Fasting in the month of Ramadan can have many advantages for some individuals living with various psychological disorders such as mild degrees of depression, anxiety, and insomnia. According to Dr Suhaila Ghuloum, Senior Consultant Psychiatrist at Hamad Medical Corporation (HMC), fasting, and the spiritual and social practices that accompany it, can help some individuals cope with certain stresses in daily life.
Fasting and associated acts of worship, such as Taraweeh (the evening prayer usually performed in a congregation with other worshipers) during the holy month of Ramadan helps to promote communication and social interaction among people. ‘Qiyam al-Layl’ (the special late evening voluntary prayers) in Ramadan can also contribute to peace of mind and thereby curb frustrations associated with the burdens and pressures of life.
During the first few days of fasting, the body starts to release these ‘feel good’ hormones. As a result, individuals may find that their ‘mood’ improves. Sleep is known to improve in quality during fasting, though cultural practices of staying up late may partially interfere with that.
According to Dr Ghuloum, international research has revealed that fasting had a great positive impact on individuals undergoing therapeutic treatment for addiction and substance abuse, as this act of worship promotes positive behavioural change in these individuals. In fact, there has been some research suggesting that spiritual practices result in structural changes to the brain in areas associated with depression, thereby offering a protective element.
HMC Senior Consultant of Emergency Medicine, Dr Saad Abdul Fattah Al Nuaimi, has stressed that consuming large quantities of food or eating an unbalanced diet during Iftar or Suhoor (pre-dawn meal) can lead to an upset stomach, intestinal disorders and a worsening of other pre-existing health problems. He added that health is the key to happiness and the food that we consume directly affects our health.
- Do not skip Suhoor (pre-dawn meal) as this will increase the length of your fast, which is not advisable in the hot season and may result in dehydration and fatigue.
- Drink as much water as possible between Iftar and sleeping particularly in the hot season.
- Avoid salty foods during Iftar and Suhoor meals.
- Avoid caffeinated drinks such as coke, coffee or tea.
- Also avoid refined carbohydrates and sugar (e.g. white bread, white rice, sweets and pastries) which can cause blood sugar surges, leading to weight gain.
- Try not to consume heavy fatty foods, which often cause gastrointestinal disturbances. When using oil in food preparation, use only a small amount of olive oil or other polyunsaturated fats)
- For the Suhoor meal, it is advisable to eat proteins, oils, complex carbohydrates such as beans, and drink half a cup of fresh juice or eat a piece of fruit.
- Break your fast for your Iftar meal with a simple, easily digestible meal such as three pieces of dates, half a cup of orange juice or one cup of vegetable soup. These help your glucose levels return to normal and help to control your appetite during the main meal.
- Store food items properly in the refrigerator or as directed on the food label.
- During fast hours, avoid direct exposure to sun as well as exercise in a hot environment which can lead to sweating and fluid loss with subsequent dehydration.
Acknowledging that it is difficult for many people to quit smoking, Dr Ahmad Al Mulla, Head of HMC’s Smoking Cessation Clinic, encourages smokers to seek professional help, such as through HMC’s Smoking Cessation Clinic, where patients can obtain advice, treatment and support from specialists to help them to quit smoking permanently. The clinic provides patients with ways to replace their nicotine consumption and cope with withdrawal symptoms, and supports patients through the process of quitting.
Exercising, drinking plenty of water after Iftar and keeping away from other smokers are some steps that people can take to decrease the urge to smoke, according to Dr Al Mulla. Avoiding places such as shisha cafes and other areas frequented by smokers will also help prevent inhalation of secondhand smoke, which is responsible for thousands of heart disease-related deaths every year.
Ayman Alawneh, HMC Dietitian, emphasised that patients with kidney disease must consult their dietitian to ensure adequate protection against potential complications while fasting. He mentioned that many kidney disease patients tend to overlook the importance of maintaining a healthy and balanced diet while fasting.
Patients suffering from kidney disease should not skip Suhoor (the pre-dawn meal) to avoid feeling weak, bearing in mind that they need more calories than individuals in good health. Kidney disease patients should be careful not to ingest high quantities of sodium, potassium and phosphorus, especially during Ramadan. Sodium is abundant in table salt, as is potassium in some vegetables such as tomatoes, potatoes, okra and green leafy veggies as well as some fruits, including bananas, oranges, mangos, dates, apricots, peaches and cantaloupe. Phosphorus is found in beans, carbonated drinks, nuts and dairy products.’
Alawneh stressed that patients who are on phosphorus lowering medications should take their pills during meals, not before or after eating. According to him, each kidney disease has its own dietary requirements for Ramadan.
