Wednesday 7 June 2017

Management of Islamic Fasting associated Adverse effects:









More presentations from Naina Mohamed, PhD

§    The Prophet Muhammad (PBUH) said that fasting is a shield, which protects a person from sin and lustful desires.
§    Islamic fasting is observed during the holy month of Ramadan.
§    Apart from Ramadan, Muslims are encouraged to observe fasting on the following days too…
Ø The 9th and 10th, or 10th and 11th days of Muharram (First month of Islamic Calendar).
Ø Any 6 days of Shawwal (Tenth month of Islamic Calendar).
Ø Mondays and Thursdays of every week, if possible.
Ø 13th, 14th, and 15th day of every Islamic month.
Ø 9th day of Dhu'I-Hijja (12th Month of Islamic Calendar).
Ø During the months of Rajab (7th month) and Sha'aban (8th month) before Ramadan, if possible.
§    Devoted Muslims keep themselves refrain from food, drinks, smoking and sexual activities from the dawn to the dusk, during Ramadan Fasting.
§    Fasting helps to control one's desires and to focus more on devoting Allah (swt).
§    Islamic fasting is similar to Alternate Day Fasting (ADF), since the feast and fast periods of Islamic fasting lasts 12 hours in average.



§    Islamic Fasting associated Adverse Effects include…
Ø Dehydration
Ø Headache
Ø Hypoglycemia
Ø Heartburn
Ø Constipation
Ø Muscle cramps
Ø Anemia

Fasting associated Dehydration:
 Dehydration may occur with Islamic fasting due to insufficient fluid intake.

TIPS to minimise Fasting associated Dehydration:
©   Drink enough water and fluids between Iftar and Suhour. 
©   Consume more fruits and vegetables with high water content like Watermelon, Tomatoes, Cucumber, Grapes, etc.   
©   Avoid Salty and spicy foods, which increase the feeling of thirst.
©   Avoid consuming high fat and fried foods especially at Suhour, which may lead to thirst.
©   Eat less or no sweets, which increase thirst.
©   Avoid caffeinated beverages like energy drinks. Caffeine can increase the fluid loss and thirst due to its Diuretic activity.
©   Minimise or avoid smoking, which slows down salivation, and induce Dry mouth and Thirst.
©   Avoid direct sun exposure to reduce sweating.
©   Indulge in physical activity only during non-fasting hours to replenish lost fluids during exercise.

Fasting associated Headache:
 Caffeine withdrawal, Hypoglycemia, Lack of sleep, Stress and Dehydration may contribute to the Fasting associated Headache.

TIPS to minimise Fasting associated Headache:
©   Reduce the consumption of Tea, Coffee and Cigarette gradually one or two weeks before Ramadan.
©   A cup of strong coffee at Suhour (Pre-dawn meal) may prevent Ramadan headache occurring due to caffeine withdrawal.
©   Eating foods with low glycaemic index value would minimise the risk of headache induced by Hypoglycemia.
©   Drink large amounts of water and fluids between Iftar and Suhour to avoid headache induced by Dehydration.
©   Try sleeping at least 7 hours a day.

Fasting associated Hypoglycemia:
 Decreased or no food intake and consuming too much refined carbohydrates at suhour, may result Hypoglycemia.

TIPS to prevent Hypoglycemia:
©   Predawn (Suhour) meal is necessary to prevent the risk of Hypoglycemia.
©   At Suhour, eat more complex carbohydrates (Slow-digesting foods) such as barley, wheat, oats, beans, lentils, brown rice and nuts.
©   Avoid quickly digestible foods containing sugar, white flour or other refined carbohydrates.
©   Avoid consuming Sweets at suhour.
©   Eat vegetables such as broccoli, cucumber, and carrots, which provide fiber and essential nutrients.
©   Drink enough water and fluids between Iftar and Suhour. 
©   Avoid excessive physical activity while fasting.
©   Get enough sleep.

Fasting associated Heartburn:
Consuming a high volume of Bulky, Fatty and fried foods especially during the Iftar meal, may increase the risk of Heartburn and GERD.

TIPS to minimise Heartburn:
©   Avoid spicy, bulky and fatty foods to prevent heartburn induced by Ramadan fasting.
©   Avoid carbonated drinks, which may increase gastric acidity.
©   Avoid eating a lot at once. Divide iftar meals in two portions.
©   Drink a glass of Milk, which may help to minimise Heartburn.
©   Do not lie down right after meals.
©   Avoid excessive use of Analgesics.
©   Take Antacids, if required.
©   Limit or Quit Smoking.


