit has been mentioned in glowing terms in Hadīth. Although martyrdom in the way of Allah is the ultimate act of devotion, the Holy Prophet sallal-lāhu 'alayhi wa-ālihi wasallam says: The rank of a learned person over a martyr is superior, and the rank of a martyr over a worshipper is superior . . . and the superiority of a learned person over the rest of mankind is like the superiority of myself over the smallest of them. ( Tafsīr Majma' al-Bayān).

Many HadIth talk about the superiority of people with knowledge over worshipers. This is to show the distance between the two groups. Worship with faith is good and praiseworthy but cannot be compared with one who understand things clearly and then acts. The value of the later is vastly superior. In fact, the people with knowledge cannot be compared to any other groups of people. Allah (swt) says: Say, are those who know equal to those who do not know?' Only those who possess intellect take admonition (Q 39:9)

Seeking knowledge is one of the most noble ways of spending time. The Prophet (s) says: One who proceeds on a path in the pursuit of knowledge, God makes him proceed therewith on a path to the Garden (Paradise). And, verily, the angels spread their wings for the seekers of knowledge out of delight. Verily, every creature of the heaven and the earth asks forgiveness for the seeker of knowledge, even the fish in the sea. The merit of the 'ālim (the learned) over the 'ābid (the devout) is like the merit of the moon over the stars on a full moon night. The learned are the heirs of the prophets, for the prophets did not leave behind a legacy of wealth but that of knowledge. So whoever partakes of it derives copious benefit. (Al Kulaynī, al-Kāfī, vol. 1, Kitāb fadl al 'ilm, H. 1).

With the present restrictions of being home bound due to the pandemic, it is a good opportunity to spend time in seeking knowledge. Because of Internet and YouTube, numerous resources are available. Here are a few things that believers can do:
1) Enroll for online courses being provided by a number of Shi'ī Islamic organizations and learning institutions. You can choose from a short course that runs weekly for a month, or long courses that run over several months.
2) List a few Islamic topics of interest to you and search for them on internet. You will be surprised to see that many good lectures by renowned scholars are available gratis in different languages for our benefit.
3) Team up with your spouse, family members, friends, or acquaintances to discuss on an Islamic issue. When in doubt or for additional clarification ensure to seek guidance from resident scholars in your city.
4) Within your social circles form a Book Club to read together and discuss the contents of books on Islamic creed, history, and ethics.
5) With your family members, every day discuss about five short Hadith from the Holy Prophet (s) and his Ahlul Bayt (a). You can select the Hadith from www.al-islam.org and https://hadith.academyofislam.com/ which has a database of over 33,000 Hadiths in Arabic with English translation.

We pray to the Almighty to grant us tawfīq in making Islamic learning a lifetime practice for all members of the family. Undoubtedly this will raise our ranks with Almighty God and allow us to appreciate Islamic culture, teachings and values.

Sources: Shaykh Tabarsī, Tafsīr Majma' al-Bayān; Allāmah Syed Muhammad Husayn Tabātabā'ī, Tafsīr al-Mīzān; Āyatullāh Nāsir Makārim Shirāzī (Ed.), Tafsīr-e Namūneh.

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Quranic Reflection No. 475. Āyat 58:11 - Spending time in seeking knowledge

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يَرْفَعِ اللَّهُ الَّذِينَ آمَنُوا مِنْكُمْ وَالَّذِينَ أُوتُوا الْعِلْمَ دَرَجَاتٍ Yarfa'i-llāhul-ladhīna āmanū minkum walladhīna ūtul-'ilma darajāt Allah will raise in rank those of you who have...

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smileeee it’s sunnah✨

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arabia becomes green.

killing will become widespread.

good deeds will decrease.

time pass rapidly.

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arrival of Imam Mahdi.

arrival of Dajjal.

Gog and Magog.

arrival of Prophet Isa.

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Ihsan is that "you worship God as if you see Him, but if you do not see Him, then indeed He sees you." (Meaning based on a hadith narrated by Muslim from Umar bin Khattab).

That is, devoting yourself to God should be with the feeling as if you are seeing Him and if you do not have the feeling of seeing Him, then you should feel that God sees you.

Meaning: sincerely in worship or sincerely practicing Islam and Faith.

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improvement:

i don’t have that much opinion because i do enjoy every meetings😍.
the naqibah gave good speech.

i hope there will be more more grouping activities like explorace and more.

wish:

i learn a lot about islam.

every each topics make me realise to do better and improve myself.

i have a chance to know many people that makes my connection bigger.

i want to improve myself to be brave in giving opinions, talk in front of many people and be a better muslimah.

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ADAB WITH PARENTS👨‍👩‍👧

help them to do house chores.

ask their permission before come in to their room.

listen to their advice unless it’s opposite with shariah.

ADAB WITH FRIENDS👭

call them with nice name.

not whispering in front of other friends.

do not talk back about them.

ADAB WITH TEACHERS/LECTURERS👩‍🏫👨‍🏫

focus during lectures.

come to class early.

ask about their time before consultation.

ADAB WITH NEIGHBOURS🏠

greetings and smile.

giving gifts or food.

help them while they’re in trouble.

