Dr. Tariq Jagnarine

The Muslim holy month of Ramadan is currently ongoing. The ninth month of the Islamic calendar is a month of fasting. Fasting during Ramadan carries a high risk of dehydration, as food and drink are limited to before sunrise and after sunset. Furthermore, as fasting individuals are encouraged to wake up very early to have their Sahur/Suhoor (or pre-dawn meal), sleep deprivation and dehydration can lead to headaches.
People with health issues like diabetes may face many challenges in fasting during the month of Ramadan. Those who have early diabetes, which is well controlled with small doses of medicines, can fast safely; but those people who have advanced disease — who are taking multiple medicines, including insulin or any other medicines, such as sulfonylureas, which can cause episodes of low sugar; or those people who have significant medical comorbidities, like heart disease, kidney disease or liver disease — fasting may not be a very safe option. They need to be more prepared to avoid any complications or risks of fasting.
It’s always better to discuss the desired change in the treatment plan before starting to fast. Ask a doctor whether fasting is safe. So, there is a risk of glucose levels going up and down. Risk is both hypoglycemia and hyperglycemia for people with type 2 diabetes, because there’s very long fasting starting from early morning to the evening, when the glucose levels can go down. If people are using insulin or sulfonylureas, and if the meal choices are not right, then there will be the risk of sugar levels going very high at night time if people eat meals with high carbohydrates, or sugary fruits and juices, etc. So, to avoid these fluctuations, plan meals accordingly, discuss the treatment plan, appropriate changes, the timing of the medicines: if anything needs to be changed during the days of fasting, and stick to non-sugar fluids to keep yourself hydrated.

Stay hydrated
Begin and end the fast with plenty of water, to prevent dehydration. Incorporate hydrating foods like watermelon, cucumbers and soups during non-fasting hours to maintain hydration levels throughout the day.

Balanced meals
Opt for balanced meals that include complex carbohydrates and lean proteins, healthy fats and fibre-rich foods, to sustain energy levels and promote satiety during fasting periods. Avoid overindulging in fried or sugary foods during Iftar to prevent digestive discomfort.

Nutritious meals
Start the day with a nutritious meal that includes slow-digesting foods like oats, whole grains, eggs and yogurt, to provide sustained energy throughout the day. Avoid excessive caffeine and salty foods, which lead to thirst and dehydration during fasting hours.

Moderate exercise
Engage in light to moderate physical activity during non-fasting hours, to promote circulation, improve mood, and maintain muscle mass. Opt for activities like walking, yoga, or stretching, and avoid strenuous exercises during peak fasting times in order to conserve energy.

Mindful eating
Practise mindful eating during Iftar and Suhoor by chewing slowly, savouring each bite, and paying attention to hunger and fullness cues. Avoid overeating by starting with small portions and taking breaks between servings to allow the body to register satiety.

Hygiene practices
Maintain good hygiene practices, including regular handwashing, proper food handling, and cleaning food preparation surfaces, to prevent foodborne illnesses and gastrointestinal issues during Ramadan.

Manage stress
Prioritise stress management techniques such as deep breathing, meditation, prayer, and spending time with loved ones in order to promote emotional well-being and reduce cortisol levels, which can affect hunger and digestion.

Consult with healthcare provider
If you have pre-existing medical conditions or concerns about fasting, consult with a healthcare provider or registered dietitian to ensure that fasting is safe and appropriate. They can provide personalised guidance and recommendations based on individual health needs.

Listen to your body
Pay attention to the body’s signals, and adjust the fasting routine based on the feelings. If you experience symptoms like dizziness, weakness, or extreme thirst, break the fast and prioritise rehydration and nourishment to maintain overall health and well-being.
Use this Ramadan to cultivate good dietary and other healthy habits, and by the time the fasting month ends, you will feel healthier.