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Fatty liver disease and type 2 diabetes: Partners in crime

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Non-alcoholic fatty liver is the accumulation of fat in liver cells (hepatocytes) in patients who do not consume significant amounts of alcohol. Commonly called fatty liver disease, this is the most common liver disease worldwide. In the United States, fatty liver disease is the second most common cause of liver transplantation, first being Hepatitis C – related liver disease. Although we have no formal data in India, but it is thought to be a significant contributor to end-stage liver disease and liver transplantation.
Fatty liver disease in patients with type 2 diabetes is a partner in crime. Type 2 diabetes accelerates the progression of fatty liver to more severe liver diseases like steatohepatitis (inflammation in liver), fibrosis and cirrhosis (scarring of liver) and hepatic cancer in some patients. These are the long-term hepatic consequences of fatty liver disease.
People who have fatty live disease and no diabetes, are more prone to develop diabetes. They are also more prone to develop cardiovascular disease (heart attack and stroke), rhythm disturbances of heart and chronic kidney disease. These are the long-term extra-hepatic consequences of fatty liver disease.
Fatty liver disease in patients with diabetes is a public health problem. Let’s see the burden of this disease in our society. In a population of 1000 people with diabetes at age 40, seventy percent (700 individuals) will have fatty liver disease. Out of these 700 individuals, 15 percent (105 individuals) will develop inflammation of liver over 15 years. Out of these 105 people, 15 percent (16 individuals) will develop cirrhosis over 10 years. Therefore, out of 1000 diabetes people of age 40 today, 16 patients would be struggling with liver failure at age 65.
Fatty liver disease, like type 2 diabetes, obesity and cholesterol problems, is a life-style disorder. It stems from long-term over-nutrition and under-activity. You will be surprised to know that there is not a single medicine approved for treating fatty liver disease. This is because we have no medicine that has been proven significantly beneficial for this disease. However, we have some strategies/medicines that help to some extent. Life-style modification (diet and exercise) has been shown to reduce liver fat to some extent in a number of studies. But same studies as well as studies in diabetes field showed that this strategy (diet and exercise) is not sustained for prolonged period of time. It is a common experience in diabetes management that although diet and exercise is advised for all the patients but only a small proportion of patients are actually able to adhere to the advice. The first line medicine for type 2 diabetes, metformin, has also been shown to help in fatty liver disease. But a number of other studies revealed only a modest or no effect on fatty liver disease. The prevalence of fatty liver disease in patients with type 2 diabetes is between 50-75 per cent. This is despite most of these patients having already been advised life-style modification and metformin therapy. This shows that these two strategies for improving fatty liver disease are not sufficient. We need other better strategies/medicines for reducing the incidence and complications of fatty liver disease.
Another diabetes medicine, pioglitazone, has been shown to improve fatty liver disease. However, in a famous PIVANS study, the improvement was not statistically significant and was inferior to vitamin E. Another reason for its lack of use in fatty liver disease is its undesirable adverse effects. Pioglitazone increases body weight that most patients do not like. It also causes fluid retention that is not desired in patients with type 2 diabetes who are already at risk for heart failure and cardiovascular disease. Pioglitazone also has an adverse effect on bone health, especially in post-menopausal women. Above all, although minimal, pioglitazone has been incriminated in bladder cancer. These are the reasons pioglitazone is not a favorite medicine among most experts as well as patients. For fatty liver disease, we need a medicine that has minimal side-effects because it has to be a long-term treatment.
Liraglutide is a daily injectable medicine that has been approved for type 2 diabetes. This medicine reduces body weight as well. In fatty liver studies, liraglutide failed to decrease liver fat in 3-month studies, but reduced liver fat in studies of 6-month duration. This shows that the treatment for fatty liver disease has to be a long-term treatment. Although liraglutide has a potential for being approved medicine for fatty liver disease (if further studies show similar favorable effect), but the patient acceptability of liraglutide is poor as this is an injectable therapy.
Vitamin E has been studied in patients with fatty liver disease and no diabetes. Vitamin E proved to be better than pioglitazone in this population. But it failed to be an approved medicine for fatty liver disease because of long term adverse effects of vitamin E supplementation. In the famous SELECT (the selenium and vitamin E cancer prevention trial) study, vitamin E actually increased the incidence of prostate cancer by 17 per cent.
Ursodeoxycholic acid was thought to improve liver function in fatty liver disease, based on open label single arm studies. But a long term (2 years) histological study showed that ursodeoxycholic acid is no better than a placebo in improving inflammation of liver in patients with fatty liver disease.
Sodium/glucose cotransporter 2 (SGLT-2) inhibitors, also called gliflozins, are a new class of anti-diabetes medicine. Empagliflozin, a member of this group, was first approved for type 2 diabetes in the USA in 2014. In India, it was launched in November 2015 for use in type 2 diabetes. As this medicine causes loss of glucose through urine, its long-term use leads to chronic calorie loss and thereby weight loss. Remember life-style diseases stem from chronic over-nutrition and under-activity. This class of medicine at least tends to correct one basic cause of lifestyle diseases, that is, over-nutrition.
In January 2016, a Japanese study on mice model of fatty liver disease was published that examined the effect of ipragliflozin (another gliflozin) on fatty liver disease. They found that ipragliflozin reduced not only liver fat, but also improved inflammation as well as fibrosis in mice. We had no data of this class of medicine on human liver fat. In February 2016, we registered a study, called empagliflozin on liver fat (E-LIFT trial) to see its effect on human liver fat. We randomized 50 patients with type 2 diabetes and fatty liver disease into empagliflozin group (empagliflozin 10 mg in addition to preexisting anti-diabetes medicine) and control group (standard anti-diabetes medicine without empagliflozin). Liver fat was measured by a robust technique of MRI called proton density fat fraction, which measures liver fat accurately in percentage. After 20-week of follow-up, liver fat decreased from 16.4 % to 15.5% in the control group and from 16.2% to 11.3% in the empagliflozin group. There was an absolute liver fat reduction of 4.9% and a relative liver fat reduction of 32% in this arm. This study also showed improvement in liver enzymes. The study got widespread acceptance first in the US endocrine society and then in global media. This is a first study that shows beneficial effect of gliflozins on human liver fat by using a robust method of liver fat quantification.
This medicine, and probably the other members of this class, has a potential of becoming approved medicine for fatty liver disease at least in patients with type 2 diabetes. For that we need similar and histopathological studies in other population groups. If the same effect of this medicine is reproduced on liver fat, this might be approved for fatty liver disease. As we know that this class of medicine has many other beneficial effects like weight loss, some reduction in blood pressure and prevention of death in patients with cardiovascular disease, its use has been on increase in the world. Although it is a costly medicine at present (which is hoped to decrease with time when competition increases), its patient acceptability is not a problem as this is available in tablet form and also causes weight loss.
(The author is a Kashmiri endocrinologist and researcher working in Medanta-The Medicity Hospital, Gurugram.)


