Muslim Medical Association of Canada
ramadan kareem
Muslim Medical Association of Canada
"Medicine in Ramadan"
"The month of Ramadan in which was revealed the Qur'an, a guidance for mankind, and clear proofs of the guidance, and the Criterion (of right and wrong)."
Holy Qur'an 2:185
In This Issue
Feature Article: Fasting & Health
Medical Literature on Fasting
URB Updates
MMAC Application Guide 2009-2010
URB Inaugural Meet & Greet
Link to Previous Issues

The MMAC is entirely volunteer run and with increasing demands and challenges, seeks to expand its current Board of Directors.

The following positions in the MMAC Board of Directors are currently available:

- Director Finance
- Director Public Relations
- Director Humanitarian Aid

We invite all attendings, residents and students to play an active role in further developing the MMAC.  This organization is for YOU, help make it work!

All interested individuals should contact us at

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University Representative Body 2009-2010

General Enquiries:
Dr. Raza Naqvi

U of British Columbia
Br. Ali-Reza Merali

University of Alberta
Sr. Sana Ghaznavi

University of Calgary
Br. Hamza Jalal

McMaster University:
Br. Hisham Ali

Queen's University:
Sr. Waseema Hoosainny

University of Ottawa:
Br. Salam Al-Attar

University of Toronto:
Br. Nasir Khan

U of Western Ontario:
Br. Hassan Mir

Issue: #3 August 2009 /
 Ramadan 1430
Introduction to this Issue
"Medicine in Ramadan"

Asalamu alaykum dear friends & colleagues,

As Muslims around the world welcome the start of the holy month of Ramadhan for 2009, we at MMAC extend our best wishes to our Muslim brothers and sisters for a month full of blessings, peace, and good health, and we take this opportunity to present our third MMAC e-newsletter issue. 

No doubt, every practicing Muslim recognizes the distinctiveness of Ramadhan in Islam.  It is the month of fasting, of course, but even more importantly it is the month of moral and spiritual development, a crucial annual shakeup of our usual routines so that we may consider how to improve ourselves, in our relationship with God and with our communities.  Though often overlooked, this imperative for self-improvement (physically, spiritually, and on the community level) is a far more significant aspect of Ramadhan than the mere act of abstaining from food and drink between dawn and dusk. 

The mission of MMAC is in line with this mandate for better self-awareness and community service.  Our aim as an organization is to provide a platform for Canadian Muslim physicians (and trainees in the field) to achieve excellence, solidify their role as leaders in their communities, and advocate on behalf of their patients as well as for the health of their community as a whole.  Of course, any organization is only as strong and as successful as the activity of its members.  In order for MMAC to grow and achieve its stated goals, an active interest and involvement from its target community is needed.  

We invite and encourage all Canadian Muslim physicians, residents, and medical students to participate in developing MMAC, by taking on the leadership and/or joining others in projects that are important to them.  The purpose of MMAC is to meet the unique professional and health-related needs of Canadian Muslim medical practitioners and the  Canadian Muslim community; please help us identify and address these needs.

To date, we are proud of the efforts of our members in organizing the University Representatives Board (URB), which includes medical school representatives for eight universities across Canada, and which has produced the largely circulated Medical School Admissions Guide as well as organizing local events to educate fellow medical students about issues pertaining to care of Muslim patients.  Read about recent and upcoming URB events in this e-newsletter, and we hope that medical students who have yet to join will be inspired to do so. 

Also in this issue of the e-newsletter, read about the impact of fasting on cardiovascular risk factors by Dr. Adnan Hameed, FRCP (cardiology), and we providelinks to some published papers and reviews addressing several health issues in the context of Ramadhan fasting, including diabetes, kidney function in transplant patients, seizures, maternal/fetal health in pregnancy, and sleep.  We leave critical appraisal of these papers up to our readers, and hope they inspire more research into the healthcare of fasting Muslims during Ramadhan.

Happy fasting and have a productive and healthy Ramadhan!
MMAC Boad of Directors
Aug 2009
Feature Article: Fasting & Impact on Health
dates Adnan Hameed, MD, FRCP(C)
Internal Medicine; Cardiology Fellow
Dalhousie University

In various cultures and across the ages, fasting (abstinence from food) has been used to assist the body to relieve itself from discomfort, pain or disease.  Regulatory and reparative processes are allowed unimpeded progress by the temporary omission of food, which often helps restore balance in physiologic function.  Thus, fasting affects overall well-being and can even positively impact certain diseases.(1)  Indeed, as a conservative approach to managing diseases such as hypertension and dyslipidemia, fasting has been shown to be an effective treatment for addressing major cardiovascular risk factors.