ADAB IN SOCIAL MEDIA 📱

amanah in selling online.

only leave good comments.

do not insult each other.

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6 Pillars Of Faith | Arkan Al Iman 6 - Mishkah Academy

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6 Pillars Of Faith | Arkan Al Iman 6 - Mishkah Academy

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“O mankind! Remember the Grace of Allah upon you! Is there any creator other than Allah who provides for you from the sky (rain) and the earth? None has the

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salah
https://youtu.be/dcBmuv4Ae9w?si=83oRJMsgSrAS-Kyr

sawm
https://youtu.be/jk15IQsQIOY?si=qBg47TtmRBQxo7ws

zakah
https://youtu.be/Iwo-prXZPYU?si=fPazz0JSGmez_0js

hajj
https://youtu.be/kZViSQsQdik?si=HDid3n0ryH8-jwrP

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improvement:

pay more attention to every presentations by naqibah.

overall performance by naqibah was good and i really enjoyed this semester’s usrah.

wish:

more interesting games to be added.

every week of meeting reminded me of things i have learned before.

i learn so much about being khusyuk in doing ibadah.

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& WARNINGS AGAINST ABANDONING IT

SALAAH

Definition of SalaaH

1. The linguistic definition is "du'a."

Al 'Qadia said this is the saying of most scholars of fiqh and Arabic language.Du'a means 'supplication'. In Arabic language we usually refer to something by what is included in it.

The technical definition in the Sharee'ah is the 'sayings and actions beginning with takbeer and ending with tasleem along with intention.

Salaah is a pillar of Islam. Prayer is the greatest after the Shahadah and this is established in the Qur'aan and the Sunnah. The Ijmaa says that the one denying this pillar goes out of Islam. There are many benefits to Salaah - religious, worldly, health-wise, social, political, systematic, regulating etc. This shows the wisdom of Allah when He made the Salaah obligatory- it upholds that which is in this world and the Hereafter. It is the foundation of this life and the cause of happiness in the next life.

VIRTUES OF SALAH

Salaat (Prayer) performed genuinely with humility and submission to Allah (subhanahu wa ta'ala) has unlimited virtues and benefits. It is the noblest expression of faith and the surest way of thanking Allah (subhanahu wa ta'ala) for His unlimited favors. It is the way to obtaining Allah's mercy, generosity, kindness, blessings and a sure way to paradise. Allah (subhanahu wa ta'ala) says in the Qur'an: " Prosperous indeed are the believers who are humble in their prayers " (Qur'an 23:1-2).

It is a deliverance on the Day of Judgement for those who used to observe it well. The Prophet ﷺ says: " The first thing that the servant of Allah (subhanahu wa ta'ala) will be called to account for on the Day of Judgement will be the prayer; and if it was good the person's deeds will have been good, but if it was bad, the person's deeds will have been bad " (Reported by Imam Bukhari).

Prayer purifies the soul, refines the character and inculcates in man the excellent virtues of truthfulness, honesty and modesty. It keeps one who performs it from falsehood and from all forbidden actions as is categorically confirmed by the following verse of the Qur'an: " Verily, prayer refrains from indecency and evil" (Qur'an29:45).

Rasulullah ﷺ said " Allah has obligated five prayers. Whoever excellently performs their ablutions, prays them in their proper times, completes their bows, prostrations and khushu` [Khushu` in the prayer is where the person's heart is attuned to the prayer.] has a promise from Allah that He will forgive him. And whoever does not do that has no promise from Allah. He may either forgive him or punish him." [Recorded by Malik, Ahmad, Abu Dawud, al-Nasa'I and others.]

SubhanAllah Allah (swt) is giving us a PROMISE that he will forgive us! What more can we ask for? How can I pray when I have so many sins, they should realize this prayer is a way for them to get their sins forgiven.

MERITS OF SALAH

1. It prevents you from Fahsha and Munkar

Verily, As-Salat (the prayer) prevents from Al-Fahsha (ie great sins of every kind, unlawful sexual intercourse, etc) and Al-Munkar (ie disbelief, polytheism, and every kind of evil wicked deed, etc)
Surah al-Ankabut, 29:45

Fahsha = illegal sexual intercourse Munkar = all types of sins

2. It is the best deed after the Shahadah

3. It washes away your sins --from salah to salah jummah to jummah Ramadhan to Ramadhan -- it washed away your sins if you abstain from the major sins --Hadith Rasool the man who has a spring

Narrated from Abu Hurairah (may Allah be pleased with him) that the Messenger of Allah ﷺ said: "Shall I not tell you something by means of which Allah erases sins and raises people in status?" They said: Yes, O Messenger of Allah. He said: "Doing wudoo' properly at times when it is difficult to do so, taking many steps to the mosque, and waiting for prayer after prayer. That is Ar-Ribaat." (Muslim, 251)

Narrated AbuHurayrah (RA) Rasulullah ﷺ said: Five prayers and from one Friday prayer to (the next) Friday prayer is an expiation (of the sins committed in between their intervals) if major sins are not committed. (Sahih Muslim Book 2, Number 0448)