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Opinion

WHAT RAMADAN TEACHES US EVERY YEAR!

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By Moin Qazi

O you who believe! Fasting is prescribed for you as it was prescribed for those before you, that you may attain Taqwa [God-consciousness]


– (The Qur’an, Al-Baqarah: 183)

 

Religious fasting traditions- from Ramadan to Ekadasi to Yom Kippur and Lent -are meant to unburden believers from day-to-day compulsions, helping them replenish their spirituality, remember the poor, give up bad habits, make amends for moral deficiencies and get closer to their conscience. The most prominent among these spiritual fasting customs is Ramadan. Islam does not have a tradition of monasticism. Instead, observant Muslims become ascetics by seeking sacred abstemiousness during Ramadan every year.

Fasting(“Sumoo”, derived from the Arabic root of “Saama” and Syriac, “Sawma.”) means “to refrain” – and not only is it abstaining from eating, drinking , smoking and sex , but all forms of immoral actions including talking about others behind their backs, or indulging in impure or unkind thoughts. Fasting, like prayers, is an essentially solitary act; it represents a personal relationship each one of us has with God. When fasting, Muslims have one meal before sunrise, called sahur-the pre-dawn meal -together, and share another meal with friends and family after sunset, called iftar-the fast- breaking meal. The fast is actually much longer than what everyone normally perceives .It commences at the first ray of dawn, or, as it is said in the Qur’an, “when the white thread of day becomes distinct from the blackness of night.”

During Ramadan, the Muslim communities across the far corners of the world are unified by one food: the date, one of the earliest cultivated crops and an ancient icon of the Arabia, where the thick-trunked date palm is a symbol of hospitality, rest and peace.it is recorded that Prophet Muhammad always broke the fast with dates and water.

