Our team of doctors at First Response Healthcare have prepared the following general health tips for Ramadan
TIPS ON RAMADAN HEALTHY EATING
- Start your meal with dates:
Dates are very important source of sugar that will replenish the energy you lost throughout the long hours of fasting, it is rich in fibers that will regulate your bowel movements. They are rich in magnesium and potassium as well.
- Break your fast slowly:
Start with dates, water, followed by soup, a bowl of salad and then go to the main meal. If you fell full after salad, you can take a break and continue your meals later. Overeating can cause stomach pain and bloating which is a very common problem that people face during Ramadan. Starting your Iftar meal with a warm soup comforts the stomach after a long day of fasting, replenishes your body with fluids and help prepare the digestive system for this meal.
- Stay hydrated:
This year Ramadan will be at the peak of summer when temperatures are hitting as 45 degrees. You have to make sure that you drink enough water after you break your fast so that you do not feel thirsty or have any signs of dehydration the following day. Drink 8 glasses of water throughout the night.
- Avoid thirst:
Avoid salty foods, such as canned or processed foods, salted nuts, and pickles, because these will increase your thirst during the fasting period. Also avoid foods that are too spicy or salty, and consume more fruits and vegetables that are refreshing to prevent getting thirsty.
- Ensure that your meal has all food groups:
Your iftar should have a source of grains, proteins, vegetables, fruits and healthy oils.
- Make healthy food choices:
Choose whole grains, lean meat, chicken breast, fish, olive oil in moderation and whole fruits instead of fruit juices. Stay away from fried food, and food high in fat.
Meats, legumes, eggs and dairy products are rich in proteins. Ensure you have at least one of these sources in every Ramadan meal since proteins are very important for your body cells. They also increase your satiety level thus reducing the temptation for eating sweets.
- Avoid salty and sugary foods:
Eating sweets immediately after iftar will result to bloating and cause a delay in digestion. It will also cause a fluctuation in the blood glucose level, which will lead to you craving for more sweets. That’s why, it is recommended to have sweets in moderation 2-3 hours after iftar.
Delightful sweets in Ramadan are hard to resist. To avoid consuming too many calories, indulge and enjoy with your family the tasty and creative delights while making sure you always practice portion control and moderation.
The more the food is salty, spicy and processed the more it will make you thirsty the following day. The body breaks sugary foods faster, and this will also make you hungry sooner.
- Divide your meals:
Having three meals is still important during this holy month: iftar, a light evening snack, and suhoor. This would help you avoid continuous snacking throughout the non-fasting hours.
Divide your main course into three parts. Have one quarter of the plate filled with complex carbohydrates, one quarter with lean meat or meat alternatives, and half with vegetables. This will ensure that you have a healthy balanced meal.
- Avoid coffee:
If you are a coffee drinker, try and reduce your coffee consumption two weeks prior to Ramadan in order to avoid headaches and sleepiness.
Adding exercise to your daily routine during Ramadan is very beneficial. This will help you maintain a healthy weight and healthy lifestyle.
If you are a regular athlete used to moderate or vigorous exercise, you can still maintain this by incorporating your exercise session just before iftar. Make sure to hydrate immediately after your session and eat slowly to replenish your fluid and nutrients. Try exercising an hour or two after you break your fast.
Water is the human body’s most needed nutrient after Oxygen, About 60% of the human body is made up of water. On average, the body loses about 2 to 3 liters of water daily through urination, sweating, and breathing. When we are fasting, we even needs more water especially if we live in a hot climate area.
Fasting for a long period in the summer is a great risk developing dehydration. Children, elderly people, patients with diabetes, kidney or other chronic diseases, patients with diseases associated with diarrhea, vomiting, high fever or increase in urine flow. As well as those who perform physical activity under the sun, all are at a higher risk of dehydration.
Although it may seem like a challenge, managing your water-intake and diet to stay sufficiently hydrated throughout the fast is achievable, and has many benefits. Here are some tips that can help you:
- Drink between eight to twelve cups of water ( 2-3 liters) between Iftar and Suhour.