Narrated Abu Huraira: I heard Allah's Apostle saying, "If there was a river at the door of anyone of you and he took a bath in it five times a day would you notice any dirt on him?" They said, "Not a trace of dirt would be left." The Prophet added, "That is the example of the five prayers with which Allah blots out (annuls) evil deeds." (Sahih Al Bukhari Volume 1, Book 10, Hadith # 506)

4. It is a light for the one who performs it Both in this life and the next

5. It causes you to gain intercession of Muhammad --and therefore it causes you to enter the paradise --in order for you to enter paradise, you need the intercession of Muhammed --and you gain this by establishing salah

6. It causes you to gain the dua of the angels -- The person who establishes salah the angels make supplication for that person

7. For you to sit in your place of Salah waiting is like you are doing ribaat

ribaat = watching the borders of the Muslim State

8. The Salah raises your status in the Sight of the Allah The Creator and the creation

And mention in the Book (the Quran) Ismail (Ishmael) Verily! He was true to what he promised, and he was a Messenger, (and) a Prophet (Surah Maryam, 19:54, 55)

And he used to enjoin on his family and his people As-Salat (the prayers) and the Zakat, and his Lord was pleased with him (Surah Maryam, 19:54)

This ayah tells you when you establish salah it raises your status -- in the sight of ALLAH and in the sight of your fellow human beings

9. It makes Allah love you and the people love you

The Dua of Ibrahim: "O our Lord! I have made some of my offspring to dwell in an uncultivable valley by Your Sacred House (the Kabbah at Makkah); in order, O our Lord, that they may perform As-Salat (Iqamatas- Salat), so fill some hearts among men with love towards them, and (O Allah) provide them with fruits so that they may give thanks (Surah Ibrahim, 14:37)"

Non-cultivatable valley nothing grows there! --The scholars of Islam use this ayah to say --that the people will love you if you establish salah

Whenever a man and his wife do not pray, they always end up in divorce --a family that prays together, stays together --when a couple prays together their love grows

10. Your salah is a covenant between you and Allah ta'ala

And We shall drive the Mujrimoon (polytheists, sinners, criminals, disbelievers in the Oneness of Allah, etc) to Hell, in a thirsty state (like a thirsty herd driven down to water), None shall have the power of intercession, but such a one as has received permission (or promise) from the Most Beneficent (Allah) Surah Maryam 19: 86-87

The only one who will receive the intercession --is the one who fulfills the covenant --the covenant is to establish the salah --the one who will receive this intercession is the one who established salah

11. It is the greatest form of dhikr

"Verily! I am Allah! La ilaha illa Ana (none has the right to be worshipped but I), so worship Me, and perform As-Salat (Iqamat-as-Salat) for My Remembrance "(Surah Ta-Ha, 20:14)

ALLAH's commandment to Musa proving that salah is the greatest dhikr

12. It teaches you punctuality --all prayers have a prescribed time

13. It teaches you community cohesion, unity

When you go to the masjid to pray, you mix with your brothers and sisters

The salah teaches you unity and uniformity --if you keep your line straight, --Allah will make your line like the lines of the angels --so by keeping your lines straight, not crooked, --this means that your salah is teaching you --to be organized and it teaches you unity (community cohesion) --you see you bros and sisters on a regular basis

Narrated by al-Bukhaari (690) and Muslim (433) from Anas, that the Prophet ﷺ said "Make your rows straight, for straightening the rows is part of the perfection of prayer" According to the version narrated by al-Bukhari "... is part of the establishing of prayer"

14. Your Salah teaches you humility

When you pray with your head on the ground: --this is the ultimate act of humility (to bow in that manner) --so your salah teaches you unity

15. Your Salah teaches you brotherhood and sisterhood

You pray shoulder to shoulder with all races, black white yellow brown, Arab and non-Arab.

16. It causes you to be blessed by ALLAH

"He (Iesa (Jesus)) said Verily! I am a slave of Allah, He has given me the Scripture and made me a Prophet;" "And He has made me blessed whosesoever I be, and has enjoined on me Salat (prayer), and Zakat, as long as I live" (Surah Maryam 19:30-31)

Therefore Salah is a means by which you are blessed by ALLAH

17. It causes you to attain yaqeen, certainty

Yaqeen is the opposite of doubt (ie when you doubt your faith)

So glorify the praises of your Lord and be of those who prostrate themselves (to Him) And worship your Lord until there comes unto you the certainty (ie death) Surah al-Hijr, 15:98-99

18. Salah is an investment between you and ALLAH

You will reap the rewards in both worlds (in this life and the next

ALLAH refers to salah in the Quran as tijaara --the first thing ALLAH will ask you about on Judgment Day is your salah --if your salah was messed up, ALLAH won't bother to look at your zakat --or your sawm, hajj, etc --if your salah is good, ALLAH will look at your other good deeds

Verily, those who recite the Book of Allah (this Quran), and perform As-Salat (Iqamatas-Salat), and spend (in charity) out of what We have provided for them, secretly and openly, hope for a (sure) trade gain that will never perish (Surah Fatir, 35:29)

19. Salah is a gift given to the Rasool ﷺ on the night of al Isra wal Miraj

20. Salah is a mercy from ALLAH to the ummah of Muhammad ﷺ

You were commanded to pray 50 times a day initially --then the Rasool passed by Musa, and Musa asked the Rasool --to ask Allah to decrease it --due to Musa's experience with his own ummah

The Prophet (ﷺ) kept going back again and again, --until ALLAH reduced the salah to 5 times a day --therefore ALLAH says he will give us the reward of praying 50 times a day --if we establish the salah 5 times a day

21. It's a regular exercise that reduces the cholesterol level

Your 5 daily salah is the minimal amount of exercise that is needed to keep your cholesterol levels down, high cholesterol causes many problems in the body, salah reduces this.

