Healthy fasting during Ramadan

FASTING during the holy month of Ramadan is a privilege and an honour to observe. However, according to the Muslim religion, if you are not well, or have a chronic illness, you are excused.

“There’s no forcing in the Muslim religion so if you are not well or if you are going to have some problems, then it’s all right not to fast but you have to pay alms or replace it.

“But most senior citizens would fast because they are not really big eaters,” says Prof Dr Fatimah Arshad, head of Nutrition & Dietetics at the International Medical University (IMU), citing her own mother as an example.

Prof Dr Fatimah Arshad: 'It's okay for them to fast, provided they take sahur (the early morning meal) and have their diet properly planned.'
Prof Dr Fatimah Arshad: ‘It’s okay for them to fast, provided they take sahur (the early morning meal) and have their diet properly planned.’

“It’s okay for them to fast, provided they take sahur (the early morning meal) and have their diet properly planned. If they have brittle diabetes and they easily get hypoglycaemic without food then it’s quite dangerous for them to fast,” she adds.

According to her, it is best to advise the elderly on the consequences should they decide to fast. However, the decision is ultimately theirs.

That means if they feel light-headed, start sweating or show signs of hypoglycaemia and if their blood sugar is low, then they should break their fast.

She informs that before Ramadan, the seniors would have had a chance to “practise” fasting during the months of Rajab and Shaban (of the Muslim calendar).

“Normally they will fast unless they have signs or symptoms of illness.

“We advise patients and encourage them to practise before the fasting month. We would then follow up in their other visits to see if they were successful in fasting. But, it’s up to them; we cannot say don’t fast, so we tell them that if they want to fast they should take their meals properly and make sure they drink plenty of fluids at night and are not so active in the day time. Perhaps they can rest at home or take a nap in the afternoon. Normally the elderly are not that active compared with the young anyway,” says Prof Dr Fatimah.

She informs that there should still be three main meals – breakfast, lunch and dinner. Typically, if the elderly is able to eat well, then sahur would consist of a lunch type of meal.

The buka puasa (break of fast) would be a lighter meal – like breakfast. They could perhaps have juice or a milky drink and some snacks and dates.

Then, after Maghrib prayers, they can have their dinner – rice, vegetables and perhaps a piece of fish and with fruits and milk or water.

If they go to the mosque for tarawih prayers, they might have a biscuit or milky drink after that.

“I would recommend them to take more of vegetable soups during the evening meal. I wouldn’t force them to drink a lot of water because normally the recommendation is 4-6 glasses of water for the elderly. That should be enough, especially if they don’t go out in the sun much,” says Prof Dr Fatimah, informing that the sense of thirst is not so acute in old age.

She cautions that their diet should not change just because it is Ramadan and they are fasting. They should have whatever types of food they normally eat and are used to.

When it comes to preparing food for the elderly, Prof Dr Fatimah says it must be tasty and up to the expectations of the elderly, otherwise they won’t eat.

If buying food from the Ramadan bazaar, the professor says to be careful. Cleanliness and hygiene should be a priority to avoid getting food poisoning.

Tips for fasting

Nutrients – Look into the nutrients that the elderly is getting. For example, calcium, iron, vitamins and minerals. Their diets must incorporate milk or milky drinks, at least two glasses of low fat milk or skimmed milk powder. They can either drink it like that or flavoured with Horlicks or Milo. That would take up about 400 calories.

An elderly person would require about 1,500 calories a day. Some of them don’t eat much and can get about 1,000 calories from their meals. So, topping it up with two glasses of milk should add up to about 1,500 calories.

Make sure they have three meals and at least two pieces of fruits and two glasses of milk a day. Every meal should have more than one serving of vegetables, too.

The elderly also need calcium because in ageing there is the problem of the bone become porous and the tendency to have osteoporosis.

Bone health depends on the adequate intake of calcium, a good balanced diet and exercise. Prof Dr Fatimah suggests the elderly get about 10-15 minutes of exposure to the sun as they get a bit of exercise in the morning. This would be sufficient Vitamin D to enhance their bone health.

Easy food preparation – Prof Dr Fatimah suggests the family provide the elderly with food preparations that are easy to manage such as milk, three-in-one drinks or a banana. This would come in handy if they don’t feel like eating a full meal.

“If they can’t take the taste of plain milk, then they can make flavoured milky drinks. Or they can take yoghurt, or soya milk or tau fu fa. That would be a good alternative for them but make sure it’s not too sweet,” she adds.

Take walks – Prof Dr Fatimah recommends the elderly continue taking walks to prevent from getting stiff. If necessary, they should be accompanied by an adult to ensure they don’t fall.

They should be physically active to ensure blood circulation.

Speak to your doctor – Those who have medical problems, should see their doctor to ask if it is advisable for them to fast, and to find out the possible consequences if they fast.

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