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.

Our body is perfectly coordinated to regulate our blood sugar level. But when our insulin levels are artificially altered, serious diseases can occur.

The human body needs energy. ATP (Adenosine Triphosphate) is to each cell in the body what gasoline is to a car. This energy is stored inside the bonds of the three phosphate molecules attached to an adenosine nucleotide. The light energy that exists in the sun’s rays is converted into chemical energy, stored in the form of carbohydrates, proteins, and fats through the photosynthetic reactions taking place in the chloroplasts of plants. Molecules of chemical energy are broken down in the mitochondria organelle of the cells in order to utilize their energy for ATP synthesis. This chemical energy (ATP) derived from nutrients is used by the eyes to see, the ears to hear, the hands to grab, the feet to walk, the heart to pump blood, the stomach to digest foods, the kidneys to filter blood, red blood cells to carry oxygen, white blood cells to fight germs, and the brain to think, memorize, and remember.

ATP is primarily synthesized from glucose – commonly known as blood sugar (glycolysis) – in approximately 100 trillion cells in our body. Glucose means fast energy. A sensitive metabolic balance is established (homeostasis) to maintain a blood glucose concentration in between 70-100 mg/dl for a nonstop energy flow and to prevent any cellular damage. If this balance is thrown out of order, many medical problems will ensue, primarily cardio-vascular diseases. How is the homeostatic balance of blood sugar maintained in healthy people?

Maintenance of blood sugar balance

The blood sugar balance is provided by the assistance and cooperation of the pancreas, liver, fat tissue, muscle tissue, the brain, the digestive system, and the kidneys. The chiefs of the orchestra here are the insulin and glucagon hormones synthesized in the pancreas, which operate in great harmony and yet have opposite functions. Insulin is in charge of dropping blood sugar; however glucagon increases it.  

The fine balance of blood sugar is conserved before we sense it for various energy situations such as exercise, sleep, or various energy intake cases such as overeating or skipping a meal. The real hunger is the 8-10 hour long “night fasting” period. During this time, since there is no food intake, the glucose that cells require for energy production is obtained from reserves in the liver. Thus, cells get their energy and blood sugar levels are kept at normal levels. If there is no additional food intake and the fasting time becomes longer, the glycogen reserves of the liver get consumed within 10-18 hours and necessary energy is obtained from fats and proteins. However, real fullness corresponds to a period of 4-6 hours “after meal.” During this time, the complex and macro size carbohydrates are converted to glucose in the liver and this glucose is stored as glycogen. Because the glucose storage capacity of the liver, which has numerous tasks, is limited, the excess glucose is stored by conversion into fatty acids. The unspent excess calories from three meals eaten in five hour intervals will be stored in either the liver or as fat tissue during the 12-18 hour long fullness period. The utilization of fats stored in the humps of camels which form by food intake to compensate for their energy and water needs during long desert travel can be given as an example of this.

In fact, when we say “I am hungry,” we acknowledge that the time has come to resupply our ATP reserves of nearly 100 trillion cells. The most important stimulator for the secretion of insulin from the pancreas is glucose. With the first bite, the readied insulin reserves of the pancreas are released into the bloodstream. This event, which takes place approximately within the first 6-10 minutes, is called the first-phase insulin response. With the language of reduced glucagon as a result of increased insulin, the message that it is no longer necessary to release glucose into the blood is transmitted to the liver. The blood sugar levels increase with continuing food intake (hyperglycemia) and this information is relayed to the pancreas through hormones secreted by intestinal cells. As directed by this signal, the proper insulin amount necessary for blood sugar levels is secreted into the bloodstream from the pancreas. This is called the late-phase insulin response.

The tasks of insulin

Cells are in need of insulin to uptake glucose into capillary vessels. Insulin binds itself to its specific receptor on the membrane of a cell, conducting its message, especially to muscle tissue. It’s saying, “The glucose food that you need is brought here by the blood vessels, and you can retrieve it.” After receiving the message inside the cell, GLUT (glucose transporters) molecules, which are in charge of glucose intake and are stored in the cytoplasmic vesicle pool, are carried to the cellular surface. Molecular gates are established once these molecules merge with the cellular membrane for the entrance of glucose through it. Glucose is inserted into the cell via this gate. The retired GLUTs are collected back in the cytoplasmic pools after cellular energy demand is met.

While these events are taking place, commands are given to the liver to prepare for the load of glucose arriving from the intestines and for adipose tissue to store the excess fat. These meticulous processes last for approximately two hours. The blood sugar level recedes back to its normal limits, but the activities of the liver and the adipose tissue continue at a rapid pace. If overeating occurs, the liver cannot take such a load. This can cause a delay in its functions, which will cause the body to feel tired.

The insulin and glucagon hormones have a half life of 3-5 minutes and are rendered ineffective in the liver and kidneys once they conclude their tasks. Thus, the body prevents lower blood sugar levels because of high insulin concentrations (hypoglycemia) or because of higher glucagon levels; it also prevents higher blood sugar levels (hyperglycemia).

The disruption of the blood sugar balance

Diabetes is the chronic observation of blood sugar above normal limits. This happens when the insulin hormone levels secreted from the pancreas are reduced and not able to carry out their function. There might be genetic factors present that contribute to diabetes; however, stress, a lack of exercise, obesity, and the consumption of processed foods containing elevated levels of carbohydrates often lead to the onset of diabetes in adults. The fine balance in between the liver, pancreas, muscles, and fat tissue can be disrupted by the following reasons:

1. If the number of cells in charge of insulin production in the pancreas decreases, sufficient insulin cannot be produced.
2. The message of insulin cannot be retrieved completely because of a disruption occurring at the receptors where insulin binds on cells, or due to lower numbers.
3. There may be a problem with reactions regarding GLUT production in accordance with the internal message retrieved upon bondage of insulin to the receptors.
4. During fullness, if the necessary suppression of glucagon production in pancreatic cells is not adequate, the glucose release from the liver continues.
5. The secretion of late-phase insulin response hormones in charge of pancreatic stimulation from the intestines is reduced.
6. Emptiness of the stomach is delayed, and a longer absorption time of nutrients occurs.
7. The appetite center is over stimulated and the urge to eat increases.

