Diabetes is one of the most serious public health risks today. The United Nations declared diabetes as a global threat in 2007 in order to highlight just how widespread and destructive diabetes had become.

Diabetes is one of the oldest known diseases, and was even mentioned in the ancient Egyptian, Indian, and Chinese texts. Ancient Egyptian texts defined diabetics as “… so thirsty that if they drank all the water of the Nile, their thirst would still not be quenched.” The ancient Indian and Chinese texts mention insects and flies swarming over the urine discharged by the diabetics.

Ancient scientists Al-Razi and Ibn Sina (Avicenna) made important findings about diabetes. Al-Razi linked diabetes with obesity and nutrition habits. Ibn Sina specified that no tissues or organs could survive diabetes, which additionally caused sexual dysfunctions and gangrenes.

There are two main problems that emerge in relation to diabetes:

• Type 1: Lack of adequate secretion of the insulin hormones from the pancreas
• Type 2: Non-functional and insulin-resistant tissues, regardless of adequate insulin secretion

These two types do not coexist in one patient. The first occurs mostly among children or young people. The second occurs mostly among the elderly who largely contract diabetes due to obesity. Diabetes can be detected by a surge of sugar in the blood and urine. If blood sugar exceeds a certain limit then sugar will appear in urine.

Diabetes reveals itself by a surge of sugar in the blood and the urine. It not only impairs the sugar balance of the body, but also disrupts the fat and protein metabolism. Cells fail to absorb sugar, fats, and amino acids, which in turn increases sugar, fat, and amino acid levels in the bloodstream. It can plainly be said that diabetes complications originate from an increase in fat levels, not sugar levels, in the blood. Additionally, diabetic disorders in fat metabolism cause the lethal appearance of acid levels in the blood (acidosis) and vascular stiffness (arteriosclerosis). Decrease in protein-synthesis ability among patients with long-term diabetes leads to depletion of tissues and multiple cellular dysfunctions. Consequently, diabetes originating from insulin deficiency disrupts the fat and protein metabolism along with the sugar metabolism.

The pancreatic gland is where insulin is released in our body. The surgical removal of this gland in experimental animals showed that fat levels in their bloodstreams increased faster than sugar levels. In diabetics, fat around the abdomen and hips oozes into the bloodstream, thus leading to an increase in neutral fat (triglyceride) and cholesterol levels in the blood along with an accumulation of fat in the liver.

If fats remain in the bloodstream after nutrition, then they begin to adhere to vein walls which can cause clogging and stiffness in blood vessels. That is why it is crucial to transfer fat from the bloodstream to fat storage around the abdomen and hips by means of sugar and insulin. The storage fat is called neutral oil, or triglyceride. A triglyceride molecule contains three units of oil and one unit of sugar. Therefore, almost 25% of the fat storage is sugar. Without sugar supply from bloodstream, as in the case of diabetes, the cells which by default store fat are unable to do so. Diabetes, as a serious disorder, even reverses this mechanism: fats start moving from the storage to the bloodstream, not from the bloodstream to the storage. This causes the surge of all fats including the triglycerides, cholesterol and phospholipids, and this is when the body becomes even more prone to disease.

Obesity or excessively fat-based (steatopygic) diet is one of the main causes of diabetes. People are already overweight before the disorder strikes. However, if they do not receive treatment after contracting diabetes, the diabetics start losing weight quickly and more than they should. This happens because relatively harmless fats in storage start to dissolve into the bloodstream.

