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Issue 25 August 2011 The E - Bulletin is a service provided from the in-house team of physicians (Specialists, GP’s & the In-house Training Center) at the CEDARS – Jebel Ali International Hospital in order to raise awareness about health issues. Fasting during Ramadan Ramadan is the 9th month in the lunar year. During this month, healthy Muslim adults observe Fasting during the daylight hours. Muslim Fasting is a total abstention from eating, drinking, and sexual relations from dawn to dusk for 29 or 30 days of the month of Ramadan. Also, avoiding immoral behavior and anger and showing compassion is part of the requirements of the fasting. Restraint from food, water, and undesirable behavior makes a person more mentally disciplined and less prone to unhealthy behavior. Fasting and its impact to health Fasting during the Islamic month of Ramadan can be good for one's health and personal development. Ramadan fasting has spiritual, physical, psychological, and social benefits; however, man-made problems may occur, if fasting is not properly practiced. First of all, there is no need to consume excess food at Iftar (the food eaten immediately after sunset to breakfast), dinner or Sohur (the light meal generally eaten about half an hour to one hour before dawn). The body has regulatory mechanisms that activate during fasting. There is efficient utilization of body fat. A diet with less than a normal amount of food intake yet balanced is sufficient enough to keep a person healthy and active during the holy month of Ramadan. Ramadan is also time for family gatherings CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001 CEDARS - Jebel Ali International Hospital is upgraded as a Full Fledged Hospital since Aug 2004 with 16 beds including an ICU and one major and a minor Operation Theatre. With Specialties ranging from Occupational Health, Laparoscopic Surgery to Cardiology, CEDARS - Jebel Ali International Hospital aims to be the Complete Community Hospital for new Dubai and is geared to grow into a University Hospital in the near Future Fasting during Ramadan Page 2 Fasting (cont..) Health problems can emerge as a result of excess food intake, foods that make the diet unbalanced, as well as insufficient sleep. Drink sufficient water between Iftar and have enough sleep to avoid dehydration. The body's immediate need at the time of Iftar is to get an easily available energy source in the form of glucose for every living cell, particularly the brain and nerve. Dates and juices are good sources of energy. Dates are excellent source of sugar, fiber, carbohydrates, potassium and magnesium. Dates 3 numbers and 4 ounce of juice are sufficient to bring low blood glucose levels to normal. Consume sufficient vegetables at meals. Eat fruits at the end of the meal. Avoid intake of sugary foods through sweets or other forms. Take more of complex carbohydrates. Complex carbohydrates are slow-digesting foods that contain grains and seeds such as barley, wheat, oats, semolina, beans, lentils, whole meal flour. Avoid spicy foods. Avoid caffeine drinks such as coke, coffee or tea. Caffeine is a diuretic. Gradually reduce the intake of these drinks about three to five days before Ramadan. A sudden decrease in caffeine prompts headaches, mood swings and irritability. Smoking is a health risk factor. Avoid smoking cigarettes. If you cannot give up smoking, cut down gradually starting a few weeks before Ramadan. Smoking negatively affects utilization of various vitamins, metabolites and enzyme systems in the body. Try to exercise, or have light yoga for at least 20 minutes a day. Also when you are breaking a fast, it must be planned and done slowly and carefully to prevent creating symptoms and sickness. Fasting for Elderly An elderly with good health may fast and benefit from fasting. However, an elderly with underweight or with a chronic illness should not fast in Ramadan. Elderly who are not generally healthy should discuss with their physician before they attempt fasting. Suggestions Dehydration is one of the most serious problems for the elderly; and that is because of their lack of the sense of thirst and consequently the lack of drinking water. The elderly should drink water and fluids in abundance and at frequent intervals after breaking the fast. The breakfast meal must be balanced in its content of different nutrients, preferably of low-calorie, easily digestible and low fat ingredients. Excessive fat hinders digestion in addition to causing many complications to the liver and blood vessels. CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001 CEDARS - Jebel Ali International Hospital is upgraded as a Full Fledged Hospital since Aug 2004 with 16 beds including an ICU and one major and a minor Operation Theatre. With Specialties ranging from Occupational Health, Laparoscopic Surgery to Cardiology, CEDARS - Jebel Ali International Hospital aims to be the Complete Community Hospital for new Dubai and is geared to grow into a University Hospital in the near Future Fasting during Ramadan Page 3 Fasting for Elderly (cont…) It is preferable that the breakfast meal be thoroughly cooked, to be easy to digest and swallow Eat green salad is essential to provide the elderly with vitamins, minerals and the necessary salts. It provides the necessary fiber to avoid constipation in addition to its content of liquids. The elderly can walk (as a kind of sport) in the period after breaking the fast. Such sport has many benefits, such as activating the blood circulation and relaxing the muscles. The Sahur is important for the elderly. It provides the body with the necessary food and energy and helps them to endure the long periods of fasting. Delaying having the sahur is better than taking it early as it diminishes the feeling of hunger or thirst. The Sahur must contain fluids and dairy products such as yogurt and cheese as well as a kind of fruit. The elderly may complain of headaches, especially during the first days of fasting, when the body tries to adjust and adapt to the requirements of fasting. We must differentiate between the headaches originating from illnesses which may occur due to the change in the pattern of treatment or as a result of the patient’s inattention to treatment, and that which often occurs as a result of fasting. One of the causes of headaches associated with fasting is the drop of the level of blood sugar as a result of longer periods of fasting. This syndrome disappears when the body adapts to fasting. “ Prayer carries us half way to God, fasting brings us to the door of His palace, and almsgiving procures us admission.” Fasting for pregnant and lactating women Pregnant and lactating women need more energy and calories than the other. There may be side effects on the pregnant women or the fetus, or breastfeeding mother or the baby, if not taken care properly. The energy and nutrient requirements is very hard to meet during this fasting time. SUGGESTIONS Pregnant and Breastfeeding mothers should check her as well as the baby’s health and be flexible during the fasting Ramadan. Before deciding to fast, please consult your doctor. He of she will know your medical history and your present condition. If your doctor permits you to fast, do it safely. Try taking lots of water before and after fast. Break the fast by eating healthy, well balanced nutritious meals. Avoid physical strenuous exercise. Listen to the doctor. Finally, a balanced diet improves blood sugar, cholesterol profile, reduces gastric acidity, prevents constipation and other digestive problems, and contributes to an active and healthy life style. So have a safe fasting! CEDARS - Jebel Ali International Hospital, Dubai, UAE. Tel: 04-881-4000 Fax: 04-881-4001 CEDARS - Jebel Ali International Hospital is upgraded as a Full Fledged Hospital since Aug 2004 with 16 beds including an ICU and one major and a minor Operation Theatre. With Specialties ranging from Occupational Health, Laparoscopic Surgery to Cardiology, CEDARS - Jebel Ali International Hospital aims to be the Complete Community Hospital for new Dubai and is geared to grow into a University Hospital in the near Future