If the reasons above take place, then the blood sugar level is above normal. Normal blood sugar drops below 140 mg/dl two hours after a meal in healthy people, whereas this cannot be maintained in diabetic patients.

An iron pipe with salty sea water running through it for years is similar to a capillary vessel that has blood with high sugar levels inside it in terms of the damage that they undergo. Once hypertension and cholesterol joins diabetes, the heart, eyes, and kidneys will not function properly. These organs are great blessings granted to our body which we often appreciate only once we lose them. Therefore we must follow an intermediate path in eating and drinking, just as in every situation, avoiding excess.

A sugar is a monosaccharide if it is made up of a single sugar molecule; it is disaccharide if it is built by two sugar molecules; and a polysaccharide if it is composed with multiple sugar molecules.

Sugars that we ingest are broken, in the digestive system, into monosaccharides of glucose, fructose, and galactose. Almost all of the absorbed monosaccharides are first converted into glucose in the liver. This conversion is a very important task of the liver: 80% of the sugars passing into the blood are glucose. As a result, very limited amounts of fructose and galactose are present in the blood. Therefore, when blood sugar is mentioned, normally glucose is taken into consideration and the fructose and galactose levels in the blood are ignored. Glucose, which is also called grape sugar, is most abundantly found in grapes, while fructose is called fruit sugar, as it is plentiful in fruits, and galactose is named milk sugar after its dense presence in milk. The most important characteristic of fructose is that it is sweeter compared to other simple sugars.

Insulin is secreted from the pancreas in order to lower elevated blood glucose levels after digestion. Insulin functions in the transport of glucose from the blood into cells to provide necessary energy, therefore reducing blood sugar levels; furthermore, it also plays a role in the storage of excess glucose as glycogen, which is found primarily in the liver. Once glycogen storage limits are reached in the liver and muscles, glucose is then stored as fat. Fat tissue acts as sustenance during long fasting periods.

Differences between fructose, glucose, and galactose

Glucose and galactose are absorbed actively, depending on salt. They cannot be absorbed without salt while passing through the intestines. Salt is necessary for the absorption of glucose which is present in the starches of potatoes and other foods. Thus, when potato is consumed with salt, the transport of glucose into the blood is facilitated.

However, salt is not necessary in the case of fructose absorption. The intestinal absorption of fructose contained in fruit is delayed by fruit fibers, since these fibers prevent or balance the transport of fructose into the bloodstream. However, when fructose is ingested as a fruit juice, it is absorbed and joins the bloodstream much faster because of the lower fiber content.

A person feels full after a meal when neurons in the satiety center of the hypothalamus are stimulated by elevated blood glucose. Then, hunger center neurons are repressed, eliminating the feeling of hunger. Therefore, a person reduces their food intake during a meal as their blood glucose levels increase. Increased levels of amino acids and fatty acids in the blood also suppress hunger and stimulate fullness after meal. However, one important point is that fructose does not stimulate fullness in the brain. Therefore, if the blood fructose levels are elevated instead of glucose, a person cannot generate a sensation of fullness sensation. As a result, a person desires to intake more food during consumption of fructose. It is only possible for fructose to generate fullness after it has been converted into glucose by liver.

How to consume fruits?

We should prefer direct consumption of fruits instead of drinking natural or industrial fruit juices because of the high fructose content of fruits. The Prophet Muhammad, peace be upon him, consumed fruits before meals, the wisdom of which we learn only today. Fruits should be consumed at least an hour before or two hours after a meal, for sufficient time should be given for the fructose of an ingested fruit to be absorbed by the intestines and converted to glucose by the liver. Such practices will result in a reduced appetite and food intake. If fruit is consumed after a meal, a delay occurs in the conversion of fructose into glucose since the liver will be occupied by other biochemical processes, along with a full storage of nutrients; this will increase blood fructose levels and fail to reduce appetite. Fatty liver occurs as a consequence of high fat content of the blood. Arteriosclerosis and cirrhosis of the liver may be seen in people with a habit of excessive post-meal fruit consumption.

In a research carried out on laboratory animals, it was found that glucose induces fullness in the hypothalamus and suppresses food intake, whereas fructose was found to repress this effect of glucose, stimulating food intake.¹ Insulin reduces the harms of accumulating sugar in the blood by increasing lipid synthesis. Insulin also takes place in leptin secretion from adipose (fatty) tissue. Leptin is important in the prevention of obesity; therefore, insulin helps in weight loss, too. The leptin hormone causes reduced food intake by stimulating nerve cells in certain parts of the hypothalamus.² Fructose does not cause any leptin secretion because it does not stimulate an insulin release; therefore, it is not effective in generating a sense of fullness.

Ghrelin is a hormone secreted into blood by stomach cells during hunger. This hormone, which produces stomach acids, is enacted through the hypothalamus. It induces hunger, and therefore increases appetite. Insulin secretion increases along with the blood glucose levels during satiety. This eventually causes the increase of the leptin hormone, which also leads to a decrease in ghrelin secretion. As a result, fructose gets absorbed more than glucose in the intestines. Elevated fructose in the blood leads to insufficient or reduced insulin secretion. In this case, a person continues eating.