22. Your Salah is a demonstration of your love to ALLAH and to his Rasool

When you read the Quran, ALLAH is speaking to you, when you pray, you speak to ALLAH. It's a demonstration of love to the Rasool because you pray the same way he prayed. You establish your salah in accordance to the sunnah of the prophet.

Why did you do this? Because you love the prophet --the Rasool said "pray the ways you see me pray" --therefore you if pray the way the Rasool prayed, this is a testament to your love to the Rasool

23. It is the closest you can get to ALLAH

The Prophet Muhammad ﷺ said

The shaitan is jealous of you when you are in sajda.

There is no other position in salah that brings you, closer to ALLAH than when you are in sajda

ALLAH loves you the most when He sees you in sajda

"A servant is nearest to his Lord when he is in sajda, so increase your supplication when in sajda" (Muslim)

When you are in sajda, you can beg ALLAH for anything, in any language, because this shows your humility.

24. The Salah is the legacy of the Prophets

When the Rasool ﷺ went to Isra wal miraj, he led the other prophets in prayer, he lead them in prayer, and they prayed behind him their salah and his salah was the same exact salah there is no difference between the salah of the previous Prophets.

"He (Iesa (Jesus)) said Verily! I am a slave of Allah, He has given me the Scripture and made me a Prophet;" "And He has made me blessed whomsoever I be, and has enjoined on me Salat (prayer), and Zakah, as long as I live" Surah Maryam, 19:30-31

25. Praying 12 rakahs a day will build a house in jannah every day for each day that it is done

It was narrated that the Prophet ﷺ said: "Whoever prays twelve rakahs during the night and day, a house will be built for him in Paradise: four beforeZuhr and two after, two rak'ahs after Maghrib, two rakahs after isha and two rakahs before Fajr prayer." (al-Tirmidhi, no. 380; classed as saheeh by al-Albaani in Saheeh al-Jaami', 6362)

26. Hellfire will be made haram for one who prays four rakah before and after Zuhr

Narrated from Umm Habeebah (may Allah be pleased with her) that the Prophet ﷺ said: "Whoever prays four (rakahs) before Zuhr and four after it, the Fire will not touch him." (Al-Nasaa'i (1817) and al-Tirmidhi (428); classed as saheeh by al-Albaani in Saheeh al-Nasaa'i)

27. Praying Ishraaq after praying in congregation in masjid and doing dhikr will give reward of doing umrah and hajj

Anas ibn Maalik (may Allah be pleased with him) said: The Messenger of Allah ﷺ said: "Whoever prays Fajr in congregation then sits remembering Allah until the sun rises, then prays two rakahs (known as Ishraaq), will have a reward like that of Hajj and 'Umrah." He said: The Messenger of Allah ﷺ said: "In full, in full, in full."

(al-Jumu'ah 535; classed as hasan by al-Albaani in Saheeh Sunan al-Tirmidhi, 480)

28. Praying fajr will put a person under the protection of Allah

Messenger of Allah ﷺ said: "Whoever prays Fajr is under the protection of Allah, so do not fall short with regard to the rights of Allah, for anyone who does that, Allah will seize him and will throw him on his face into the Fire of Hell." (Muslim (657))

28. Praying two rakah of duha is sufficient enough for giving thanks of 360 joints of body to Allah

Messenger of Allah ﷺ said: "In a human (body) there are 360 joints and man must make a charity for each one." The people said: "Who can do that, O Messenger of Allah?" He responded: "One may cover the mucus that one finds in the mosque or remove something harmful from the road. If one could not do that, he could pray two rak'at of duha and that will be sufficient for him." (Ahmad and Abu Dawud)

Messenger of Allah ﷺ said: "Charity is required from every part of your body daily. Every saying of 'Glory be to Allah (subhan Allah)' is charity. Every saying of 'Praise be to Allah' is charity. Every saying of 'There is no God but Allah (La ilaha illal Allah)' is charity. Every saying of 'Allah is the Greatest (Allahu Akbar)' is charity. Ordering the good is charity. Eradicating the evil is charity. And what suffices for that (as a charity) are the two rak'at of duha." (Ahmad, Muslim, and Abu Dawud)

WARNING AGAINST ABANDONING SALAH

Allah (SWT) says "Then, there has succeeded them a posterity who have given up As-Salât (the prayers) [i.e. made their Salât (prayers) to be lost, either by not offering them or by not offering them perfectly or by not offering them in their proper fixed times, etc.] and have followed lusts. So they will be thrown in Hell. Except those who repent and believe (in the Oneness of Allâh and His Messenger Muhammad SAW), and work righteousness. Such will enter Paradise and they will not be wronged in aught." (Sura Maryam, ayat 59-60)

Here we see what is the place for those who have abandoned the prayer but Allah (swt) is the most merciful and gives us chances to repent and be saved.