The entity called metabolic acidosis, which can cause coma and death in diabetics, actually originates from the surge of fat products in the blood and the liver, not from the surge in blood sugar. In diabetics, when the cells cannot use sugar, they resort to obtaining their energy from fats. Consequently, stored fats start to dissolve and ooze into the bloodstream. Fats traveling to the liver through the bloodstream turn into acidic substances called ketone bodies (acetoacetic acid, beta hydroxy butyric acid, and acetone). These acidic substances pass from the liver to the bloodstream and are received by the cells to meet their energy needs. However, in diabetics, cells cannot convert these acidic fat products i.e. ketone bodies, into energy. Oxaloacetic acid from sugars is required for the energy production cycle called the Krebs cycle. In short, humans need sugar to burn fat. This is why it is normal for some people to feel the need to eat something sweet after a fatty meal, because they need sugar to dissolve the fats in their bloodstreams. Since the cells cannot draw sugar from the blood, they suffer from the deficiency of oxaloacetic acid to convert fats into energy. Fats and ketone bodies teem in the bloodstream and, since ketone bodies are acidic, they can cause acidity levels to surge to extremely high levels in the bloodstream which can result in a coma or even sudden death. The lethal substances here are not sugars but ketone bodies, or fat products.

The most crucial abnormality caused by diabetes is vascular stiffness (arteriosclerosis), which originates not from excess sugar but excess fat in the bloodstream. In diabetics, triglyceride, cholesterol, and phospholipid levels increase in the bloodstream due to the reasons described earlier. Fats in the bloodstream do not circulate freely; they are carried in micro-droplets called lipoprotein. The liver loads the fats onto lipoprotein “trucks” and sets them into the bloodstream to be used by the cells. However, due to insulin deficiency in diabetics, lipoproteins cannot empty their shipments of fat into fat storages. The most dangerous lipoproteins for vascular stiffness are classified as LDL (low-density lipoprotein) and HDL (high-density lipoprotein) types. HDLs are like empty trucks specially produced by the liver, which dispatches them into the bloodstream. While circulating in the bloodstream, these “trucks” collect the fat and cholesterol stuck on the vein walls like magnets and, after cleaning the inner vein walls, they return as loaded trucks back to the liver. Using the HDL “trucks,” the liver removes fat from the bloodstream. Physicians gauge the LDL and HDL levels while checking their patients for the risk of vascular stiffness. An increase or decrease in LDL rate is not good for patients, whereas high HDL rate is a positive sign.

Other causes of vascular stiffness include lack of exercise, sedentary life and work habits, smoking, alcohol consumption, obesity, overconsuming foods rich in animal fat, and high blood pressure. Vascular stiffness is one of the leading causes of cardiac dilatation (enlarged heart), cardiac insufficiency (heart failure), and heart attack. In addition to these complications, vascular stiffness may also lead to high blood pressure, cerebral hemorrhage, paralysis, kidney failure, and vascular occlusion in the brain or other organs. If not treated, almost all of these disorders result in death.

Diabetics should follow an effective treatment regime to keep their blood sugar level under control. Fasting is known to be beneficial for controlling blood sugar. If blood sugar is normal, the fats in the bloodstream will move to the storage and not damage the blood vessels. Among the elderly and the obese diabetics, any damage originating from high blood sugar does not surface immediately, and this may mislead patients. It is extremely crucial to check blood sugar in order not to fall into this error. Treatment should never be neglected. If blood sugar can be effectively reduced, it is not right to give up sugar completely in the diet. As mentioned earlier, humans need sugar for storing fats or converting fats (or ketones) into energy in the Krebs cycle.

In short, high blood fat is a more serious cause of diabetes than high blood sugar.

There are many ongoing studies into fasting, a practice prescribed across many religions. Increasingly, there is evidence to support that intermittent fasting is beneficial to human health.

The opposite of fasting – overeating – has been revealed to be a major culprit in many illnesses, including cancer, obesity, and heart disease. For many years, the medical consensus was that fasting, i.e. prolonged hunger, too, could have deleterious effects on the human body. From kidney failure to loss of muscle, fasting was believed to be harmful – thus calling into question the benefits of this widespread religious commandment.

People of faith – including Muslims – have long believed that God wouldn’t recommend a practice that was harmful to the body. The hardships and troubles that accompany a religious practice are not too extreme for people aware of their servitude to God: they regard their trials as a testament of their faith. Part of that faith is the certainty that God wouldn’t recommend a harmful or unbearable practice.

In this article, we will share with you two unknown benefits of fasting that have been recently discovered.