- You can also increase water intake by eating hydrating foods like fresh fruits and vegetables for example adding a fluid rich fruits such as watermelon to your Suhoor meal or eat it as a sweet treat after Iftar or add The traditional Arabic salad which contains plenty of hydrating cucumber and tomato to your meals.
- Avoid salty, spicy and processed foods as they will increase your thirst sensation during the fasting period.
- Avoid caffeinated drinks such as coffee, tea and cola, because caffeine can make some people urinate more often and will increase your thirst sensation.
- Stop smoking as it triggers a continuous dry mouth and thirst.
- Limit your sweet intake , Eat fruits instead that provide your body with fluids.
- Avoid sun exposure or physical activity during daytime.
RAMADAN AND WEIGHT LOSS
Are you planning to lose weight? Well, Ramadan could be the right time to start:
- Avoid using too much oil when cooking. Replace cream soups with grain or vegetable soups.
- Use grilling or boiling cooking methods to prepare meals rather than frying.
- Eat lean red meat or skinless grilled chicken and more grilled fish.
- Substitute sweets with fresh fruits within the allowed limits. Eating two servings of fruits per day is sufficient with three dates being the equivalent of one serving, delivering about 60 to 70 calories.
- Use low fat or skimmed dairy products when preparing dishes and pastries during Ramadan and eat fat-free yoghurt.
- Observe moderation when eating raw and unsalted nuts.
- Substitute sweetened juices and concentrated drinks with fresh juices and limit intake to one cup per day.
- Increase fluid intake, especially water, between Iftar and Suhour.
- Eat fresh vegetables and serve salads without high-fat and mayonnaise dressings. Instead, use a small quantity of olive oil and vinegar without adding salt.
- Reduce the amount of starch by mixing steamed rice with vegetables or legumes to add flavor, and incorporate fiber into your dish that increases the feeling of fullness. One cup of cooked rice or spaghetti is sufficient for a meal.
- Figure out your everyday meals in advance. Irregular dining hours, tendency to overeat and the fried or starchy nature of many dishes are all contributing factors to an expanding waistline. Tackle this by planning your meals. By identifying the meals you want to prepare each day, you will reduce the amount you cook and introduce a healthy dish or a healthier cooking method.
- Continue exercising, for instance walking for 30 minutes a day, swimming or working out in an air-conditioned gym.
FASTING DURING PREGNANCY
Many pregnant women are able to safely fast, but there are exceptions. It is not medically advisable for women who have pregnancy complications such as diabetes and high blood pressure to fast.
Nutrition during pregnancy plays an important role in the health of both mother and baby. It is therefore extremely important for pregnant women who are fasting to be aware of how to fast safely.
- Avoid stimulants such as coffee, tea and soft drinks to reduce the intake of caffeine.
- Take care to consume a healthy and balanced diet.
- Drink sufficient amounts of water, between eight to twelve cups per day to avoid dehydration.
- Start Iftar with a glass of milk and some dates, followed by a variety of foods that contain all food groups.
- Eat a healthy snack before bedtime i.e. about an hour after Taraweeh prayer.
- Consume the permitted quantities of starches and keep away from saturated fats.
- Eat protein such as meat, chicken, fish, eggs and cheese.
- Take advantage of the opportunity to eat Suhour.
- Avoid excessive use of spices when cooking.
- Eat multiple meals in low quantities when permitted to avoid the feeling of satiety.
- Stay away from fatty foods and fries to avoid heartburn and weight gain.
- Eat at least two to three servings of fresh fruit daily.
- Perform some kind of physical activity for half an hour a day.
RAMADAN GUIDELINES FOR PATIENTS
- With Ramadan approaching, First Response Healthcare is urging patients with chronic medical conditions, such as diabetes and hypertension, to speak with their doctors before beginning a fast. Specialists from across the healthcare provider’s network of hospitals say it is imperative that patients seek professional advice before making any changes to their diet or medication regime.