Fasting during Ramadan is obligatory for all able-bodied Muslims from when they reach the age of religious observance. Those who are exempt from fasting are those who are sick, the elderly, those suffering from a mental illness, and those who are travelling long distance .Menstruating and pregnant women are also exempt. So are breastfeeding mothers. However, the exemption has a caveat that those who skip the fast have to make up for the lost days after Ramadan. But if a person is not able to fast at all – particularly if that is for health reasons – he can compensate and partake of the holy month’s blessings by feeding a needy person for each day he does not fast (fidiya, or “expiation”).

Ramadan is a commemoration of the descent of the word of God, the Qur’an, from heaven to the earth. Just as the word of God has come down, the word of supplicants goes up to God more vigorously and efficaciously in Ramadan than at any other time.

The most significant hallmark of the month of Ramadan is the Night of Destiny, Night of Value or Night of Measure: Lailat al Qadr, in Arabic. According to the Qur’an, angels descend from heaven on this special night -most important, the archangel Gabriel — bringing peace and divine presence into the world. Prophet Muhammad did not mention exactly when the Night of Power would be, although most scholars believe it falls on one of the odd-numbered nights of the final ten days of Ramadan.
The Qur’an says:

“The Night of Power is better than a thousand months.

Therein come down the angels and the Spirit by Allah’s permission, on every errand:

Peace… This until the rise of morn! “(Q97)

Better than thousand months. A thousand months are equivalent to 83 years and 4 months. The importance of this night is also mentioned in hadith, which are the sayings of the Prophet Muhammad as remembered by his companions:

“Whoever establishes the prayers on the night of Qadr out of sincere faith and hoping to attain Allah’s rewards (not to show off) then all his past sins will be forgiven.” (Sahih Bukhari Vol 1, Book 2:34).

Ramadan is always a very amazing month .We undertake a month long spiritual odyssey that is meant to rejuvenate us, both physically and morally. It enables us to detach from worldly pleasures to invest our time in intense prayer, charity and spiritual discipline and focus on our deeds, thoughts and actions. Every Ramadan, we undergo illuminating and enriching experiences that provide valuable lessons in understanding life and ourselves better. The extremity of the test reminds us of the fragility of human life and is meant to foster a closer relationship with God.

Over the years, the experience has been life-changing for me. I learnt to be disciplined; started feeling empathetic towards the poor, as Ramadan taught me how it feels to be less fortunate. Every year, we gain something substantial, as the entire spiritual gymnastic nurtures our soul, leaving us like a computer reformatted or an engine overhauled.

I remember the early years of fasting when my mother would recount her childhood stories about Ramadan –how the table at sunset would be full of delicacies; how she and her siblings would hold handfuls of food in front of their mouths, waiting for the cue from my grandfather to eat. At the end of the month of fasting, he would sacrifice a lamb, in the name of God, and feed it to the poor.

The first time I fasted was when I was attending school away from home. Marching up to the man in charge of the cafeteria, I fully expected to be rebuffed when I asked for food to take back to my dorm for a predawn breakfast. But he just looked me in the eyes and asked what I would like to eat. Had I not been so stunned by his acceptance, I might have asked for a table full of treats. I fortified myself by hearty food and sealed the fast with a full glass of fruit juice. The fast seemed interminable and intolerable because, as every Muslim would confess, no matter how much food or water or juice you pour into yourself at dawn, it is never enough to drown the body’s yearnings until sunset.

Later that night, nibbling on the meat sandwich, I realized, ”I’m fasting for Ramadan!” For the first time, I was doing something that wasn’t primarily for myself or for parents or for good grades. By fasting, I was doing something for God- that which would bring me closer to the creator and sustainer of all existence .it is said that it’s the only Islamic practice that’s invisible to an observer.

Later in college, on Saturday nights, other Muslim students and I would take the college van to a pancake house at 4 a.m. I told my non-Muslim friends, who always accompanied me to dinner in the dining hall at sunset, how the entire holy month of Ramadan was about feeling spiritually charged and elevated despite the hunger and deprivation.
The fasting ritual is an eagerly awaited interlude for utilizing the abstinence from food, drink and other indulgences to concentrate on prayer, meditation and worship. This, in turn, encourages greater reflection on one’s life and appreciation for resources we sometimes take for granted. It teaches us about patience, self restraint, spirituality, humility and submissiveness to God.

The act of fasting for spiritual prowess makes us more conscious, not just of food habits but of how we think, behave and interact throughout the day. Fasting does not mean Muslims retreat from their daily chores; rather they are encouraged to continue their normal routine. This is the real challenge, and fasting helps us hone our patience and endurance because, by refraining from consumption throughout the day, we learn the benefit of refraining from gratifying each of our desires in the moment.

