Healthy Diet During Ramadan

Mohammad Zafar A. Nomani, Ph.D., R.D.

It is a globally recognised and foremost part of dietary guidelines that eating a variety of food using principles of moderation and balance is key to good health. This is particularly true during the Islamic month of Ramadan when Muslims fast from dawn to sunset. To be healthy, one must consume food from the major food groups: bread and cereal, milk and dairy product, meat and bean, vegetable and fruit. During the month long fast of Ramadan the metabolic rate of a fasting person slows down and other regulatory mechanisms start functioning. Body and dietary fat is efficiently utilised. Consuming total food intake that is less than the total food intake during normal days is sufficient to maintain a person's health. Intake of fruits after a meal is strongly suggested. A balanced diet improves blood cholesterol profile, reduces gastric acidity, prevents constipation and other digestive problems, and contributes to an active and healthy life style. (Int. J. Ramadan Fasting Research, 3:1-6, 1999)

Fasting during the Islamic month of Ramadan can be good for one's health and personal development. Ramadan fasting is not just about disciplining the body to restrain from eating food and drinking water from predawn until sunset. Ramadan is also about restraining anger, doing good deeds, exercising personal discipline, and preparing oneself to serve as a good Muslim and a good person during and after Ramadan.

Ramadan fasting has spiritual, physical, psychological, and social benefits; however, manmade problems may occur, if fasting is not properly practiced. First of all, there is no need to consume excess food at iftar, dinner or sahur (sehri). The body has regulatory mechanisms that activate during fasting. There is efficient utilisation of body fat. Basal metabolism slows down during Ramadan fasting. A diet that is less than a normal amount of food intake but balanced is sufficient enough to keep a person healthy and active during the month of Ramadan.

Health problems can emerge as a result of excess food intake, foods that make the diet unbalanced, and insufficient sleep. Ultimately also, such a lifestyle contradicts the essential requirements and spirit of Ramadan.

DIET DURING RAMADAN
According to Sunna (the practices of Prophet Muhammad, Pbuh) and research findings referred in this report, a dietary plan is given:

1. Bread/Cereal/Rice, Pasta, Biscuits and Cracker Group: 6-11 servings/day; 2. Meat/Beans/ Nut Group: 2-3 servings/day. 3. Milk and Milk Product Group: 2-3 servings/day. 4. Vegetable Group: 3-5 servings/day; 5. Fruit Group: 2-4 servings/day. 6. Added sugar (table sugar, sucrose): sparingly. 7. Added fat, polyunsaturated oil 4-7 table spoons.

Breakfast, iftar:
Dates, three
Juice, 1 serving (4 oz.)
Vegetable soup with some pasta or crackers, 1 cup
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 cells. Dates and juices are good sources of sugars. Dates and juice in the above quantity are sufficient to bring low blood glucose levels to normal levels. Juice and soup help maintain water and mineral balance in the body. An unbalanced diet and too many servings of sherbets and sweets with added sugar have been found to be unhealthy.

Dinner:
Consume foods from the following food groups:

Meat/Bean Group: Chicken, beef, lamb, goat, fish, 1-2 servings (serving size = a slice =1 oz); green pea, chickpea (garbanzo, chana, humus), green gram, black gram, lentil, lima bean and other beans, 1 serving (half cup). Meat and beans are a good source of protein, minerals, and certain vitamins. Beans are a good source of dietary fiber, as well.

Bread/Cereal Group: Whole wheat bread (roti), 2 servings (serving size = 1 oz) or cooked rice, one cup or combination. This group is a good source of complex carbohydrates, which are a good source of energy and provide some protein, minerals, and dietary fiber.

Milk Group: milk or butter-milk (lassi without sugar), yogurt or cottage cheese (one cup). Those who can not tolerate whole milk must try fermented products such as butter-milk and yogurt. Milk and dairy products are good sources of protein and calcium, which are essential for body tissue maintenance and several physiological functions.

Vegetable Group: Mixed vegetable salad, 1 serving (one cup), (lettuce, carrot, parsley, cucumber, broccoli, coriander leaves, cauliflower or other vegetables as desired.) Add 2 teaspoons of olive oil or any polyunsaturated oil and 2 spoons of vinegar. Polyunsaturated fat provides the body with essential fatty acids and keto acids. Cooked vegetables such as guar beans, French beans, okra (bhindi), eggplant (baigan), bottle gourd (loki), cabbage, spinach, 1 serving (4 oz). Vegetables are a good source of dietary fibre, vitamin A, carotene, lycopenes, and other phytochemicals, which are antioxidants. These are helpful in the prevention of cancer, cardiovascular diseases, and many other health problems.

