Ramadan is an excellent opportunity to shed some extra pounds. You are already resetting your metabolism by the protracted, long overnight fast, as well as the daily fasting. Your metabolism resets and your body begins to change the way it does things.

Weight loss during the first few days is just dehydration. It may be exciting to see that you lost 2-3 pounds in the first day or two, but that's all water loss and dehydration. No human can lose 2 pounds of fat overnight. It's just water. But it's still exciting!

So how can we maximize weight loss during Ramadan?

The most important factor is to avoid gorging or "binge eating" at night. We have found that gorging once a day is the fastest way to gain weight. Your body thinks it's in a state of famine, and will store everything you eat as fat, because it is worried about food supply. Further, eating once a day scares your body and your body starts to shut down and slow down your metabolism. You don't want to slow down your metabolism or you will gain weight.

Eating small meals through out the evening and morning (after sunset) is the best way to maintain an adequate metabolism level and avoid the highs and lows of blood sugar associated with eating one massive meal. After eating a large meal, our blood sugar level increases. In response to this, our pancreas secretes a ton of insulin to bring the levels back down. That extra sugar is stored as fat. That is very bad. We want to eat small, well proportioned meals and snacks throughout the evening to avoid the sudden rise in blood sugar. We want to maintain an even and balanced level of blood sugar. Certain foods raise blood sugar levels more than others, and we will discuss that thoroughly.

Why do I feel hungry?

A lot of people ask why they don't feel hungry throughout the day if they skip Suhoor (breakfast meal before dawn), but are starving by 9AM if they eat Suhoor. It all comes down to blood sugar levels.

Eating a massive meal in the early morning hours (before dawn) leads to a large surge in blood sugar and a subsequent secretion of a lot of insulin to help bring down your sugar level. In about 2-3 hours your blood sugar levels will drop to lower than normal, and this triggers a hunger response. By 9AM you will feel like you are starving. And you have the whole day left. By noon that feeling will go away, but why do you want to do that to yourself? You can avoid that problem by eating the right things throughout the evening and early morning and you can avoid this feeling of hunger. Later on I will discuss what you can eat to minimize the hunger response.

The other option is to just skip Suhoor. If you can't do that or you want to fulfill the religious recommendation (not obligation), just wake up and drink some water. Water has no consequences in terms of blood sugar levels. You could also just skip it altogether and continue the overnight fast into the day, you are already living off your fat stores, and can continue to do so throughout the day. You won't feel hungry. Overnight, your liver makes sugar for you to live off of, but can only do so for a limited period of time. If you continue this overnight fast into the day, you can start living off your fat stores. Isn't that the best way to lose weight? By burning fat?

So what can you eat?

What we are talking about is "Glycemic Index". This is a measurement of your blood sugar response to certain foods. For example, consuming 50 grams of pure white sugar, has a glycemic index of 111. That's really high. The idea is to eat foods that don't raise your blood sugar level. This will keep you from feeling hungry and will fill you up with very healthy food choices.

Vegetables like celery, lettuce, cucumbers, onions, and spinach have a glycemic index of less than 15. They have almost no effect on your blood sugar levels. Berries like strawberries, blue berries, raspberries as well as apples, have a glycemic index of 20-30 and are better than other fruit options. Some fruits like mangos and bananas have a glycemic index in 40-55 range. The fruit with the highest glycemic index is a pineapple with a GI (glycemic index) of about 66. This is still better than eating bread and baked goods.

Some vegetables are higher in sugar than others and have a higher glycemic index. Potatos, corn, tomatos (really a fruit), and carrots are all higher in simple sugars than other more fibrous vegetables. In fact, a baked potato has a GI of 115! That's about as high as it gets. The reason is that a baked potato is so processed, that it is very easy for our stomach to get at the simple sugars. The stomach has to do almost no work at all to get to the sugars. They are all there and readily accessible. Leaving the skin on and eating the baked potato with the skin, decreases the GI to 98, but it's still high. The skin acts as a fibrous buffer that keeps some of the sugars away from the stomach. The more fiber you eat, the harder it is for the stomach to get at the sugars. Leave the peel on apples, cucumbers, peaches, apricots, dates, kiwis, and other edible peels. Eat a lot of fiber!

Foods with the highest glycemic index are baked goods and simlpe carbohydrates like bread, cake, desserts, pasta, rice, potatos, fruit juices, candy, soda, pop, and coffee and tea that you put a lot of sugar into. Some of these have glycemic indices as high as 100 or more. The food with the highest glycemic index is Corn Flakes breakfast cereal with a GI of 132. Breakfast cereals have some of the highest GIs. Instead eat real oatmeal with fruits slices! Real oatmeal doesn''t have as high of a GI as the prepackaged ready to eat stuff. Or make your own yogurt parfait with real fruit slices and sprinkle oat meal on top.