Each fasting day during Ramadan is a trial on the body and our spiritual resolve. Removing the regular comforts from daily routine is intended to focus the mind on spirituality, prayer and charity. By fasting, we cut ourselves off from the temptations and distractions of our busy, hectic, materialistic lives and try attaining “taqwa”, or “piety” or “God-consciousness”. With a decaffeinated, empty stomach, and a thirst that is difficult to tolerate, this act of fasting connects us to someone else.

Our fasting draws us to the story of a woman in Somalia who has been walking for miles in brutal temperature, with hot and dust-filled wind blowing in her face, to fetch firewood and water; successive droughts have scorched and ravaged her land, her body, and her children. She’ll thank God, if they all make it alive to the feeding centre. The baby she is carrying no longer gets milk from her breast; she feels him shrinking in her arms as she walks. Her other children, languorous and emaciated, are trailing her. The mother keeps repeatedly telling them that they must put their trust in God and keep moving. One can understand her thirst as she utters the words of prayer with every precious drop of water she goes without to give to her children for their survival.

Our act of fasting brings empathy for her that is greater than any ordinary day. We remember her when our head would go dizzy with thirst after running out on a simple errand in triple-digit heat. We can step back into our air-conditioned refuge; she can’t. We won’t complain of our exhaustion from too little sleep because we know she won’t find a sheltering place to rest in the harsh landscape. We’re hungry, but I can break my fast in a celebratory mood when the day is finished; we’ll take a cooling sip of clean, filtered water and literally feel it splash down in my empty gut at sundown. As we feel our body reviving, we are reminded that the Somali woman’s fast has been going on since well before Ramadan, and it will continue past. It is her way of life for years on end .For her “fasting” is not a choice, for her hunger is part of daily life.

As we slice up exotic fruits to refresh our families after fasting, we keep seeing this poor woman. How can we set a table with melons, dates, rice, other lavish goodies and dollops of dainty creams when she has none? How can we keep stocking up on provisions featuring a variety of so many alluring and exquisite foods, such as sweetmeats, spices, savouries and sugary drinks, with which to break our daily fasts, without thinking of the woman’s broken heart when she has to tell her children she has nothing for them; the crops failed, the livestock died, and food prices have shot so high that they are a luxury she can hardly afford. .She has no way to feed them. The suffering of these unlucky ones reminds us to be grateful for our fortunes.

At times we don’t realize how hard and coarse our hearts have become. The absence of regular and consistent times for contemplation and self-reflection has made us insensitive to the suffering around us. The pursuit of complacency has become our goal rather than the pursuit of contentment and we sacrifice things that would bring us everlasting comfort in pursuit of those things that simply give us the facade of comfort. The empathy for the suffering of those less fortunate people around us, created by the act of fasting, is only worth something to them — and to us — if we do something about it.

The emphasis on enduring the fast stimulates us to move beyond simply the physical aspects of it and reach out in the direction of a spiritual fast. It’s not just about mortification of the flesh. It’s about refraining from complaining, a fast from thinking ill of others, a fast from coarse language and harsh speech, a fast that’s focus is not on food or drink, but how the absence of those things leads towards the development of a strong heart and soul. That’s the fast that we should strive for – one that moves beyond not feeding our bodies but feeding our souls. The essence of Ramadan is to become humble, simple and free from ill-will, anger, meanness and hate. It is a one-month refresher course from which we can emerge as the greatest version of ourselves. It is a month of penance, peace, forgiveness, atonement and reconciliation.

I pray that Ramadan gets into our hearts and minds and makes us embrace all shades of mankind with dignity, respect and care acknowledging the diverse swath of traditions and cultures.

The greatest lesson every Ramadan teaches us is indeed the wisdom expressed in the Qur’an, Al-Hujurat:

“O mankind! We have created you male and female, and have made you nations and tribes that ye may know one another. The noblest of you, in sight of God, is the best in conduct. God Knows and is Aware of everything you do.”(Q49:13)