Allah (swt) says in Sura Al-Mâ'ûn "So woe unto those performers of Salât (prayers) (hypocrites),Who delay their Salât (prayer) from their stated fixed times, Those who do good deeds only to be seen (of men)," (Sura Al-Mâ'ûn, ayat 4 - 6)

This ayah shows us that we have to pray our Salah on its fixed timings and not delay them without a valid reason (i.e. traveling, jihad etc..) and how much we need to have sincerity in your prayer and do it only for Allah (swt).

Allah (swt) further warns us in the Quran "O you who believe! Let not your properties or your children divert you from the remembrance of Allâh. And whosoever does that, then they are the losers." (Sura Al-Munaafiqoon, ayah #9)

The commentators of the Qur'aan say: "The 'remembrance of Allaah' mentioned in these Aayaat means the five daily prayers. If anyone is so busy in buying and selling, or with his daily work of earning a livelihood, or with his children, that he cannot perform prayers on time, he will be among the losers."

Informing us about the inhabitants of Hell, Allaah (SWT) says "(The people in Hell will be asked) What has caused you to enter Hell? They will say: "We were not of those who used to offer their Salât (prayers). Nor did we feed the poor. And we used to talk falsehood (all that which Allaah hated) with vain-talkers. And we used to belie thE Day of Recompense. Until there came to us that which is certain (i.e., death). So no Intercession of intercessors will benefit them. (Sura Al-Muddaththir, ayah 42-48)

The Prophet ﷺ said "The covenant between us and them is prayer, so if anyone abandons it he has become a disbeliever." (Agreed upon by Ahmad, Tirmidhee and Nasaa'ee to be authentic)

In another Hadith of the Prophet ﷺ, he said "What lies between a man and disbelief is the abandonment of prayer." (Agreed upon by Muslim, Abu Dawood and Nasaa'ee as sahih authentic)

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1. The linguistic definition is "du'a." Al 'Qadia said this is the saying of most scholars of fiqh and Arabic language.Du'a means 'supplication'. In Arabic language we usually refer to something by what is included in it. The technical definition in the Sharee'ah is the 'sayings and actions beginning with takbeer and ending with tasleem along with intention.

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Is Ramadan fasting related to health outcomes? A review on the related evidence

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Abstract

Background:

Fasting during Ramadan is an Islamic rule. Although previous review studies have assessed the impact of Ramadan on cardiovascular risk factors, athlete performance, diabetes and transplantation, in this study we have appraised some on these reviews by focusing on limitations and also, we have reviewed more recently published study and several recent studies, which are not reviewed till now.

Materials and Methods:

In this article, we reviewed recently conducted studies in regarding the impact of Ramadan fasting on weight, lipid profile, diabetes, immune system and gestation. MEDLINE ( http://www.pubmed.com) was searched by using "Ramadan" as keyword and the most recent articles in mentioned topics since 2009 until February 2014 were selected.

Results:

Although weight has been decreased during Ramadan in the most studies, weight regain is prevalent during the following months. Meta-analysis of pre-Ramadan lipid profile in comparison to post-Ramadan values had been showed that total cholesterol and triglyceride were decreased in men and high-density lipoprotein was increased among women. In regarding diabetes and fasting, diabetic patients should be aware that medical, nutritional and physical activity consulting is necessary for individuals with diabetes who want to fast during Ramadan. Although published studies show that Ramadan fasting had no serious adverse effect on offspring, it is strongly recommended that pregnant women avoid fasting because of the limitations of studies. The effect of fasting during Ramadan on the immune system is favorable. Ramadan fasting has no impact on kidney function and urine component.

Conclusion:

Studies showed that Ramadan fasting has health protective effects. More precise studies should be conducted for more reliable conclusion.

Keywords: Body weight, diabetes, fasting, immune system, lipid profile, pregnancy, Ramadan

INTRODUCTION

Fasting during Ramadan is an Islamic rule and, therefore, Muslims fast a 29-30-day consecutive period per year. This Islamic rule is excepted for patients and whom fasting may be harmful to them. Ramadan is a month of Islamic lunar calendar and, therefore, its duration varies in different seasons year to year. In fasting days, individuals do not eat anything from brightening to sunset. From sunset to brightening, Muslims can eat freely. Hence, time of sleeping and eating may be affected by Ramadan.[ 1] Approximately, 1.5 billion Muslims live world widely, especially in Asia and Africa.[ 2] So, many studies have focused on the effect of Ramadan fasting on metabolic changes and health outcomes in different groups of Muslims population. Studies reported that total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and blood glucose have been improved after Ramadan compared to before Ramadan among athletes.[ 3] As Smocking has been forbidden during fasting of Ramadan, studies revealed a significant reduction in second-hand smoke levels in public places[ 4] that might be related to mortality and morbidity.[ 5] Moreover, reported evidence illustrated that smoking is positively related to elevated TC and LDL,[ 6] poor glycemic control[ 7] and increased risk of type 2 diabetes prevalence,[ 8] lower birth weight and increased short for gestational age rates,[ 9, 10] impaired function of dendritic cells[ 11] and altered immune cell count.[ 12] Furthermore, a direct association between smoking and weight reduction was observed among older adults.[ 13] Conducted studies have assessed the impact of Ramadan fasting on a different aspect of human metabolic and healthy such as an immune system, hormones secretion and gestation. The effect of Ramadan on diseases (e.g., gastrointestinal diseases)[ 14, 15] has been also examined. Although previous review studies have assessed the impact of Ramadan on cardiovascular risk factors (i.e., body mass index [BMI] and lipid profile),[ 16] athlete performance,[ 17] diabetes[ 18, 19, 20] and transplantation,[ 21] in this study we have appraised some on these review by focusing on limitations and also, we have reviewed more recently published study. Moreover, several recent studies have been published in these regards (e.g., the impact of Ramadan fasting on the immune system) that is not reviewed till now. In this article, we reviewed recently conducted studies in regarding the impact of Ramadan fasting on weight, lipid profile, diabetes, gestation, immune system and kidney function.

