Persons with medical conditions should consult doctors before fasting: Dr Sheikh Mohd Saleem
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Persons with medical conditions should consult doctors before fasting: Dr Sheikh Mohd Saleem

Post by on Wednesday, April 20, 2022

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Ramadan is a month of spiritual reflection for Muslims worldwide. During Ramadan, Muslims refrain from eating and drinking from pre-dawn to dusk. Although exempted from fasting, many patients undergoing treatment also fast. 


Dr Sheikh Mohd Saleem, public health expert, health consultant UNICEF J&K, in conversation with Rising Kashmir’s Senior Health Correspondent, Mansoor Peer talks about the health benefits of fasting and how people should stay healthy and maintain their eating habits.


Does fasting help to lose weight by utilizing extra body fat for body energy?

Traditionally, the best way to lose weight has been to limit calories. Replace ordinary drinks with diet coke, and eat an apple instead of a cookie and you'll lose weight, that’s the norm.

Instead of attempting such calorie reductions, many people are increasingly pursuing more strenuous measures to reduce their average daily calorie counts. This latest diet method, known as intermittent fasting, takes a unique approach.

You modify when you eat rather than how much you consume. Intermittent fasting is informally described as times of not eating followed by periods of eating. Fasting’s beginnings may be traced back to religion. Researchers revealed that skipping meals had a few health benefits, including weight loss and decreased blood pressure and cholesterol.


How does all this work?

Normally, our pancreas releases the hormone insulin after we eat. That burst of insulin aids in the transport of sugar from our bloodstream into our cells, where it may be utilised for energy production. Whatever sugar is left over, it is either absorbed by our muscles or processed and stored as triglycerides in our fat cells. Fasting causes insulin levels to drop, causing our bodies to burn stored fat for energy.


Does fasting help improve mental health? 

Fasting throughout the month of Ramadan provides several benefits for people who suffer from moderate depression, anxiety, or sleeplessness. Fasting, as well as the spiritual and social rituals that accompany it, help these people to tolerate and cope with life's anxieties and misfortunes, allowing them to achieve a state of tranquillity.

During Ramadan, fasting and accompanying acts of devotion, such as evening mass prayer foster communication and social engagement among people. Fasting is believed to result in the release of endorphins - body’s naturally released ‘happiness’ hormones.

Patients with mild to severe depression who participate in such activities tend to be distanced from their reclusive lifestyle and, on the other hand, become very upbeat and begin to think favourably of themselves and the people around them.


How can people avoid the increased risk of dehydration during Ramadan?

Fasting increases the danger of dehydration if Ramadan falls in summer, it can cause tiredness and nausea. Children, elderly, those with diabetes, renal illness, other chronic conditions, anyone who engages in physical activity are more likely to get dehydrated.

Severe dehydration is characterised by symptoms such as a dry mouth, dry and wrinkled skin, sluggishness, loss of focus, overall fatigue, oversleeping, trouble urinating, constipation, and cardiac arrhythmia. Individuals who suffer any of these symptoms or are suspected of having dehydration should contact their doctor right away.

During Ramadan, the following techniques and advice might help you avoid dehydration: Between Iftar and Suhour, drink 8-12 glasses of water. It is recommended to consume lukewarm water rather than cold water since it is more quickly absorbed by the body.

Soup is a healthy source of fluids and is suggested to be consumed every day. Furthermore, fruits and vegetables with high water content, such as watermelon, tomatoes, cucumber, grapes, and so on, aid in the reduction of thirst.


What is your advice for pregnant and breastfeeding women before fasting in Ramadan?

Pregnant or nursing women who don't feel well enough to fast during Ramadan, or who are concerned about their health or baby should consult their doctor before fasting.

While fasting, they should take numerous breaks throughout the day and ensure that they acquire the proper nutrients and calories when they break their fast each evening. They should also drink up to three litres of water during Suhoor and Iftar. Pregnant women should also avoid eating sweets and other sugary foods after Iftar.

