How to balance your health and fasting during Ramadan

During the entire month of Ramadan, more than one billion Muslims fast every day from sunrise to sunset. This means there's a good chance you or someone you know will fast for the 30 day period. Fasting is a time when you refrain from food and water, as well as other habits such as alcohol, gambling, smoking and sex, and redirect your energy to one of spiritual discipline - deep contemplation of the Qur'an and relationship with God, additional prayers and increased charity and generosity. 

What is the religious significance of fasting for Ramadan? And how can those who partake in the holy month keep their health front of mind?

The religious significance of fasting during Ramadan
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The holy month of Ramadan is the ninth month in the Muslim calendar. It signifies one of the five pillars (fundamental duties) of Islam and represents a time of compassion, restraint, charity and self-accountability. For 30 days, it also marks a time when Muslims refrain from eating and drinking (yes, even water) for 11-20 hours per day depending on where in the world you may be. 

Almost all Muslims are expected to fast during Ramadan. The Qur’an specifically exempts the elderly, young children, those who are sick or suffer from a chronic condition (such as diabetes), people with intellectual disabilities, women who are menstruating, pregnant or nursing and those who are travelling.

According to Islamic tradition, the Qur’an was first revealed to the Prophet Muhammad during the last 10 days of Ramadan. Because Ramadan runs the period of a lunar month, the number of fasting hours will vary each year and from country-to-country. In Australia, we have some of the shortest fasting hours in the world as over half a million Australian-Muslims began fasting for Ramadan in mid-May 2018.

Besides breaking the daily fast with water and food at sunset, other traditional practices during Ramadan include reading the Qur’an, making donations and social visits to the sick and elderly, doing acts of charity and performing additional prayers.

No, not even water: A guide to Ramadan for non-Muslims
Not sure what Ramadan is all about? Here's why many Muslims fast during the month.

Is fasting healthy or unhealthy?
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For 30 days, two meals; one prior to sunrise (suhur) and another after sunset (iftar); replaces the typical three.

Accredited Practising Dietician (APD) and practising Muslim Lina Breik, says people who fast may feel dehydrated during the day. Your concentration and focus may decrease and you could feel sluggish and lethargic. “Any change in [eating] behaviours will always create a shock to the system and Ramadan is a shock to the system,” Breik tells SBS.

Caffeine-withdrawal headaches, feeling dehydrated and tired during the day can be quite common. Breik explains that “fasting, just like overeating, can affect someone negatively, especially if they are unwell, have a pre-existing condition or are on medications, so that is why consulting your doctor prior to commencing is so important”.

“But if you’re fit, well and healthy then there shouldn’t be any problems, especially if you’re maintaining healthy eating and keeping active during Ramadan.”

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Ramadan and diabetes
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Fasting during Ramadan may be a challenge if you have a chronic health condition that is influenced by the food you eat. So if you have a health concern of note and want to fast, you may have to plan to cater for your specific health needs ahead of Ramadan.

Diabetics may experience serious health complications. Those with type 1 diabetes may experience hyperglycaemia, hypoglycaemia and blood clots if they fast without adequate preparation and self-care, stresses Breik. 

According to the Diabetes Australia website, it is possible that during a period of fasting with diabetes could develop high blood glucose level and experience large swings if they don't take their medication. Because of this, it is absolutely vital that diabetics speak with their doctor and seek professional medical advice on how to best manage this before choosing to commence.

Accredited Practising Dietitian (APD) and Diabetes Management Specialist Cameron Johnson largely focuses on behavioural aspects of eating and how this affects diabetes management. “First and foremost, safety is the most important thing to be mindful of during Ramadan and this caution overlaps between general and diabetes-specific advice,” he tells SBS. Johnson explains that monitoring blood glucose levels and checking high and low readings with your doctor is extremely important.

According to Johnson, a very common misconception is that because Ramadan only lasts one month, it can't affect diabetes control or health in general. “At this time, it's very important to monitor, record and report blood sugar levels, and maintain an appropriate diet for nutritional adequacy and also for diabetes management,” he tells SBS. 

Johnson recommends the following steps for diabetics who wish to fast during Ramadan while being mindful of their health:

  1. Your decision to fast should be discussed with your treating doctor, diabetes educator and dietitian.
  2. It is important to maintain adequate hydration and nutrition, which may be different for individuals depending on their age, gender, type of diabetes, and medications, including diabetes medications (tablets or insulin).
  3. The meal before sunrise should be the largest daily meal and provide slowly digested (complex) carbohydrates to sustain energy through the day. Including some protein will assist with maintaining muscle stores. Always drink enough water to prevent dehydration.
  4. It is important to eat the right type of complex or low glycaemic index carbohydrates at meals and snacks like rolled oats, grain bread, grain biscuits, basmati rice, fruit, pasta and potato. The amount consumed also needs to be considered. Ensure you have enough low GI carbs to meet your energy and blood sugar requirements, but don’t have too much as your levels may peak.
  5. Eat your evening meal slowly, balancing it with raw or cooked salads/vegetables, some protein and carbohydrates. Avoiding large amounts of fried foods, sugary desserts and salt is best. Again, it’s important to stay hydrated during the meal and over the following few hours.
Is there a healthier way to fast?
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In short, Breik says yes.

We’re all culturally different and food plays a huge role in cultural identity. Breik doesn’t believe there are hard and fast rules for exactly what meals people should be consuming after sunset. Ensuring you have meals with all the five major food groups and avoiding oily, fried or high-in-salt foods and overindulging in sweeter and refined sugar foods will be beneficial for you in the long run. Fasting throughout the day doesn’t give you the leeway to eat anything and everything you like after sunset. Ramadan isn’t about over-indulging or gorging on junk foods and takeaways to make up for not eating during daylight hours.