Fructose and diseases

Free circulation of lipids in the blood damages arteries and veins. For this reason, lipids are transported in “molecular vehicles” that are called as high, low, and very low density lipoproteins (HDL, LDL and VLDL). Neutral lipids (triglycerides) that are present on VLDL (very low density) vehicles are broken down with an enzyme. These lipids are then unloaded from the vehicles by cellular uptake and stored as fats. This transfer of lipids into adipose (fatty) tissue is enhanced via the insulin hormone. In the case of fructose intake, without its insulin secretion effect, lipids accumulate in the blood and liver and eventually prepare ground for liver damage and arteriosclerosis.As the result of a fructose based diet in laboratory animals, it was discovered that lipid production shifted from adipose tissue into the liver, therefore elevating the risk of high blood and liver fat levels.

There are two reasons for this shift. The first one is that fructose acts on the fat producing enzymes of the liver whereas it does not act likewise in adipose tissue.

Secondly, fructose plays an inhibitory role in the conversion of glucose into lipids in adipose tissue. Also, fructose consumption in humans has been linked to elevated blood fat levels.

Overconsumption of fructose causes increased liver fat synthesis. Phosphofructokinase is the limiting enzyme regarding the breakdown of glucose in the liver. This enzyme is regulated by citrates and ATP produced by glucose catabolism and the Krebs cycle, limiting glucose breakdown. However, there is no such limitation in fructose breakdown. Through fructose catabolism, glucose, glycogen, pyruvate, lactate, glycerol and the acyl part of acylglycerol are synthesized. This synthesis can not be limited. As a result of this excessive output and high amounts of triglycerides, VLDL is produced.³ It has been found that persons who consume two or more boxes of fructose sweetened beverages every day carry a 35% higher risk of heart disease.⁴

This isn’t the only disease associated with fructose. In some studies on laboratory animals, it has been reported that a high fructose diet is associated with hypertension.⁵ A lot of research exists suggesting that excessive fructose consumption leads to insulin resistance in both the liver and peripheral tissues, which can often cause diabetes.⁶ In a recent study, it was claimed that excessive fructose intake poses risks for renal diseases leading to glomerular hypertension, renal damage, and inflammation and damage to renal tubules and tissues.⁷

In a study conducted on 21,483 Americans who were older than two years, daily consumption of 37 gr. of fructose (8% of total calorie need) was found to be elevated to 54.7 grams (10.2% of total calorie need) gradually between the years of 1988-1994, mostly consumed by younger people. Increased use of fructose syrup was linked to obesity during the last 35 years.⁸ Furthermore, in a study carried on 1,749 male and female children and teenagers, a positive relation was found between body mass index (BMI) and excessive consumption of carbonated beverages containing high fructose concentrations.⁹ There many studies that support this report.¹⁰ Excessive fructose consumption is known to cause “metabolic syndrome” in which many diseases like obesity, arteriosclerosis, and diabetes emerge together.

Are fruit juices harmful?

Fructose syrup is being used at increasing rates in the food industry. According to the annual report of US Food and Drug Administration (FDA) for the year 2000, fructose syrups are sugar solutions containing approximately more than 50 % fructose. It is often synthesized by a conversion of corn starch into glucose by glucose isomerase.¹¹ There is also a third syrup type containing 90% fructose, however this has limited uses.

The sweetness of fructose syrup is similar to that of table sugar. It prevents the dehydration of food with its hydrophilic character. It is mostly used in aromatic foods, especially carbonated beverages and fruit juices. It prevents the proliferation of microbes with its high osmotic pressure property and makes food more resistant against them. Syrups containing 42 to 55% of fructose are used in baked goods, cereal products, dairy products, processed foods, both carbonated and regular beverages, ice creams, and frozen desserts. High fructose syrups are used in foods to decrease water activity and prevent spoilage.

Fructose syrups have a very low ash level due to application of intense purification processes during production and product color is water-white. Therefore colors of fructose used industrial foods are white as well. Fructose syrups have a lower viscosity and density compared to glucose syrups and therefore it is runny like water and not as sticky.

How to consume sugars after a meal?

Especially after a fatty meal, our body seeks sugar. The reason behind this is the requirement of sugar for the storage of lipids into fat tissue. However, this sugar should absolutely be glucose instead of fructose. Therefore, some amount of sugar can be consumed to facilitate the removal of lipids from blood after meals. This is recommended to lower blood lipid levels. However, this should not be done with fruits but with natural sugars like grape molasses. A baklava or a dessert made with industrial sugars (fructose) will not be beneficial but harmful.

In conclusion, the consumption of corn-derived fructose syrup is gradually increasing in recent years. Fructose syrup is used both in various carbonated or regular soft beverages, and in desserts. The reason for our fructose syrup preference is that it helps preserve foods longer and it leads to food addiction because it enhances appetite due to its strong sweetness. Fructose syrup is synthesized by the conversion of natural glucose in corn into fructose by isomerase enzymes. In this sense, today’s increased consumption of fructose is altering the existing sugar balance of natural food items. Overconsumption of fructose can pave the way to obesity, metabolic syndrome, arteriosclerosis, diabetes, hypertension, and arteriosclerotic heart and kidney diseases.

Arifagaoglu is a professor of medicine in Ankara, Turkey.

