The changes that occur in the body in response to fasting depend on the length of the continuous fast. Technically the body enters into a fasting state eight hours or so after the last meal, when the gut finishes absorption of nutrients from the food. In the normal state, body glucose, which is stored in the liver and muscles, is the body's main source of energy. During a fast, this store of glucose is used up first to provide energy. Later in the fast, once the stores of glucose run out, fat becomes the next store source of energy for the body. As the Ramadan fast only extends from dawn till dusk, there is ample opportunity to replenish energy stores at pre-dawn and dusk meals. This provides a progressive gentle transition from using glucose to fat as the main source of energy, and prevents the breakdown of muscle for protein. The use of fat for energy aids weight loss, preserving the muscles, and in the long run reduces your cholesterol levels. In addition weight loss results in better control of diabetes and reduces blood pressure. A detoxification process also seems to occur, as any toxins stored in the body's fat are dissolved and removed from the body. After a few days of the fast, higher levels of certain hormones appear in the blood (endorphins), resulting in a better level of alertness and an overall feeling of general mental well-being. The kidney is very efficient at maintaining the body's water and salts, such as sodium and potassium. However, these can be lost through sweating, to prevent muscle break down, meals must contain adequate levels of ‘energy food' such as carbohydrates and some fat. Hence, a balanced diet with adequate quantities of nutrients, salts and water is vital. Foods that harm, foods that benefit The fasts of Ramadan can improve a person's health but - if the correct diet is not followed - can possibly worsen it! The deciding factor is not the fast itself, but rather what is consumed in the non-fasting hours. To fully benefit from fasting a person should spare a great deal of thought to the type and quantity of food they will indulge in through the blessed month. Overeating can not only harm the body but it is thought to also interfere with a person's spiritual growth during the month. • Complex Carbohydrates are foods that will help release energy slowly during the long hours of fasting. Complex carbohydrates are found in grains and seeds, like barley, wheat, oats, millets, semolina, beans, lentils, wholemeal flour, basmati rice, etc. • Fibre-rich foods are also digested slowly and include bran, cereals, whole wheat, grains and seeds, potatoes with the skin, vegetables such as green beans and almost all fruit including apricots, prunes, figs, etc. Foods to avoid are the heavily-processed, fast-burning foods that contain refined carbohydrates in the form of sugar, white flour, etc. as well as of course, too much fatty foods (e.g. cakes, biscuits, chocolates and sweets. It may also be worth avoiding the caffeine content in drinks such as tea, coffee and cola. (Caffeine is a diuretic and stimulates faster water loss through urination). Meals Suhoor, the pre-dawn meal should be a wholesome, moderate meal that is filling and provides enough energy for many hours. It is therefore particularly important to include slowly-digesting foods in the suhoor. Iftar is the meal which breaks the day's fast. Dates will provide a refreshing burst of much needed energy. Fruit juices will also have a similar, revitalising effect. Try to minimise the rich, special dishes that traditionally celebrate the fast. Many of the foods which are mentioned and encouraged are in the Holy Qur'an and the Sunnah also correspond to modern guidelines on a healthy diet and will help to maintain balanced, healthy meals in Ramadan. The most commonly consumed foods by Prophet Muhammed (peace be upon him) were milk, dates, lamb/mutton and oats. Healthy foods mentioned in the Holy Qur'an are fruit and vegetables such as olives, onions, cucumber, figs, dates, grapes as well as pulses such as lentils. Heartburn The stomach is an acidic environment, designed to digest food and kill bacteria. The stomach and oesophagus (gullet) are normally protected from this acid, by the body's own special juices, and “valves” between these two organs. If either too much acid is produced or the valve at the bottom of the oesophagus is “faulty”, you may experience heartburn. Fasting usually reduces the amount of acid produced, but thoughts of food or the smell of it makes the brain order the stomach to produce more acid. Hence if there is a net increase in acid, heartburn could be a problem during the fast. Those who are on regular medication for indigestion, such as antacids or proton pump inhibitors are advised to continue taking them, at Suhoor for instance. The control of heartburn or belching can be aided by eating in moderation, avoiding oily, deep fried or very spicy food. Reducing your caffeine intake and/or stopping smoking can also be of benefit, if relevant. Sleeping with your head raised on a few pillows and long term weight loss may also help prevent heartburn. Controlling diabetes Those injecting insulin are advised not to fast, as the potential risk to health, both in the short and long term, of not taking insulin is too great. People, who have their diabetes under control using tablets, should ensure that they visit their doctor prior to Ramadan, in order to discuss any possible changes to their drug regime which would facilitate a safe fast. If not, such patients are at risk of poor control of their diabetes during and outside the fasting times. Regular self-monitoring of your blood glucose is strongly advised. Low blood sugar levels (a hypo) is dangerous, and if untreated may lead to faint or fits, and hence must be strictly avoided. Feeling dizzy, sweaty and disorientated may all suggest “a hypo”. If suspected, you should have a sugary drink, or place sugar or a sugar-rich sweet below the tongue, immediately. Diabetics with further complications, such as angina or heart failure, stroke, retinopathy (eye disease), nephropathy (kidney disease) and neuropathy (nerve disease of feet/hands with numbness/loss of feeling) should seek careful advice from their doctor before starting a fast. Headache This is a common problem and has many causes. Headaches during a fast could commonly be due to dehydration or hunger, inadequate rest, or due to the absence of addictive substances such as caffeine or nicotine. A moderate and balanced diet, especially not missing the pre-dawn meal, consuming adequate quantities of fluid and if necessary taking a dose of painkillers such as paracetamol, may all go a long way towards either preventing, or reducing the risk of developing a disabling headache. Headaches can be prevented by sensible measures, such as not exposing oneself to direct sunlight, wearing a hat when out, using sunglasses to reduce the effect of glare from the sun or relieving any tense muscles by a short gentle massage. Dehydration Dehydration is a common occurrence during a fast. The body continues to lose water and salts through breathing, sweat and urine; the quantity of water loss will vary depending on the weather, how much you had to drink before your fast, the degree of physical exertion and the ability of the kidney to retain water and salts. Prevention is always better than cure. However, if you do not adequately re-hydrate before a fast, your risk of dehydration is increased. This risk is higher in the elderly, and in those taking tablets such as diuretics. Depending on the severity of the dehydration, you may experience a general feeling of being unwell, lethargy, muscle cramps, dizziness, disorientation and even collapse or faint. If you are unable to stand-up due to dizziness, or disorientated, you should urgently re-hydrate with regular moderate quantities of water, ideally with sugar and salt, such as Dioralyte or Lucozade. Constipation Constipation could be a very irritating problem for the person undertaking a fast. Maintaining good hydration outside the fast, eating healthily, with lots of fruit and vegetables in your diet, increasing the fibre content using bran and being active, all help to keep your bowel motions as regular as would otherwise be expected. If the problem persists, a short course of bulk laxatives may help. __
