CHENNAI: The ninth month of the Islamic calendar is the holy month of Ramadan, during which many Muslims around the world observe a 29-30-day fast. An iftar meal to break one’s fast after the sun sets and suhoor, a short meal before dawn, are common Ramadan customs.
Ramadan fasting causes extended periods without nutritional intake and restriction with regards to the period of eating and drinking throughout the day because it requires abstaining from food and liquids from dawn to sunset. Special eating rituals may also alter dietary choices. Meals during Ramadan could be high in calories, drinking less water in hotter climates might make you dehydrated, you might overeat right before bed, and your typical sleep patterns might be disrupted.
Ramadan fasting is an integral part of the Muslim religion, and body composition changes, although small, may be additive and, over the long term, may have various implications on energy requirements, depending on whether a change in body weight is the result of a reduction in body fat or lean mass.
During fasting hours when no food or drink is consumed, the body uses its stores of carbohydrates (stored in the liver and muscles) and fat to provide energy once all the calories from the foods consumed during the night have been used up. Depending on the weather and the length of the fast, most people who fast during Ramadan will experience mild dehydration, which may cause headaches, tiredness and difficulty concentrating. Once the fast is broken, the body can rehydrate and gain energy from the foods and drinks consumed.
While breaking a long fast, it is preferable to eat slowly and start with a lot of fluids and low-fat, fluid-rich foods. It’s crucial to drink a lot of liquids and eat meals abundant in fluids including fruits, vegetables, yogurt, soups, and stews, to replenish the fluids you lose throughout the day and prepare your body for the fasting day the next day. As salt increases thirst, it’s best to limit your intake of salty meals. Suhoor, the meal eaten before dawn, gives water and energy for the upcoming fasting day, so it’s crucial to choose healthy foods.
Iftar
When breaking the fast, go for plenty of fluids, low-fat, fluid-rich foods and foods containing some natural sugars for energy (avoid consuming a lot of foods or drinks with added sugars).
Options: Dates, smoothies, fruit juices, fruits, soup
Suhoor
Drink plenty of fluids, and choose fluid-rich foods to make sure you are well-hydrated for the day ahead. Choose high-fiber or whole grain varieties where possible as these can help keep you feeling fuller and aid digestion, helping to prevent constipation.
Options: Oats, yogurt, bread, starchy foods, fiber-rich breakfast cereals. People with diabetes, who fast, require nutrition education, knowledge of diabetes management plans and adaptations to self-monitoring of blood glucose (SMBG) schedules and medication regimens. The insulin sensitivity during fasting and deficiency of insulin can lead to excessive breakdown of glucose among people with diabetes which can cause potential health hazards such as hypoglycemia, hyperglycemia, dehydration and acute metabolic complications such as diabetic ketoacidosis (DKA).
Pre-Ramadan-focused education plays a vital role in ensuring safety during Ramadan for people with diabetes. Dietary recommendations to people with diabetes need to be individualised, accounting for an individual’s personal preferences, lifestyle, age, ability to manage their diabetes and other medical needs.