KARACHI: Cut down on deep-fried foods as they cause indigestion, heartburn, weight gain and make you feel bloated. Try grilled, baked, steamed or shallow-fried foods. High sugar and high fat foods give body a sudden energy rush which makes it difficult to fast the whole day.

Dr S.M. Wasim Jafri, a senior hepatologist and gastroenterologist, offered these suggestions as he spoke to Dawn about fasting during Ramazan, its impact on health and nutrition.

On what constituted the right food in Ramazan, he said that slow digesting and energy rich foods helped the body to avoid feeling bloated and tired.

“These foods include porridge, muesli, bran, semolina, beans, egg, chicken, fish, wholemeal bread/roti, rice, fig, dates, bananas, apricots and pears.

“Good hydration aids digestion, reduces headaches and dizziness. For desserts, people should try to have more milk-based desserts like yoghurt,” he explained.

On likely dehydration during fasting, he said it’s a genuine concern given the fact a person consumed restricted quantity of food and fluids.

“Studies have shown that total water intake decreases during Ramazan. The body responds by decreasing the output of urine and increasing urine concentration. If proper care is not taken to ensure rehydration during non-fasting hours, dehydration can be a serious complication and can even be fatal,” he observed.

Serious symptoms of dehydration included dizziness, lethargy, muscle cramps, disorientation, or fainting.

“If such a situation occurs, immediate steps should be taken to provide fluids to correct the dehydration. In healthy individuals, however, kidney function and urine output are not impacted negatively despite the increased need for the body to concentrate urine,” he said.

How to benefit

Talking about how the body responds to and benefits from fasting, he said that the month of Ramazan required giving the stomach a break, helping the body expel accumulated toxins.

Fasting, he said, offered a great opportunity to focus on a balanced and healthy lifestyle and start learning ways to develop self-control and improve eating habits.

“It’s a time to develop heightened consciousness for spiritual matters, concern for community and personal behaviour and attitudes,” he said, adding that the body’s response to fasting depended on the length of the fast.

Once the body digested and absorbed all of the food and nutrients from the last meal, which takes eight to 12 hours, the body goes into a fasting state and relies on stored nutrients for energy.

The body changed certain hormones to access these stored nutrients, keeping a constant supply of glucose (energy).

“After about 24 hours, a healthy adult will run out of stored glucose sources and begin making new glucose by breaking down protein stores, including muscle tissue.

“Fortunately, however, fasting from dawn to dusk during Ramazan allows for a gentle and normal transition to using glycogen and fats for energy without the undesirable protein breakdown associated with longer fasts,” he pointed out.

The impact of Ramazan fasting on metabolic markers of health, according to Dr Jafri, has been the topic of many studies. A recent review shows beneficial effects of fasting in Ramazan on markers of cardiovascular risk, diabetes, glucose control and kidney function.

“Scientists are uncovering evidence that short periods of fasting, if properly controlled, could achieve a number of health benefits, as well as potentially helping the overweight. Benefits include reduced risk of cardiovascular heart disease, bad cholesterol, stomach disease, bowel disease, obesity, restarting smoking, nerve impairment and psychological illnesses,” he said.

Guideline for diabetics

Meanwhile, the Jinnah Sindh Medical University held a public awareness programme on health in Ramazan on Thursday where speakers highlighted various health benefits of fasting and answered related queries.

Gynaecologist Dr Lubna Ali of Dow University of Health Sciences said that pregnant women could safely fast after the first trimester as no significant impact of fasting had been observed on foetal growth.

“However, individual consultation with a gynaecologist was necessary to determine any other factors that might affect pregnancy during Ramazan,” she cautioned.

Cardiologist Dr Fawad Farooq of National Institute of Cardiovascular Diseases said that patients who have had a heart attack more than a month ago must seek a proper consultation with their doctor to see if their individual condition permitted fasting.

Head of the Jinnah Postgraduate Medical Centre’s nephrology department Dr Abdul Mannan said that people suffering from acute kidney disease along with complaints of blood pressure should avoid fasting in Ramazan.

A person on dialysis, he suggested, should take three separate meals at Sehar, Iftar and midnight. He advised against excessive consumption of dates, bananas, and citrus fruits because these foods delivered excess potassium causing problems for a patient.

He also asked patients to avoid excessive sugar and salt in all meals.

“Patients with recurrent problem of kidney stone formation can fast but should have increased intake of water between Iftar and Sehar,” he said.

Dr Mohammad Yaqoob Ahmadani of Baqai Institute of Diabetology and Endocrinology emphasised the need for making guidelines for fasting for diabetics as the country had a high number of people affected by the disease.

These patients, he said, should visit their doctor two months before Ramazan to seek proper individual guidance and prepare themselves for fasting.

Head of the Department of Medicine at JPMC Dr Masroor Ahmed said that human life was sacred in Islam. Therefore, if a need for medical intervention arose, a patient must be helped even if it required breaking fast.

Published in Dawn, May 18th, 2018