New Medical Study on the Baha’i Fast

The team at Baha’i Blog was excited to learn of a new medical study that was conducted specifically on the Baha’i Fast. This mixed methods research project involved specific lab tests and measurements, as well as interviews and questionnaires and it was initiated by Dr. Daniela Koppold and her team in Berlin, Germany. It’s the first time we’ve heard of such a scientific initiative and we were thrilled to find out more!

The Baha’i Writings describe the spiritual benefits of fasting in various passages, but what are the material effects of abstaining from food and drink, from sunrise until sunset, for 19 consecutive days? Dr. Daniela Koppold and her colleagues set out to explore that very question. Here’s what she shared about how they went about their research and what they discovered:

Baha’i Blog: Daniela, thank you so much for taking the time to share with us. Can you please tell us a little bit about yourself and your background? And how did this study come about?

I’m a medical doctor, a general practitioner (GP), and I specialize in natural therapies and integrative medicine. I work as a GP but also do research at the Charité University Hospital in Berlin. In my research department we concentrate a lot on natural healing methods and traditional medical systems like Ayurveda, and a large part of our work has to do with plant-based nutrition and fasting. I have the privilege to be coordinating the studies on fasting for different indications, for different patient groups, such as those with neurodegenerative diseases like multiple sclerosis, but also for metabolic diseases. The studies involve various types of fasting like intermittent fasting, prolonged fasting, fasting during chemotherapy, and so on.

When I was in university, my colleagues would ask me, “How can you do the Baha’i fast? It doesn’t seem healthy. How can you not drink for such a long time?” and all the other usual questions. My father, who is also a medical doctor, encouraged me to write my PhD thesis on the Baha’i fast. At that point I wasn’t in the research department I’m in now and I didn’t know how to go about it — there was no research yet on Baha’i fasting. I found a professor who said I could do a study on other kinds of religious fasting, a review. I did that (you can find the English abstract of it here Qucosa – Technische Universität Dresden: Auswirkungen religiösen Fastens auf anthropometrische Parameter, Blutfettwerte und Hämodynamik normalgewichtiger gesunder Probanden), and on the way of writing about these divers religious fasts I stumbled upon a lecturer who connected me with fasting researchers, among them Prof. Andreas Michalsen. He took me on because he saw that I have an interest in fasting, and there weren’t many medical doctors who are interested in that. I was able to work in that department for two and a half years on the ward, where we used fasting as a therapeutic intervention, having many patients fast over five, seven or ten days. And then I switched to the research department where I’m at now. And I thought, as soon as I can do a study on the Baha’i fast, I would love to! And that’s when the confirmations came and made it possible. For example, this study was supported by the sponsoring of the Association for Baha’i Studies. That opened the way to do this research because, of course, we had to pay personnel and everything. With our small budget, and a team of students devoting a lot of their free time, it was a great effort to conduct the study and analyze its outcomes. But it was all worthwhile!

Baha’i Blog: What was the nature of the study?

It was an observational study using mixed methods, so we had lab measurements including chronobiological measurements (which means we looked at what the inner clock does to the body during fasting). We also had questionnaires, did interviews, and some very special metabolic measurements — for example we did microdialysis in the muscle and the adipose tissue. Mixed methods means that you have different approaches. Laboratory measurements and interviews are very different and you analyze them differently: one is a quantitative approach, the other one is qualitative. But you can relate them in certain ways to get a more profound understanding of the phenomenon you’re studying.

For those really interested in a few more details, here’s the abstract of one of the publications currently under review:

Background: Religiously motivated Baha’i fasting (BF) is a form of intermittent dry fasting celebrated by abstaining from food and drinks during daylight hours every year in March for nineteen consecutive days.

Aim: To test safety and effects of BF on hydration, metabolism and circadian clock.

Methods: Thirty-four healthy Baha’i volunteers (15 women) participated in this prospective, exploratory cohort study. Laboratory examinations were carried out in four study visits: before fasting (V0), in the third week of fasting (V1) as well as three weeks (V3) and three months (V4) after fasting. Data collection included blood and urine samples, anthropometric measurements and bioelectrical impedance analysis. At V0 and V1, 24- and 12-hour urine and serum osmolality were measured. At V0 – V2, alterations in circadian clock phase were monitored in sixteen participants. Our study was augmented by an additional survey with 144 healthy Baha’i volunteers filling out questionnaires and with subgroups attending metabolic measurements (n=11) and qualitative interviews (n=13) […].