Regenerating stem cells

There is a substantial body of evidence showing that staying hungry during certain periods of the day heals the body’s metabolism, hastens loss of fat, decreases oxidative stress,* and improves the functions of the tissues that make up various organs including the liver, the intestines, and the brain. The first of the two new discoveries about the underlying processes, however, provides a missing piece of the puzzle by helping us understand the incredible changes hunger triggers in stem cells.

Researchers at MIT, Duke University School of Medicine, and Whitehead Institute for Biomedical Research in Cambridge published an article recently on stem cells, indicating that part of stem cell’s mystery could lie in the oxidation (burning) of fat in the mitochondria [1]. Omer H. Yilmaz and his fellow researchers found that a 24-hour fast hastens fat breakdown in intestinal stem and special progenitor cells of rats.

To run the study, Yilmaz and colleagues let the mice go hungry for 24 hours to study the state of their stem cells. They found that the functions of intestinal stem cells increased, and fat metabolism quickened, in both young and aged mice, even during early periods of hunger. They saw that the body’s tapping into fat for its energy needs maintained the health and strength of the intestinal stem cells. Moreover, they noticed that if the aged mice did not fast, they started to lose their ability to break down and use fats for energy expenditure.

The researchers obtained more interesting results as the studies progressed. It was found that a single period of hunger for 24 hours boosted renewal of intestinal cells – and the stem cell functions increased even more significantly in aged mice. Another interesting finding was that mice with damaged intestines that were fasted recovered faster than those that were fed.

“My lab is really interested in understanding how diet, in general, can be used to improve tissue function,” Yilmaz said. “One of the tissue types I study is the intestine. In my lab we study the intestine because it’s one of the largest organs in the body. It’s also a tissue that experiences rapid cellular turnover.” [2]

The intestine is lined by a single layer of cells, Yilmaz explains, that turns over every 5 to 7 days. The workhorses of the intestinal lining and this cellular turnover are intestinal stem cells. These cells must retain a high level of function or cellular health in order to replenish the intestinal epithelium on a regular basis. Intestinal stem cells are particularly important in terms of repairing intestinal damage caused by gut infections and chemotherapy, for example.

The single layer of epithelial cells needs to be renewed every 5-7 days: the aids and enzymes secreted in the intestine for digestive and absorptive activities damage cells despite the protective mucus layer, and some other cells already burst and die as they empty their secretions. Moreover, some medications, particularly chemotherapy, cause the destruction and breakdown of the epithelial cell layer. However, fast-multiplying stem cells replenish the epithelial cells. Stem cells are very active and young and have the ability to divide and multiply continuously.

Dr. Yilmaz also says:

“As we age, stem cells in the intestine as well as in many other tissues of the body, including in the blood and nervous systems, become less functional. We believe that reduced adult stem cell function contributes to some of the decline of function associated with old age. My lab is very interested in studying low-calorie interventions to delay this decline. As a field, we’ve known for over 100 years that low-calorie states such as fasting or caloric restriction can have positive effects on tissue health and aging. We’ve seen evidence that fasting during times of intestinal infections that lead to diarrhea may promote healing of the intestinal lining, for example.” [2]

This quote emphasizes the importance of the issue. Yilmaz adds that despite all this knowledge, the cellular mechanisms of this renewal have not been discovered, and he and his team are working to find out how fasting and hunger enable this recovery.

Stem cells become happy in fat!

The researchers discovered through the experiments that the stem cell function could be brought about in hungry mice by the burning (oxidation) of fatty acids in intestinal cells. When they stopped the fat metabolism through genetic engineering, they noticed that the benefits of fasting on intestinal stem cells were negligent.

In the present dietary conditions, we obtain nearly 60-70% of our energy from carbohydrates or sugar, 20% from fats and 10% from amino acids. Yet an interesting finding revealed by Dr. Yılmaz and his research team is that we essentially obtain much greater energy from using fats once we fast. According to their experiments on mice, during fasting, the intestinal stem cells in both young and aged mice switch from carbohydrates to fats as the primary source of energy, and this shift enables improvement in stem cell functions.