References

1. Wolfgang MJ, Cha SH, Sidhaye A. et al. Regulation of hypothalamic malonyl-CoA by central glucose and leptin. Proc Natl Acad Sci USA. 2007; 104: 19285-19290.
2. Guyton AC, Hall JE. “Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitemans and Minerals.” Textbook of Medical Physiology, Saunders, 2010, 843.
3. Rutledge A, Adeli K. Fructose and the metabolic syndrome: pathophysiology and molecular mechanisms. Nutr Rev. 2007; 65: 13–23.
4. Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, Hu FB. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89:1037–42.
5. Barone BB, Wang NY, Bacher AC, Stewart KJ. Decreased exercise blood pressure in older adults after exercise training: contributions of increased fitness and decreased fatness. Br J Sports Med. 2009;43:52–6.
6. Blakely SR, Hallfrisch J, Reiser S, Prather ES. Long-term effects of moderate fructose feeding on glucose tolerance parameters in rats. J Nutr. 1981;111:307–314.
7. Johnson RJ, Sanchez-Lozada LG, Nakagawa T. The effect of fructose on renal biology and disease. J Am Soc Nephrol. 2010; 21(12): 2036-9.
8. Bray G. Fructose: should we worry? Int J Obes 2008;32: S127-131.
9. Forshee RA, Storey ML. Total beverage consumption and beverage choices among children and adolescents. Int J Food Sci Nutr. 2003; 54: 297–307.
10. Forshee RA, Anderson PA, Storey ML. The role of beverage consumption, physical activity, sedentary behavior, and demographics on body mass index of adolescents. Int J Food Sci Nutr. 2004; 55: 463-478.
11. Melanson KJ, Angelopoulos TJ, Nguyen V, Zukley L, Lowndes J, Rippe JM. High-fructose corn syrup, energy intake, and appetite regulation. Am J Clin Nutr. 2008; 88(6):1738S-1744S.

Some medications are effective directly over the area they are applied to. Some however are transported to distant regions via blood flow and that is where they are most effective. Medication is either taken orally or through injection. When medicine passes into the blood stream from the place of administration, it is considered to be absorbed. A good example is the transportation of medicine into the blood stream of capillary vessels between the muscle cells when injected into muscle tissue. A drug taken orally however is absorbed through the blood vessels in the gastro-intestinal system.

For orally-taken medication to be absorbed, it should be able to dissolve in gastro-intestinal fluids. First, it is broken into smaller units due to the corroding effects of stomach acid and various enzymes are secreted, then chemicals in the drug composition pass into the gastro-intestinal fluid in a molecular form. This event resembles the dissolving of a sugar cube inside a glass of hot tea. First, the sugar cube gets broken into pieces and then dissolves. A mix with a tea spoon makes this event happen a little faster. In a similar fashion gastro-intestinal movements help with the absorption of medicine. Liquid drugs like syrups dissolve in the gastro-intestinal fluid faster since they are already in smaller units; therefore they get absorbed faster.

Drugs mostly get absorbed through the small intestine. The most important task of this organ is to enable the absorption of nutrients. It is approximately 10 meters long and 4 centimeters wide. The inner lining of the small intestine has finger-like projections called villus and even smaller projections that are located on these villi are called microvillus. One of the reasons, maybe the most important reason, why the our intestines are created in this way is that as a result, the inner surface area of intestines increases multifold. Such that the inner surface area of a human beings small intestine can increase up to 200 m2 and this greatly facilitates the absorption. These projections are made of intestinal cells.

The molecules carrying the medication reach the capillary vessels by passing through these cells and then join the blood stream by crossing through capillary vessel cells. Furthermore, intestinal cell membranes host a special protein that filters unwanted substances for the cell and returns them back to intestinal lumen. Thus these unwanted substances are excreted out of the body along with other unabsorbed matter. In the same way, some drugs are held by this protein and released back into the lumen thus decreasing absorption rate for drugs experiencing this reaction.

Liver: The organ responsible for eliminating the harmful effects of medication

As soon as medication joins the bloodstream after absorption, it is first transported to the liver. This is because pulmonary veins that collect blood from the intestines are connected primarily to the liver. One of the many functions of the liver is the elimination of harmful substances entering the body. For this reason, absorbed substances are directly sent to the liver. The liver is employed with the task of chemical conversion with these substances that are transported to it. One of the wisdoms behind liver metabolism is to reduce the effects of these harmful substances via these events and to convert them into an excretal material. In the same way, drugs are metabolized in the liver, lose their efficacy and prepare for excretion.

Many drugs interfere with each other’s metabolism. If one drug’s metabolism is inhibited, blood concentration of such chemicals increase and adverse effects of drugs become more frequent. Irresponsible drug use must be avoided for this reason. Drug interactions may lead to major damage in addition to the drug’s individual adverse effects. Moreover different nutrients also affect drug metabolism. For instance, grapefruit inhibits metabolism of certain medicines, as a result blood concentration of these medicines increase and adverse effects can be observed. On the other hand, some nutrients like broccoli, cabbage, and charcoal roasted meat speed up the metabolism of certain medicines. In this case, the blood concentration of the affected drug drops and may lead to reduced benefits from intended use. Because of this reason, patients on long-term medicine treatment should not consume these types of food.

The rest of the drug molecules that escape these metabolisms is directed towards blood vessels feeding other organs. Some drug metabolisms in the liver present individual differences as metabolic levels change from person to person. Thus, a drug with the same dosage develops desired blood concentrations for some people, fails to meet this level for others or can even cause high blood concentrations enough to generate adverse effects in other individuals. That is why a medicine that has benefited a patient should never be used by somebody else without consulting a doctor.

The function of bile

Bile secretion originating from the liver and gall bladder has critical importance in the digestion and absorption of fats. Bile breaks apart fats into small pieces so that digestive enzymes can affect them. As a result of this, absorption is provided for fats and vitamins like A, D, E, K that are soluble in fats. In a similar fashion bile improves solubility and absorption of some drugs that does not dissolve in gastro-intestinal fluid. Another task of bile secretion is the removal of certain substances from the body. Waste materials in the bile that is dumped into duodenum are excreted through the digestive track. Some drugs are excreted in this way.

Drug intake before or after meals

It is a well known practice that medications are advised either to be taken after or before meals. When medications are taken after a meal, they cause less of the possible unwanted disturbances such as stomach sickness, aches or indigestion.