Hypertension places excess stress on the walls of the blood vessels and thereby damages the inner lining of arteries and veins.  An elevated blood pressure increases the risk of heart attacks, strokes, peripheral vascular disease and renal failure.  Fasting, a natural intervention has been studied in various forms throughout the world as a method of lowering blood pressure.  In Russia, Murav'ev et al., demonstrated that a two week fasting period resulted in a statistically significant reduction of weight, a decrease in average daily systolic and diastolic ambulatory blood pressure readings and improved hemodynamic parameters of the left sided chambers of the heart.(2)  Goldhamer et al., showed that a water only fasting diet dropped blood pressure by an average of 37/13 mmHg with the greatest reduction being observed in those with the most severe hypertension.(1)

Caloric restriction has also been shown to decrease elevated lipid profiles with remarkable success.  At Washington University, researchers conducted a study over a six- year period which concluded that a regimen of fasting decreased atherosclerosis as compared to age matched controls consuming a typical American diet.(3) Several variables, including serum lipids, lipoproteins, fasting plasma glucose and insulin, blood pressure, body composition and carotid artery intima-media thickness were assessed.  Participants in the fasting arm showed an improvement in all variables at the end of the study.  Higher HDL levels and less atherosclerotic disease were found in the study arm by the end of the trial.  Similarly, the Journal of Nutrition, Metabolism and Cardiovascular disease, which focuses on the interplay between nutritional and metabolic alterations and cardiovascular disorders, published an article analyzing the connection between diet, obesity and dyslipidemia earlier this year.(4)  It revealed a statistically significant reduction in total cholesterol and LDL levels with a coincident rise in HDL in persons consuming a lower calorie diet.  In the American Journal of Cardiology, scientists from the University of Utah published an article showing that people who performed intermittent fasting benefited from a 40% reduction in heart disease risk.(5)  By lowering cholesterol levels, fasting ultimately reduces the burden of disease on the human body.

Various pathophysiologic mechanisms have been postulated to explain the positive impact of fasting on hypertension and dyslipidemia.  Some theories suggest that the reduced oxidative stress and increased cellular resistance which occurs in the fasting state account for the health benefits.  Low calorie consumption results in less cellular damage as the byproducts of digestion, which are toxic to the body, are decreased.(6)  A slower metabolic rate, more efficient protein production, an improved immune system and increased production of hormones are also postulated to explain the health benefits of fasting.

Some opponents of fasting argue that fasting is a form of starvation which harms the body; however, many studies dispute this.  With more than 1 billion Muslims participating in the obligatory fasting during Ramadan, research has been preformed to assess the effects of no dietary intake from dawn to dusk for 30 consecutive days.  The results show that this particular mode of fasting is not detrimental to the body, at least not in the short term.  Moreover, investigators have found no negative impact of fasting on acute coronary syndromes, stroke or admissions to hospital for heart failure.(7,8,9) Of course, it should be recognized that fasting during Ramadhan does cause unique metabolic changes in most individuals(10), and the potential for harm exists if the fast is practiced inappropriately, such as through inadequate hydration or indulgence in greasy or sweet foods during the non-fast hours.  Furthermore, fasting patients should be counseled about the importance of adhering to prescribed medications, with any change in schedule being carefully monitored and approved by their physicians and pharmacists.  Some chronic diseases, such as diabetes, may still be safely managed during fasting if the appropriate care and monitoring is observed.(11) 

Improvements in many medical conditions have been associated with fasting, while few if any detrimental effects to health or medical conditions have been conclusively attributed to abstaining from food for fixed periods of time.  Beyond the medical benefits, fasting has many immeasurable rewards, not least of which is strengthening of will-power and spiritual wellbeing, both of which can ultimately help improve physical health as well.  Therefore, it behooves the medical community to continue studying the impact of fasting on health so that physicians may offer their Muslim patients the best advice on optimizing their health during fasting.


1) Goldhamer A, Lisle D, Parpia B et al.  Medically supervised water-only fasting in the treatment of hypertension.  J Manipulative Physiol Ther. 2001 Jun;24(5):335-9.  Center for Conservative Therapy, Penngrove, Calif, USA.

2) Murav'ev SA, Malishevskii MV, Makarova GA, et al. Central and peripheral hemodynamics in patients with essential hypertension on a fasting diet
Klin Med (Mosk). 2003;81(9):35-9.
3) Fontana L, Meyer TE, Klein S, et al.  Long-term calorie restriction is highly effective in reducing the risk for atherosclerosis in humans.  Proc Natl Acad Sci U S A. 2004 Apr 27;101(17):6659-63.
4) Tapsell L, Batterham M, Huang XF, et al.  Short term effects of energy restriction and dietary fat sub-type on weight loss and disease risk factors. [EPUB ahead of print]
5) Horne BD, May HT, Anderson JL, et al.  Usefulness of Routine Periodic Fasting to Lower Risk of Coronary Artery Disease in Patients Undergoing Coronary Angiography.  American Journal of Cardiology.  2009 Oct;814-1819.e1.