MATERIALS AND METHODS

MEDLINE ( http://www.pubmed.com) was searched by using "Ramadan" as keyword. Found articles were categorized as original or review article. Included papers were sorted by year of publication to determine the most recent review articles. Then we reviewed original articles published after the last review article. Therefore, we can choose the most recent studies and articles not reviewed till now regarding weight, lipid profile, diabetes, gestation, immune system and kidney function [ Table 1 ]. Reviewed articles have been published since 2009 until February 2014.

Table 1

RESULTS

Weight

Based on the results of a currently published meta-analysis included 21 articles, 531 men and 299 women, fasting during Ramadan results in a moderate reduction in body weight in men but not in women (−0.24, 95% confidence interval [CI] = −0.36 to −0.12; P = 0.0001 and −0.04, 95% CI = −0.20 to 0.12; P = 0.62, respectively).[ 2] The overall estimated effect size for both genders was also significant (−0.17, 95% CI = −0.26 to −0.07; P = 0.001). Moreover, within study heterogeneity was not significant ( I ² = 0%, P = 0.82).

A recent study reported that body weight, BMI and body fat had a significant reduction in 3 rd week of Ramadan in comparison with 1 week before or after Ramadan fasting ( P < 0.01 for all).[ 22] However, the changes in hip circumference, weight circumference and waist to hip circumference ratio were not significant. Moreover, lost weight during Ramadan was regained and reduced BMI was returned to pre-Ramadan values in short-term after Ramadan.[ 22] Moreover, a significant increase in body fat percent measured in 30 th day after Ramadan was observed in comparison to pre-Ramadan values.[ 22]

Lipid profile

Meta-analysis of pre-Ramadan lipid profile in comparison to post-Ramadan values showed that TC (−0.44, 95% CI = −0.77 to −0.11; P = 0.009) and triglyceride (TG) (−0.35, 95% CI = −0.67 to −0.02; P = 0.04) were decreased in men and HDL (0.86, 95% CI = 0.11 to 1.61; P = 0.03) was increased among women. Although the overall pooled changes for TC (−0.29, 95% CI = −0.57 to 0.00, P = 0.05) was marginally significant, the pooled effect sizes for TG (−0.20, 95% CI = −0.44 to 0.04, P = 0.1) and HDL (0.73, 95% CI = −0.10 to 1.57, P = 0.09) were not statistically significant. In both genders (500 men and 240 women), a significant reduction in LDL (−2.22, 95% CI = −3.47 to −0.96; P = 0.0005 in men and −0.81, 95% CI = −1.61 to −0.00 in women; P = 0.05) was observed.[ 2] The data of 581 men and 225 women was used to calculate overall effect size of TC. Analyses for estimating overall changes in HDL were conducted on 462 men and 199 women.

The effect of Ramadan fasting on lipid profile has been assessed among athletes.[ 3] Results showed that TC and LDL were decreased, and HDL and TG were increased during Ramadan in compared with pre-Ramadan assessment.[ 3] A trend of reduction in TG and very low-density lipoprotein and increase in HDL was observed after Ramadan month. TC and LDL reached to pre-Ramadan values during after Ramadan fasting period. Another study conducted on healthy subjects reported that Ramadan fasting had a favorable impact on LDL and HDL among men ( P < 0.001 for both).[ 34] The authors of foresaid study could not observe any reduction in TG and TC after Ramadan fasting in comparison with pre-Ramadan values in men ( P = 0.25 for TG and P = 0.06 for TC). In women, although TC was decreased during Ramadan in compared with pre-Ramadan measurements, it reached higher values in after Ramadan period than pre-Ramadan. In contrast to LDL that showed a remarkable reduction trend, an increasing trend was observed for HDL and TG from pre-Ramadan to post-Ramadan period in women.

