Is it safe to follow the keto diet while fasting during Ramadan?

Three experts weigh in on the pros and cons of the diet during the holy month

Experts are divided on whether or not keto is safe while fasting. Photo: Be More Keto
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With Ramadan rapidly approaching, Muslims around the world are preparing to fast.

The holy month is often a time when Muslims cleanse their diet of bad eating habits and embark on a journey towards health.

This Ramadan, many health-conscious people are turning to the ketogenic diet as a way to lose weight, increase energy and improve mental clarity.

But what is the keto diet and is it healthy to follow it while fasting?

The keto food planner

Put simply, keto is an extremely low-carbohydrate, high-fat diet that puts the body into a state of ketosis, forcing it to use fat for fuel in the absence of carbs.

Nyma Peracha, founder of food plan delivery service Be More Keto, has followed the diet for six years and sticks to it while fasting during Ramadan.

“It’s very healthy to do the keto diet while fasting,” says Peracha, a practising Muslim. “The whole point of fasting during Ramadan is to detoxify our bodies.

“Keto has a bad reputation because people go into it without knowing what they’re doing, but when done correctly it has huge benefits.”

Peracha started following the diet as a way to balance her hormones, and launced her meal plan company to share the benefits with others.

“When you’re fasting, your body is using fat stores throughout the day,” she explains. “Then when you break your fast your body stays in that fat-burning stage because you’re feeding it with fats, rather than carbs.”

Before taking up keto, Peracha struggled with her sugar intake during Ramadan.

“I have a very sweet tooth. I used to break my fast with something like lentil soup, but then I’d need a sugar fix a little while later,” she says.

“When you eat carbs, your insulin level spikes; and when your blood glucose levels drop, you need sugar. With keto, my blood sugars are more stable.”

Now, Peracha has more energy than ever before during Ramadan and credits her low-carb lifestyle for her stamina.

During the first three to five days of following the keto diet, you’re also likely to experience keto flu
Nyma Peracha

“Nine out of 10 times I go to the gym while fasting on the keto diet,” she says. “If anything, it increases my energy.”

Despite being a staunch advocate of the keto diet, Peracha admits there can be difficulties and says she has faced her own fair share of challenges. “Doing keto can make you dehydrated as high fats don’t carry as much water,” she explains. “I’d recommend drinking one litre of extra water every day, which can obviously be quite hard during Ramadan.

“During the first three to five days of following the keto diet, you’re also likely to experience keto flu, during which your body transitions from using carb energy to using fats.

“In both of these cases, electrolytes are your best friend.”

The doctor’s case against the keto way

The keto diet has caused controversy over the years with experts falling on either side of the fence.

Dr Lina Shibib, a nutritionist at Medcare Hospital who has a PhD in diabetes, strongly advises against the keto diet, especially during Ramadan.

“It’s not healthy, particularly when your body is already deprived,” she says.

“This year, we will be fasting for about 11 hours a day. It’s a long time, especially in the heat that we live in, and there’s the risk of dehydration.”

For Shibib, a practising Muslim, carbohydrates should form part of every iftar in order to sustain the body during the following day.

However, in recent years, she has seen more people than ever turn to “fad” diets while fasting.

“A lot of people use Ramadan as a reason to diet because their routine is already disturbed and they take it to extremes,” she explains.

“Unfortunately, diets like keto are always popular around this time of year and a lot of my patients are starting to cut carbs this week to prepare their bodies in advance.

“Everybody knows their own limits and everybody has the right to take control of their health and diet, but if you’re set on doing keto I would recommend doing it in the winter when your body doesn’t require as much sustenance.”

In extreme cases, Shibib has seen people being rushed into hospital because of a lack of sustenance.

If anything, you should be giving your body all of the nutrients possible. Give it macros, micros and just look after yourself
Dr Lina Shibib

“It’s not rare for people to faint because they’ve gone on some crazy diet during Ramadan,” she says.

“There’s no equilibrium between what you’re putting into your body and your energy expenditure.

“If anything, you should be giving your body all of the nutrients possible. Give it macros, micros and just look after yourself.”

The nutritionist’s dramatic weight loss

Nutritionist Shirley D’Souza shed 35 kilograms by following the keto diet and says it can be good if done right.

Despite being a non-Muslim, she plans to fast this Ramadan and intends to keep up the keto diet, but admits it’s not for everyone.

“I’d encourage anyone thinking about doing the keto diet to do their research,’ she says. “It’s not completely safe to start the keto diet while fasting.

“If you’re doing keto before Ramadan, then it’s a great time to heal your body. If you jump straight into it, however, you’re going to have a sugar crash and you’re going to run into problems. You have to do it properly.”

As well as drastically cutting down on carbohydrates and increasing healthy fats, D’Souza recommends eating plenty of green vegetables for potassium and protein for magnesium.

And, when it comes to seeing results, she says consistency is key.

“You’ve got to give it a couple of weeks to reap the benefits,” she says. “If you’re eating high amounts of fat and then revert to large quantities of carbs, you're going to gain weight.

“That being said, if you begin to feel weak or experience consistent headaches, I’d recommend getting off it.”

Most importantly, D’Souza advises getting medical advice before starting the keto diet.

“Keto isn’t the best approach for everyone,” she says. “All good nutrition is about finding what works for you and doing your best to stick to it.”

Updated: June 01, 2023, 8:29 AM