Abu Dhabi: Pregnant women may wonder if it's safe to fast during Ramadan, diabetics may question whether they can delay their insulin and medication intake to after iftar, and some families speculate on early age fasting.
Being the most blessed month of the year, many Muslims, regardless of their health condition, choose to fast during Ramadan, however pregnant women, children, and those with a medical condition, are advised to consult a physician before they do so.
Four prominent women dieticians from Al Rahba Hospital, offer tips on how to stay hydrated and healthy during Ramadan if you are either pregnant, diabetic or young.
Al Rahba is managed by Johns Hopkins Medicine International, under the Abu Dhabi Health Services Company (Seha) and located a few blocks from the E11 highway connecting Dubai and Abu Dhabi.
Reema Al Tamimi, dietician at Al Rahba Hospital, offers tips on staying fit as a pregnant mother during Ramadan. A pregnant or lactating woman's needs for energy and nutrients are more critical during Ramadan, and the emphasis should be placed on nutrition. Overeating isn't healthy, and a mistake that some pregnant mothers make.
Biggest challenge
Simply rest as much as possible, and spread meals between dusk and dawn, getting the body used to a healthy balance of proteins and carbohydrates during this time period.
Staying well hydrated is perhaps the single biggest challenge for a pregnant or breastfeeding woman. The good news is research tells us that short-term fasting will not decrease a woman's ability to nurture a baby still in the womb or to breastfeed.
Severe dehydration is one of the most common health issues seen during Ramadan every year. Water should remain as the foundation for any pregnant woman. Adding electrolytes, water-solvent nutrients, and fresh juices are very important in keeping nutrient levels high and constant even during daytime fasting.
Women who suffer from severe nausea and morning sickness through the first three months of pregnancy will begin to lack essential fluids and minerals. In these cases, women may be advised to take small nutrients and fluid injections which can have a very positive — and fast effect on restoring normal levels of fluids and minerals. This is technically ending the fast, but sometimes necessary until excessive morning sickness stops.
Amani Kamal, dietitian at Al Rahba Hospital said fasting provides benefits to healthy individuals. The use of fat for energy aids weight loss, preserves muscle strength, and in the long run reduces cholesterol levels. In addition, weight loss results in better control of diabetes and reduces blood pressure.
Ramadan is also a time for your body to go through a natural detoxification process. After a few days of the fast, higher levels of certain hormones appear in the blood, called endorphins, resulting in a higher level of alertness and an overall feeling of mental well-being.
Dehydration is common when fasting, as the body continues to lose water and salts through breathing, sweating, and urinating. The quantity of water loss varies, depending on the weather, how much you had to drink before your fast, the degree of physical exertion, and the ability of the kidneys to retain water and salts.
If you do need a dehydration cure, try rehydrating with moderate quantities of water mixed with sugar and salt, or oral rehydration fluids. In the event that you faint due to dehydration, whoever is with you should raise your legs above your head and hold them there. When you come round, you should urgently rehydrate as outlined above.
To prevent muscle breakdown, meals must contain adequate levels of "energy food". Most vegetables and fruit are more than 70 per cent water and full of vitamins, sugars and trace minerals essential for good body chemistry. Choose vegetables with dark colouring (more nutrients), fruit rich in vitamins such as berries and bananas, and put it all into a blender. Add fresh yogurt, peanut butter or nuts and blend to make a snack you can sip on throughout the evening and store in the fridge for a ready-made suhour in the morning.
Although there's an urge to stay awake for long hours during the night, tea, coffee, and cola should be taken in moderation as caffeine is a natural diuretic, stimulating faster water loss. This effect will remain until the following day. Anything that is heavily-processed is also not going to give your body everything it needs to stay healthy. Fast-burning foods that contain refined carbohydrates in the form of sugar and white flour may taste good, but they won't sustain energy levels for long and will actually increase your body's thirst.
Fatima Al Marzouqi, dietician at Al Rahba Hospital, discusses early age fasting in Ramadan.
For a growing child, eating fresh or dried fruit is very important to keep blood sugar constant throughout the evening and daytime, in turn easing the fasting process by reducing the amount of "sugar lows" caused by artificial sugars.
Children shouldn't fast on the days they don't have suhour as advised by the Hadith.
Children under the age of ten shouldn't fast the full month of Ramadan, as the aim of allowing children to fast is just to get them used to performing the ritual once their bodies are physically capable of doing so safely.
Encourage obese children to take the opportunity to reduce their weight by avoiding large amounts of food and eating several smaller, more frequent meals.
Ensure any child interested in fasting has been screened for chronic diseases such as asthma, diabetes, and blood diseases such as thalassaemia. Often these diseases are not so apparent in young people while the potential for danger by fasting is increased dramatically.
Smaller meals
Most parents prefer that their children fast only part of the day, encouraging them to be honest regarding their fasting. Discuss this with youngsters beforehand so they can benefit as much as possible from the experience.
Khowla Al Hosani, dietician at Al Rahba Hospital, offers tips on controlling diabetes during Ramadan.
Muslims with Type 2 diabetes not requiring insulin can usually fast without problems, and those needing one insulin injection daily can also fast without major problems. It's advisable to consult your doctor on the correct type of insulin to be used, and how your routine may change during the fasting month.
If your diabetes is well controlled and you're otherwise healthy, you're at low risk of fasting related complications. This will generally include people who can control their diabetes with diet alone, or with oral anti-diabetic drugs.
If blood glucose is less than 70mg in the first few hours after the start of the fast — especially if insulin or other drugs are taken at predawn — stop fasting. You should also break the fast immediately if your blood glucose is less than 60mg at any time, even if symptoms are mild.
Check blood glucose levels many times daily and write the results, date and time in your diabetes record.
Record your weight daily and inform your doctor of a change of more than two kilograms during Ramadan.
Eat a healthy diet with two or three smaller meals during the non-fasting period to prevent after meal hyperglycaemia (high blood sugar).
Avoid large amounts of complex carbohydrates (potatoes, wheat bread) and fried foods when ending the fast at Iftar. Instead, eat more simple carbohydrates as these are digested faster (fruit & yogurt), eating complex carbohydrates before the start of the daily fast to help maintain a normal blood sugar during the fast. Exercise is a great way to avoid hyperglycaemia. The best time for exercise is two hours after the sunset meal. Light exercise is recommended. However, test your blood sugar before you exercise.