Diabetes

Reported evidence showed a decrease in intake of total fat, saturated fatty acid, cholesterol and polyunsaturated fatty acid during Ramadan month among type 2 diabetic obese women.[ 35] On the other hand, there are two major complications for diabetic patients during Ramadan: Hypoglycemia, hyperglycemia.[ 19] The risk of hypoglycemia is increased significantly among diabetic individuals during Ramadan.[ 36] Hyperglycemia usually occurred due to overeating during nonfasting hours of Ramadan and change in dosage of antidiabetic drugs to prevent hypoglycemia.[ 19] Fasting during brightening to sunset results in remarkable changes in eating pattern and daily physical activity. Studies reported that insulin delivery should be rescheduled during Ramadan in which need to insulin reduction in daytime and increase in nighttime.[ 23] Therefore, it is recommended that diabetic patients use the insulin pump for regulating their insulin requirement during Ramadan.[ 23] Previous studies demonstrated that fasting blood sugar and postprandial plasma glucose was decreased among type 2 diabetic patients during Ramadan in comparison to before and after Ramadan values.[ 24] Serum fructosamine, an indicator of overall glycemic control, showed a favorable change during Ramadan fasting.[ 24] Reported guidelines for diabetic subjects during Ramadan emphasized that all recommendations should be individualized for each person.[ 37] Nutritional recommendations advised that carbohydrate and fat content of sunset meal should be restricted and complex carbohydrate should be consumed before daily fasting.[ 37] Diabetic patients should be aware that they have to break fast as hypoglycemia occurred.[ 37] Medical, nutritional and physical activity consulting is necessary for individuals with diabetes who want to fast during Ramadan.[ 38]

Pregnancy

In the most cases, pregnant women have been forbidden to fast during Ramadan but arbitrary fasting is observed in pregnant women. An Iranian historical cohort study on pregnant women aged 20-35 years ( n = 189) who fasted 13 days in average, illustrated that in comparison to nonfasting mothers' offspring, fasting could not significantly affect on incidence of low body weight in neonatals.[ 25] In comparison to those who were nonfasting during Ramadan, the risk of low birth weight was not statistically higher in fasting mothers (odds ratio: 1.50; 95% CI: 0.23-1.74; P > 0.05).[ 25] In overall, the results of foresaid study showed that Ramadan fasting had no effect on intrauterine growth, pregnancy duration and anthropometrical measures of infants.[ 25] Similarly, another study conducted on 25 fasting (mean of fasting days: 23 ± 6) and 27 nonfasting healthy women reported that there are no significant differences in femoral length, abdominal circumference, biparietal diameter, fetal weight, amount of amniotic fluid and fetal heart rate between two groups.[ 26] The results of a prospective cohort study on 402 women (201 Ramadan fasted and 201 nonfasted) demonstrated that time of delivery had no difference between fasted and nonfasted pregnant women and BMI is the most important factor which affect on time of delivery.[ 27] The mean of fasting days in foresaid study was 22 ± 9. Moreover, the finding disclosed that Ramadan fasted mothers had lower rate of cesarean delivery (28.4% in fasted and 39.3% in nonfasted women; P = 0.027) and birth weight average (3094 ± 467 g in fasted and 3202 ± 473 g in nonfasted; P = 0.024).[ 27] Researches regarding the effect of fasting during Ramadan on offspring are not limited to childhood, and it is evaluated till adulthood. A recent population-based study compared the BMI and height of adults whose fetal period had been in Ramadan with those whose fetal period had not been in Ramadan.[ 28] After adjusting for adulthood BMI, results showed that subjects with fetal period during Ramadan were thinner and shorter than other Muslims.[ 28] Similar differences were not observed between non-Muslims who were not in the fetal period during Ramadan and non-Muslims who were in the fetal period during Ramadan.[ 28]

Immune system

Animal studies reported that the expression of immunoglobulin A (IgA) in the intestinal mucosa, monocyte killing, natural killer-cell activity and macrophage activity were increased during fasting.[ 39, 40] In a human study, 35 healthy men recruited and pre-Ramadan IgS concentrations and immune system activity were compared with post-Ramadan.[ 29] Findings illustrated that although IgG concentration was decreased in post-Ramadan period in comparison to pre-Ramadan, it was not out of the normal range.[ 29] The reduction in concentration of salivary IgA was also observed, but the lymphocyte number was elevated.[ 29] These results show that Ramadan fasting has no severe effect on the immune system. Another study conducted on 50 subjects reported that the concentration of interleukin 6 (IL-6), IL-1β and tumor necrosis factor-α (TNF-α), and the number of total leukocytes, granulocytes, lymphocytes and monocytes were significantly decreased during Ramadan in comparison to pre-Ramadan.[ 22]

KIDNEY

Ramadan fasting has no impact on kidney function and urine component in healthy subjects[ 41] but the effect of fasting on renal function should be assessed among nonhealthy individuals. One study conducted on 31 chronic kidney diseases patients evaluated the renal function at 3 times: 1-month before Ramadan, during Ramadan and 1-month after Ramadan.[ 30] In comparison to before Ramadan period, estimated glomerular filtration rate (eGFR) was improved, and proteinuria and urinary sodium were decreased during and after Ramadan.[ 30]

The effect of Ramadan fasting on kidney transplant patients has been assessed in recent studies. One study compared the post-Ramadan measurements of renal function with pre-Ramadan values.[ 31] Findings illustrated that creatinine, urea, uric acid, and sodium, potassium and HCO3 content of urine had no significant difference between two periods.[ 31] These results are approved by another study conducted on 43 fasters and 37 nonfasters kidney transplant recipients.[ 32] The changes in the eGFR were not significantly different between two groups.[ 32] The general conclusion of these two study demonstrated that fasting has not adverse effect on kidney transplant recipients.