It is not yet known what underlies the fat metabolism that boosts stem cell functions in response to fasting, but it is observed that stem cells work better when they burn fat. The ability to metabolize fats efficiently decreases with age.

It is likely that this hastened metabolism – encouraged by certain diets, like the keto diet, where the amount of fat ingested is raised to 70% and carbohydrate intake is limited to 5% – helps with epileptic seizures and similar neurological disorders: the ketone bodies generated during metabolism of fats are used as energy sources by the brain.

According to Dr. Yilmaz, if fasting can improve the functions of intestinal stem cells through metabolism of fats, the key is the mitochondria, the powerhouses of the cell responsible for this function. Fat metabolism, or the immediate breaking down or “burning” of the fat entering the cell, is carried out in the mitochondria. Disrupted energy generation associated with aging and decreasing mitochondria can be a reason for the brain’s susceptibility to age-related illnesses. Positive developments in brain functions can therefore be viewed in connection with the correlation between fasting and the oxidation of fatty acids.

Cleaning by fasting

Just like the spring cleaning in our homes, our cells need a thorough cleaning to function properly. Wrongly folded protein particles, remains of damaged organelles, broken molecular pieces, and aged cells that can no longer divide should be disposed out of our cellular structure. Fasting perfectly performs the task of cleaning these wastes and clearing the area in the cell.

“Everything has zakat (a means of cleaning), and the zakat of the body is fasting.” (Ibn-i Majah, Siyam: 44)
“Fasting is a protective shield.” (Bukhari, Sawm: 2)

What is autophagy?

Autophagy is the compound of two ancient Greek words: auto (self) and phagos (eating). What is meant by “self-eating,” is the breaking down and recycling of protein waste and old, impaired molecules by intracellular digestive organelles called lysosomes. In this way, proteins or cellular organelles are digested and taken out of circulation. We can liken autophagy to garbage collection.

Japanese researcher Yoshinori Ohsumi’s study, which brought him the 2016 Nobel Prize for Medicine, found that the autophagy that occurs inside the cell due to fasting or starvation plays an important role in preventing ageing, infections, and tumors. If autophagy breaks down, many illnesses may be triggered, including cancer. Conversely, if autophagy activity is regular, tumors may be suppressed – depending on the stage of development and type of tumor. Cancer research has long focused on channeling these autophagic activities. Restriction of food intake through fasting shows promise: it may protect normal cells while triggering autophagy and thus increasing the effect of cancer treatments. Autophagy might offer solutions or treatment options for other illnesses, too, including inflammatory diseases [3], neurodegeneration [4], metabolic and cardiovascular diseases [5], obesity [6], and metabolic disorders.

Preclinical studies have shown that dietary restrictions by fasting contribute to the increase of a person’s lifespan and slow the development of age-related diseases such as cancer and neurodegenerative and cardiovascular diseases [7].

* Oxidative stress: The damage caused as a result of excessive proliferation of free oxygen radicals released from foods that spike blood sugar (with high glycemic index) as metabolic waste. A good example of oxidative stress is the browning of certain foodstuff such as apples, bananas, etc. sometime after they are peeled.

References

1. Yilmaz, Omer H. et al. 2018. “Fasting Activates Fatty Acid Oxidation to Enhance Intestinal Stem Cell Function during Homeostasis and Aging.” Cell Stem Cell, Vol. 22, Issue 5, May 3, pp. 769–778.
2. Paige Brown Jarreau. 2018. “Eating (Or rather, Fasting) Our Way to Rejuvenated Stem Cells?” in Life and Tech @ LifeOmic. June 7. A Medium Corporation.
3. Cadwell K. 2016. “Crosstalk between autophagy and inflammatory signaling pathways: balancing defence and homeostasis.” Nat Rev Immunol.16 (11): 661–75.
4. Menzies FM, Fleming A, Caricasole A, Bento CF, Andrews SP, Ashkenazi A et al. 2017. “Autophagy and Neurodegeneration: Pathogenic Mechanisms and Therapeutic Opportunities.” Neuron. 93 (5):1015–34.
5. Bravo-San Pedro JM, Kroemer G, Galluzzi L. 2017. “Autophagy and Mitophagy in Cardiovascular Disease.” Circ Res. 120((11)):1812–24.
6. Lavallard VJ, Meijer AJ, Codogno P, Gual P. 2012: “Autophagy, signaling and obesity.” Pharmacol Res. 66 (6):513–25.
7. O’Flanagan CH, Smith LA, McDonell SB, Hursting SD. 2017. “When less may be more: calorie restriction and response to cancer therapy.” BMC Med. 15(1):106.