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Opinion

THE ROOT OF MANY EVILS

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By Zeeshan Rasool Khan

From time immemorial, Kashmir has been enjoying recognition all across the world as ‘Resh Waer’ – Abode of Sages because the sages, savants, and saints from different parts of the world have visited this place. Some of them stayed permanently here and some had a transient stay. Also, there is a significant number of native godly and spiritual personages who were born here and exercised their influence on the masses. Consequentially, the religious, moral, and ethical influence on every aspect of Kashmir has always been predominant and conspicuous. However, dismally, the unique status that Kashmir holds is eroding day by day. Unscrupulous incidents that do not suit particularly to this land are happening at regular intervals. The occurrence of such unethical, immoral, and shameful episodes has seen a huge jump. Recently, a three-year-old child fell victim to the debauchery of the beast in human form. And such incidents amply suggest that moral values are declining and moral degradation has permeated the major segment of the society. These awful happenings undoubtedly involve moral decadence. Thus, while we raise our voice against these crimes, which these offenses demand, we as a society also need to look for a permanent solution to this emerging problem. And, that is not possible without elimination of root cause of the problem i.e., moral decline.

To prevent moral degradation, it is important to reach at its roots to know where this moral decadence comes from. It is bitter truth that moral degradation starts from home and parents are mainly responsible for it. Parents have a key role in the life of a person. Home is the primary training institute for a child and parents are his/her first trainers. For the child’s physical, mental character, moral, and ethical development no outside influence is greater than that of parents.

 

However, the main problem that world including our Kashmir is facing is that; the parents are too busy to be parents. They are too much engaged that they do not have time for their wards. Entrusting wards to maids has become the new norm and in the absence of proper parental care, how one can expect ethically and morally sound child. As it is self-evident that the way a parent can foster his/her child is least anticipated from others.

In some cases, parental care has been reduced to the providence of luxury to the child. Furnishing the child, costly clothing, gadgets, gifts, toys, etc., and giving in to his/her demands is miscalculated as parental care. This misinterpretation of parental care has sharpened the moral decadence. In this way, immorality is purchased by parents into homes and into the hands of their children. Exposure to cultural and technological modernity in the absence of parental supervision is a contributive factor of moral corruptness. The child equipped with all modern facilities is bound to fall into the quagmire of vileness unless he/she would be under the observation of his elders. Similarly, some believe caring for the physical growth of a child is all that parental’ role is, but they are wrong. Parents have a great role in the moral and character development of the child. As a matter of fact, the way parents would guide their wards would be reflected in his/her ethics. In other words, the conduct that the child develops largely depends upon the mode of his/her upbringing by parents. Given the fact, the children imbibe everything rapidly, the approach of parents greatly influence them. Therefore, from the families with moral excellence, coming of morally declined children is near to impossible. Hence, if parents would discharge their responsibilities fairly, the problem of moral degradation is not invincible. It is also worth to mention that the impact parents have on their children is long-term and does not fade with time and circumstances. Whatever the child learns from parents’ remains with him forever and is least vulnerable to any sort of change.

There is no denying that there is huge contribution of teachers and friends in the moral development of a person. After parents, teachers have a significant role in the life of a child as the school-going child spends a big chunk of their day with teachers. It is the responsibility of the teachers at school to take care of a child’s overall development. Apart from imparting education, teachers must be keen about the character development of the child so that any lacuna, which may have remained during parenting, could be removed. Although teachers normally never evade their responsibilities in this regard, however; from several months videos are surfacing on social media, in which school students were seen immodestly, which indicates that the school administration is nonchalant about changing scenario.

Likewise, examples of moral degradation come into view in and around the tuition centers. Such flaws need to be removed so that the necessary ambiance is created that could boost the child positively.

Friends have a big influence over a person’s life and it can be positive as well as negative. Most often, a person coming from a noble family suffers due to his company he/she keeps and sometimes-good parenting fails to bring fruitful results because of the impact of bad friends over a person. Nevertheless, parents have a part to play here as well. They are authorized to know about the friends of their ward. They need to keep track of a child’s friend circle and their activities. This will help them to prevent their child from the effects of bad company.

To put it in a nutshell, by adhering to responsibilities and discharging duties justly; the chances of moral degradation will reduce per se. Resultantly, the valley that is going through a difficult phase on account of growing moral turpitude will be back on track and would be an actual representation of ‘Resh waer’ again.

(The author hailing from seer Hamdan, writes on diverse issues. He tweets @zeeshan_rk and can be mailed at: mohdzeeshan605@gmail.com)

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Understanding Zakat

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By Mohammad Aafaq

Zakat is one of the major religious duties in Islam. Literally, zakat means to “purify”. It refers to the purification of a believers’ wealth and soul. Wealth purification denotes the mobilization of assets for the purpose of financial growth and justified distribution. Purification of the soul implies freedom from hatred, jealousy, selfishness, uneasiness and greed. Other Quranic connotations also include the purification of sin.

