Ramadan is a special time of the year for those who are fasting. However, those with certain health conditions, should keep a few pointers in mind while fasting, particularly during summer. 


Anaemia

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People with anaemia are generally able to observe fasting during Ramadan as long as they are careful and control their diet appropriately. Anaemic who fast during Ramadan must include iron-rich foods in their suhour and iftar meals.

Eating foods that contain vitamin C (tomatoes, guavas and strawberries) with iron-rich foods will help aid iron absorption.

Vitamin C is a strong promoter of iron absorption so when vitamin C rich foods are combined with foods rich in iron, absorption of the iron is substantially increased. Some of the most important iron-rich foods are seafood, chicken and red meat as well as eggs. Whole grains, iron fortified breakfast cereals, legumes, green and leafy vegetables, broccoli, dried fruits and dates, peanut butter, sesame seeds, pumpkin seeds and sunflower seeds are healthy vegetarian alternatives that are also rich in iron.’


Thalassaemia

The body has fewer red blood cells when one has thalassemia, so the person may experience symptoms such as low blood count, or anaemia. In general, patients with Thalassemia are advised to avoid fasting during Ramadan.


Compromised immunity

If one is prone to having a weak immune system, then it is important to identify this concern much in advance of the fasting period, and work on improving it.

Vitamin D deficiency

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It is advisable to get all health checks 2-3 months in advance of the fasting period. The most accurate way to measure how much vitamin D is in your body is the 25-hydroxy vitamin D blood test. Common manifestations of vitamin D deficiency are symmetric low back pain, bone pain, muscle weakness and muscle aches. If you are diagnosed with the deficiency, consult with your doctor for the best course of action; supplements are a guaranteed method to provide your body with adequate vitamin D.

Foods that naturally have some vitamin D are fatty fish such as salmon, tuna and mackerel, cheese, mushrooms and egg yolks that need to be include in your diet. You can also get vitamin D from fortified foods. You can check the food labels to find out whether a food has vitamin D.

Try going for early morning walk or during your lunch break walks. You’ll get some of the much-needed sun that your body’s missed out on, and you’ll add an exercise boost to promote a healthier and stronger body.

Recent surgery

After a surgery it is generally advised for people to refrain from fasting during Ramadan since the body may not be able to cope with sudden changes in dietary practices. It is best recommended to consult with your doctor and understand how the fasting rules can be relaxed and the best practice to be followed for you in order to avoid any severe health consequences.

For those trying to lose weight

For those trying to lose weight, fasting should not be an excuse for you to sleep all day or be lazy. In Ramadan, you should maintain your usual daily activity level to a certain extent, but do avoid the sun and heat at its peak. After you end your fast, aim for 30 minutes of exercise a day that you can do from home such as lunges, sit-ups and squats.

Challenge yourself to only eat naturally occuring sugar such as fruits, dried fruits, molasses and honey. Keep a check on the quantity of food that you consume during Iftar and Suhour. Excessive eating during this period might make you gain weight. During this period, your body has been subjected to the state of famine, when you now eat excessively, it will store food as fat because it will be worried about its shortage of food supply. Consume lots of natural fluids, but avoid carbonated drinks and fruit juices with high sugar content.


For pregnant and new mums

Pregnant or breastfeeding women are advised to talk to their physician and get a general health check before deciding to fast.

It is absolutely vital for the health of the baby. It is medically not advisable for women who have pregnancy complications such as diabetes, high blood pressure or anaemia to fast. Pregnant women with these underlying conditions should avoid fasting in order to protect themselves and their unborn babies from any further unwanted complications.

In general breastfeeding women need to ensure they eat a balanced diet and up to 500 extra calories in addition to the normal daily recommended amount of 2000 calories for females. Lots of fruits, vegetables and foods rich in minerals and calcium are also recommended. If a fasting lactating woman begins to notice any signs of dehydration (feeling very thirsty, dizzy, weak, very tired, fainting, having a severe headache, passing dark-coloured strong-smelling urine) she should immediately end her fast by taking sweet fruit juice or salt-water solution and rest. If she still feels unwell after 30 minutes, she should consult 
her doctor.


