Health tips for Ramadan

By Patricia Khashayar, MD


Ramadan, the ninth month of the Islamic calendar, is the month of fasting, in which Muslims refrain from eating and drinking from dawn to dusk. Fasting is intended to teach Muslims about faith, spirituality, self-accountability and self-restraint.

Apart from strengthening the willpower and developing one's appreciation of values such as patience and humility, fasting improves eating habits. By reducing the three daily meals to two, it rests the stomach and the other organs in the gastrointestinal tract.

Adopting a healthy and balanced diet based on an individual's condition, daily function and underlying disease plays an important role in helping them enjoy the considerable advantages of fasting. Many individuals, however, ruin their efforts by overeating in the morning or at night.

There is no need to binge during Ramadan as fasting intends to regulate the body mechanism. Adopting a healthy and balanced diet during Ramadan can help regulate blood lipid levels, reduce extra weight, excrete the poisons from the body and control blood pressure levels.

An appropriate diet for Ramadan should include all the five food groups. It should be planned in a way to prevent any weight gain or loss during this month. Following a low calorie diet, however, provides obese individuals with a great opportunity to lose their extra weight in this month.

Considering the fact that this year's Ramadan has coincided with summer, certain tips should be kept in mind to help individuals who want to fast endure the long summer days without food and water. These individuals are recommended to have two major meals (Sahari and Iftar) and a snack consisting of fruits and drinks before sleeping.

Suhoor or Sahari -- the food those who fast eat before dawn -- is believed to have an importance equal to breakfast, as it provides the body with the energy and nutrients required for studying, working and doing the daily routine.

Individuals, therefore, are recommended to wake up to eat Suhoor in order to avoid burnout at the end of the day. Fasting without Suhoor may lead to halitosis, headaches and muscular pain as the body would be required to use fat deposits as its energy source.

Many individuals skip Suhoor, saying they do not have any appetite at that time in the morning. Setting the table for Suhoor is believed to be effective in improving the appetite.

Eating a meal rich in fat for Iftar is the main cause of appetite loss at the time of Suhoor. Individuals therefore are recommended to have a light meal rich in calories if they intend to fast the following day. Having a fatty meal for Iftar -- the food those who fast eat after sunset -- may also lead to fatigue as a lot of time is needed for fat to be digested.

Eating too much for Suhoor, on the other hand, is not recommended as it is of no help in fighting hunger usually experienced at the ending hours of the day. Such heavy meal only imposes a heavy burden on the stomach, leading to symptoms such as indigestion, heartburn and bloating.

Sleeping early at night and waking up at least 90 minutes before dawn also helps the digestion process. Individuals are also recommended not to sleep after Suhoor in order to reduce reflux, when acid from the stomach leaks up into the esophagus.

Eating protein-rich foods such as eggs, grains, dairy products and meat along with fruits, vegetables, low-fat milk, fruit juice and several cups of weak tea is an effective way to reduce daytime thirst particularly in the elderly. Drinking at least six glasses of water or tea between Iftar and Suhoor can also compensate for an individual's need for water.

Despite the general belief, drinking a lot of tea for Suhoor does not quench thirst. As a matter of fact, the caffeine increases urination, leading to an increased excretion of water and minerals from the body and, in turn, causes more thirst. Having weak tea or adding a little lemon juice to tea, however, can be helpful. Drinking too much water during Suhoor, similarly, dilutes the stomach content and causes bloating and indigestion. Individuals are also recommended to drink gradually while eating Suhoor.

Individuals are urged to eat more vegetables and fruits for Suhoor to not only overcome thirst but also prevent constipation. While having small amounts of watermelon and cantaloupe can effectively fight thirst, honeydew melon is not a good choice for those who fast. Grape extract has tonic properties and is suggested for those who feel weak during the day. Diabetic people, however, should avoid the extract. Having soup for Iftar is also an effective way to compensate the required water and minerals.

While foods high in complex carbohydrates such as bread, rice and potatoes and whole grain breads are highly suggested for Suhoor, individuals should avoid other carbohydrate-rich foods including candies and chocolate as they release energy rapidly. As for Iftar, however, having foods high in carbohydrate can compensate for the reduced glucose levels experienced as a result of fasting.

Salt should be avoided during Ramadan as it increases the excretion of fluids from the body, causing thirst. Following a balanced diet can provide the body with the required amounts of salt, indicating that there would be no need for extra salt.

Soup and pottage along with date, milk and weak tea are the best options for Iftar as they are fairly light and prepare the stomach for dinner. It is recommended that individuals avoid drinking too much water during Iftar as it may contribute to fatigue and stomach pain.

One should avoid heavy meals for Iftar in order to prevent extra pressure on the stomach. If an individual intends to eat dinner as well, two hours after Iftar is the best time for a light dinner. Eating a fruit or nuts after Iftar is recommended. Half a glass of fruit juice can substitute a fruit.

Sweet desserts are not recommended as they make the individual feel hungry after a while (such foods contain simple carbohydrates which enter the blood rapidly; they stimulate pancreas secretion and shortly cause reduced blood glucose levels).

Nutritionists also urge individuals to replace butter, fat, mayonnaise and various desserts including chocolates with herbal fats such as those extracted from olive and nuts (peanuts, nuts, hazelnuts and …).

Constipation, indigestion and bloating, fatigue, aggressiveness, reduced vision, dizziness, low blood pressure, headaches, loss of concentration, excessive sweating, tremor, palpation and muscular cramps are frequent complications experienced while fasting. These are all believed to be secondary to adopting a bad diet in Ramadan rather than fasting per se.

Lowering the intake of fat-rich, spicy and fried foods as well as refined carbohydrates and foodstuffs with flatulence properties - such as eggs, lettuce, lentils, beans and carbonated sodas and adding more water and whole grain bread to the diet can help individuals overcome many of these problems.

Individuals with underlying diseases such as diabetes, high blood pressure, cardiovascular diseases and renal disorders should consult their physicians before making any decision about fasting. Individuals suffering from active peptic and duodenal ulcers should not fast as it may activate the ulcer, leading to troublesome conditions such as bleeding.

Diabetics older than 20 who have controlled blood sugar in the past three months and are not suffering from any underlying diseases including infectious, cardiovascular and respiratory diseases neither renal stone and high blood pressure are allowed to fast.

Individuals on insulin can fast only if they depend on low doses of the medication, do not experience hypoglycemia attacks during the day and are not suffering from any diabetes-related complications. Fasting is not recommended in cases with blood glucose levels near 300.

Diabetics, however, should break their fast as soon as they experience the symptoms of hypoglycemia characterized by low blood glucose levels, hunger, shakiness, nervousness and confusion.

Considering the fact that this year's Ramadan coincides with summer, individuals who fast are recommended to reduce their physical activity as body loses too much water and salt during exercising and intense exercises may cause severe fatigue. Exercising particularly brisk walking should not be overlooked in this month.

When an individual intends to do a heavy sport following Iftar, they are recommended to have meat, egg yolk and fish for Iftar. Drinks such as fruit juice before exercising are also recommended.

Athletes need more protein, carbohydrate and vitamins during Ramadan. They are recommended to drink more water for Suhoor. Date, soup, vegetable and milk are the best choices for Iftar in athletes. They can start exercising some three hours after Iftar as the food has been completely digested within this time.

A gap between breaking the fast and exercising helps provide sufficient blood flow to the muscles.