During Ramadan, Muslims fast from dawn until sunset. This year brings new challenges because the length of the day increases as the holy month progresses.
For many, fasting can be a challenge and people must address issues ranging from how to exercise while fasting to how to control conditions such as diabetes.
Over-indulging at iftar and suhoor can be tempting but can cause weight gain. But by following simple guidelines, it is possible to fast safely and look after your health.
Dr Farhana bin Lootah, an internal medical consultant at Imperial College London Diabetes Centre, part of Mubadala Health, outlines how to navigate the holy month in a healthy way.
Preparing to fast for people with diabetes
More than one in six people in the UAE have diabetes and it is a factor in more than two thirds of deaths of people under 60. People with diabetes need to take a few extra precautions while fasting but, provided they have been medically cleared to fast, there is no reason they should not be able to do so healthily.
1. Consult a doctor
Some people with diabetes are advised not to fast, so you will need to ask your doctor whether it is safe for you.
2. Space out your meals
Resist the urge to eat continuously from iftar until just before fajr. It is a good idea to pace your mealtimes during the non-fasting hours. At iftar, break your fast with a light snack such as water and dates, then about an hour later, eat a full meal. In the morning, just before fajr, eat suhoor.
3. Choose food wisely
Eat protein with each meal because it increases your feeling of being full. Your dietician can help to calculate your protein requirement. It is advisable to include fruit, vegetables and yoghurt in your meals and healthy fats such as avocado, olive oil, and fish. Opt for complex carbohydrates such as wholegrain bread, nuts and brown rice.
4. Rehydrate well
Drink plenty of fluids (sugar-free), particularly water, to avoid dehydration.
5. Plan to incorporate moderate exercise into your day
Moderate physical activity every day is a healthy option. Walking is one of the most recommended activities for patients. Avoid excessive exercise when fasting.
Ramadan and weight management
While it sounds counterintuitive, some people put on weight when fasting.
Dr Farhana advises that food eaten at iftar and suhoor be simple and not differ very much from your normal diet. It should contain foods from all the major food groups.
Some foods should be avoided, such as processed, fast-burning foods that contain refined carbohydrates, such as sugar and white flour; deep-fried foods, for example pakoras, samosas and fried dumplings; foods high in sugar and fat, including sweets such as gulab jamun, rasgulla and balushahi; and high-fat cooked foods, for example, parathas, oily curries and greasy pastries.
Instead make or choose healthier options such as baked samosas; chapattis made without oil; baked or grilled meat; homemade pastry; and milk-based sweets and puddings. Water is the most important fluid to replenish your thirst during Ramadan.
"Unfortunately, some people do not drink enough water and have only small amounts at iftar and then forget to drink water until the next day," Dr Farhana said. It's also helpful to avoid caffeine-based drinks, especially fizzy drinks. Caffeine is a diuretic and can stimulate faster water loss.
Our bodies have trouble coping with a sudden, high intake of food if we overindulge at iftar, leading to indigestion and heartburn, Dr Farhana said. Other common digestive problems include bloating, constipation, nausea and vomiting. Generally, problems occur when people try to eat too much too soon.
“It’s important not to try to consume the amount of food normally eaten during an entire day in just six to eight hours. Focus on eating gradually, beginning with fluids and non-fatty, low-calorie food."
Ramadan and exercise
It is important to incorporate regular exercise into your routine.
“As simple as it may sound, a brisk walk for 30 minutes a day, five times a week, greatly reduces the chance of developing diabetes."
Dr Farhana said the benefits of regular exercise include better blood glucose control, increased insulin sensitivity and weight management. Other benefits include lowered blood pressure, decreased risk of heart disease and stronger muscles and bones.
She suggested that people take some moderate exercise just before they break their fast at iftar, and again just before going to bed, as well as right before suhoor.
Returning to normal eating
It is important for everyone who fasts, especially for patients with diabetes, to reintroduce foods in a controlled and disciplined manner once Ramadan is over.
"Returning to a normal diet after Ramadan may be a shock to your body and could trigger undesirable side effects if not managed properly," Dr Farhana said.
To avoid this, Dr Farhana advises starting with small meals and chewing foods slowly to encourage proper digestion. “Practise the 80/20 rule: that is, eat slowly and only until you feel 80 per cent full. By eating slowly, you are allowing your brain to register the food in your stomach, which in turn leads to increased satiety levels and prevents over-consumption of food.” As many people choose to continue fasting for six days of Shawwal after Eid, she advises them to continue with the healthy eating tips they practised during Ramadan.