Spokesperson from Association for Dietetics in South Africa and registered dietitian, Nasreen Jaffer says fasting during Ramadaan has a number of physiological effects on both homeostatic and endocrine processes.
In patients with diabetes, these changes and the type of medication being taken to treat the condition can be associated with the development of complications such as hypoglycaemia and hyperglycaemia.
With Covid-19 on the rise in South Africa, the elderly are in a very vulnerable position during the fast as they have been identified as high risk in contracting the virus by health officials.
Jaffer says elders should consult health practitioners before and during the fast for assessment to see if they can fast because the process of normal ageing causes a weakened immune system.
And, Jaffer adds, coupled with any clinical condition, you have an immune system that is less capable of fighting off attacks from bacteria and viruses. It is therefore of utmost importance that they follow a healthy meal plan and continue taking their medications as prescribed by your health practitioner.
“Ramadaan fasting not only alters the timings of meals but it may also disturb sleeping patterns and circadian rhythms, all of which can affect a person’s metabolic state. Sleeping patterns are often altered during Ramadaan. Typically, sleep is broken before dawn to enable Muslims to eat before fasting begins (suhoor).
“Many will return to sleep afterwards and wake for a second time to start the day. Some fasting Muslims may sleep in the afternoon. Following the evening meal (iftar), many will stay awake until midnight, or later. The impact of Ramadaan on sleep includes decreased total sleep time, delayed sleep, decreased deep sleep duration. Sleep deprivation has been associated with metabolic changes such as decreased glucose tolerance. Sleep deprivation in itself can lead to fatigue which then further impacts negatively on the immune system," says Jaffer.
Health specialists have identified that some Muslims follow unhealthy eating habits during the fast such as leftover foods, cakes etc for breakfast and when breaking fast there is a large array of cakes, savouries which is followed by a huge meal. Jaffer says the Ramadaan principles should be based on healthy eating guidelines and avoidance of overeating especially in the evening
Some additional tips to keep healthy while fasting:
- Adhere to general healthy eating guidelines, low fat, low salt, high fibre etc
- Try to avoid high fat snacks or only have one.
- When breaking fast have a date/fruit/ and water, vegetable soup, followed by a healthy meal. Drink enough water.
- Multivitamins might be recommended especially for individuals at risk of poor nutritional status during Ramadan
- Bake instead of frying savouries e.g. Samoosa’s, Spring rolls, half moons.
- Make a fresh fruit salad with a variety of fruits each night as part of “boeka” which will make you eat less savouries.
- After Maghrieb(sunset prayer), be sure to have your cooked meal as per normal which includes lean proteins, whole grain complex carbohydrates, healthy fats and vegetables.
- Make sure you have a protein serving as part of your morning meal such as, leftover fish, meat or chicken, egg, milk, yoghurt, legumes- split peas, dhal,
- sugar beans or lentils