On the other hand, nutrients may reduce intake of certain drugs, therefore they need to be taken before meals. However medications taken right before a meal does not apply in this case since the food will still mix with the medication in the stomach. When taking these medicines, it should at least be an hour before meals. Generally consumption of a medicine before or after a meal does not really change its absorption level. But medications taken before meals pass the stomach into the intestines without delay and therefore get absorbed faster. This practice is important in cases where an immediate effect is desired such as pain relief. Plentiful water intake also helps with faster and improved absorption of drugs.

Some medications are packed into capsules made of gelatin-like substances. Medicines with undesirable taste and smell can be offered in this form for consumption. Moreover, if a drug is harmful to the stomach or gets degraded in stomach acid, then this drug can be prepared in capsules that are durable to stomach acid but soluble in the intestines. That is why consumption of medication without its intended capsule should be avoided. In a similar fashion, some medicinal tablets are designed to deliver its molecular contents particularly to the intestines. These types of medication must be taken as a whole unit. Otherwise it can be ineffective or may lead to harmful reactions.

Delivery of drugs to targeted regions

The molecules carrying medication that join the blood via absorption get dispersed by blood circulation throughout the body. These molecules reach various parts of the system via blood vessels, and then diffuse into organs via capillary vessels. However, their entry to the brain is difficult because this vital organ of the body has a special protection to guard itself from possible harmful effects of various substances that enter the body from the outside. Capillary vessels in the brain are different from other capillary structures in the rest of the body as they are created without an intercellular space in between vessel cells. Furthermore, these cells are bound to each other with their tight connective regions.

These capillaries are surrounded by a thicker membrane compared to other capillary vessels. This membrane is also host to various cells that wrap around the vessel. Therefore, because of these factors and other similar ones, some medications can enter the brain in very limited amounts. Drug molecules can display their targeted effects when they bind to target proteins, called receptors, in the organs. These proteins, which are very unique to each drug, exist on the cell membrane or in the cell. In addition, drug molecules also bind to other receptors that are not specific for them, and this causes adverse effects as a result.

Excretion of drugs from the body

Drugs are excreted from the body via the liver and kidneys. One function of these organs is to filter the blood from foreign substances. It was previously mentioned that absorbed substances from intestines are transported to the liver first where some amount gets metabolized and the remaining amount rejoins blood circulation that feeds other organs. Drug molecules that pass through the liver return back to it repeatedly many times because of continual blood circulation. In each of these arrivals, some amount is again metabolized. Molecules of metabolized drugs are excreted out of the body via the kidneys and through the bile at a limited level.

Only some portion of drug molecules get excreted via the kidneys without being metabolized. This ratio is higher with some medications. These types of medications are considered to be removed only by the kidneys, whereas some other drug types cannot be excreted without getting metabolized through the liver. As previously mentioned, the purpose of drug metabolism is to convert drugs into easily removable forms. If these types of drugs are not metabolized, they are rejoined to the blood circulation after filtration by the kidneys without joining the urine. It is impossible for the liver to sense these happening within the kidneys if it was not that the liver and every cell in it were employed by one authority who created them in the first place. Drug molecules concentrate in the liver and kidneys since these organs are employed with drug removal. As a result harmful effects of drugs are often experienced in these organs. Therefore unnecessary drug use should be avoided, otherwise the health of these organs deteriorate and eventually fail to carry out their basic functions.

As noted above, events that are taking place within many of our organs, stomach and elsewhere like kidneys impact on the journey of drugs in our body, therefore changing its effect. The harmonious creation of our organs that are home to many miraculous events is the major component of the entire process in which causations have their due role only as much as they are allowed by their Creator. As a test for humankind, both illness and the cure is provided by God, the All-Healer. Therefore it is the duty of a patient to see a doctor, take the medication properly and never forget that cure is only provided by the Almighty, without obsessing over causational chains.

References

• Guyton, Arthur C., John E. Hall. 1991. Textbook of Medical Physiology, Saunders.
• Patton, Kevin T., Gary A. Thibodeau. 1993. Anatomy & Physiology, Mosby.
• Rang, Humphrey P., Maureen B. Dale, James M. Ritter. 1999. Pharmacology, Churchill Livingstone.
• Brunton, Laurence, John Lazo, Keith Parker. 2006. The Pharmacological Basis of Therapeutics. McGraw-Hill Professional

Why is this surface area so large? What could the wisdom behind it be? Tiny endoplasmic canals play a role in inner cell transportation and distribution of matter. ER is the organized industry district in the cell. Most of the factories of molecules produced by chemical reactions are found here. ER is the production spot in the cells of proteins and hormones. Consequently, a broad surface area is very necessary and important.

Different degrees (pH) of acid are necessary for each reaction. However, because the acid necessary for one reaction can negatively affect the other reactions, thousands of opposite, intricate and different reactions take place. For this reason, membrane surface areas need to be wide. Sometimes hundreds of protein molecules are produced in just a second in a cell. The rapid and flawless lining up side-by-side of tens, hundreds or thousands of amino acids can only be achieved with a knowledge and power that surpasses these very small structures.

Wrapping the inside of the cell like a web and forming a buffer against mechanical effects, ER is responsible for establishing the flexibility and soundness of the cell. In muscle cells, ER takes the name Sarcoplasmic Reticulum (SR), which has a very important duty in the contraction of muscles. The size of the surface area of SR in the muscles of the structural frame is proportionate to the speed of muscle contraction. Consequently, there is more SR in muscle cells where there is rapid contraction. SR also serves as a calcium depot in muscle cells. Normally calcium is a deadly poison for the cell, and for this reason it is kept out of the cell. The concentration of calcium outside the cell is 10,000 times more than it is inside the cell. However, SR stores calcium in the cell in its own body. Thus, it both prevents the cell from being harmed and it provides the necessary calcium for contraction.