The sugar maltose, which is found in beer, has a GI of over 150 and signals to the body to start storing the extra calories as fat right away! That's why you see a "beer belly" in people who drink a lot of beer.

There is an entire section on Glycemic Index on the Alo Diet Website. Check it out!

What can I eat?

The key is to eat foods that have a minimal glycemic index impact, yet still eat healthy and nutritious foods. Fruits, vegetables, nuts, beans, eggs, and lean meats are all very natural and very good for you. They also don't cause a significant increase in blood sugar levels.

Timing of meals

Here in the US, most Muslims indulge after sunset and don't wake up to have an early meal. Busy work schedules and busy lifestyles promote this bad eating behavior. This is a major contributor to gaining weight. The human body is very smart. The body figures out that it is only getting one meal a day and decides that it needs to store everything. So everything you eat gets stored as fat.

Normally, we tell our patients to eat small frequent meals throughout the day. Well, you can't do that in Ramadan. So you have to eat small, frequent meals throughout the night. This helps avoid the spikes in blood sugar levels and will keep you even and balanced.

So what do you eat?

At Iftar time (break-fast time), eat the traditional three dates and drink plenty of water. If you are really concerned about the amount of sugar in the dates, eat one date, but take three bites (or skip the date). Then take a break, go pray Maghrib (sunset prayer) and come back for the actual meal. For your meal, drink plenty of water, start with soup and salad, and pace yourself. It takes 20 minutes for your stomach to tell your brain that it is full. So slow down your process. Drinking plenty of water also starts stretching the stomach earlier and lets you know you are full earlier.

Then you can go to Taraweeh (the Ramadan nightly prayers), afterwards eat a small snack like a cheese stick or a handful of almonds or a bowl strawberries and light whip cream. You could even drink some unsweetened tea or coffee (or use a sugar substitute). Then you can go to sleep.

Wake up before dawn, and do not eat cereal! Eat an omlette with spinach, mushroooms, onions, brocholli, and some other healthy alternatives. Even a few nuts and an apple is fine. Or you could eat a banana and dark chocolate. Or another bowl of strawberries and bananas and light whip cream, but put some cocoa powder on the whip cream this time!

What should I avoid?

Avoiding simple sugars, processed foods, and baked goods will go a long way towards improving your metabolism, your health, and your well being. You will also feel more energetic and feel happier. Simple sugars (carbohydrates) are the culprits we discussed above; sugar, bread, potatos, pasta, rice, ice cream, sweets, candy, dessert, baked goods like cakes, muffins, and many others.

You don't have to avoid these every day. You can have these once a week. But you must cut down on portion size. Eat a third of what you normally would eat. Cut a slice of cheese cake into thirds and eat just a small amount. You have to control your portions. Otherwise, you are just going back to your previous state of metabolism and gluttony.

Ramadan is meant to be a month where Muslims feel what poor people feel. We are supposed to empathize with the poor and needy. We are not supposed to be gorging and over-eating at night. That is the opposite of what Ramadan is supposed to be about. You aren't supposed to like Ramadan! It's supposed to be hard.

What about desserts?

Ramadan is a time when families make certain desserts and foods that they don't normally make. Kanafa, Katayif, Baklawa, special ice creams, and sweet rice puddings are all traditional Ramadan treats. You have to restrain yourself. Once a week is ok, but very small portions. Do not indulge. Otherwise, you will put weight back on. It's very hard to control yourself sometimes. But remember what Ramadan is supposed to be about.

What about after Ramadan?

Ramdan is a great time to start new good habits and stop bad habits. There is no reason why you can't continue eating this well and this healthy after Ramadan. Diets aren't temporary. You eat every day! Why not make sure you are eating the right things every day? Use this to kickstart a new way of eating and living.

If you quit smoking (or hookah) during Ramadan, use this opportunity to continue to avoid these awful habits. Make no mistake, smoking of any kind IS KILLING YOU! Use this time to reflect on that and stop smoking.

In cardiology, we know that the single biggest risk factor for heart disease is either being a current smoker or having a history of smoking in your past. If you could make one single change in your life, it should be to quit smoking. I don't mind if you put on 30 pounds of fat, just quit smoking. Smoking is far worst than being overweight. Don't do it!

Go on! Lose Weight!

If you enjoyed reading these recommendations and want a diet and life plan for the rest of your life, I highly recommend reading the Alo Diet online. It's totally free! No regsitration, no subscriptions, no fees! And it's physician approved!

