Ramadan : To fast or Not to Fast

Ramadan is a special month for Muslims with significant blessings as the Holy Book, the Quran was revealed to Prophet Muhammed (PBUH). Muslims follow a lunar calendar that moves forward 11 days every year, hence every year Ramadan falls at a different time and in some years, a different season which in turn may provide a different fasting experience. Certainly, the days are longer in the summer and spring seasons and eating patterns are adjusted to suit the longer fasting hours. ³

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This year Ramadan begins the third week of March and runs until the near end of April, therefore the fasting hours are expected to be around 14-15 hours long. Initially, this can be quite difficult resulting in headaches, dehydration and possibly nausea, due to sleep deprivation and fatigue. Here are some tips to make fasting a little easier.

The month of Ramadan provides a sense of self-reflection, spiritual reflection, charity and gratitude to Muslims and those that are healthy and deemed able to, observe a fast.  While there are groups of healthy people (pregnant, lactating, travelling) that can postpone their fasts during Ramadan due to their circumstances, ³ there are also those groups of people that fasting is not mandatory upon due to chronic illness like diabetes and eating disorders. This article will look at both groups of people and the effects fasting can have on those individuals that are exempt.



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Ramadan & Diabetes

Estimates suggest that there are over 150 million Muslims with diabetes worldwide.¹ Therefore, Ramadan has a major impact on the management of diabetes in the Muslim population. Due to the metabolic nature of the condition, people with diabetes are at particular risk of complications from marked changes in food and liquid intake.

Risks of Fasting ¹ :

1. Hyperglycaemia- high blood sugar levels can be an issue for those who have any complications associated with diabetes; poor vision, heart disease or kidney disease, the risk of worsening this is high and you should be really careful about if you should be fasting or not.

2. Dehydration is when there is not enough water in your body. This Ramadan, the fasts are longer and this means long hours without fluid intake. Dehydration can also happen if your blood sugar levels are too high which will result in dizziness or loss of consciousness.

3. Fasting carries a risk of hypoglycaemia. Therefore, during your fast when you feel that you are having a hypo, you must break your fast and take some sugary fluids followed by starchy food. If not, this can cause serious harm to your body and will require medical attention.

4. Diabetic ketoacidosis (DKA) is a serious condition which requires hospital treatment. This could also develop when you do not take your prescribed medication or have low activity levels than usual which leads to an increase in your blood glucose levels which could then lead to KDA.



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Tips for a healthy Ramadan with diabetes¹ ² :

1. Know your risk before you decide to fast - consult your doctor to understand your risk category before you decide to fast

2. Medication adjustments during fasting - talk to your doctor about the adjustments required to the dose, timing or type of medication to reduce the risk of low blood sugar. It is important to remember that measuring your blood glucose and injecting insulin will not break your fast.

3. Keep moving - perform light to moderate exercise to ensure you are staying active.

4. Include low glycaemic index, high fibre foods that release energy slowly before and after fasting.

5. Hydration - stay hydrated at or between the two main meals by drinking water or other non-sweetened beverages. Avoid caffeinated, sweetened drinks and sugary desserts.

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Ramadan & Pregnancy

Within the laws of Islam, pregnant women in their third trimester are able to postpone their fasts and provide a ‘fidyah’ towards feeding a needy individual.⁴ Many pregnant women do choose to fast during their first and second trimesters and the research is unresolved on the effects fasting has during these stages of pregnancy.⁴ Low birth weight and preterm delivery in relation to an increased risk of chronic disease have been explored within recent studies.  However, the results remain inconclusive with small sample sizes and contrasting trimester results.⁵⁶

Ramadan during the summer months certainly involves longer fasting days during warmer temperatures and dehydration can be a cause for concern for all persons fasting. ³ If you do decide to fast during pregnancy, it is essential to drink plenty of fluids and include foods that have an increased water content during your meals at suhoor and iftar. It would also be advisable to seek advice from your midwife or doctor to discuss your pregnancy health and any complications that could arise from fasting during your pregnancy.⁴




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Ramadan & Eating Disorders

Fasting during Ramadan can present as a risk factor for individuals with eating disorders as eating behaviours are modified due to the iftar and suhoor meal times, unsettling cognitive and physiological control. ⁷  Restricted eating times may trigger disordered eating behaviours and enhance temptations to eat unhealthier foods. ⁷ To learn more about Ramadan & Eating disorders press here.

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Our Advice

- If you are unable to fast, remember there is alot more to Ramadan than fasting itself. Prayers, reciting the Quran, donating to charities (Sadaqah), feeding those fasting and in need and a time for deep reflection & contemplation.

- Be mindful and kind to each other - there will be many who will not be able to fast due to medical or personal reasons. Instead of making them feel guilty for not fasting, we should be supportive and focus on ourselves. 

- Ultimately, it is a personal choice whether or not to fast. However, if you do choose to fast, then you must consult your doctor or healthcare team before Ramadan, to make sure that you are able to look after yourself properly.



Humaira AzeemComment