ER has the duty of eliminating the poison in the liver cells from the body by means of gall. For example, jaundice-causing bilirubin is a deadly poison for the brain especially in newborn babies. If jaundice is not treated, motor loss (paralysis) and intelligence loss can result from brain damage. Bilirubin and glucuronic acid combine by means of some enzymes on the surface of ER in the liver and are thrown into the gall bladder. In this way ER plays an important role in making foreign matter harmless and in reducing the side affects of medications to a minimum. Babies’ sensitivity to some medications during the first three months of life is due to ER’s not yet being developed enough to eliminate their harmful effects.

If it is taken into consideration that all of these mechanisms exist in human, animal and plant cells, it can be clearly seen that a broad and complex structure in such a small volume and its many functions can only have been placed there by the All-Powerful whose knowledge, wisdom, artistry, will and power permeate every moment and every spot.

Celaloglu is a freelance writer from Turkey with a degree in biology.

All the organs functioning in your body have a direct or indirect relationship with me. I can be compared to a kind of “chemical brain.” All metabolic activities are among my duties, including the control of excretions, digestion, and the composition of blood. You would be stupefied if I listed every single function I carry out, but let me tell you this much: biochemists have discovered that I am directly included in more than 80 different activities and related to more than 5,000 chemical reactions taking place in your body. Surprised? But this is only what they’ve learned so far; you do not know me in detail yet. My plain appearance is in contrast with my numerous functions. My size is about one-tenth of the body of a six-month-old fetus; now that you have become a young man, I weigh about one fiftieth of your body weight. Since I am the largest excretory organ in your body, I am firmly strapped with mesentery so you can run, jump, and make other movements without trouble.

Most people see me merely as a bile-producing organ, which happens to be among the simplest of my duties. Let me explain it another way: the heat I produce while working is equal to one-third of the heat your body produces while resting. I have a special circulatory system. Since I am located at a “junction,” the blood coming from the intestines which bear nutrient molecules come to my vein first together with the blood from the spleen, before joining the rest of the bloodstream. It can be compared to an obligatory customs check. The amount of blood I supervise within 24 hours is about 2,000 liters. With every heartbeat, almost 28 percent of the blood being pumped passes through me.

I adjust the level of blood sugar in a very sensitive balance. If you eat desserts or pastries I convert excess sugar into glycogen (animal starch) and store it. If your blood sugar decreases from hunger, I break down glycogen into sugar (glucose) and come to your help so that you do not come to a halt, like a car out of fuel.

I use various protein molecules to synthesize numerous enzymes. I also play a role in blood coagulation, red blood cell production, and storing the iron you need. You know, nothing is wasted in the divine system of nature. So how can I waste anything? When the aged red blood cells die, I help the spleen to break them down and store the iron they contain. My job in fat metabolism is no less important. Thanks to the bile I produce, the fatty food you eat is broken down to smaller molecules to be absorbed in a way similar to detergents remove oily remnants from dishes. Naturally, the fat-soluble vitamins (A, D, E, K) are also absorbed along the process. I store the excess of both these vitamins and fats. Fats are an important fuel particularly for your heart muscles. I excrete an average of 600–700 grams of bile a day. Two minutes after oily foods pass to duodenum the walls of my gallbladder are operated. Through contractions of 2–6 times a minute and a pressure of 25–30 mmHg, the bile is passed to duodenum in a time span of 15 to 90 minutes. What gives bile its yellowish-green color is the substance named bilirubin, which appears with the breaking down of the old red blood cells and disposed of through the bowels.

The Kuppffer cells—as you name them—have the duty of checking out newly produced blood cells one by one in addition to producing antibodies against germs. If any ill-formed blood cells come up, I must detect and destroy them. Otherwise they corrupt your blood. Thanks to the Kuppffer cells, the ill-formed blood cells are destroyed as soon as they are detected.

The average longevity of my cells varies between 150-180 days (220 days maximum). New cells are produced immediately to replace the dying ones and the system works smoothly. In each of these cells there are 1,000-3,000 mitochondria and millions of ribosome. An average of 180 new ribosome are produced every second. Although none of my cells have consciousness or intelligence, thousands of them come together to form little lobes resembling hexagons. The number of these lobes varies between 50,000 to 100,000.

Dear Peter, you intake various toxic substances together with the foods you eat. You don’t even realize that food has been corrupted by bacteria and fungi until its taste changes. Frankly, you should not have lived very long with so much toxic intake; Providence has given me an important duty to protect you from such harm. I capture these toxic compounds released into your bloodstream and neutralize them. The same goes for different medicines you take; I try to neutralize their toxic effects as well. But I have my own limits of tolerance; if I am faced with more toxic substances than I can handle, then I give signals of danger. You wonder how. Well, I shout “help” through red spots in your hands and itchy spots on your skin. You should be more careful about what goes down your throat.

Given that I fulfill various important functions, the littlest failure in me reveals itself as a health problem immediately. Hepatitis is among the common diseases heralding my failure. Excessive increase of bilirubin in your blood causes the white of your eye and your skin to turn yellow. I fear viruses most. Particularly hepatitis B and C viruses destroy my tissue. And alcohol, as you know, is my sworn enemy. I have to exert myself to neutralize even a tiny amount of alcohol. And if the hepatitis virus is added, I become knocked down and contract cirrhosis. It does not happen suddenly, though. Along the process which you know as liver failure I give various signals: skin eruption, digestion problems, sleepiness, and headache after meals, and so on. Since these symptoms are not serious problems, most people ignore these signals I give. Due to my various functions, the lab tests about me are more than a hundred.