Imagine: I have just been cooked, and I am now waiting on a dish. Oh, what’s that? A metal thing with four prongs has just stuck itself into my chest, and it threw me into a shaking room with a gate moving up and down. There are, in this room, 32 flat and occluding rocks, some of which are sharp, while some are like millstones, all being lined up in a U-shape row. The frontal rocks have divided me into large pieces by squeezing and cutting. My pieces are pushed backwards by a soft shovel underneath. The rear rocks have made me almost like a paste, thoroughly mashing my pieces. Meanwhile, many taps on the right and left sides and in bottom of the room began flushing water upon me, and the carbohydrates within me have began dissolving by the pityalin enzyme (alpha amilaz) in this water. The flushing water contains substances such as lyzozym and antichore to eliminate any probable microbes within me.

I was fully softened and turned into something almost like gruel, when suddenly I was impelled by the actions of that soft shovel to an extremely tight tube inside of which movements continuously push me downward. A gate opened while I was being brought down and, as I was hoping to enter into a more spacious room and be saved from the compressive movements, I suddenly flopped into a well containing a light-colored liquid. I have come to know, while I was expecting to have some refreshment, that the liquid I flopped into was an acid capable of eroding marble (pH=0,8). I cried ‘Oh My God!’, but it was too late. This acid began to break my proteins down. The pepsinogen which was simultaneously being secreted by some cells over the walls of this large room and which were ineffective within an acid-free environment, became instantly activated by this acid and began to thoroughly break me up. Most of my proteins were broken. While I was wondering and asking ‘how come the liquid I flopped into is capable of eroding the marble but not capable of breaking up this well?’, I have come to notice that walls of the well were coated with a thin layer of mucous substance (membrane) which is unbreakable by acids.

I said ‘Oh My God! As long as you do not permit, these acids, which can erod marble, are not capable of damaging a soft tissue!’. Together with other foodstuff, I have been both blended and broken in this well-like room for about an hour. Later, the outer walls have again squeezed us, and we have been ejected yet again, this time into a new tube at an opposite direction to the one we were just pushed out of, by a sudden loosening and opening of a valve. This tube (called duodenum in Latin) has a length of about 15-18 cm and, appears as if lined up side by side. Here too, we felt wretched and were faced by a basic secretion (sodium bicarbonate) being ejaculated from a tap. This liquid was inactivating (neutralizing) the acids mixed with us, i.e., preventing them from damaging the unprotected walls of the tube which we were in.

Here again the amylaz, lipaz, trypsin, kymotrypsin and carbocsypolypeptidas attacked me, all of which break up, in a respective order, carbohydrates, fats and proteins of my ingredients, along with a lot many other enzymes, and they broke me up to my smallest constituents. Meanwhile, I started pondering the reasons why these enzymes, which are making mincemeat of me, are not damaging the tap (pancreas), which are composed of the same proteins, fats and carbohydrates that they come from. Then, I have come to realize that these enzymes could not become activated in pancreas tissue, since it does not have any activating factors, but they gained shredder features only after we arrived in the tube we are in, and only with the help of such factors which are being secreted from the intestinal walls.

After having been fully shredded within this narrow tube, a green liquid (bile), was poured on us as we were approaching its end. This detergent-like liquid was particularly responsible for shredding the fats in my ingredients. I understood, after all of this, that I was passing through a very excellent factory. As I and my fellow meatballs proceeded inside this narrow tube of approximately three meters long, no part of us remained un-shredded, except the cellulose fibers of plants such as parsley and onion which accompanied us. They continued their journey until arriving at a very thick and short tube. I have found out that their sap have been absorbed and their leftovers, after being amassed for some time, have been thrown into a cesspool called a toilet.