- It is important for patients to talk to their doctor before making any modifications to the drug dosage, as changes can affect the medicine’s efficacy and the appearance of side effects. As an example, medications prescribed to be taken once or twice daily can normally be taken at Iftar or Suhoor, whereas medications that should be taken every six or eight hours may require a more complex solution that is best determined by a physician.
- Type 2 diabetics who have poorly managed blood glucose levels, elderly patients with Type 1 or Type 2 diabetes who take insulin, pregnant women who take insulin, and breastfeeding mothers who have Type 1 or Type 2 diabetes are generally advised not to fast. Patients with long term diabetes complications, such as kidney failure or heart disease, are also advised not to fast.
- Patients with diabetes should speak with their doctor or health educator about when and how often they should check their blood glucose levels. As a general rule, a reading of 80 – 180 mg/dl post meal is considered normal and it is advisable to eat the Suhoor meal as late as possible. Patients should refrain from strenuous workouts during Ramadan, particularly during the few hours before the sunset meal as this is when they are at risk for low blood sugar. Low intensity activity is encouraged and performing prayers should be considered as part of the daily exercise program.
- While fasting is not recommended for some heart patients, including those who have recently had a heart attack or heart surgery, research indicates that fasting is good for the heart. Fasting not only lowers one’s risk for coronary artery disease and diabetes, but it can also cause significant changes in a person’s blood cholesterol levels, increasing HDL-C, the ” good cholesterol” by 30 to 40 percent. However, it is important for patients to consult with their doctor, especially patients who take medications and will require timing and dosage modification.
- Many pregnant women are able to safely fast, but there are exceptions. It is not medically advisable for women who have pregnancy complications such as diabetes and high blood pressure to fast.
MEDICATIONS IN RAMADAN
Any patient intending to fast should be examined by his healthcare provider to assess him on an individual basis (especially those with diabetes and unstable chronic conditions). Your overall medical condition and treatment must be reviewed. You should also be informed of the potential risks fasting may have on your health. Changes and/or adjustments can then be made to your drug regimen to allow fasting. When Ramadan ends, you should ideally see your doctor to assess the effectiveness and safety of management during the fasting period. Any changes that have been made to the dosage regimen may now need to be switched back to the original treatment.
Here are some frequently asked questions on medications during Ramadan:
What medications are allowed during Fasting?
The following administration routes do NOT nullify fasting:
- Eye and eardrops.
- All substances absorbed into the body through the skin, such as creams, ointments, patches and medicated plasters.
- Injections through the skin, muscle, joints, or veins, with the exception of intravenous feeding.
- Oxygen and anesthetic gases.
- Nitroglycerin tablets placed under the tongue for the treatment of angina.
- Mouthwash, gargle, or oral spray, provided nothing is swallowed into the stomach.
- Nasal drops, nasal sprays.
How can I use my High Blood Pressure medications ( antihypertensive drugs)?
- Best taken at Iftar time, or/and at Suhoor time .
- Diuretics, preferable to be taken either with Iftar or about two hours following Iftar.
- If you use a beta-blocker medication (example: metoprolol, carvedilol, bisoprolol) should take the medication on an empty stomach/Iftar time.
- If taking calcium channel blockers (example: amlodipine, nifedipine). Avoid herbs that can increase blood pressure (like ginger and ginseng) and herbs that can lower blood pressure like garlic.
How can I use my asthma medications?
- Patient using the reliever spray should administer the medication whenever need arises, even if it is during the daylight hours of Ramadan.
- If using the preventer inhaler do so at Suhoor and at Iftar.
When I should take my medications for high cholesterol (hyperlipidemia) in Ramadan?
- Hyperlipidemia medications are given once daily, hence it is preferable to take your medication at bedtime or at Iftar time.
- Avoid high quantities of Grapefruit juice with statins (such as, atorvastatin).
How can I use levothyroxine during Ramadan?
- Levothyroxine is a Thyroid hormone in the form of tablets that is used as a replacement therapy in order to treat patients of hypothyroidism. During Ramadan, the tablets shall be taken once a day before Iftar.
