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Doctor’s Orders for Embracing a Healthy Ramadhan

Dr Hina J Shahid explains the multitude of health benefits that can be attained in Ramadhan.

Ramadhan is one of the holiest months for Muslims, a time enriched with spiritual benefits, but the effects don’t just stop there. There are many physical, mental and social health benefits too. Unfortunately, we often overlook and don’t attain all the other health benefits of Ramadhan.

 

 

 

In the Qur’an we are informed that the purpose of fasting is to increase taqwa (Qur’an Al-Baqarah :183). The translation of taqwa has many shades of meaning including awareness, mindfulness, consciousness and fear of Allah (SWT), as well as self-restraint and piety. If we reflect upon this for a minute, we can see that being conscious and mindful extends to everything we do in Ramadhan and the choices we make (and don’t make), including in relation to our health, which has been described as the greatest blessing after faith by our Beloved Prophet (SAW).

 

 

 

What happens to the body during fasting?

The medical definition of fasting is not eating or drinking for more than eight hours. Normally the main source of energy for the body is glucose, the simplest carbohydrate, which is stored in muscles and the liver. During fasting, glucose stores are the first to be mobilised to provide energy. When these run out, the body starts to burn fat to make energy which, results in weight loss. With prolonged fasting, also known as starvation, the body turns to protein for energy, which can result in the breakdown of muscles, which is harmful for health. Starvation is unlikely to be reached in Ramadhan because the fasting state is broken every day.

 

 

 

The body cannot store water, and the only way of conserving water is by reducing the amount of urine produced by the kidneys. Feeling mildly dehydrated with symptoms such as thirst, headache and difficulty concentrating are experienced by most people but if you feel dizzy, faint or disorientated then you will need urgent rehydration with fluids containing salt and sugar.

 

 

 

Fasting can help with weight loss, but heavy iftars replete with rich food items means many of us end up gaining weight instead of losing it. Fasting can improve glucose control in people with diabetes, reduce blood pressure, reduce blood cholesterol levels and overall risk of heart disease, boost immunity and regulate food binges. After a few days of fasting, there is a rise in the level of endorphins, also known as “happy hormones”, which makes us feel more alert and positive. The strong community spirit palpable in Ramadhan and focus on charity and self-regulation of our actions, emotions and behaviours, all help improve our relationships with ourselves and others, contributing to improved mental and social well-being.

 

 

 

Reaping healthy blessing in Ramadhan

Below are eight things you can do this Ramadhan to maintain your health in a holistic way.

 

 

 

 

  • Eat healthy

 

We are instructed in the Qur’an (Al-Baqarah :168) to eat food that is both halal and tayyib (good for you). It is important to eat a balanced diet during Ramadhan, which should be based on eating the right proportion of carbohydrates, proteins, fats and dairy and making sure you eat plenty of fruit, vegetables and include nuts and fish. You should have your two meals a day, as tempting as it might be to skip suhoor out of fear of disrupting your sleep. Your suhoor will provide you with the essential energy and nutrients you need to carry you through the rest of the day, so it is important to make sure you wake up and eat a nutritious and wholesome meal.

 

 

 

Base your meals on complex carbohydrates and fibre-rich foods, which are digested slowly and allow for sustained release of energy, making you feel full for longer. These include wholemeal flour, wholegrain bread, basmati rice, wheat, oats, barley, semolina, cereal, quinoa, and potatoes (with skin). Combine these with healthy proteins such as fish, eggs and white meat, or vegetarian proteins such as beans and pulses. Add healthy fats such as nuts, seeds, olive oil, avocadoes, and include yogurt, milk, low fat cheese for some dairy and calcium. You can include a healthy salad and soup for starters, which are rich in vitamins, minerals and fluid, and have fruit –based desserts instead of traditional sugary sweets. Dates provide natural sugars, are full of energy and fluid, and are rich in vitamins and minerals.