Water drinking is forbidden during Ramadan fasting, and consequently, dehydration may occur. Dehydration is considered as a risk factor for kidney stones.[ 33] One study evaluated the effect of Ramadan fasting on calculus formation among 57 men (37 calcium calculus formers).[ 33] Results showed that in comparison to nonfasting period, a reduction in calcium, phosphate, magnesium and urine volume was observed but the concentration of uric acid, citrate, phosphate, sodium, and potassium was increased.[ 33] These findings do not support the hypothesis that Ramadan fasting is a risk factor for calculus formation.

DISCUSSION AND CONCLUSION

A statistical significant weight lost was observed among men during Ramadan. A is that during Ramadan, men should continue their usual outdoor activities while most Muslim women are housekeeper and, therefore, their activity level is lower than men.[ 2] In general, two possible reasons were suggested for weight reduction in Ramadan: Decrease in calorie intake and subsequently body fat reduction, and negative fluid balance.[ 22] Moreover, the correlation between the decrease of body weight and a decrease in meal frequency in people with type 2 diabetes was found, which leads to a decrease in calorie intake.[ 35] Although a statistical significant weight lost was observed during Ramadan, Foresaid reduction (170 g) is not physiologically valuable, because it is too small for a 1-month period. One study reported that the lost weight during Ramadan was regained and reduced BMI was returned to pre-Ramadan values. A possible reason of this finding may be that individuals would return to their pre-Ramadan lifestyle in which dietary habits result in weight regain. It is suggested to evaluate the sustainability of the reduced weight in Ramadan during the following months to see whether or not this reduced weight is maintained during the following months.

The results of a meta-analysis were reported in "weight" and "lipid profile" section. It should be kept in mind that the design of conducted studies regarding fasting during Ramadan is similar to before-after intervention studies except that the control of confounder is weaker in Ramadan-related studies because they are categorized as observational study. Hence, the results of this meta-analysis may be affected by confounders of included studies. Moreover, the authors of this meta-analysis did not discuss regarding confounder adjustments, and it seems that different studies with different confounder adjustments were pooled. These differences may be a source of heterogeneity as well as cause of attention of attenuated the effect of Ramadan fasting on weigh and lipid profile. The heterogeneity this meta-analysis was high. So, the results were not reliable.

As mentioned regarding the effect of Ramadan fasting on pregnancy, the risk of low birth weight was not statistically higher in fasting mothers.[ 25] Appropriate nutritional status has an important role in these findings, so that fasting in well-nourished women had no adverse effect on offspring.[ 25] Although published studies shows that Ramadan fasting had no serious adverse effect on offspring, it is strongly recommended that pregnant women avoid fasting because the most of current studies did not adjusted the impact of several confounder variables such as pregnancy duration, nutritional status before, during and after the Ramadan, maternal age, socioeconomic status and other potential covariates.

Studies reported that Ramadan fasting may decrease the concentration of IL-6, IL-1β, TNF-α and number of leukocytes and monocytes.[ 29] Elevated concentration of proinflammatory cytokines (e.g., IL-6, IL-1β and TNF-α) is known as a risk factor for cardiovascular diseases,[ 42, 43] insulin resistance[ 44] and cancers.[ 22] Suggested mechanism is that Ramadan fasting results in oxidative stress reduction, and therefore, lower level of reactive oxygen species.[ 45] On the other hand, body fat decreased during Ramadan in this study, and therefore, proinflammatory cytokines secretion would be decreased.

This reviewed studies approved the safety of Ramadan fasting for chronic kidney diseases patients. Suggested mechanism for this improvement in renal function is a reduction in blood pressure and body weight and decline in dietary protein and creatinine intake.[ 33]

Although conducted studies regarding Ramadan fasting and health outcomes were designed similar to before-after intervention studies, confounders were not controlled as well as possible. It is suggested that researchers should collect sufficient data for estimating confounders. Several studies reported that Ramadan fasting has health protective effects; however these effects were attenuated during post-Ramadan period. Dieticians should provide a guideline for maintaining health protective effects of Ramadan fasting during post-Ramadan period. In conclusion, although studies showed that Ramadan fasting has health protective effects, patient individuals should consult their medical team for fasting during Ramadan. More precise studies should be conducted for more reliable conclusion.

AUTHOR'S CONTRIBUTIONS

MHR searched databases and selected articles. MHR and LA wrote the manuscript. All authors have read and approved the content of the manuscript.

Footnotes

Source of Support: Nil

Conflict of Interest: None declared.

Articles from Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences are provided here courtesy of Wolters Kluwer -- Medknow Publications

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Is Ramadan fasting related to health outcomes? A review on the related evidence

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Fasting during Ramadan is an Islamic rule. Although previous review studies have assessed the impact of Ramadan on cardiovascular risk factors, athlete performance, diabetes and transplantation, in this study we have appraised some on these reviews by focusing on limitations and also, we have reviewed more recently published study and several recent studies, which are not reviewed till now.