Fasting is not recommended for women who have pregnancy issues such as diabetes, high blood pressure, or anaemia. Fasting should be avoided by pregnant women with certain underlying disorders to protect themselves and unborn offspring from further complications.

Women who solely breastfeed their children are not required to fast during Ramadan. Most Muslim scholars think that women who are nursing are exempt from fasting. Before fasting, such moms should examine their overall medical status by seeing a physician.


Do we need to establish regular sleeping patterns during Ramadan?

Establishing and sustaining normal sleeping habits during Ramadan is a critical step for re-adjusting after the holy month. Many individuals have frequent and irregular sleeping patterns because they stay awake at night. 

This is frequently due to a shift in their bedtime and wake-up pattern, which might raise the chance of developing a biological clock issue such as delayed sleep phase syndrome (DSPS) or melatonin secretion rhythm abnormality. People who vary their sleeping and waking routines may experience drowsiness, headaches, and mood fluctuations.

What’s your advice for diabetics fasting during Ramadan?

Before fasting during Ramadan, diabetics should take the appropriate measures and visit their doctor. For diabetics, the choice to fast includes number of possible hazards and problems. Individuals with diabetes who wish to fast should seek medical consultation and specific recommendations on medication and dietary changes.

Diabetics who opt to fast should be informed of the health hazards. They must also be willing to follow the advice of their healthcare team to have a safer fasting experience.


Do patients with heart diseases need to take care when fasting?

To minimise difficulties, those with cardiac issues should take special measures when fasting during Ramadan and consult their cardiologists, particularly in deciding the right timing and dose of their medications.

Patients should consult their cardiologists on how their medication should be administered during Ramadan. Patients and doctors may have to explore the possibility of substituting ordinary medication with long-lasting ones to compensate for the daily fasting time.


What is your advise for kidney patients?

Patients with renal problems are encouraged to exercise caution if they opt to fast. Chronic kidney disease (CKD), a long-term disorder characterized by the progressive loss of kidney function, is classified into five stages based on severity.

The severity of a patient's renal illness might suggest whether or not he or she will be able to fast safely. Patients with acute renal failure, for example, should not fast until they have fully recovered.

CKD patients, on the other hand, have different stages of nephropathy (kidney disease), and patients diagnosed with stage three or higher CKD are advised not to fast because their kidneys fail to retain normal rates of body fluids, making them vulnerable to further renal dysfunction and renal damage.

Fasting is particularly discouraged for kidney transplant patients owing to the requirement to adhere to their specified medication dosages and schedules.

Fasting may have a deleterious influence on the health of many kidney transplant patients who are diabetic. As a result, it is critical that these patients check with their doctor before embarking on a fast.

Pre-dialysis renal patients should drink two to three litres of fluid per day if their urine volume is normal; otherwise, they should lower their fluid intake to minimize water retention, which can harm the heart and lungs.

When fasting, individuals with kidney illness should avoid spending substantial time outside in extreme temperatures, and they should also avoid consuming salty meals.


What do you advise for those with high blood pressure during Ramadan?

Because people with high blood pressure may have no symptoms for years, it is dubbed the "silent killer." Despite the fact that it is a common and widespread disease, many individuals are unaware that they have it unless they have symptoms.

The majority of medical research has proven that people with hypertension may finish their fast if they do not have any difficulties or other medical concerns. If you have high blood pressure and want to fast, it will not affect your blood pressure equilibrium.


What are the foods that should be avoided in Ramadan?

Individuals who opt to fast throughout should pay attention to their nutrition, as the disruption of their typical diet and eating patterns may cause discomfort and heighten food sensitivities, particularly when consuming certain types of foods heavy in sugar or fat.

During Ramadan, it is typically advised to avoid or limit certain types of meals, such as: 

? Fried and fatty foods like fried potato and samosa. These items include a high percentage of the daily required fat and salt consumption, consuming them regularly may exacerbate the fatigue and exhaustion caused by Ramadan fasting.

? Pickles and other foods with high salt content. Sodium has the potential to dehydrate the body and impair its ability to absorb water.