Talking about my enemies may have upset you a bit, but it’s not all doom and gloom. After all, I am the organ with the highest capacity to renew itself. Sounds good, right? Otherwise I would have been finished off long ago, so this ability is a real blessing. Let me give you an example: although 90 percent of my cells are destroyed during hepatitis, I can help you survive with the remaining 10 percent if you rest well and control what you eat. If you ignore the disease, it might lead you and me to the grave. Do not ever believe those who take this lightly and say: “This doctor says that a small amount of alcohol is good for health.” Tell it to the marines. Those who say that should visit hospitals first. I’m sorry, Peter, but it really gets on my nerves. If they could only appreciate a work of art like me. Anyway, that’s all for now, please take good care of me.

I hang between your stomach and your duodenum under it, attached to the intestinal mesenteries. I have two different identities in terms of my structure and function. I carry out two very different duties as a compound gland made up of both exocrine and endocrine tissues. So, I am granted a very special structure and chemical abilities to function well. One of my duties is related to the physiology of digestion: I break up the food passing from the stomach to the duodenum by pouring on it the four types of digestive enzymes I have been enabled to produce. These juices are carried through a tiny pipe to your duodenum. Two of them are used for breaking up proteins, one for carbohydrates, and one for fats. You don’t even realize it! As the food you take in passes from the stomach to the duodenum, my enzymes begin flowing faster. This is a very fine balance: while food is being digested, neither the enzymes should be wasted, nor should your intestinal walls be harmed. I don’t control the release of the enzymes. That duty is given to two hormones produced in your intestinal mucosa by the stimulus of the vagus nerve. When those hormones reach me by the bloodstream, my cells are stimulated and they secrete water, bicarbonate, and the digestive enzymes I mentioned and they flow into your duodenum through my duct.

My second job is the production of insulin and glucagon hormones, as the endocrinal pancreas. My cell clusters, which are also known as islets of Langerhans, have different types as separate groups, which you call alpha and beta. The insulin, which is produced by my beta cells, is used for regulating the glucose level in your blood. The duty of insulin is to stimulate your body cells to take the glucose in your blood and use it.

After you have a meal, the carbohydrates in it are broken down into glucose molecules, pass into the blood, and increase your blood sugar. For your body to function in a healthy way, the amount of glucose should be around 100mg/ml (it varies from 80–120). When the level is above the normal value, I secrete insulin. In this way, the sugar is carried to your cells and burned to produce energy, and its increase in your blood is brought back under control. Also, insulin helps you to store sugar in fat tissues and to turn them into fatty acids, and it slows the breaking down of fatty acids. Moreover, insulin helps you to make protein in your body by holding amino acids within your muscle tissues and storing glucose in your liver and turning it into glycogen.

The failure of my beta cells to secrete insulin is a serious problem; the consequence is “diabetus mellitus,” or what we commonly know as diabetes. A person with this disorder must abstain from various delicious foods and drinks. In cases where a strict diet does not solve the problem, patients may have to take insulin shots every day. Diabetes can cause many complications by damaging your nerves and blood vessels; I won’t go into types of diabetes so I don’t get sidetracked too much. I just wished to make a point: even a substance produced by a tiny cluster of cells can upset the functioning of many of your mechanisms. After having a meal, put your hand to the left of your abdomen below the stomach and remember what a blessing I am!

As for the glucagon hormone I secrete from my alpha cells, it does just the opposite of insulin and causes the sugar stored in your cells to be released into your bloodstream. When your blood sugar decreases-due to hunger, overwork, exercise, and so on-it causes the glycogen in your liver to be used in order to increase the level of your blood sugar. As adrenalin secreted by the adrenal glands helps glycogen to be broken down and to be released into the blood as glucose, they function as an integrated system. Glucagon also slows down the synthesis of glycogen, and it accelerates the break-up of proteins and fat metabolism. I think now you get it, Peter. Insulin and glycagon are parts of a biological feedback mechanism controlling one another. People discovered all these facts after years of lab research; now do you see how ridiculous it is to see me as a work of blind chance?

Like any other organ, I can also contract various diseases. The most common ones are acute or chronic inflammation, tumors, and cysts. I am easily troubled with inflammation in people with alcohol habits. Since enzyme secretions-and therefore digestive processes-are then not carried out properly, some undigested fats and fibers with proteins are excreted with the feces. A problem can arise with the intestines due to digestive deficiency. And if I completely fail to fulfill my duty owing to a chronic inflammation or tumor, then doctors take me out and you become dependent on insulin and a special liquid obtained from the pancreas.

It is sad to say that my cancer is not quickly recognized. It develops very fast and I try to keep up my duty as long as possible. Therefore, it is usually too late when diagnosed. There is nothing much modern medicine can do after it spreads. Although it is not definite yet, I suspect cigarettes play a role in my cancer.

As for diabetes, even though a promising method of treatment has been discovered, certain problems haven’t been overcome yet. The transplant of beta cells from the pancreas of someone who has just died-with as much tissue compatibility as possible-has had partial success. As with every other organ transplant, tissue rejection is a challenge. If the human genome project succeeds and the genetic code of the human body is thoroughly solved, it may be possible to cure diabetes by genetic engineering techniques. This is only at research level for now, but if scientists do their best, it is possible to find a way, since there is a treatment for every disease except for old age and death. You see Peter, as the vicegerents on earth, you humans are supposed to explore the secrets of the universe and appreciate the beauties you discover. I think I have said enough now. Thanks for listening, Peter!

Irfan Yilmaz is a professor of biology at Dokuz Eylul University, Izmir, Turkey.

Mothers shall suckle children for two whole years, for those who desire to complete the suckling. It is for the father to provide for them and clothe them honourably. No soul is charged save to its capacity: no woman should suffer because of her child, nor any man because of his. The same responsibilities are incumbent on the heir. But if (the couple) decide by mutual consent to wean (the child), there is no blame on them. And if you desire to seek nursing for your children (by hiring a foster mother), there is no blame on you provided you pay her fairly. Fear God, and know that God sees everything you do (Qur’an, 2.205).