You will get an in depth education on nutrition, metabolism, digestion, glycemic index, cardiology, diabetes, women and weight loss, and lots of tips and tricks for losing weight. If you are a physician, have your patients follow the diet. They can read it all online for free and download plenty of resources and pamphlets. Tell all your friends about it to!

http://www.AloDiet.com

From the website:

A free, healthy, easy to follow, physician approved diet that works!

Other diets have come along over the years and advanced our knowledge of metabolism, nutrition and weight loss. The Alo Diet aims to take all of the information from previous diets, improve on certain aspects, eliminate concepts that have been proven wrong, and bring us up to date on everything we know on diet and weight loss. The Alo Diet is a totally free and comprehensive diet and life plan!

• What have we learned from other diets?
• Why is the Alo Diet different?
• Why do women have trouble losing weight?
• Is Obesity genetic?
• Never feel hungry
• Calculating your Body Mass Index
• How to break through a weight loss plateau
• Substitution
• Losing weight year round
• Don't count calories
• You don't have to exercise to lose weight
• Things humans should never eat
• Diabetes and weight loss
• Men and weight loss
• You can eat cholesterol
• Do we need Supplements?
• Stop blaming your thyroid

While other diets require you to buy the book, pay for food, subscribe, pay fees, register for their website, The Alo Diet doesn't require any of that.

The Alo Diet doesn't require registration, fees, nor purchases. You don't even have to register for our website!

Click over to the book section and start reading and start losing weight

Totally Free!

I am not big on New Year's Resolutions. I think that if you decide to do something good, you should start right away. Not wait for some magical time. Don't delay, procrastinate and waste time. Just start your new habit.

If you are a big fan of New Year's Resolutionsm here are some that I think you should consider:

1. Stop smoking! This is the single most important lifestyle modification that will make the biggest impact on your life. Stop hookah, cigarettes, cigars, chewing tobacco, whatever it is.... Just stop! Nothing makes a bigger impact on your health and future than quitting smoking. If you have already tried quitting, try again! Most people try quitting 7-11 times before they finally kick the habit. It is the hardest addiction to break, we know that. But you have to fight it! I can't tell you how bad it is. Every patient I've had who has had a heart attack under the age of 50 has been a smoker! Smoking runs in families. If you smoke, your kids are more likely to smoke. Of all the things your kids could inherit, don't let this be one of them. People who smoke are dumber, have lower IQs, are more likely to be depressed and have mental issues, and teens that smoke are more likely to be obese adults. Please stop this God awful habit.

2. Stop eating! I know you aren't going to start an exercise program. Our lives are busy. We can squeeze in some exercise once or twice a week if we try. That's just life. Instead, stop eating! Eighty-five percent of your body composition is what you eat. The last 10-15% can be fixed by exercise. If you want to look good and lose weight, stop eating so much. I like to use substitution. Substitute good things for bad. Instead of mayonaise, use mustard. Instead of ground beef, use ground turkey. Instead of butter, use oil. Instead of white bread, use multigrain. Instead of sugar, use splenda. Salad instead of potatoes. Veggies instead of fries.

All diets work! Just pick one and do it! Atkins, Low Fat, Zone, Southbeach, Weight Watchers, whatever it is..... just pick one and do it! They all work. Pick one you can actually do! Then..... eat like that forever! A diet is not temporary! Do you breathe temporarily? A diet is a lifelong committment. Just do it!

3. Start moving! I realize that it's hard to get people to move and exercise. Just try to get moving somehow. Get an exercise bike or something. Get a health club membership (and actually use it). Get your kids and friends involved. Pick up a new hobby or sport that involves activity. Biking, weight-lifting, hiking, climbing, basketball, golf, anything. Exercise helps your mental health, mood, longevity, waist size, and overall wellbeing! Just do it!

4. Stay out of the sun! If you don't want wrinkles and don't want to age, steer clear of UV rays. It's that simple.

5. Change your worst characteristic! Figure out what you hate about yourself. Or what people hate about you. And change it! What is it that you do that you wish you could change? Temper? Lying? Condescending? Not romantic? Arrogance? Non-commital? Ignorant? Racist? Get better!

6. Change careers! If you hate your job and your life.... now is a great time to quit and be what you've always wanted to be. Stop making yourself (and everyone else at work) miserable. Take classes, move to a new city, explore your dreams!

7. Adopt a charity! If you don't give to charity.... you should. Find a cause you like and decide to adopt that cause. Find a charity for that cause and give them financial support as well as volunteer your time. It can be anything!

8. Spend more time with family! If you haven't seen your parents, grandparents, kids, spouse, cousins, whatever it is.... find them, call them, spend time with them. I am sure we all do this anyways, but put in some extra effort this year.

