Nutrition and Ramadan

Background 

Ramadan is the ninth month of the Islamic calendar and a time when many Muslims across the world fast during daylight hours for 29-30 days. It is a month of fasting, prayer, reflection, practicing kindness and patience. Muslims abstain from consuming any food or drink from sunrise to sunset during the holy month of Ramadan. A meal is eaten before sunrise (the ‘suhoor’ or ‘sehri’) and another after sunset (the ‘iftar’).  ‘Eid-ul-Fitr’ (Festival of the Breaking of the Fast) marks the end of Ramadan where a special celebratory meal is eaten during the festival, the first daytime meal for a month. 

All Muslim adults who are in good health must fast, although there are exceptions for those who are physically or mentally unwell, the elderly, or whose health could be negatively impacted by fasting, such as pregnant or breastfeeding women and people with diabetes. 

Impacts of Fasting on the Body 

Once all the calories from the foods consumed during the night have been used up, the body uses its stores of carbohydrate (stored in the muscles and liver) and fat to supply energy during fasting hours. 

The body cannot store water, so the kidneys conserve as much water as they can by minimising the amount lost in urine. However, some losses are inevitable through the skin during warm temperatures or exercise. 

It is important to mention that most people who fast throughout Ramadan will experience mild dehydration, which may result in headaches, fatigue, and difficulties concentrating. This may depend on the weather and the length of the fast. 

This enhances the importance of ensuring that enough fluids are consumed after breaking the fast to replace those lost during the day.  

However, if you are unable to stand due to dizziness or are disoriented, you should immediately drink water preferably with sugar and salt. If you faint because of dehydration, your legs should be raised above your head by others, and when you awake, you should urgently rehydrate as described above. 

Nutrition and Hydration Tips 

Try to mirror your normal mealtime routine in your non-fasting hours. It’s important that we eat and drink regularly to nourish our bodies and our microbes. Think of starting your fast as breakfast (sohour), ending your fast with a main meal (iftar), and having a supper later in the evening. 

What to eat and drink at Iftar 

Try splitting iftar or ‘breaking fast’ into two or three meals to aid a ‘little-and-often' approach to support fullness. It should include plenty of fluids, fruit, foods containing some natural sugars for energy (avoid consuming a lot of foods or drinks with added sugars) and well-balanced meals providing a balance of starchy foods including wholegrains where possible, vegetables, dairy foods and foods rich in protein such as meat, fish, eggs and beans, as highlighted by the Eatwell Guide.  

In addition, try to reduce quantities of high fat, sugar and salt food items and sweetened beverages you consume at iftar. The quality of your food is particularly crucial during Ramadan since you only have a limited amount of time each day to eat and drink in order to provide your body all the vital nutrients, vitamins and fluids it requires to remain healthy. 

Some examples include: 

Drinks: water, sugar free cordial, milk, fruit juices (150ml a day) or smoothies with low-fat dairy alternatives. Avoid drinking a lot of drinks with added sugars after breaking the fast as these can provide too many sugars and calories. 

Dried fruit: dates are a great way to break the fast as they provide natural sugars for energy, provide minerals like potassium, copper and manganese and are a source of fibre. Other dried fruit options include apricots, figs, raisins or prunes, which also provide fibre and nutrients. 

Fruit: provide natural sugars for energy, fibre, fluid and essential micronutrients. 

Soup: is a light way to break the fast and provides fluid. Traditional soups frequently include starchy foods like pasta or grains, as well as pulses like lentils and beans, to add nutrients and energy. These soups are typically based on a meat broth. 

What to eat and drink at Suhoor: 

Drink a lot of water, choose foods that are high in fluids to ensure hydration for the day ahead and choose starchy foods for energy. Where possible, choose high-fibre or whole-grain varieties as these can help you feel fuller longer and can aid in digestion, which can help prevent constipation. 

Examples include:

Oats: these wholegrain options include overnight oats, muesli with milk or yoghurt, and porridge, all of which will add fluids to your diet. As toppings, you can experiment with fresh or dried fruit, nuts, or seeds. 

High fibre breakfast cereals: These are nutrient-dense foods that are high in fibre and frequently fortified with vitamins and minerals. They are often consumed with milk, which also provides fluids and nutrients like calcium, iodine, and B vitamins. 

Starchy foods: such as rice, quinoa and couscous - you may try rice pudding with fruit or experiment with couscous or other grains with dairy or fruit. If you choose savoury dishes for suhoor, it's a good idea to make sure they aren't very salty as this could cause you to break your fast by being extremely thirsty. 

Yogurt: is a nutritious food that is suitable for suhoor since it contains nutrients like protein, calcium, iodine, and B vitamins. It could be combined with fruit and cereal and/or seeds. 

Bread: Use wholegrain breads like wholemeal toast or chapattis since they are higher in fibre. Bread should not be eaten with meals high in salt, such as hard cheese or preserved meats as this can increase thirst. You could try banana, soft cheese, or nut butters (without salt added). Drink plenty of water or other liquids while eating bread because it tends to be very dry.  

Additional Tips: 

• In the week before Ramadan, cutting back on caffeine intake may be beneficial. Herbal tea, water, decaffeinated tea, and coffee can all help with headache relief and better sleep. 

• Limit your salt intake. Throughout the fast, salt can exacerbate thirst and dehydration. Be cautious of processed foods with high salt content, such as chutneys, sauces, and cheese. Swap out using herbs and spices to flavour food. 

• Divide your fluid requirements equally between iftar and suhoor. Drinking too much at once can be satiating and may reduce appetite. 

• Prioritise protein in meals such as meat, fish, eggs and beans to prevent muscle mass loss.

• If you or your healthcare provider are concerned about weight loss: add extra tahini to hummus and extra full-fat milk and cream to smoothies, cream to soups, and peanut butter to dates to increase the energy density of meals. 

• Practice mindful eating - consume food slowly and monitor your fullness levels. 

• An over-the-counter multivitamin may be appropriate if vitamin and mineral targets are not met through a well-balanced diet. In the UK, during the months of Ramadan, a 10mcg vitamin D supplement a day is also advised because sunlight is still limited.