Healthy Fasting During Ramadan: A Medical Guide

Ramadan is a month of spiritual reflection, prayer, and community. Muslims who are able to fast abstain from food and drink from dawn to sunset. In the UAE, fasting hours typically range from 13 to 15 hours depending on the time of year. With proper preparation and awareness, most healthy adults can fast safely.

Is It Safe to Fast?

For most healthy adults, fasting during Ramadan is safe. However, certain groups should consult their doctor before fasting:

People Who Should Seek Medical Advice

• People with type 1 diabetes (high risk - medical guidance essential)
• People with type 2 diabetes on insulin or sulfonylureas
• People with kidney disease
• People with heart disease or recent cardiac events
• Pregnant or breastfeeding women
• People taking multiple medications
• People with low or high blood pressure
• Children and elderly with chronic conditions

People Who Are Generally Exempt

Islamic scholars and medical guidelines agree that the following groups should not fast:

• People with serious acute or chronic illness where fasting poses a health risk
• Pregnant or breastfeeding women if there is risk to mother or baby
• People with uncontrolled diabetes
• Elderly individuals who are frail

The International Diabetes Federation and the Diabetes and Ramadan International Alliance have published guidelines for people with diabetes wishing to fast, categorising risk from low to very high.

Nutrition During Ramadan

Suhoor (Pre-Dawn Meal)

• Eat as close to dawn as possible (do not skip suhoor)
• Choose slow-release carbohydrates: Oats, wholemeal bread, brown rice
• Include protein: Eggs, cheese, yoghurt, beans
• Include healthy fats: Nuts, avocado, olive oil
• Hydrate well: Water, milk, or fresh juices (avoid caffeine as it increases fluid loss)
• Fruit (dates, bananas) for fibre and potassium

Iftar (Breaking the Fast)

• Break your fast with dates and water (a Sunnah tradition that also provides quick natural sugar and hydration)
• Avoid overeating - eat slowly and in moderate portions
• Include vegetables and salad with your main meal
• Choose grilled or baked foods over fried
• Limit sugary desserts (or have small portions)
• Continue drinking water throughout the evening

Hydration

• Aim for 2-3 litres of water between iftar and suhoor
• Avoid caffeinated drinks late in the evening
• Reduce salty foods (they increase thirst)
• Include water-rich foods (watermelon, cucumber, tomatoes)

Managing Medications During Ramadan

Common Adjustments

• Once-daily medications: Can often be moved to iftar or suhoor time
• Twice-daily medications: Can often be taken at suhoor and iftar
• Three-times-daily medications: May need to be changed to a long-acting formulation

Diabetes Medications

• Metformin: Usually safe during fasting; dosing may be adjusted
• Sulfonylureas (glyburide, gliclazide): Risk of hypoglycaemia - may need dose reduction or timing change
• Insulin: Requires careful adjustment - do NOT change doses without medical guidance
• SGLT2 inhibitors: Risk of dehydration; discuss with your doctor

Important Rules While Fasting With Medication

• Monitor blood sugar more frequently if you have diabetes
• Break your fast immediately if blood sugar drops below 3.9 mmol/L (70 mg/dL) or rises above 16.7 mmol/L (300 mg/dL)
• Carry glucose tablets or a sugary drink in case of hypoglycaemia

Physical Activity During Ramadan

• Light to moderate exercise (walking, stretching) is safe for most people
• Best times: after iftar (1-2 hours) or shortly before iftar
• Avoid strenuous exercise during fasting hours, especially in the heat
• Stay in air-conditioned environments during peak heat hours

Common Health Issues During Ramadan

Headaches

• Often due to dehydration, caffeine withdrawal, or low blood sugar
• Prevention: adequate hydration at suhoor, gradual caffeine reduction before Ramadan

Constipation

• Due to reduced fluid and fibre intake
• Prevention: high-fibre foods, adequate water, fruits and vegetables

Indigestion

• Due to overeating at iftar or eating too quickly
• Prevention: eat slowly, in moderate portions, avoid very fatty or spicy food

Fatigue

• Common, especially in the first few days
• Usually improves as the body adjusts
• Ensure adequate sleep and rest

When to Break Your Fast for Medical Reasons

• Feeling faint, dizzy, or very unwell
• Blood sugar below 3.9 mmol/L or above 16.7 mmol/L
• Signs of dehydration: severe thirst, dark urine, confusion, rapid heartbeat
• Chest pain or difficulty breathing
• Any acute illness

This article is for informational purposes only and does not replace professional medical advice. Consult your doctor before Ramadan to plan your medication and fasting safely.