Zakat is a fixed proportion collected from the surplus wealth and earnings of a believer. It is then distributed to prescribed beneficiaries and for the welfare as well as the infrastructure of a society in general. This contribution is made payable by a Muslim once every year.

 

Zakat is paid on the net balance after a Muslim has spent on basic necessities, family expenses, due credits, donations and taxes. Every Muslim male or female who at the end of the Hijri year is in possession of the equivalent of 85 grams of gold or more in cash or articles of trade, must pay his or her zakat at the minimum rate of 2.5 percent.

Zakat has a deep humanitarian and social-political value. This religious act prevents the hoarding of wealth and advocates solidarity with humanity because excessive wealth is distributed among the poor. The paying of zakat also helps purify one’s soul and encourages a person to have gratitude towards God’s bounties.

Zakat is mentioned along with Salat (prayer) in 30 verses of the Quran. It was first revealed in Surah 73:20;

“…. and establish regular prayers and give regular charity; and loan to Goda beautiful loan. And whatever good ye send forth for your souls, ye shall find it in God’s presence, Yea, better and greater in reward and seek ye the grace of God: for Godis oft-forgiving, Most Merciful.”

In another verse, God declares that those who pay zakat, are included within the Muslim society

“But (even so), if they repent, establish regular prayers, and practice regular charity, they are your brethren in Faith: (thus) do We explain the Signs in detail, for those who understand.” (9:11)

God says in the Quran:

“They were enjoined only to worship God, sincere in their faith in Him alone – and of upright religion – and to establish the Salat and the Zakat. Such is the upright religion, (98:5)

“Those who lay up treasures of gold and silver and spend them not in the way of God; give them the news of a painful punishment, on the Day when that (wealth) will be heated in hellfire, and their foreheads and their sides and their backs branded therewith: “This is the treasure which you laid up for yourselves! Taste, then, your hoarded treasure!” (9:34-35).

“Let not those who are miserly with what God has given them of His bounty think that this is good for them. Rather, it is bad for them. That which they withhold shall be hung around their necks on the Day of Arising. (3:180)

Bukhari and Muslim relate on the authority of Ibn Abbas that the Messenger of God sent Mu’adh to the Yemen he told him, “You are going to a people who have a Scripture, so call them to testify that there is no deity but God, and that I am the Messenger of God. If they respond to this, then teach them that God has imposed five Salats upon them in every day. If they respond to this, then teach them that God has imposed upon them a charity to be taken from the wealthy amongst them and given to their poor. If they respond to this, then beware of taking any more of their wealth! Beware also of the prayer of the oppressed, for there is no veil between such a prayer and God.”

Then he recited the verse: “Let not those who are miserly with what God has given them of His bounty think that this is good for them. Rather, it is bad for them. That which they withhold shall be hung around their necks on the Day of Arising.” (3:180)

Several conditions must be fulfilled before zakat can be paid. These conditions are necessary as zakat can only be applied on those who are of legal age and who own enough assets. These conditions are categorized into two broad categories, namely performer and asset.

Every Muslim who is of a certain age and owns enough assets is required to pay zakat.

Zakat is payable only on those assets that are acquired for the purpose of creating or generating wealth. Some examples of this type of assets are livestock or crops that are traded or sold, inventory of goods used for trading, and investments such as gold or securities that have potential for appreciation in value. However, zakat is not payable in the case of fixed assets such as buildings, if they are not subjected to “capital circulation”.

Zakat need only be paid on those assets that exceed a minimum value. This minimum value is calculated based on the market price of 85 grams of gold or 595 grams of pure silver. This minimum value is termed Nisab. The Islamic Fiqh and Research Councils, as well as Jumhur (majority) of Ulama’ recommend that gold be used as the basis for the calculation of nisab.

Haul is defined as the completion period for a zakat asset. The length of time for haul is one Islamic or Hijri year (1 year Hijri = 354.5 days, 1 year Solar = 365.25 days). Zakat is only payable on assets that have been held for at least this period.

Zakat can only be distributed to any of the eight eligible beneficiaries (asnaf) that are mentioned in the Quran in Surah Taubah: 60. However, priority should be given to the poor and needy. Where there is no central authority to administer zakat, it can be paid directly to the needy.

Those without sufficient means of livelihood to meet their basic necessities. For instance, those who, although may have a job, a house and a car, but whose income is below the minimum requirement.

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