Medical Considerations While Fasting

Fasting means not consuming food or water for a set length of time. People practice fasting for various reasons, including spiritual, personal or health reasons. The length of time for fasting can vary based on a person’s individual goals, or the fast may be an established timeline for a religious observation.

Why Do People Fast?

Religions including Christianity, Judaism, Islam, Hinduism and Buddhism observe fasting during special celebrations. Athletes might practice intermittent fasting to boost metabolism or blood sugar control. Fasting is often required before surgery to prevent vomiting or other issues. Fasting also can serve as a form of weight management.

Is It Safe for Children to Fast?

There is currently no evidence to suggest that fasting is harmful for the older healthy child with normal body weight. However, it is important to note that fasting studies have focused on children ages 10 years and up. Very young children who fast for medical reasons might be at risk for low blood sugars. Studies including older children and teens found no low blood sugars. Make sure you consult with your child’s doctor before you consider fasting for any reason. It’s best to work with your doctor to develop a full plan to consider all medications and illnesses to ensure fasting is done safely.

Considerations Before Fasting

There are several factors to consider before starting a fast.

• Patient condition: How is your child’s overall health? Are they at a safe age and weight to participate in a fast?
• Disease state and stability: If your child has a medical condition (such as type 1 diabetes), is it controlled enough to participate in the fast? For children with type 1 diabetes, fasting risks can include diabetic ketoacidosis, hypoglycemia, hyperglycemia, dehydration and thrombosis.
• Medication: Take time to speak with your child’s doctor about whether it's safe to delay any treatments that would break the fast. Make sure that waiting won't harm the child’s health. This includes things like taking pills, getting nutrition through an IV and dialysis. In some situations, fasting may be considered too dangerous so that your child may be advised to avoid fasting.
• Fasting safely: Talk with your doctor before your family or child begins the fast. Talking with the medical team one or two months before the fast gives everyone time to prepare.

Talking to Your Doctor About Fasting

We live and work in a diverse world. Survey data of North American primary care physicians show a lack of comfort and knowledge when medically counseling patients about fasting, especially relating to spiritual and religious fasting. In fact, many patients are not asked about their fasting habits at their primary care physician’s office. Many patients with chronic medical conditions (e.g., diabetes) may still choose to fast without consulting their primary care physician. Cross-cultural competence and communication between health care providers and patients is crucial to promote the safe fasting practices.