In the meantime, we have noticed that the walls of this tube are plicate and protuberant. These walls are apparently the places where our particles penetrate into another realm through two different ways. We understood that, via rather thin capillary channels situated inside these protuberances, we were being transferred into narrower tubes which contained two different (red and white) types of liquids (blood and lymph vessels). Now, there isn’t ‘me’ anymore, instead, there is only an ‘us’ which is composed of very smaller particles. While glucoses, the simplest forms of carbohydrates and aminoacids, the simplest forms of proteins are being transferred into the red liquid, our fat acid siblings are transferred into the white liquid of lymph vessels. Our glucose and aminoacid siblings have been carried by the red liquid to a factory called a liver. They are being returned to the red liquid after having passed through certain processes and being equipped with some useful characteristics here. But, the fats (lymphs) of the white liquid are, for some reason or another, being separately transferred into the red liquid, bypassing this factory. I learned the reason later: if the fat acids came to the liver together with glucoses and aminoacids, they would spoil this factory and kill its workers.

Finally, the red liquid carried us to tiny cell chambers numbering almost 100 trillion. Each of our tiny particles were sent to separate cells. Here, water, carbondioxide and energy were being produced by primarily coupling of our sibling glucose with oxygen. I learned that energy was needed for the functioning of these cells. Our fat siblings were also being utilized (consumed) for producing energy if glucoses were found insufficient for that purpose. Our amino acid siblings were being utilized (consumed) in the production of sound (strong) proteins and glucoses, and of energy in cases of the unavailability of fat sources for use in the cells’ structures. Excessive amounts of fat and glucose were being stored in these tiny cells. That is to say, I, who was a meatball at the beginning, was converted into water, carbondioxide and energy at the end of this painstaking journey. I was promoted (exalted) to the degree of humanness and rewarded a great deal of honor, as some parts of me became constituent of and some other parts of me assumed responsibility in vital cell functions of the human body.

After all these disintegrations and absorptions, some parts of us took their share in the structure of the body, while some others which were used in energy production including me were converted into a choky and dirty gaseous state called carbondioxide. We have been thrown back into the red liquid again since we would perhaps choke the cells we are within should our density increase very much. We have been brought to a marvellous and sponge-like factory named a lung, and composed of millions of vesicles, by being placed onto a molecule called hemoglobin, which is being pushed by a big pump. We have replaced the oxygen of the fresh air arriving to the lung vesicles. Now is the time for bidding farewell the human body. I thanked God, for I regained my freedom as a carbondioxide passing through and escaping from very dark and narrow places.

However, I was placed upon the leaf of a green plant after aimlessly roaming in the air for some time. After being filtered through the little windows (stoma) over the leaf, I was brought inside by the chlorophyll factory marvelously functioning inside these cells. Here, they forced me to unite with the water brought by tubules from the soil. Upon telling them that I cannot afford to do that, they instantly changed my true nature with solar rays and turned met into a chemical energy depot. I was no more a simple carbon atom; thus, I found a place for myself within an energy-emiting glucose molecule. I was in a position suitably convertible to starch, protein or fats in accordance with the true nature and genetic program of the plant I was within. Something incredible happened while I was swinging around on a green clover leaf. The leaf I was in has been eaten by a cow with real pleasure.

A new chapter has now opened inside the cow’s body. I was assigned with certain duties within the muscle proteins of my new host after having passed through a number of chemical processes. And I really enjoyed them. I was feeling myself more as an animal protein than a simple grass. By leaving the grass for a cow’s body, I was promoted (exalted) one more degree on the way to becoming manifestations of the divine attributes of God.

This blessed animal in whom I was assigned has been sacrificed during a Muslim feast of sacrifice, its meat ground into a meat grinder, and I have been served to you once again as a meatball.

Ali Uguz is a teacher of biology. He lives in Turkey.