 

 

 

Another important aspect of healthy eating is portion sizes. Keep your portion sizes reasonable and avoid the temptation to have second and third rounds. Instead make sure you have healthy starters and plenty of fluids to prevent over indulgence and improve your fluid and nutrient intake. Counting your calories when you are buying and consuming food can help ensure you do not consume excess energy which can lead to weight gain. Average recommended intake for women is 2000kcal (84000kJ) and for men 2500kcal (10,500kJ), but this varies according to individual body composition, metabolism and activity.

 

 

 

 

  • Avoid unhealthy foods

 

Many people associate Ramadhan with our favourite fried foods, such as samosas and pakoras, which are rich in calories and saturated fat that raise blood cholesterol and cause weight gain. Avoid deep fried foods, replacing them with healthier options. For the same reason, high fat-foods such as parathas, biscuits, pastries and chips should be avoided. Replace sugary drinks and desserts with healthier options, you should not have more than 30g/day of free sugar (seven teaspoons) as too much sugar is associated with diabetes, weight gain and tooth decay. Salt intake should be restricted to 6g/day, as this has been shown to reduce blood pressure, and therefore overall heart risk. Red meat is consumed in abundance in our communities. However, this should be restricted to 70g/day, and if possible limited to a couple of times a week, as excess red meat and processed meats have been linked to bowel cancer, as well as being high in fat content. As a guide, three thin-cut slices of roast lamb or beef are 90g, a quarter pounder is 78g, a large doner kebab is almost twice the recommended daily intake at 130g and a grilled 8oz beef steak is over twice the recommended intake at 163g. Learning to read and interpret nutritional labels every time you buy food can help you check what your eating and turn it into a habit.

 

 

 

 

  • Use healthy cooking options

 

If using oil, use healthier options such as olive oil or pure coconut oil and try shallow frying instead of deep frying, or avoid frying altogether and instead bake, steam or boil your food. You can substitute salt with herbs, spices and lemon to add flavour, but be careful not to add too much as they can make you feel thirsty, as well as cause indigestion and heartburn. Replace sugary desserts with fruit or milk-based desserts and puddings. Try and shop for locally produced seasonal fruit and vegetables and eat wholesome foods whenever you can. If you are in a rush, you can look for healthy and halal-convenient options, but planning meals and recipes in advance can help avoid this.

 

 

 

 

  • Drink plenty of water

Our body is two-thirds water and it is important to keep hydrated. Aim to drink around two litres of fluid a day even during Ramadhan and try and space this out during the non-fasting hours. Taking a bottle of water to taraweeh prayers and sipping on this during prayer breaks can help you consume a reasonable amount of fluid gradually. You should avoid caffeine-based drinks as caffeine is a diuretic and stimulates water loss. An alternative is unsweetened herbal teas. Adding yogurt to meals as well as fluid rich foods such as fruits, vegetables, soups, stews, cereals, porridge, muesli (with milk or yogurt) can also help you get more fluid. Be mindful of fruit juices and smoothies which can be high in sugar and calories.

 

 

 

 

  • Do physical activity

If you are doing physical activity, it is important to do the right type at the right time. This also depends on your baseline fitness level as training whilst fasting can be harmful for health. Amongst elite athletes there are those who are able to fast during Ramadhan, but equally there are many who are not able to and this is very much an individual factor. You are encouraged to consult with your General Practitioner, personal trainer, physical therapist, or sports specialist, especially if you are relatively inexperienced, or have any long term medical conditions, or are recovering from an injury or complication. Going for a light walk after iftar can help with digestion as well as help you get some exercise. If you are planning to do a cardio workout, experts suggest that the best time to train is before suhoor, to ensure maximum fat loss. If this is too early, an alternative is an hour after a light iftar, although other experts recommend delaying this for at least 2-3 hours.

 

 

 

 

  • Get enough sleep

This is a big challenge for lots of people, especially with late taraweeh and early suhoor interrupting our regular sleep patterns. Sleep deprivation can lower mental performance and also has negative physical health effects. Ideally you should try and get as close to eight hours sleep as possible, for example having lunch time naps if work permits or having a nap after work and before iftar.