? Foods that contain a lot of sugar. These meals are frequently rich in calories while being low in nutritional value. While these nutrients deliver quick energy to the body, the energy is usually transient.

? Foods containing chocolate or any other caffeine source. Caffeine is a diuretic, which means it causes the body to lose fluids, salts, and other essential elements.


What is your message for our readers from you, this Ramadhan?

Be careful not to overeat during Ramadan. Large amounts of food or an imbalanced diet during Iftar can cause stomach distress and intestinal issues, which can aggravate pre-existing health concerns.

People's health might suffer during Ramadan if they eat past the point of fullness at the time of breaking their fast. As a result, our hospitals are seeing an increase in the number of patients with gastrointestinal issues in the Emergency Department.

Overindulging violates the aim of the fast if they do not keep a modest food intake. It can also cause weight gain and obesity, as well as consequences such as diabetes and heart disease. Fasting may help us establish a healthy lifestyle, as well as strengthen community bonds and increase compassion and generosity.

Abdominal discomfort is one of the most typical symptoms of Ramadan overeating. This occurs when individuals eat extremely rapidly following the Maghrib adhan (call to prayer). High carbohydrate content in meals causes bloating, which is the most common cause of stomach aches.

The easiest approach to avoid becoming sick is to prepare your Iftar meal ahead of time and make sure it is light, with enough of drinks to keep you hydrated and energized.


What should an ideal Ramadan diet be like?

Ramadan is a chance to break poor eating habits that are harmful to our health and replace them with better and more nutritious meals. Fasting relaxes and strengthens the digestive system while enhancing its efficiency and aids in the adjustment of blood triglyceride levels.

Despite this, many people have broken the rule. People typically break their fast with sumptuous feasts rich in a variety of cuisines, sweets, and fried food, leading to a rise in triglycerides and cholesterol, and maybe diabetes and weight gain, which is the reverse of what the fasting individual is attempting to achieve.

Rather than being deprived of food and sweets, what is necessary is a balanced and nourishing meal in terms of amount and quality.

The ideal meal plan

1. Soups and salads should be included in your diet.

? Avoid fried and fatty foods as much as possible.

? Avoid consuming sweets on a daily basis throughout Ramadan, and instead save them for exceptional occasions (such as dining out or inviting guests to the Iftar meal).

     ? Iftar meal: Eat three dates with one cup of water first.

2. Eat soup on a daily basis. Avoid creamy and fatty soups and replace them with vegetables, lentils, barley, or chicken soups (cream-free).

3. Appetizers: Appetizers should be consumed after soup to prepare your stomach for the digesting process. As a result, vegetable-rich appetizers such as fatoush, green salad, and taboule dusted with a dash of lemon or vinegar and no extra salt are advised.

4. The main course: It is preferable that Ramadan tables feature one main dish, as food variety and indulgence generally lead to overeating.  Carbohydrates such as rice, pasta, bread as well as protein such as red meat, chicken, or fish, should be included in Iftar meal.

5. Late-night snack: The food offered at this meal is a balancing act that is determined by the person's food consumption at the previous three meals. For example, if a person has a substantial Iftar, the late-night snack should be light, as opposed to the tradition of indulging in lavish late-night feasts with major courses, fried foods, and sweets, then going to bed immediately after eating, which might lead to health concerns.

For example, you can eat carbs (whole wheat bread, rice, pasta, etc.) while switching the protein source to a vegetarian protein (fava beans, chickpeas, lentils, etc.)

Include a salad to guarantee that the body's fibre, vitamin, and mineral requirements are satisfied. Avoid serving fried foods and sweets at this meal and remember to drink sufficient amounts of water to ensure an adequate supply of the body’s requirements for liquids.

6. Suhoor meal: Suhoor is ideally eaten half an hour before the call for prayers (Adhan). You can eat something light before starting your fast. You can include:

? Whole grain bread with a fruit piece.

? Cereals made with fresh milk and dried fruits

Avoid sweets, which might boost your appetite a few hours after you begin your fast. Avoid salty meals as well since they make you thirsty.

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