Fasting is an important spiritual aspect of many religions, such as Islam, Hinduism, Christian and Judaism, the abstinence from food (and sometimes drink) Fasting is also usually a time of prayer, reflection and purification. Depending on the Religion, fasting will last for different lengths of time. In Hinduism, Christian and Judaism there tend to be individual days of fasting. However, Ramadan is the ninth month of the Islamic calendar with duration of 29-30 days. Fasting in Ramadan is obligatory for all adult healthy Muslims which amount to refraining from eating; drinking, taking oral medications and smoking from predawn to sunset so there are no restrictions on food or fluid intake between sunset and dawn. It usually consists of two main meals; a Predawn Meal (Suhoor ) and the Sunset Meal (Futoor). the time period of fasting varies from around 10 to 20 hours depending on the geographical location and the time of the year.
Fasting in Ramadan causes a major change in the dietary patterns of individuals with diabetes in comparison to the rest of the year. Changes in meal timings also take place and a person takes 2-3 meals a day as opposed to the 5-6 meals that are suggested normally. People generally tend to over eat during this period and the diet is typically rich in carbohydrates and fats which may lead to post prandial hyperglycemia as well as weight gain
If you are already following a healthy balanced diet, as is recommended for everyone, then there is a big chance that you do not have to change the ingredients of your diet.
In fact, you should eat as you normally do, with the only difference being the time you eat your meals, rather than quantity or type of food consumed. also, eat slowly when breaking your fast. This will help you avoid indigestion, as well as help your blood sugar levels come into balance more easily.
The Ramadan diet should be kept simple and contain foods from all the food groups including: bread, cereals or rice, meat, chicken, fish or beans – milk, Laban or yogurt, fruit and vegetables
It is important to ensure that futoor (Sunset Meal) remains a meal and does not become a feast. One other thing to be particularly aware of is the risk of increasing blood sugar levels after futoor, especially if you eat sweet food. high calorie foods rich in refined carbohydrate and high fat foods such as samosa (baked pastry with savory filling), falafel (fritters), spring rolls, fried bread (fried flat bread), deep fried sweetened flour pretzels should be avoided.
Eating dates traditionally marks the end of a fast but they are very rich in sugars. A portion of 1-2 dates may however not raise blood glucose.
It is advisable to have the evening meal or dinner as early as possible at futoor. This should comprise of whole wheat flour bread, vegetables and a meat dish.
Salads should be taken to increase the Fiber intake.
You must take special care to increase non- calorie fluid intake during the non-fasting hours, so that you remain comfortably hydrated during fasting hours.
At suhoor (Predawn Meal) you should eat complex carbohydrates that release energy slowly & your blood glucose levels more stable throughout the fast such as multigrain bread, oat-based cereals, semolina, beans, pulses, lentils, fruit and vegetables etc.
Long hours without eating increases the risk of hypoglycemia (low blood sugar levels). You must try to eat a meal at Suhoor just before sunrise and not at midnight, as is common practice. This will help to keep your glucose levels more balanced throughout the fast & prevent rapid stomach emptying.
A late night snack with a glass of milk or a portion of fruit will maintain normoglycemia till the suhoor meal.
Avoid caffeine-based drinks such as tea, coffee and cola. Caffeine is a diuretic and stimulates — water loss through urination.
As with all meals, eat sensibly, do not over eat and remember to drink plenty of water specially, before you sleep to rehydrate yourself and rest well to rejuvenate your body for the next day’s fast.
Apart from consuming a calorie dense diet, there is often a decrease in physical activity. Normal levels of exercise during Ramadan should be undertaken however the duration and intensity of exercise should be modified i.e. 2 hours after sunset. it is prudent to avoid exercise in the final few hours of the fast when the risk of hypoglycemia is maximal particularly in insulin-treated patients. If Mustahib Prayers are performed they should be included in a person’s daily exercise regimen.
Diabetics who are motivated to observe fasting in Ramadan must visit a physician and a dietician before Ramadan. Dietary and glycemic control should be achieved and advice relating diet adherence, appropriate exercise, self-monitoring of blood glucose and compliance with medical therapy should be emphasized. Approaching the fast with discipline & maintaining a balance diet is the key to successful fasting.
Prepared by:
AZRA ROOHI
CONSULTANT DIETITIAN AND NUTRITIONIST