6) Mattson MP, Wan R.  Beneficial effects of intermittent fasting and caloric restriction on the cardiovascular and cerebrovascular systems.  J Nutr Biochem. 2005 Mar;16(3):129-37.  Laboratory of Neurosciences, National Institute on Aging Intramural Research Program, Baltimore, USA.
7) Al Suwaidi J, Bener A, Suliman A, et al. A population based study of Ramadan fasting and acute coronary syndromes. Heart. 2004;90:695-696.
8) Bener A, Hamad A, Fares A, et al. Is there any effect of Ramadan fasting on stroke incidence?. Singapore Med J. 2006;47:404-408.
9) Al Suwaidi J, Bener A, Hajar HA, et al. Does hospitalization for congestive heart failure occur more frequently in Ramadan? (A population-based study (1991-2001)). Int J Cardiol. 2004;96:217-221.
10) Leiper JB, et al.  Effects on health of fluid restriction during fasting in Ramadan.  European Journal of Clinical Nutrition 2003;57(Suppl 2):S30-S38.
11) Kobeissy A, et al.  Suggested insulin regimens for patients with type 1 diabetes mellitus who wish to fast during the month of Ramadan.  Clinical Therapeutics 2008;30(8):1408-1415.
Medical Literature on Health & Fasting
Over the last several years, there has been an increase in the body of medical literature pertaining to fasting in Ramadan and its relation to one's health or varying medical conditions.  Below is a list of a few articles which try to address the issue of Ramadan and Medicine.

MMAC does not necessarily endorse the articles below, and as with all medical literature, requests its readership to review them critically prior to adopting them into your clinical practice.

Below are a few articles we thought would be worth sharing.  Click on the article to see it in pdf.

Al-Arouj M, et al.  Recommendations for management of diabetes during Ramadan.  Diabetes Care 2005;28(9):2305-2311.

Benaji B, et al.  Diabetes and Ramadan: Review of the Literature.  Diabetes Research and Clinical Practice 2006;73:117-125
Dikensoy E, et al.  The effect of Ramadan fasting on maternal serum lipids, cortisol levels, and fetal development.  Archives of Gynecology and Obstetrics 2009;279:119-123.
Aadil N, et al.  Drug intake during Ramadan.  BMJ 2004;329:778-782.
Ghalib M, et al.  Does repeated Ramadan fasting adversely affect kidney function in renal transplant patients?  Transplantation 2008;85:141-144.
Gomceli YB, et al.  Does the seizure frequency increase in Ramadan?  Seizure 2008;17:671-676.
University Representative Body
The MMAC University Repre-sentative Body (URB) has been growing at a rapid pace since its inception in 2007.  For the current academic year (2009-2010), we have representatives at the each of the following medical schools:
  • University of Ottawa
  • University of Western Ontario (Schulich School of Medicine & Dentistry)
  • Queen's University
  • McMaster University (Michael G. DeGroote School of Medicine)
  • University of Toronto
  • University of Alberta (*NEW)
  • University of Calgary (*NEW)
  • University of British Columbia (*NEW)
  Recent activities by MMAC student members have included:
  • Organizing interview help sessions for medical school applicants
  • Fast-a-thons (proceeds to the food bank) and Eid dinner during Ramadhan
  • Hosting guest speakers to discuss issues related to treating Muslim patients
  • Sandwich run
  • 2009-2010 MMAC Application Guide (see below)
  • Meet and Greet for MMAC members (see below)
Several projects are being planned for the upcoming academic year, including a career fair, a lecture series on the contribution of Islam to medicine, and an orphan sponsorship dinner.

To become involved or if you have questions, contact a university representative (please see the contact email addresses list in the sidebar of this e-newsletter).  If you are a medical student or resident at a medical school not yet represented in MMAC, please contact the MMAC Board of Directors at

admissiondoc MMAC Application Guide 2009-2010

The MMAC URB is proud to annouce the release of the 2009-2010 MMAC Medical School Admission Guide - complete with new additions and fresh advice from current medical students across the country! 

For a copy, click on the picture above or download it here.
Meet 'n Greet (sitting in rows) URB Inaugural Meet & Greet

The MMAC inaugural Meet and Greet on August 8 2009 was a great success with a variety of undergraduate students, medical students, residents and physicians in attendance.  We had members from Ottawa to London make the trip to support the MMAC's vision of unity and cooperation.
Br Saif Al-Mousawy, a third-year medical student from the University of Ottawa and former MMAC chapter representative, coordinated the event and was the Master of Ceremonies.

Following recitation of the Holy Quran, Dr. Raza Naqvi, MMAC VP Education and resident at U of T spent some time discussing MMAC's mission, vision, and accomplishments over the past two years.

A copy of his presentation can be viewed here.

Br Saif then outlined the steps required for individual chapter building for the various medical students and representatives from around Ontario. He expanded on his own personal experiences in establishing a Chapter at the University of Ottawa in the past year.

This was followed by a very unique discussion from MMAC's McMaster representative, Br Hisham Ali, about his medical elective in East Africa through CanAID Africa. The elective was a fantastic opportunity both personally and professionally. Dr. Shiraz Datoo, the Secretary General of CanAID Africa, was also in attendance and answered questions regarding medical electives overseas.  Should anyone wish to inquire further regarding elective opportunities in Tanzania, kindly email Dr. Shiraz Datoo at

The event was very well received and a great opportunity for brothers and sisters in the medical field to finally meet one another in person. The event helped put faces to names and foster a further sense of brotherhood and sisterhood amongst various MMAC members. It was a pleasure to see people bonding, making connections and strengthening their position within our Muslim community. We look forward to hosting the event again next year.

Click the links below for pictures of the event:
Picture 1, Picture 2, Picture 3
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