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a guide to healthy fasting Supported by the amad an he alt h g u i d e Contents

a guide to healthy fasting Supported by the amad an he alt h g u i d e Contents Page 28 Tips for healthcare professionals Page 3 Foreword Page 4 Acknowledgements and useful contacts Page 5 Introduction Page 6 The physiological changes that occur during a fast Page 8 Foods that beneﬁt and foods that harm Page 20 Frequently asked questions Page 12 Spirituality and food Page 14 What could you gain from fasting? Page 16 Potential health complications and possible remedies Page 24 Key points in translation FASTING is complete abstinence from food and drink between dawn and dusk. All those who are ill or frail, pregnant or menstruating women, breastfeeding mothers and travellers are exempted. They are required to make up the number of days missed at a later date or give a ﬁxed sum to charity. 2 I am very pleased to support the development of the Ramadan health guide, which has been independently produced by Communities in Action in order to provide information and advice on maximising health gain during the Muslim fast. We hope it will also prove useful to others fasting for religious or spiritual reasons. The Department of Health is committed to responding to the needs and preferences of all sections of our diverse population, and this guide is one of a range of activities we have supported in order to promote public health among all sections of the population. There is considerable evidence to suggest that large sections within Muslim communities experience signiﬁcant health inequalities, although this is not uniform across all Muslim communities or all aspects of health. In particular, Pakistani and Bangladeshi communities tend to suffer poorer health than the general population. We hope that this guide, alongside the Department’s targeted campaigns, such as our Asian Tobacco Helpline, will help to address these inequalities. As part of our commitment to creating a patient-led NHS, the Department of Health and the NHS will continue to work in partnership with community-based organisations to meet the needs of all communities, including faith communities, and to promote better health for all. Surinder Sharma National Director, Equality and Human Rights Department of Health Foreword 3 Communities in Action would like to thank the following individuals for their contribution to this publication: Edited and compiled by: Ajmal Masroor, Director, Communities in Action Authors: Dr Razeen Mahroof, BM, MRCP(UK), FRCA, Anaesthetist, Oxford Dr Rizwan Syed, BM, DRCLG, General Practitioner, Birmingham Dr Ahmed El-Sharkawy, BM, MRCP(UK), Specialist Registrar in Gastroenterology Tehseen Hasan, BSc(Hons), State Registered Dietitian, Birmingham Sahra Ahmed, MPharm, Pharmacist, Manchester Dr Fuad Hussain Revised: Dr Naveed Ahmed Dr Amar Ahmed Research: Henrietta Szovati, Communities in Action Dr Shahnaz Ahmad, DRCOG, MRCGP Dr Amar Ahmed, MBBS, DCH, DRCOG, MRCGP Dr N Ahmad, MRCS, MSc, BSc(Hons), DO-HNS, Specialist Registrar in ENT Surgery Advisors: Dr Fatima Husain, MBBS, MRCGP, MRCOG, DIPM, Consultant Obstetrician and Gynaecologist Dr Usama Hasan, Imam and Lecturer Layout and design: Nafe Anam Acknowledgements British Heart Foundation 14 Fitzhardinge Street London W1H 6DH 020 7935 0185 www.bhf.org.uk Diabetes UK Central Ofﬁce Macleod House 10 Parkway London NW1 7AA tel: 020 7424 1000 fax: 020 7424 1001 email: info@diabetes.org.uk www.diabetes.org.uk NHS Asian Tobacco Helpline For free and conﬁdential advice on how to stop smoking or chewing tobacco: Bengali 0800 00 22 44 Urdu 0800 00 22 88 Punjabi 0800 00 22 77 Turkish 0800 00 22 99 Gujarati 0800 00 22 55 Arabic 0800 169 1300 NHS Smoking Helpline 0800 169 0169 www.gosmokefree.co.uk The Muslim Council of Britain PO Box 57330 London E1 2WJ tel: 0845 26 26 786 fax: 020 7247 7079 email: admin@mcb.org.uk www.mcb.org.uk Useful contacts 4 Introduction Health is the key to happiness, and what we consume directly affects our health. Islam encourages Muslims to ensure that they are mindful of their health. The blessed Prophet said: “Take advantage of the good health before illnesses afﬂict you”. He also encouraged Muslims to try their best to take up a healthy living lifestyle that includes a balanced diet, regular mental and physical exercise and a balance between material and spiritual needs. The Health Survey for England 2004 (Department of Health, 2005) has shown poor health and lifestyle choices of the Asian community in general and Muslim community in particular. Compared with the 24% of men in the general population who smoked cigarettes, higher levels of cigarette smoking were reported by Bangladeshi men (40%). South Asian men and women had the highest rates of diabetes. Pakistanis and Bangladeshis were up to ﬁve times more likely than the general population to have diabetes, and Indian men and women were up to three times as likely. Some 33% of Pakistani men and women eat the recommended ﬁve or more portions of fruit and vegetables a day, compared with 28% of Bangladeshi men and women. The month of Ramadan is a great opportunity to focus on bringing back a balanced and healthy lifestyle in your life. Through fasting you begin to learn how to manage your eating habits, how to improve self-control and discipline. This month requires you to give the stomach a break, and by doing so you are able to break down and expel the accumulated toxins from your body. This booklet is aimed at helping you understand the health issues related to fasting, so that you are able to make more informed choices, minimise complications and maximise the beneﬁt of your fast. The booklet will: guide you through physiological changes that occur when you are fasting; give examples of beneﬁcial and harmful foods during fasting; discuss potential medical problems and remedies; suggest a diet plan; and respond to the most frequently asked questions about fasting in general and medical issues in particular. The booklet also contains a section for doctors and medical professionals, to enable them to provide more informed services. The booklet has been put together by medical experts, Islamic scholars and researchers, who have stayed within the spirit of Islam, while ensuring the medical advice and suggestions are scientiﬁc and culturally sensitive. 5 For many people, the key question regarding fasting is whether it is good or bad for your health. The answer to this requires a quick overview of what happens inside the body during fasting: the physiology of fasting. 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. Small quantities of glucose are also ‘manufactured’ through other mechanisms in the liver. Only with a prolonged fast of many days to weeks does the body eventually turn to protein for energy. This is the technical description of what is commonly known as ‘starvation’, and it is clearly unhealthy. It involves protein being released from the breakdown of muscle, which is why people who starve look emaciated and become very weak. 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. Balanced food and ﬂuid intake is important between fasts. 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 breakdown, 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. The physiological changes that occur during a fast 6 Normally produces insulin. During fasting, insulin production is shut down and hormones that tell the liver and muscles to release sugar stores are produced. Also, production of digestive juices is reduced Acid production by the stomach is reduced during fasting No changes known to occur during fasting This is where a lot of the water absorption occurs from the food, and second to the kidney it is important in water balance in the body Digestive juices production is shut uploads/s3/ ramadan-health-guide.pdf