Fruits Group: 1-2 servings of citrus and/or other fruits. Eat fruits as the last item of the dinner or soon after dinner, to facilitate digestion and prevent many gastrointestinal problems. Citrus fruits provide vitamin C. Fruits are a good source of dietary fiber.
Fruits and mixed nuts may be eaten as a snack after dinner before sleep.

Pre-dawn Meal (sehri):
Consume a light sehri. Eat whole wheat or oat cereal or whole wheat bread, 1-2 serving with a cup of milk. Add 2-3 teaspoons of olive oil or any other monounsaturated or polyunsaturated fats in a salad or the cereal. Eat 1-2 servings of fruits, as a last item.

Blood cholesterol and uric acid levels are sometimes elevated during the month of Ramadan. Contrary to popular thinking, it was found that intake of a moderately high-fat diet, around 36% of the total energy (calories), improved blood cholesterol profile. It also prevents the elevation of blood uric acid level (8-10). The normal recommended guideline for fat is 30% or less energy. On weight basis, suggested fat intake during Ramadan is almost the same as in normal days. Fat is required for the absorption of fat-soluble vitamins (A, D, E, K) and carotenoids. Essential fatty acids are an important component of the cell membrane. They also are required for the synthesis of the hormone prostaglandin. Keto-acids from fat are especially beneficial during Ramadan to meet the energy requirement of brain and nerve cells.

During Ramadan increased gastric acidity is often noticed, exhibiting itself with symptoms such as a burning feeling in the stomach, a heaviness in the stomach, and a sour mouth. Whole wheat bread, vegetables, humus, beans, and fruits -- excellent sources of dietary fibre -- trigger muscular action, churning and mixing food, breaking food into small particles, binding bile acids, opening the area between the stomach and the deudenum-jejunum and moving digesta in the small intestine. Thus, dietary fibre helps reduce gastric acidity and excess bile acids. It is strongly suggested that peptic ulcer patients avoid spicy foods and consult a doctor for appropriate medicine and diet. Diabetic subjects, particularly severe type I (insulin dependent) or type II (non-insulin dependent), must consult their doctor for the type and dosage of medicine, and diet and precautions to be taken during the month. Generally diabetes mellitus, type II, is manageable through proper diet during Ramadan.

Pregnant and lactating women's needs for energy and nutrients are more critical than the needs of others. There is a possibility of health complications to the pregnant woman and the fetus or the lactating mother and the breastfed child, if energy and nutrient requirements are not met during the month of Ramadan. Governments, communities, and heads of the family must give highest priority to meet women's dietary needs. In African countries, Bangladesh, India, Pakistan and many other places malnutrition is a major problem, especially among women from low-income groups. Further more, it is common among these women to perform strenuous work on farms or in factories, and other places. Malnutrition and strenuous conditions may lead to medical problems and danger to life. Under these conditions one must consult a medical doctor for treatment. Quran Al-Hakeem and Hadith allow pregnant women and lactating mothers flexibility during the month of Ramadan.

Further suggestions:
Drink sufficient water between Iftar and sleep to avoid dehydration.

Consume sufficient vegetables at meals. Eat fruits at the end of the meal.

Avoid intake of high sugar (table sugar, sucrose) foods through sweets or other forms.
Avoid spicy foods.

Avoid caffeine drinks such as coke, coffee or tea. Caffeine is a diuretic. Three days to five days before Ramadan gradually reduce the intake of these drinks. 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 utilisation of various vitamins, metabolites and enzyme systems in the body.

Do not forget to brush your teeth before sleep and after sehri. Brush more than two times or as many times as practicable.

Normal or overweight people should not gain weight. For overweight people Ramadan is an excellent opportunity to lose weight. Underweight or marginally normal weight people are discouraged from losing weight. Analysing a diet's energy and nutritional component, will be useful in planning an appropriate diet.

It is recommended that everyone engage in some kind of light exercise, such as stretching or walking. It's important to follow good time management practices for Ibada (prayer and other religious activities), sleep, studies, job, and physical activities or exercise.

In summary, intake of a balanced diet is critical to maintain good health, sustain an active lifestyle and attain the full benefits of Ramadan.

The writer is Professor of Nutritrtion, West Virginia University, USA. The article was first published in the The International Journal of Ramadan Fasting Research, a publication of the International Society for Ramadan Fasting Research, an association of scholars studying human metabolism and behavior related to Ramadan fasting. The society is dedicated to the improvement of dietary, medical, health, social and personal practices by Muslims and non-Muslim during the month of Ramadan and afterwards.