If physicians approve fasting for pre-dialysis kidney patients, they should maintain a diet low in protein-rich foods to avoid imposing an extra burden on their kidneys. This could lead to complete renal failure and increase the level of urea in their system. On the other hand, dialysis patients need to increase their level of protein intake, especially animal proteins, in order to compensate for the protein lost during the dialysis process.’
‘Pre-dialysis kidney patients should drink two to three litres of fluid per day if the volume of urine they pass is within normal levels, otherwise they should reduce their fluid intake to avoid water retention that could affect the heart and lungs.’
Hemodialysis patients should be careful not to drink more than one litre of water/fluid daily after Iftar to prevent water retention that could affect their heart and lungs. Peritoneal dialysis patients can drink up to two litres of water daily, depending on the amount of fluid discarded in the dialysis process.’
‘Kidney disease patients should be aware of the quantities of fluid they consume and reduce their intake of sweets and fatty foods as they are more prone to cardiovascular diseases.’
He further advised them to avoid spending a significant amount of time outside in high temperatures when they are fasting, adding that they should also avoid eating salty foods.
Meanwhile, HMC is urging patients with kidney disease who experience any difficulties while fasting to seek urgent professional advice or dial 999 for the Ambulance Service.
- Avoid stimulants such as coffee, tea and soft drinks to reduce the intake of caffeine
- Take care to consume a healthy and balanced diet
- Drink sufficient amounts of water, between eight to twelve cups per day to avoid dehydration.
- Start Iftar with a glass of milk and some dates, followed by a variety of foods that contain all food groups
- Eat a healthy snack before bedtime i.e. about an hour after Taraweeh prayer
- Consume the permitted quantities of starches and keep away from saturated fats
- Eat protein such as meat, chicken, fish, eggs and cheese
- Take advantage of the opportunity to eat Suhour
- Avoid excessive use of spices when cooking
- Eat multiple meals in low quantities when permitted to avoid the feeling of satiety
- Stay away from fatty foods and fries to avoid heartburn and weight gain
- Eat at least two to three servings of fresh fruit daily
- Perform some kind of physical activity for half an hour a day
High salt consumption is a major threat as it leads to high blood pressure and increases thirst. Raised blood pressure can lead to water retention and can also negatively affect heart health.’
He also warned people to show restraint when eating Arabic sweets such as pastries including Ktaev, Kunafa and Ghoriba as they contain large amounts of sugar and fat.
Dararkeh offers the following advice to heart patients during Ramadan:
- Be aware of eating too much high-fat food which can damage the arteries by depositing harmful low density cholesterol, partially or fully blocking them and causing various types of clots
- Consume a diet that is healthy for the heart. For example, eat fish instead of red meat because fish does not contain harmful fats. Instead, it contains a healthy fat called Omega 3 which is important for the heart and arteries
- Use good vegetable oil such as olive oil instead of other fats as they contain Omega fats
- Eat vegetables and fruit on a daily basis – fresh or cooked – because they contain vitamins and minerals and high amount of fibre. Heart patients are also advised to eat brown bread instead of white bread
- Carry out light exercise such as walking every day before breakfast for up to an hour to stimulate blood circulation and help maintain a healthy weight
Maintaining normal fluid levels plays an important role in staying healthy during Ramadan, according to Ashwak Muhamad, a dietitian at Hamad Medical Corporation (HMC).
‘Water is one of the most important components of the human body, representing between 60% to 70% of the human body weight. It plays an important role in maintaining the performance of body systems and organs. Water maintains the balance of electrolytes within the body and it is necessary for the absorption of many nutrients. Water also provides a suitable environment for many of the body’s chemical reactions.’
She added that a fasting person should drink more water than any other drink because water contains no calories and can compensate for the loss of body’s fluids due to fasting.
Diabetes patients should aim to do at least 30 minutes of physical exercise a day during the Holy Month of Ramadan, according to Professor Abdul Badi Abou Samra, Chairman of Medicine at Hamad Medical Corporation and Director of the Qatar Metabolic Institute.
However, diabetics should take care to avoid exerting too much physical effort during the fasting period, particularly during the two hours before Iftar.
How to Avoid Weight Gain during Ramadan
Ramadan is a period of fasting; however overindulging in food when breaking a fast can lead to weight gain.
Charina Daniel, Clinical Dietetics Coordinator at Hamad Medical Corporation said:
Fasting, if done responsibly, can benefit your health. It has been proven that reduced food intake is one of the most effective factors in improving health and longevity. Fasting in Ramadan allows our body to use stored fats and glycogen thereby promoting weight and body fat loss.’
Daniel explained that the key to avoiding weight gain during Ramadan is to plan ahead.