When I should take my anticoagulant medications in Ramadan ?
- Most of anticoagulant medications are given once or twice daily so you can take your medication at Iftar time, or/and at Suhoor time.
Can I reduce my anticoagulant medications in Ramadan ?
- It is important to take this medication exactly as ordered, since too much of the medication can cause unusual bleeding , and too little can cause clotting.
How can I use my medications for epilepsy during Ramadan?
- Patients with conditions like epilepsy should consult their physician on rescheduling their medication timings and their decision to fast during Ramadan. Epilepsy medications are usually prescribed once or twice daily as the medications have a long-lasting effect. They can be taken after Iftar or Suhoor. If a patient has an epileptic seizure while fasting, they should break their fasting immediately.
- You should consult your doctor instead of changing your dosage yourself.
- Changing your medication dosage yourself affects how your drugs work, and consequently affect their effectiveness and safety.
Please seek medical advice before attempting any of the above.
RAMADAN HEALTH FAQS
Here are some frequently asked health questions about fasting during the holy month of Ramadan.These answers have been put together by medical experts and Islamic scholars and researchers.
Should you fast if you have diabetes?
People with type1 diabetes shouldn’t usually fast, but people with type 2 diabetes on insulin
should be able to. Their GP may advise adjusting the dose of their insulin, or their insulin type may
need to be changed.
I get severe migraines when I don’t eat and they get worse when I fast.
Should I fast?
People with uncontrolled migraines should not fast. But managing your migraines is possible with
the right medicine and certain lifestyle changes. Ask your GP for further advice on controlling your
Should you fast if you have high or low blood pressure?
People with well-controlled high blood pressure can fast. Your GP may advise you to change your
medicine to help you take tablets outside fasting times. Someone with low blood pressure who is
otherwise healthy may fast. They must ensure they drink enough fluid and have enough salt.
Can you fast if you’re getting a blood transfusion in hospital?
No. Someone receiving a blood transfusion is advised not to fast on medical grounds. They may
fast on the days when no transfusions are required.
I am on regular medication. Can I still fast?
Speak to your GP for advice on specific medicines.
Can you take tablets, have injections or use patches while fasting?
Taking tablets breaks the fast. But injections, patches, eardrops, and eyedrops don’t break the
fast as they’re not considered to be food and drink – though there are differences of opinion
among Muslim scholars on these issues. Islamic law says sick people shouldn’t fast.
Is Ramadan a good time to quit smoking?
Yes. Smoking is bad for your health and Ramadan is a great opportunity to change unhealthy
habits, including smoking.
From what age can children fast safely?
Children are required to fast when they reach puberty. It isn’t harmful. Fasting for children under
the age of seven or eight isn’t advisable. It’s a good idea to make children aware of what fasting
involves and to practice fasting for a few hours at a time.
Can I use an asthma inhaler during Ramadan?
Muslim experts have differing opinions on this issue. Some say using an asthma inhaler isn’t the
same as eating or drinking and is therefore permitted during fasting. In their view, people with
asthma can fast and use their inhalers whenever they need to.
Some people with asthma may opt for longer-acting inhalers so they can fast. See your GP for
Can I swim during fasting?
Yes, but don’t drink the water. A bath or shower, or swimming, has no effect on the fast. No water
should be swallowed during any of these activities, as that would break the fast.
Could dehydration become so bad that you have to break the fast?
Yes. You could become very dehydrated if you don’t drink enough water before the fast. Poor
hydration can be made worse by weather conditions and even everyday activities like walking to
work or housework.
If you produce very little or no urine, feel disoriented and confused, or faint as a result of
dehydration, you must stop fasting and have a drink of water or other fluid.
Islam doesn’t require you to make yourself ill when you fast. If a fast is broken, it will need to be
compensated for by fasting at a later date.
Can I fast while I have dialysis?
People on dialysis mustn’t fast and should perform fidyah, such as paying for someone to be fed.