Just like any other time where you shift in your eating patterns, you need to give yourself the first few days to adjust. The fasting period can positively reset some of your body’s patterns, as long as you adopt nourishing and healthy habits after sunset. 

Ramadan isn’t about over-indulging or gorging on junk foods and takeaways to make up for not eating during daylight hours.

"Break your fast with the prophetic sunset snack of two dates, a glass of water and a small bowl of soup," Breik says. “Dates are high in iron, rich in Vitamin C and full of long-lasting natural sugars making them a great way to ease into your sunset meal.” 

Breik emphasises the importance of proteins during meal times as well as serving ratios. “Half your plate should be salad and vegetables, a quarter carbohydrate - rice, bread, couscous, polenta - and the other quarter, animal or plant protein.”

Ensuring you have that suhur (the pre-dawn meal) is also essential and Breik advises to make this meal your largest one. “It can be the hardest and most difficult part to get up at 4am, but make sure you do. Even if it’s just for a piece of multigrain bread, a little porridge, semolina or basmati rice – it’s a good time to ensure you consume complex carbohydrates for longer lasting energy that will get you through the day.”

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Lina Breik's top 3 health tips
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1.  Water is the most important beverage for you to consume, even during Ramadan. Simply have a cup of water every hour after sunset to keep up your hydration and to minimise the risk of headaches and constipation.

2. The trap many people fall in is they break their fast is that they delve too quickly into a big meal. When you break your fast– have your glass of water, a hit of natural sugars sourced from dates or a piece of fruit, a small warming bowl of soup and then take a break and step away from the table and the kitchen for at least 10-15 minutes before you start preparing to eat the main meal.

3. It may sound simple but always eat slowly and chew your food well. There’s no need to rush or overdo it and like the Hadith on eating mentions - a third of your stomach should be water, a third should be food and a third should be air to allow for digestion and breath.

Get your date fix
9 reasons to save the date this Ramadan
Eaten either fresh or dried, dates are a rich, sweet and easy win. They're a delightful way to break fast during Ramadan or to cap off an evening's meal. So save the date this Ramadan with these 9 winners.

Will you lose weight?
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Because your meal frequency has reduced, so too does energy intake. Unless you’re nourishing your body and keeping active during Ramadan, then your body isn’t going to be burning fat. It takes double the amount of energy to burn a gram of fat then it does to burn a gram of muscle. So if your body hasn’t eaten in 12 hours, it’s going to get its energy from muscle. You can lose weight, but you won’t necessarily lose fat during Ramadan and in some cases, you may even gain weight, due to the types of foods consumed and a lack of exercise.

“When you’re fasting all day your body is getting the majority of its energy from the muscle,” says Breik. “It hasn’t been fed, because you’re fasting, so the majority of the breakdown in your body is muscle mass, not fat stores. If you want to bring about fat loss, you have to combine fasting with high-intensity exercise. That’s when you’re body switches over to the higher source of energy, which is fat.” 

Are you able to exercise?

Yes, you can. Breik recommends exercising just prior to breaking fast or two-to-three hours after iftar. Be patient, listen to your body and gauge how you are feeling before undertaking any exercise. A 30-minute light jog or a 60-minute walk is a good option. 

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'I'll Fast With You'
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The long days without food and water can be a challenge for any Muslim observing Ramadan but it might be especially tough for new converts to the faith who are fasting for the first time. That's why an Islamic organisation in Melbourne has launched 'I'll Fast With You'- the first program in Australia designed to help converts make it through the holy month.

Find out more about the program. 

It’s only 30 days – will your body change?
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There aren’t many studies that have been carried out to determine the long-term effects of fasting for Ramadan.

But some studies around religious fasting have seen a lowering in blood pressure and cholesterol levels in their subjects. That being said, each individual’s responses can vastly differ. According to Breik, “this is a time when people can also get over their excess habits – whether it be salt, caffeine, sugar etc…”. Our taste buds go through a life cycle and form new taste cells every 10-14 days and during Ramadan, this is also a great time to kick old habits and form new ones as your taste receptors change.

Breik asks Muslims fasting during Ramadan to consider a few simple questions to ensure they remain in good health through the period: “Are you sleeping enough and keeping hydrated through the night? Are you eating the right types of foods after sunset and keeping active?”

“How are you going about Ramadan?”

If you have any questions or concerns, ensure you discuss your Ramadan plans with your doctor and seek professional medical advice.

If you are a diabetic, it is highly recommended that you seek medical advice before choosing to partake in Ramadan.  

Diabetes Australia with the assistance of the Australian Federation of Islamic Councils Inc (AFIC) – Australia's national Islamic organisation  – have co-created a resource that outlines the general dietary guidelines to help control glucose levels during Ramadan: diabetes and fasting for Muslims.

More on Ramadan
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I don’t like water. What can I do?
The art of travel (and food) during Ramadan
The holiest time of the Islamic calendar can also be wonderful for travellers, with a few small tweaks to your routine.
7 Ramadan recipes to cure fasting fatigue
The month-long Muslim fast, known as Ramadan, begins on the evening of May 15, across the Middle East, India, Indonesia and Australia. Each culture - and family - have their own dishes that form part of their suhoor (the meal before dawn) and iftar, (the feast that breaks the fast at sundown). Here are ours.