Modern medical practice has come back to the conclusion that diet is the key to good health and investment in good dietary advice will lead to a reduction in treatment costs, Emphasis on diet is a principle universal to almost all forms of traditional medicine. You can find sound advice on diet everywhere from Europe to China. The Prophet of Islam, upon whom he peace, set out the dietary principles that led to great advances in Arab and Islamic medicine. He said:

The stomach is the well of the body and the veins drink from it. If it is healthy, the veins pass on good health, if it is sick the veins pass on poison.

The term himya is used to mean both diet and precaution. Harith, ‘the doctor of the Arabs’, said: himya is the source of every cure and the stomach is the home of every illness’. To understand what is meant by himya we should recall the incident when the Prophet and his cousin, Ali, were invited to eat at the house of Umm al Mandari. Muhammad, upon whom be peace, began to eat and then stopped and said to Ali: ‘You are recovering.’ He gave him some barley and chard saying, ‘This is better for you’.

Himya has three functions: 1) it is used as a cute; 2) it is used to maintain good health; 3) it is used alongside cures to aid recovery

Diet and balance

In our previous article, we described the concept of mizaj, balance. Cures are prescribed according to the type of imbalance. Certain foods are classified as ‘moist’, others as ‘dry’. They match their opposites. The simplest example can he found in the Prophet’s advice: ‘Fever is from the fire, put it out with water.’ Another example would he rubbing olive oil on dry skin. One may say that these ideas are common sense and not really medical principles.. However, developing from these ‘simple’ examples came the system of medicine which went on to set the foundations for modern medical practice. Al-tibb al-Nabawi influenced surgeons and physicians like Ibn Sina and al-Hazen. It appears that in the rapid advancement of science many forgot these basic simple ‘common sense’ truths. Now we find ourselves again returning to the idea of a balanced diet.

Diet is normally described in terms of the three macronutrients, namely proteins, fats and carbohydrates. The structural parts of all body cells are made of proteins. It is these which stop them from collapsing. They are also vital in the functioning of the cells. Every protein consists of a string of building blocks called amino acids. The human body needs about 22 amino acids to make its necessary proteins. Fourteen of these can be manufactured by the body. The remainder have to be obtained through our food.The US National Academy of Sciences recommends 0.8 gms of protein per kilogram of body weight. The concept of balance is very important. It has until recently been commonly accepted that red meat is an ideal source of high-quality protein. A recent British report has been interpreted as suggesting that a vegetarian diet actually optimizes health. The reason for this is that taking in large amounts of ‘first grade’ protein from meat inevitably leads to an increased intake of harmful animal fat. This was clearly understood by the Companions of the Prophet. He told them; ‘The lord of all foods for the people of this world and the next is meat’ (related by Ibn Majah). ‘Umar also warned them: ‘Be careful of meat for it has harm like the harm found in wine.’ Another Companion of the Prophet said: ‘Do not make your insides a graveyard for animals.’ Balance is vital. ‘Second grade’ proteins found in grains and legumes are just as effective when combined with ‘first grade’ meat proteins. The different types of meat and their contribution to mizaj, can he found in Ibn al Qayum’s al – Tibb al-Nabawi. It corresponds to the now widely accepted view that red meat is vital but must be balanced with fowl and vegetables.

The second of the macronutrients are fats. They are composed of fatty acids, long molecules of carbon, hydrogen and oxygen. They produce more than twice the amount of energy of proteins or carbohydrates and also carry vitamins A, D, E and K. They are vital for growth and repair, as well as for insulating the body and maintaining a regular temperature. They cushion vital organs. There are several kinds of fat. They differ according to their degree of saturation. Saturated fats produce high levels of blood cholesterol. Cholesterol is a complex waxy substance that is essential to the walls of body cells, the production of vitamin D, hormones, bile acids and nerve tissues. The liver produces cholesterol naturally and does not need any from the diet. Therefore, any added will be excess and lead to imbalance. High cholesterol levels have been associated with high risk of heart attack. A simple way to reduce cholesterol levels would be to moderate the use of eggs and organ meats such as liver.

