Ramadan 2021: Nutrition plan for Muslim diabetic patients if they intend to fast
The Holy month of Ramadan is just at our doorstep and while Muslims across the world gear up to sight the crescent moon which will mark the onset of one month of fasting from dawn to dusk, it is essential that those with diabetes have a structured nutrition plan if they are going to observe 29 or 30 days of fast. International Diabetes Federation and the Diabetes and Ramadan (DAR) International Alliance have issued guidelines and designed a nutrition plan for Muslims with diabetes who are observing Ramadan fasting this year, to ensure a safe and healthy fast.
This can be a useful resource as it helps diabetic patients to maintain optimal glycaemic control beyond the month of Ramadan too. It might improve fasting blood glucose levels, triglycerides and the rate of self-monitoring blood glucose (SMBG) pre-dawn and pre-bed when compared to standard care in people with type 2 diabetes.
Eating iftar after prolonged fasting, skipping of workouts during the day to save up energy while in a state of fasting, dramatic changes in dietary patterns in comparison to the other months of the year and improper eating habits lead to health issues during Ramadan. To avoid the same, people with diabetes should check out these pointers of Ramadan nutrition plan by IDF and DAR for a healthier lifestyle:
1. The consumption of an adequate amount of daily calories. Calories should be divided between Suhoor and Iftar and 1-2 healthy snacks can also be consumed if necessary.
2. Meals should be well balanced, with total carbohydrates comprising around 40–50% and preferably of a low GI source; the protein content (legumes, pulses, fish, poultry, or lean meat) should comprise 20–30%; and fat should comprise 30-35% (with mono and polyunsaturated fats preferred). Saturated fat should be limited to < 10% of the total daily caloric intake.
3. The “Ramadan plate” method should be used for designing meals.
4. Sugar-heavy desserts should be avoided after Iftar and between meals. A moderate amount of healthy dessert is permitted — for example a piece of fruit.
5. Carbohydrates that are low on the GI should be selected, particularly those high in fibre (preferably whole grains). The consumption of carbohydrates from vegetables (cooked and raw), whole fruits, yogurt, milk and dairy products are encouraged. The consumption of carbohydrates from sugar and highly processed grains (wheat flour and starches like corn, white rice, and potatoes) should be avoided or minimised.
6. Maintaining an adequate level of hydration by drinking enough water and non-sweetened beverages at, or between, the two main meals is essential and should be encouraged (diet beverages may be consumed). Sugary drinks, syrups, canned juices, or fresh juices with added sugar should be avoided. The consumption of caffeinated drinks (coffee, tea as well as cola drinks) should be minimised as they act as diuretics which can lead to dehydration.
7. Take Suhoor as late as possible, especially when fasting for longer than 10 hours.
8. Consume an adequate amount of protein and fat at Suhoor as foods with higher levels of these macronutrients and lower levels of carbohydrates usually have a lower GI value than carbohydrate-rich foods. Foods such as these do not have an immediate effect on postprandial blood glucose. Foods rich in protein and good quality fat can better induce satiety than foods rich in carbohydrates.
9. Iftar should begin with plenty of water to overcome dehydration from fasting, and 1-3 small dried or fresh dates to raise blood glucose levels.
10. If needed, a healthier snack such as one piece of fruit, a handful of nuts, or vegetables may be consumed between meals. Generally, each snack should be 100–200 calories, but this may be higher depending on an individual’s caloric requirements. Some individuals may have a snack (Iftar snack) to break their fast, followed by the Maghrib prayer and then eat the Iftar meal later in the evening.
Those chronically ill, pregnant, breastfeeding, diabetic, old and sick with health restrictions are exempted from observing a fast during Ramadan. They should compensate for it by performing Fidiya which is done by feeding a poor person on every day of Ramadan or every day of missing one’s fast.
However, a majority of people living with diabetes choose to fast contrary to medical advice which is why a comprehensive set of guidelines to meet this need is required. These guidelines support people with diabetes to safely and successfully participate in Ramadan and enjoy the personal and spiritual benefits of the sacred month.