A healthy and safe fast in the month of Ramadan

We mark the start of Ramadan by looking into how to reduce fatigue, minimise dehydration and stay healthy during the fasting month, especially during the run-up to the World Cup finals.

Today marks the start of Ramadan, the ninth month of the Islamic calendar when Muslims around the world observe a month of fasting from dawn to dusk.
In Malaysia, where Islam is practised by a majority of Malaysians, this practice needs little introduction.
As Muslims in the country observe a month of restraint and reflection, non-Muslims often join their Muslim friends in breaking fast or visiting Ramadan bazaars during the month.
“The fasting month is meant for us to reflect on our observance of Islam as a believer, as well as to appreciate the suffering of others,” says occupational health physician Dr Abed Onn.
However, waking up early for the first meal (sahur) and avoiding food and drinks during the day may lead to some feeling tired and dehydrated, especially during the first few days of fasting.
With the current hot spell in Malaysia expected to last for a few more months, this fasting month may be a little more challenging compared to previous years.
For avid football fans, the nights spent staying up watching their favourite teams could also pose additional challenges to getting adequate rest.
While the Health Ministry recommends those with chronic diseases to see their doctor to determine whether they are fit to fast, the Malaysian Dietitians Association (MDA) has come up with some advice for fasting.
According to the MDA, fasting should be safe for most people with diabetes except for those with poorly controlled diabetes, serious complications such as uncontrolled hypertension or renal impairment, pregnant women and those living with certain infections.
For the healthy and fit, staying healthy throughout the fasting month is as easy as paying attention to eating well, drinking enough fluids and getting enough rest.

Eat well
During the fasting month, Muslims who are fasting would start their day with a meal (sahur) before dawn and fast until dusk, breaking their fast (iftar) after the call to evening prayers.
Later at night, Muslims are also encouraged to go for tarawih prayers – special prayers during the fasting month.
When it comes to eating during the fasting month, a simple way to plan meals is to practise, at night, what is usually done during the day, says National Heart Institute chief dietitian and senior manager of dietetics and food service Mary Easaw-John.
“You eat your breakfast when you break your fast,” she says.
After more than eight hours of fasting, some sweet foods and drinks such as dates, milk and fruit juices, will help restore blood sugar levels gradually when consumed slowly.
Instead of breaking fast with large amounts of food at buffets, Easaw-John suggests a simple Malaysian breakfast that usually consists of foods such as a packet of nasi lemak, bread or chapatti, and coffee or tea to go with it.
A few hours later, one can choose to have a snack at the mosque after tarawih prayers or at home.
While a lot of attention is being paid to the iftar or breaking of fast, it is more important to have a good sahur as it is the meal that will sustain one throughout the day.

Drink enough fluids
For workers who are out and about during the day, hydration is very important as drinks are not allowed while they are fasting.
“The workers who are most impacted are those who work in the building and construction sectors, as the heat and strenuous work they do will naturally dehydrate them,” Dr Abed says.
“There is no realistic way of avoiding this phenomenon because of the nature of the work they do.
“However, employers can minimise this by providing workers more protection from the sun and allocate rest periods.”
Besides minimising sweating during the day, it is important for those who are fasting to take sufficient fluids at night and before the end of sahur to avoid or minimise dehydration.
Excessive consumption of coffee or tea during sahur is not recommended as large doses of caffeine increase the production of urine.

Get enough rest
An aspect of health that is often overlooked during fasting month is adequate rest and sleep.
Research has shown that sleep patterns do change in those who are fasting as meals and drinks are taken at night instead of the day.
A study of eight young men in Morocco in 2001 revealed that they generally get less sleep during Ramadan and it takes them longer to fall asleep.
Although many Malaysian employers allow flexible schedules for their Muslim employees during the fasting month, it is also important for the employees to allocate adequate time to rest.
This is especially important as this is the first year Ramadan coincides with the World Cup, and matches start after midnight.
Some options include going to bed a little earlier to rest before sahur (or a match) and going back to sleep after the morning meal before going to work.
For those who are used to fasting during Ramadan, the body usually adjusts to the rhythm of the fasting month very quickly.

“Workers may ‘not feel themselves’ in the first two or three days of fasting as their body readjusts to the changes in their eating and sleep habits,” says Dr Abed.
“Once the initial readjustments have taken place, they usually adapt accordingly.”

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