Results: Serum osmolality and 24-hour urine osmolality decreased during daytime fasting, but remained within the physiological range and returned to their pre-fasting levels during night hours. BMI, total body fat mass and basal metabolic rate decreased significantly during fasting, while body cell mass and body water appeared unchanged. The phase of circadian rhythms advanced by 1.1 hrs during fasting and returned to pre-fasting values three weeks after fasting. Most observed changes were not detectable anymore 3 months after fasting.

Conclusions: Results indicate that BF is safe, has no negative effects on hydration, can improve fat metabolism and can cause transient phase shifts of circadian rhythms.

Baha’i Blog: The end of the abstract mentions your findings briefly. Could you share a little bit more with us?

We had plasma and urine osmolality measured, which means that we looked at the density of the blood and urine samples, and we saw that the density in most of the participants’ samples was lower during fasting. This means that the samples were diluted. This was a great surprise to us! We would have thought urine and plasma would be more concentrated during fasting and not diluted. There are different effects involved and probably the most significant of them being that people, as they told us in the interviews, would drink more consciously and probably even more than usual during the time they can drink, so that their fluid intake was even better during fasting than before or after. This was a very interesting finding for me, as my primary motivation to do this study was to answer my colleagues’ doubts about the health effects of not drinking during daylight hours. From now on I can answer them, that in our study we could not find any detrimental effects on body hydration or the kidneys during the Baha’i fast.

The other interesting thing is that body fat and body mass index were lower, significantly, during fasting and after three months they came back to almost the level they were at before fasting. So there was no yo-yo effect, an effect you often have in diets, where you would gain more weight in the long run than you lost during dieting. It seems that at most, you get back to the weight where you started off from — at least this is what we can see in the statistics. Actually, even after three months the participants weighed a little less than before.

And the interesting thing is that this happened although the basal metabolic rate went down, which is something we expect in diets and intermittent fasting because the less calories you take in, the more your metabolic rate gets lower. This is a calorie-saving method of the organism: if you intake fewer calories, your basal metabolic rate, which is the calorie-expenditure you have in a resting state, is lowered. And this often is the reason why people have this yo-yo effect after dieting because the basal metabolic rate gets lower, and then, as they start eating normally again, the weight goes up very quickly. This is because this basal metabolic rate does not adjust as quickly, so that they get more adipose tissue, for example, in the time of the refeeding phase after dieting.

In our study we saw the basal metabolic rate drop, as we expected, but what we also saw was that the metabolism in the skeletal muscle and in the adipose tissue, which we measured with a very specific method called microdialysis, raised their metabolism. This is a paradoxical finding. I believe this has something to do with this specific kind of intermittent dry fasting we practice as Baha’is, but I can not extract it from the data we have. I would love to look more into this in my future research. I hope there are friends out there to support this spiritually and materially! In the end this probably was the mechanism that helped the population we studied to lose or maintain their weight, i.e. not to experience a yo-yo effect.

We also saw that glucose metabolism became better. Blood sugar, which is a risk factor for chronic diseases, was less during fasting and also for some time after fasting.

An interesting finding in the questionnaires was that mindfulness and well-being increased through fasting, or during fasting, and that mindfulness was significantly higher even after three months- which means that was this effect carried over for a long time. Mindfulness is something that is being discussed more and more because it helps people be more resilient with stress, anxiety and so on.

There’s also three quotes that I would like to share with you from the interviews. Somebody said, he or she felt, “The whole body is subordinate to the spirit.” People feel that their self control increases, which was interesting for us to see. Another one said, “This moment of letting go, that you notice how many things feel easier because of that. I think that also influences daily life — that you enter your day more relaxed.” This is also interesting as it has to do with attention and mindfulness, and getting a new perspective on life. And the third quote is: “Now, you do something else, that is good, that it penetrates you — that you get out of your normal lifestyle and step aside, and that it sometimes hurts. But you get another kick. Live another frequency that is refreshing, that is soothing.” This refers to habits that help us stay healthy, and maintain health. This is a really significant thing: that people are helped to look at their habits and maybe change habits during fasting. This goes so well with the quote from Abdu’l-Baha where He says that prayer and fasting are the cause of awakening and mindfulness. And we could definitely see that in our outcomes.

Baha’i Blog: Thank you so much, Daniela, for taking the time to explain to us the nature of the study and some of its findings. I am truly inspired by your work!

We look forward to sharing where this study can be read in full once it is published.

This interview has been edited for length and clarity.

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Sonjel Vreeland

In her innermost heart, Sonjel is a stay-at-home parent and a bookworm with a maxed out library card but professionally she is a museologist with a background in English Literature. She currently lives on Prince Edward Island, an isle in the shape of a smile on the eastern Canadian coast. Sonjel is a writer who loves to listen to jazz when she's driving at night.