In one rebel-held city, residents have resorted to begging for crumbs at a local soup kitchen, while in a refugee camp on the Jordanian border, Syrians hounded by the desert heat and dust break their fast separated from relatives back home.
Reflecting the deprivation brought on by the war, the U.N food agency said that 7 million people were now reliant on food aid simply to eat. The fighting that has destroyed much of the country, combined with prices that have soared in recent months, have left many Syrians struggling to get by.
"People come by the kitchen just begging for scraps, it tears the heart," said an activist in the rebel-held northern Syrian city of Maarat al-Numan.
He said activists were using a communal kitchen to distribute a simple Ramadan evening meal of rice, vegetable stew and soup to some 400 of the city's neediest families. He identified himself only by his nickname, Abu Anas, fearing for his safety.
In the Zaatari refugee camp in the Jordanian desert, many of the 120,000 Syrians that live in the sprawling tent city home were homesick and miserable.
"Carrying out the Ramadan fast in this refugee camp is extremely difficult in every way imaginable," said Abu Qusai, a 32-year-old construction worker from the restive southern province of Daraa, where the Syrian uprising against President Bashar Assad began in March 2011. "It is as dry as a bone and the dust is kicking up ... we're thirsty, dirty and very uncomfortable. We're fed up."
Ramadan is traditionally a time of reflection and prayer, and Muslims are expected to abstain during daylight hours from food, drink, smoking and sex to focus on spirituality, good deeds and charity. The fast presents a physical and spiritual challenge every year, but particularly when the holiday falls during harsh Mideast summer when the days are longest and temperatures soar in some places to 50 degrees Celsius (120 Fahrenheit).
The Muslim lunar calendar moves back through the seasons, so Ramadan starts 11 days earlier each year under the Western calendar.
For most Sunnis and Shiites, Ramadan started on Wednesday while others are expected to begin observing the holy month on Thursday — differences based on various interpretations of sightings of the new moon.
Despite its apparent harshness, many Muslims eagerly anticipate Ramadan, the month when they believe God revealed the first verses of the Muslim holy book, the Quran, to the Prophet Muhammad. Streets are decorated with colorful lanterns, families gather at dusk to break their fasts with sumptuous feasts of meat and rice and sweets, the devout pray even more and regional cooking shows obsess over new takes on classic dishes for the Ramadan evening meal.
But the hardships in Syria, where the civil war is now in its third year, have eroded much of the Ramadan joy.
Even those considered lucky enough to have stayed in their homes found themselves cutting back on traditional Ramadan delights like sweets and meats as they awoke to their fragile currency falling once again, this time to 270 pounds to the U.S. dollar.
It was likely to set off another rise in food prices that residents say has already increased five-fold.
Still, residents in Damascus said the mood was better than last year, when rebels tried to overrun the capital. In the past few months, the military has gone on the offensive and has succeeded in clearing rebels from many areas on the edge of the capital as well as in the country's center. Encouraged, many Syrians abroad returned to visit relatives this Ramadan.
Syria's conflict began as an Arab Spring-inspired uprising against Assad's regime. It descended into a civil war that has killed more than 93,000 people, displaced over 5 million and turned over 1.5 million into refugees, according to U.N. figures.
On Wednesday, the World Food Program said it needed $27 million every month to deal with the growing ranks of Syrians made hungry because of the war and refugees crisis abroad.
If the organization did not provide for them, "they simply will not eat," said Muhannad Hadi, WFP's emergency coordinator in Syria, speaking at a new conference in New York.
The food crisis is partly caused by the rising price of fuel, a lack of imports and farmers abandoning their fields because it's unsafe to work.
The Syrian currency fell further, to 280 pounds to the U.S. dollar on Wednesday, after recovering from a record low of 310 pounds to the dollar on Tuesday. The falling pound is likely to further push up prices.
It made an average teacher's salary equivalent to some $70, a resident explained.
"Yesterday, I bought 2 kilograms of potatoes, one kilogram of beans and two kilograms of tomatoes with 1,000 pounds," said Qassem al-Zamel, a 37-year-old employee, ticking off once-cheap produce. "I stopped buying meat."
Supermarket owner Adib Mardini, 62, said he was changing food prices by the hour on some days but there were few shoppers. "People have run out of money," he said.
Across the region, governments took steps to help alleviate the 14-hour fast in the summer heat.
In the West Bank and Gaza Strip, Palestinian local governments reduced hours in the working day, alongside Jordan, Iraq, Pakistan, Afghanistan and Bangladesh, allowing fasters to sleep in.
But to ensure compliance, many countries also shutter bars, and fine people seen eating in public, including Jordan.
The oil-rich Gulf Emirate of Abu Dhabi planned to distribute nearly 30,000 sunset meals to drivers at gas stations or traffic lights in an attempt to prevent traffic accidents by speeding motorists with rushing home for iftar, the meal that breaks the fast.
In Iraq, Sunnis and Shiites both began fasting on Wednesday - a rarity in a country that has experienced some of its worst sectarian violence in years.
Starting the holy month together, Baghdad resident Ibrahim Ali said, is "a good omen for a new Iraq."
Tensions between the sects have spiked since December, when Sunnis started staging protests against the Shiite-led government over what they call second-class treatment.
Echoing complaints from Jordan to Indonesia, Ali said food prices at local markets where he shops have soared by as much as 25 to 30 percent in the days before Ramadan.
"Prices have jumped with the temperature in Ramadan ... There is nothing worse than that," he said.
Temperatures topped 41 degrees Celsius (105 degrees Fahrenheit) on Wednesday in Baghdad, where authorities struggle to provide electricity for even half the day in the hot summer months.
The Gaza government promised it would ration fuel to allow every household to receive 12 hours a day of power.
But there was little they could do to deal with rising prices, caused in part by neighboring Egypt moving to prevent the flow of food and fuel into the Gaza Strip in smuggling tunnels; one of the side effects of turmoil in Egypt.
Hadid reported from Beirut. Associated Press writers across the Muslim world contributed to this report.
Copyright 2013 The Associated Press.