Ramadan was ordained in the Koran and as such, is a duty for every Muslim who is old enough and healthy enough. Some people are exempt from fasting: for example, pregnant and breastfeeding women, people with illnesses like diabetes that do not allow fasting, etc.
Islam is a very practical religion like that, and does not require its followers to do things that would bring harm to their health.
The religious basis for Ramadan is also very simple and down to earth. It was put in place so that people would understand what the life of a poor person is like – and in order to learn compassion and kindness towards them. Hence, you’re supposed to keep right on working on your empty stomach, even though some do not and take Ramadan off to spend the days sleeping in the AC.
At the first breaking of the fast, most people follow the tradition set by the Prophet Mohamed: just some dates, fresh if they can get them, and then a drink. Very popular drinks here in Luxor are ‘sobhy’ (a kind of fermented bread drink), cold, sweetened lemon juice and ‘gooz-hind’. Then, families and friends sit and eat together – usually a bit more (in some cases a lot more) luxurious food than they would normally have (the Prophet did not do this, by all accounts he was a very moderate man). And sweets, lots of sweets! ‘Kunafa’, ‘basboosa’, ‘ghoulash’, ‘Oom Ali’, ‘zalabia’, you name it, all those delicious, pastry and honey-drenched goodness that the Arabic region is so famous for.
Fun fact: if you miss a day of fasting for reasons NOT specified in Islam, you have to pay a poor person 11 EGP as a kind of fine – and all missed days of fasting, legitimate or not, need to be caught up with later.