MIAMI — The Muslim holy month of Ramadan falls during the long, hot days of August this year, and Muslim Americans are getting ready to accommodate the daylight fasts required during Ramadan with adjustments in their schedules and eating habits. It can be even tougher for Muslims in America than for their counterparts in majority-Muslim countries, where business slows down during Ramadan and people take it easier during the day, says Dr. Elizabeth Rourke, an internist at Boston Medical Center. "In the U.S., everyone is required to do what they would do ordinarily, the entire month," Rourke says, "so it makes the fast much more demanding for American Muslims." Mubarakah Ibrahim, a personal trainer, hopes to cram all her clients in the morning when she has the most energy. She'll serve vegetables as the first course when her family breaks their fast in the evenings to make sure they get their nutrients for the day. And she'll buy her four kids — ranging in age from 10 to 17 — shiny new water bottles as a reminder to hydrate during the hours they're not fasting. "We know spirituality can get you through anything," says Ibrahim, who lives in New Haven, Connecticut "But the choice really is, you can suffer through it and still do it, or you can do it and do it efficiently without making your health suffer." Ramadan requires daily fasts of food and water during daytime hours. Typically observers eat a meal before dawn and break their fast at sunset. The fast-breaking meal — which varies by ethnic group but traditionally starts with a handful of sweet dates — is seen by many Muslims as an opportunity to gather with family and friends. This year Ramadan begins Aug. 1, when the period from dawn to sunset in the continental U.S. can range from around 14 to around 16 hours, depending where you live. The Islamic calendar follows the lunar cycle, which is shorter than the sun-based Gregorian calendar, so Ramadan creeps up 11 days every year. Ramadan can last 29 or 30 days, again depending on the lunar cycle. Fasting during Ramadan is one of the most important duties in Islam, one that even the not-so-religious typically observe. Children are not required to fast until they hit puberty, though many start building up to it when they're younger with half-day fasts. Also exempt are the elderly, women who are pregnant or nursing, and people with chronic medical conditions. But even for healthy Muslims, the daily fast from dawn until sunset can be grueling. Rourke teaches medical residents about Ramadan and its implications for patients — how to adjust medication regimens to fit the daytime fast when possible, how to advise patients on avoiding dehydration, how to enlist help from a local religious leader if someone who shouldn't be fasting expresses the intention to do so. Even for a totally healthy person to sustain that fast for a long period of time during a time where it can be very hot, it's a very demanding thing to ask of your body," Rourke says. Sheikh Ali, a college student from Boca Raton, Florida, tries to ease his body into Ramadan mode by fasting intermittently the prior month, a practice of the Prophet Muhammad that some people emulate. The premed chemistry major also extols the benefits of eating a high-fiber breakfast, like whole grain cereal, especially in the pre-dawn meal before fasting to help keep him feeling full. Still, many Muslims say they won't do much differently this year and they're not too worried about the summer Ramadan. "Once you've done it for this long," says Natasha Chida, a medical resident at the University of Miami who's been fasting since she was in middle school, "it's not really something that's physically difficult, it's just about continuing to learn self-restraint." Beyond abstaining from food and drink, Muslims try to avoid negative words, thoughts and actions while fasting. Ramadan is seen as an opportunity to improve oneself, spiritually and personally. Rizwan Jaka, a technology manager in Washington, D.C., puts the fast in perspective by reflecting on and empathizing with those in need, one of the main purposes of fasting. "In the end, we have to realize that people go without food and water on a regular basis," Jaka says. Whatever hardships people feel during their fast, he adds, "we've got it easy compared to people who don't have access to food and running water."