Carbohydrates are the third of the macronutrients. They provide the body with energy help control the breakdown of protein, and protect the body against toxins. Carbohydrates are of two types. Monosaccharides are simple single molecule sugars. An example is glucose. Polysaccharides are more complex molecules and are broken down into two or more sugars.An example is starch. They arc found in fruits, vegetables and grains. They have a high nutritive value and provide vitamins, minerals, proteins and fibre. Polysaccharides take longer to digest and are therefore more effective in keeping away hunger. Barley has been a vital ingredient in Arab medicine dating back to the Messenger as well as an important part of his own and his followers’ diet.

Digestion

A pillar in al-Tibia al-Nabawi is that illness can be related to diet and digestion. The Messenger laid special importance on position while eating as well as going to toilet. He emphasized the importance of oral hygiene and exercise. The ‘stomach’ mentioned in the saying of the Prophet quoted earlier is generally understood to refer to the whole digestive system. We are being told to keep our whole body in order. Looking carefully after our diet and digestion means looking after our whole body and ultimately our minds and inner selves. Optimum digestion means optimum health.

Digestion begins with the mouth and the teeth. Food is broken down by chewing and is moistened with saliva which stimulates the rest of the digestive process.It is then swallowed as holus. This should take a few minutes. Problems associated with this process include the interaction of bacteria and sugar or other carbohydrates. This breaks down the protective enamel and causes tooth decay. We are told to use siwak, a simple tooth stick, when we make ritual ablution. It is said to he purifying for the mouth, pleasing to the Lord and it makes the devil angry. In al-Tibia al-Nabawi, oral hygiene is not only for good health, it is a part of worship. The Messenger, upon whom he peace said, ‘Prayer with siwak is better than 70 prayers without it.’

The bolus passes to tile stomach via the muscular oesophagus. Reflux of stomach acid during this process leads to heartburn. This, according to al-Tibb al-Nabawi, can he avoided by sitting in a relaxed position while eating. The Messenger said: ‘I do not eat while leaning,’ and ‘I sit as a slave sits and I eat as a slave eats’. He used to sit and eat on the floor with his thigh resting on his foot, with due respect to his Lord and also to those he was eating with,

After the bolus has passed from tile oesophagus it enters the gallbladder. The gallbladder stores bile made by the liver and releases it into the duodenum. Gallstones are the main prob1em associated with the gallbladder. This can he avoided by himya, correct balanced diet. A diet low in animal fats reduces the risk of gallstones.

The bolus passes into the stomach which is a muscular sac that mixes acid fluid with food which then passes into the intestines. The stomach was described by the Messenger as ‘the well of the body’. It is very important that the well is kept clean. Dieticians are now beginning to fully realize the damage that is done to the stomach through smoking, alcohol and irritant foods. Fasting to ‘give the stomach a rest’ is now a common treatment. The role of fasting in Islam is well known. The obligation to fast-for one month a year benefits the Muslim’s body, mind and soul. The commended regular fasting throughout the year is either three days in the middle of the month, or on Mondays and Thursdays.

There are two intestines in the digestive system. The first, called the duodenum or small intestine, is a tube that receives strong alkaline juices from the pancreas and gallbladder which break down fats and neutralize stomach acid . The most common illness related to the small intestine is duodenal ulcers. These are commonly caused by alcohol, smoking and stress.

The passage of food takes four hours in the stomach, about four and a half in the small intestine and finally about twelve hours in the large intestine. The large intestine is a tube in which food and fluid are absorbed. Food residue is formed into faeces.

The final stage of digestion, i.e. the removal of waste, is just as important as the first. The Prophet recommended we sit or squat to avoid constipation. He was very particular about keeping the private areas clean and therefore free of infection, the use of water and performing ablution afterwards. This is not detached from worship. The prayer that he, upon him he peace, said when he completed this final act of digestion sums up the approach of al-Tibb al-Nabawi. Al-Tibb is looking after one’s health, physical and spiritual and, at the same time, remembering the source of all food and all health. He used to say:

All praise belongs to God who took out from me that which harms me and left in me that which benefits me’.