CAIRO -- The sun slips beyond the Nile and the fast is broken. As they have done for centuries during the holy month of Ramadan, Egyptians hurry home through the twilight to eat and drink after a long, scorching day.
Fasting renews the spirit but it often does little to trim the waist line. What happens between dusk and dawn can endanger health: Feasting, inactivity and disrupted sleep -– Muslims often stay up until 4 a.m. to eat a last meal before sunrise -- can add weight in a population already struggling with one of the highest obesity rates in the world.
“Unfortunately, many Muslim patients, and Muslims in general, tend to overeat upon breaking their fast, and usually the meal involves heavy, fatty foods that are high in calories,” Dr. Al Madani, head of Emirates Diabetes Society, told TradeArabia, an online news site.
The breaking of the fast usually begins with fresh dates and lots of water, followed by soups and juices, including a popular one made from berries and topped with pine nuts. Soon after evening prayers, a large meal called iftar is shared. Poor people are not left out: They dine under tents called “God’s tables,” which are donated by the wealthy and dot the neighborhoods of this sprawling, ancient city.
The feasting continues after dinner as Egyptians visit with family and friends. Special desserts such as creamy konafa and syrupy basboussa are served throughout the night. The next meal, or sohour, comes just before morning prayers; there are more sweets to supply fuel through the day’s fast.
This is repeated for 30 days.
Mahmoud Ismail said there are two ways to do Ramadan: one healthy, one less so. The 38 year-old father of two is a swim coach and physical education teacher in Cairo.
“I am working 8 until 3; then I exercise an hour before sunset,” he said.
“I cannot sleep the fast away,” Ismail added. “Too many people wake up at 3 in the afternoon or sleep at work during Ramadan.”
His wife struggles with her weight during Ramadan, often gaining more than 10 pounds: “Her schedule allows no chance to burn calories,” Ismail said. “All the night is eating and then cooking for the next iftar, then she sleeps at 3:20 after sohour until about 3 in the afternoon.”
Indeed, it is women -– the ones who in a patriarchal society spend endless hours in the kitchen -- who are most likely to have weight problems in Egypt.
Three in 4 Egyptian women are overweight, and nearly half are obese, according to the World Health Organization's most recent figures. Women here are among the fattest in the world, alongside their wealthy Arab neighbors in Kuwait and the United Arab Emirates.
Access to exercise is one more challenge for Egyptian women. Only the wealthiest can afford health clubs, said Dr. Gulsen Saleh of the National Nutrition Institute, and the rest have no place for exercise.
Unfortunately, a sedentary life may be just as harmful to health as obesity. A recent study in the journal Lancet showed that inactivity, regardless of weight and other factors, increases risk of chronic diseases and earlier death.
But sweets are also to blame. A fasting brain prefers high-calorie carbohydrates above all. Scientists in Ajman, the United Arab Emirates, observed that more fats and sweets were consumed during Ramadan.
Of 173 families interviewed in Jidda, Saudi Arabia, two-thirds reported weight gain among some or all of the family members after Ramadan. Many pointed to the rich food and lack of exercise.
Sleeping through a fast may sound inspired, but it sabotages good health in several ways. First, more time is spent awake during the feasting hours. And disrupted sleep cycles affect hormones that act on metabolic rate and appetite. The body responds by eating more.
The essence of this religious fast, said Cairo physician Wafaa Hawas, is to practice self-discipline.
Hawas advises her patients: “Start with a soup like lentil, have some salad and meat; stay away from Ramadan sweets or have a little only; I am sure if you follow this, you will lose weight by the end of Ramadan.”
As it is written in the Koran, "Eat of the good things we have provided for your sustenance but commit no excess therein."