Elderly

Elderly patients who fast can be at the risk of complications like hypoglycemia and hyperglycemia. Elderly people should be cautious when it comes to dehydration due to their lack of the sense of thirst.
Heart conditions

Patients with heart conditions should consult their cardiologists on how their medication should be administered during Ramadan. Perhaps use long-lasting medications in order to compensate for the daily 14-hour fasting time. Patients with uncontrolled hypertension should strictly refrain from going on fast.

Diabetes

For diabetes patients, dose and timing of medications is key. You should ask your doctor to adapt the dose and timings for your diabetes medication prior to Ramadan. For diabetics, the body burns sugar throughout the day and cravings increase. Watch out for foods high in sugar between Iftar and Suhour and eating healthy and balanced Iftar and Suhour. Overeating is often a problem that increases during this month and it can cause duodenal ulcers as fasting increases gastric acidity. When you have a plan to exercise after Iftar, you’ll have a lower tendency of overeating. Ramadan is not an excuse to be lazy.

General advice

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Good diet is key to healthy digestion during Ramadan. If a correct diet is not followed during the Ramadan period, a person is prone to getting ailments related to the digestive health. Some symptoms frequently encountered during Ramadan include indigestion, bloating and heartburn, particularly after eating too much at iftar or suhour meals. Eating in moderation and elimination of foods that can trigger gastro-oesophageal reflux are helpful.

Avoid fried, fatty and acid-containing foods and fruits (citrus fruits like lemons, limes, grapefruits and oranges) along with tomato-based products (tomato is technically a fruit containing a lot of acid). Also, limit your intake of caffeine-containing drinks like tea, coffee, sodas, etc. These make you pass more urine, taking with it valuable mineral salts that your body would need during the long day of fasting. Avoid smoking.

Consume complex carbohydrates or slow-digesting food at suhour so that the food lasts longer, making you less hungry as well as more energetic for the day. Drink water, non-acidic fruit juices and drinks containing potassium as much as possible between breaking of fast and bedtime so that your body may adjust fluid levels for the next day. Consult your doctor before Ramadan if you have any concerns about your condition or medications.

Children

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Children should start fasting gradually in order for their bodies to slowly adjust to new eating habits. Make sure they have a diet that includes proteins, fresh juices and other healthy drinks as well as fruits and vegetables. Kids should sleep early in order to wake up and have an equitable suhour as it’s as important as having breakfast on a regular day.

Also read: 10 initiatives in the UAE to support during Ramadan

Fitness fans

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Those who already have active lives, also need to take precautions during the fasting period.

During Ramadan, there is a lot to consider and there are a number of things you need to adjust in order to continue training while fasting; however it doesn’t mean that your training has to stop. Exercise and fasting can go hand in hand. There is no perfect time to exercise during Ramadan, it is all about what works for you. Your suhour meal must contain easily digestible protein, some complex carbs and essential fats.

Drinking plenty of water during iftar and suhour. Add sea salt to your water or drink coconut water to increase the electrolytes in your body, which are essential for heart, nerve and muscle functions. The best times to hit the gym during Ramadan is either early in the morning, after suhour or after iftar.

Training before suhour will probably mean training at 3am. You can easily replenish your protein and nutrient levels after the work out, and drink fluids during the workout itself. Exercising before iftar is advised only with low intensity work outs. Your carbohydrate levels will be very low at this time so you won’t have as much energy as you normally would. The major downside here is that you cannot drink water during your workout so make sure you get plenty of fluids the moment you end your fast. If you plan to exercise after iftar, make sure that you do not consume high-fat food, fried food and high sugar foods. Limit the intake of these. Instead, consume some quality protein at Iftar. Keep a gap of at least 45 minutes before you exercise.

Information courtesy of Dr Spurthy Sirivella, Dr Amal Upadhyay, Dr Basir Sajjad Bhatt, Dr Keya Rahul Shivadey at Aster clinics, and Dr Shukri Farah from Burjeel Hospital