Fasting associated Constipation:
Constipation may result due to the consumption of less fibrous foods, too much refined foods and too little water.

TIPS to reduce Constipation:
©   Avoid excessive refined foods such as Paratha and other Maidha (General flour) made foods.
©   Consume Slow-digesting and more fibrous foods like whole grains such as Oats, Pulses, Wheat, Lentils, Flax seeds, etc.
©   Eat fiber-rich fruits like Apples, Bananas, Papayas, Passion fruit, Figs, Avocados, etc.
©   Have snack on fiber-rich dried fruits (Dates, Dried apricots, Figs, Prunes).
©   Increase fiber-rich vegetables like Beans, Peas and Chickpeas.
©   Drink large quantities of fluids like Water, Fresh fruit juices, Vegetable soups, etc.
©   Probiotics like yougurt helps in preventing constipation.
©   Get moving and maintain the activity level.

Fasting associated Muscle cramps:
Muscle cramps may result due to Inadequate Liquids and foods containing minerals.

TIPS to prevent Muscle cramps:
©   Drink plenty of fluids, preferably fruit and vegetable juices, Soups and dairy drinks.
©   Drink more water to avoid dehydration and cramps.
©   Eat foods rich in minerals such as Vegetables, Fruits, Dairy products, Meat and Dates. 
©   Dates are a very good source of dietary potassium and it has a wide range of essential nutrients such as protein, fiber, Iron, calcium, magnesium, selenium, boron, cobalt, copper, fluorine, manganese, and zinc.
©   Magnesium rich foods include whole-grain breads and cereals, nuts, and beans.
©   Potassium found more in fruits and vegetables, especially bananas, oranges, etc.
©   Good source of Calcium is Dairy foods.
©   Avoid sleeping toes pointed to prevent nighttime calf cramps.
©   Do not tuck in bed sheets too tightly to avoid bending toes downward.

Fasting associated Anemia:
The risk of Anemia might be elevated by fasting induced reduction of Hemoglobin (Hb), Packed Cell Volume (PCV) and RBCs.

TIPS to prevent Anemia:
©   Eat Iron-rich foods such as Spinach, Broccoli, Apricot, Garlic, etc.
©   Dates are rich in iron and regular consumption of Dates helps in the formation of haemoglobin (Hb).
©   Include Lentils, which are a good source of iron.
©   Iron found in animal products such as meat, poultry, and fish, might be absorbed better by the body.
©   Plant source of iron include beans, pulses, and green leafy vegetables.
©   The absorption of Iron could be increased by eating with foods containing Vitamin C, such as lemon and tomato.
©   Avoid drinking coffee and tea with meals as this can reduce the amount of iron absorption.
©   Calcium-rich dairy products may interfere with the absorption of Iron.

Fasting associated Decreased Sleep quality:
Sleep quality might be decreased due to thermogenic effect caused by delayed mealtime and high Protein (More than 50 gm) and high Calorie (More than 1200 Kcal) food at Iftar.

TIPS to improve Sleep Quality:
©   Avoid over eating before sleeping.
©   Performing wudu before bed may reduce body temperature.
©   Get exposed to sunlight especially in the first half of the day, to strengthen circadian rhythm.
©   Avoid or decrease exposure to artificial light.
©   Keep electronic devices such as Mobile phones, Tablets and Laptops out of the bedroom.
©   Maintain the bedroom quiet, dark, and a little bit cool.
©   Avoid sleeping on the back and sleeping on the side can improve the quality of sleep by reducing sleep apnea and snoring.
©   Maintain a regular bedtime, even during weekends.
©   Avoid caffeinated drinks such as Energy drinks, Coffee, Tea, Cola drinks, etc. at least before 4-6 hours of bedtime.

§    Though Islamic fasting is associated with some adverse effects, there was no detrimental effects on health attributed directly to them, in health individuals. In addition, the adverse effects of fasting could be minimized very easily by following the preventive measures.
§    The chronic patients with Diabetes, Coronary Artery Disease (CAD), Cancer, Ulcer, Urolithiasis, Chronic Kidney Disease (CKD), etc. should consult the healthcare professionals before observing Fasting.
§    Moreover, Islam exempts the Sick, Travelers and Pregnant, Breast Feeding and Menstruating women from fasting.
§    Islamic Fasting can be good for health if it is done correctly. Moreover, it causes many physiological, biochemical, metabolic and spiritual changes in the body.









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