Breast-feeding is extremely important for the mother’s own health, as well as that of her baby. The propaganda in the sixties and seventies of some materialistic physicians in cahoots with baby-food manufacturers tried to throw doubt on the value of breast-feeding and to present it, especially in ‘Third World’ countries, as something second-best, unsophisticated. More recently, however, the scientific community has been forced to recognize the irreplaceable value of the mother’s milk, compared to any artificial product, and the World Health Organisation has banned all negative propaganda directed against it.

In what follows, I shall try to answer, from a scientific standpoint, these three questions:

1) What does mother’s milk impart to the baby?

2)What should be the frequency and duration of nursing?

3) What effect does nursing have on the mother?

1- The nature of mother’s milk

For nourishment human beings need the three basic foods, and phosphorous and vitamins. All of these substances, namely proteins, sugar, fats, phosphorous and vitamins, are present in the mother’s milk. The special worth of breast milk, however, lies rather in the fact that it contains these substances in very subtly tuned proportions, and the most important secret of its composition is that fatty molecules are dispersed within it in very fine, small particles.

The mother’s own breast milk is prepared more richly than the table of a tycoon. To begin with, the entire vitamin requirement of the baby is present in it for the first six months. Properly informed science can only be amused at the sight of over-anxious parents rushing about with a fruit press in their hands in an effort to provide baby with Vitamin C.

Secondly, there are antibodies in the mother’s milk during the first six months that protect the baby against all infectious diseases. There are even antibodies protecting against measles in the milk of a mother who has never contracted measles, an inexplicable fact in biological terms. This can only be a divine indication of the value God places on the well being of His creatures.

Certain atheistic scientists have put forward an absurd claim that breast milk is deficient in iron. It has been established in recent years, however, that in adults blood is produced in the bone marrow, whereas in babies it is produced in the liver. Iron is stored in the baby’s liver even while it is in the mother’s womb. Attempts to compensate for this supposed deficiency by medicines containing iron may condemn babies to a lifetime of enteritis.

It is a biological imperative that the baby be nursed on breast milk during the first six months, since the liver, normally the centre of digestive activities, is largely occupied with blood production in babies. Furthermore, the baby uses nutrition for the purposes of growth and development rather than energy. For this reason, it is next to impossible to select and balance the required food types and vitamins. We know that there are more than 50 vitamins in addition to the handful known to medicine. The growth and development of the baby is, through the perfect balance of breast milk, brought under perfect control by Divine Omnipotence. To attempt to imitate this divinely managed blessing with imperfect human imitations of it is both arrogant and ridiculous.

2- Intervals and duration of breast feeding

Another burden atheists have put on breast-feeding is the rule of feeding every four hours, which they have invented by analogy with the normal period of digestion. Recent research has shown that milk is completely digested in 45 minutes. When this period is over, the secretion of milk in the mother’s mummeries increases by a telepathic reflex, and the baby normally begins to cry due to hunger. All these events constitute a biological computer system, and if the feeding periods do not correspond, the baby’s stomach is filled with acid, seriously disrupting its digestive system. It has even been conjectured that this may contribute to ulcers in later life.

Regarding the duration of breast-feeding, modem medicine has imposed a wholly arbitrary period, namely nine months. But the basic logic of suckling is based on two facts:

a) The liver is heavily loaded because it is producing blood, and hence there is a need for milk. It takes about two full years for the liver to recede into the background as regards blood production. For this reason, breast-feeding should last two years.

b) The most important phase of development, the period when basic biological materials are required, is again two years. Medical science definitely recognizes that the first two years of development of the baby are the most significant phase.

Another miracle of the Qur’an’s wisdom is that it specified this period, although, before Islam, the practice in the societies in the Middle East was to breast-feed for four to five years.

A final point in regard to the length of the breast-feeding period: Research on childhood mental disorders has shown that an infant needs to be breast-fed for about two years for mental health to be robust. A study done on a global scale revealed that no child in Indonesia and the Philippines suffered mental problems, and the research committee found that this was due to the sense of security and tenderness imparted to the baby during two years of breast- feeding in those countries.

3-The benefits for the mother

a) The healthy functioning of the mammary glands:

Health statistics gathered world-wide have shown that cancer of the breast occurs seldom in mothers who breast-feed their infants for one or two-years. Mothers who do not do so, on the other hand, run the greatest risk of contracting this disease. If only for this reason, a one or two-year nursing period should be commended as a cancer preventive.

b) Biological regeneration occurring in the mother’s body during nursing:

The liver functions at full capacity in a mother who breast- feeds. All the chemical problems of the mother’s body come under scrutiny in this way. Further, since all the required substances have to be mixed into the maternal blood, the mother’s cells compensate for their deficiencies during nursing. Again, since the pituitary gland is in full control during nursing, the general hormone processes all function properly, and hence the psychological makeup of the mother is vastly improved. This harmony in the hormone balance of nursing mothers and the period of calm it imposes on the psychological structure is a priceless gift. You may have noted that despite being physically tired, nursing mothers are never ill-tempered. The reason for this is the harmonization of glandular secretions during breast-feeding.

Again thanks to this hormonal balance, the womb and ovaries of the nursing mother are also afforded a period of rest. Although this period is not equal to the nursing period, a repose of two to six months is a very valuable rest in terms of the mother’s sex organs. In the meantime, simple disorders of the womb and ovaries are also cured. Two years is, again, the ideal duration of the nursing period for these benefits to fully manifest themselves.

In sum, the disparagement of mother’s milk and of breast feeding generally by proponents of an atheistic modern medicine must rank as one of the most shameful stains on the history of medicine. Biologically and psychologically, the health of both mother and baby is greatly improved by breast feeding for, ideally, up to two years. Independent scientific studies have confirmed that this is so. We should not be surprised that they have done so. For who would know better what is best for the well-being of mankind than the One who created us?