 

 

 

 

  • Medications and vaccinations

 

Taking oral medications will invalidate your fasting but it is often possible to change the dosing regime of your medication and you should see your GP before Ramadhan.

 

 

 

Many people stop taking essential medication or change the timing without consulting their GP or pharmacist. You should never stop taking a medication or alter the dose or regime without speaking to your GP or pharmacist. There have been instances of serious interactions and complications. Regarding other routes of medication, there are some religious and medical scholars who agree that medications that are inhaled, injected or applied to the eyes, skin, nose, ears, (except if there is a hole in the ear drum and excluding intravenous feeding), or anally and vaginally do not invalidate fasting. Similarly having a blood test or vaccination does not break the fast. You are recommended to consult your respected scholars for more details.

 

 

 

 

  • Mental health and well-being

 

Ramadhan is a time for deep reflection on our lives and our connection with the Almighty. Fasting increases gratitude, shukr, which has been shown in research to improve mental health. Reciting dhikr, dua and verses of the Holy Qur’an has a powerful calming effect on the mind. Doing extra prayers, such as taraweeh and Qiyam ul Layl (night prayer) can also help with attaining focus, concentration and peace of mind. These core Islamic practices, as well as ihtikaf (seclusion), performed by some (mainly men) in the last ten days of Ramadhan are the equivalent of mainstream practises of mindfulness and meditation, and there are some scholars who translate taqwa, the purpose of Ramadhan, as mindfulness. Meditation and mindfulness are gaining increasing popularity for managing stress, anxiety, low mood and depression and therefore Ramadhan has the potential to significantly improve our mental state.

 

 

 

 

Ramadhan is also a time to practice self restraint, not just of food, drink and intimate relations, but also of the tongue and mind, and can help us improve relations with others and the way we see people and things around us. Attending group iftars or hosting iftars for friends, family or the less fortunate is a great way to connect with other people and share in the spirit of giving. All this can greatly improve our sense of well-being and purpose while simultaneously strengthening us spiritually.

 

 

 

Final words

The benefits of Ramadhan on our general health and spirituality are enormous. In our communities in particular we are facing considerable health challenges around conditions that are directly related to food and lifestyle choices, such as obesity, diabetes, heart disease, stroke and certain cancers. Health is truly a blessing from Allah SWT, so let’s use this Ramadhan to be mindful of our health and wellbeing and adopt positive changes for ourselves, families and communities, that we can continue beyond Ramadhan.

 

 

 

 

Dr Shahid is a GP and Chairperson of the Muslim Doctors Association. She qualified with a distinction in Medical Sciences at University College London and also holds a Bachelors of Science in Pharmacology from University College London, and a Masters of Science in Public Health from the London School of Hygiene and Tropical Medicine. She has also completed a one-year course in Fiqh and Aqeedah at Ebrahim College, London. She currently works as a GP in Central and West London and has an interest in women and children’s health, mental health and public health. She is an honorary clinical tutor at Imperial Medical School and an honorary faculty member at An Najah National University, Palestine at the Department of Community and Family Medicine. She has also worked in research and humanitarian settings in Lebanon, Greece and Calais. In the UK she delivers outreach clinics and health promotion workshops to ethnic minority groups. She is a keen traveller and linguist and enjoys reading and spending time with her family in her free time. She is currently learning Arabic.

Dr Hina J Shahid MBBS BSc (Hons) MScPH MRCGP DFRSH DRCOG DCH

 

 

 

The advice offered in this column is intended for informational purposes only. Use of this column is not intended to replace or substitute a formal medical assessment, diagnosis, counselling, therapy or any other treatment. The opinions or views expressed in this column are not intended to treat or diagnose; nor are they meant to replace the treatment and care that you may be receiving from a licensed healthcare professional. This column, its author, the magazine and publisher are not responsible for the outcome or results following any advice in any given situation. If you have specific medical questions, you should consult your own GP. You should never delay seeking medical advice, disregard medical advice or commence any medical action without consulting your GP.

 

 

 

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