9. Stop spending! You don't have to buy everything on earth that you want. You don't need 300 pairs of shoes! You don't need 5 computers. You don't need new speakers. You don't need that dress. You don't need a new car. Stop spending this year, and save. Americans affinity for saving is only 5%. We only save 5% of what we make. Is that not insane? Find discount stores and purchase thing online if you need them. You don't need "brand name" everything. Get the Target, Walmart, Jewel, or Aldi version. They are all made in the same factory anyways and are exactly the same. Spend less! Only buy things you need! Make that a goal this year! You will be very happy!

10. Reconnect! Find someone from your past and reconnect. In a genuine sense. See what they are up to or how they have been doing. See if they want to hang out. Facebook has brought the present and past together. Find some old friends and hang out.

11. Visit someone sick. If any of your friends or family members are ill, pay them a visit. This is rewarding for you and very uplifting for them.

12. Help someone out! Someone needs a contact, needs a letter of recommendation, needs a phone number.... help someone out! If their life is made better, so will yours!

If you think of anything else, start right away. Don't wait a year!

Smoking Hookah (aka nargileh, argeelah, narjile, goza, water pipe, sheesha) has become fashionable among educated professionals and college kids in the United States. Smoking has always been a disease of the poor and uneducated, however, Hookah seems to be transcending these bounds. For some reason, hookah smoking has been able to make it out of the ghettos of uneducated Arabia, Turkey, and Egypt and make it to America's university campii. Why are educated, intelligent young people taking up this habit? Is it peer pressure, mental illness, or just a fad?

It's been estimated that 43% of cigarettes in the US are consumed by people with mental illness. Experts feel that smoking leads to depression, and depression leads to smoking. So are these kids using Hookah to help their mental illness?

A study on young people in the United Arab Emirates found that 69% of hookah smokers had a college education, while 23% had a high school education. Are they just ignoring the facts? Or do they not care? Do they have mental health disease?

Further, the myth about smokers losing weight  has been demystified. A recent study has shown that teenagers that smoke are more likely to be obese adults. Probably because if they are making bad choices as teens, they will likely make bad choices as adults. Further, they have an oral addiction. They constantly need to be putting things in their mouth.

Is Hookah better than cigarettes?
In two words: Hell No! In one study it was found that smoking Hookah for one hour is equivalent to smoking 200 (and up to 400) cigarettes. What if you are just around but don't smoke? Even if you never touch the Hookah, if you are in the room for one hour, you have smoked nearly 100 (and up to 200) cigarettes. Another study found that one puff on a cigarette gives the user 50mL of smoke volume, whereas one inhalation on a Hookah pipe gives the user 500mL of smoke. Ten times more! And that's on just one inhalation! It's estimated that in a 30 minute Hookah session most adults consume approximately 50 Liters of smoke volume! Nearly 1000 times more! That is unbelievable!

Cancer shmanser!
We all know that smoke, tar, and the carcinogens in smoke cause all kinds of cancers. That is obvious. We don't need to repeat those over and over. Bladder cancer, lung cancer, esophageal cancer, oral cancer, tongue cancer, and nearly every other cancer! Not to mention it destroys your blood vessels from the inside out, which in turn destroys every organ system! Every single patient I have had that had a heart attack before the age of 50, has been a smoker. Some as young as 26 and 32. Awful!

Other effects?
Young people don't care if you tell them they will get cancer or a heart attack when they are old and die. What they care about is immediate results. Smoking causes yellow teeth, yellow, brittle hair, bad breath, wrinkles in your skin (especially on your face), bad hands and fingers (the tips of your fingers get fatter and shorter), vocal changes, tooth and gum disease, and a lot of things that are easily noticeable. Nasty! You can easily tell who is a smoker and who isn't by how they look.

Is Hookah Haram?
The word Haram in Arabic and Islamic tradition means "religiously forbidden." As Muslims, one of our most important tennets is "No harm and no harming". This is very similar to the physician's creed: "First do no harm!"

The Prophet Muhammad (and all religious leaders) have taught that people should not harm themselves. The Prophet Muhammad said: "No Harm and No Harming!"

Jesus and the Bible teach in Corinthians: "Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your body," (1 Cor. 6:19-20).

In other words, DO NOT HARM YOURSELVES NOR YOUR BODIES!

Professional athletes are supposed to take care of their bodies and be ready to play and do very well. Surveys of former NFL players have shown a very low smoking rate compared to the national average. That should tell you enough!

I am no religious scholar by any means, but to me it's pretty clear: Hookah is Haram (and Horrible)!

If you need resources and links to articles:

We all know that nicotine is not the worse part of cigarettes. That's just the part that keeps you addicted. By far, smoking is the hardest addiction to break, in part due to ncotine and it's physically addicting properties. They want you addicted, and put it in their. The other part of smoke is the carcinogenic, wrinkle-ogenic, and nasty-ogenic parts.

Further, hookah does contain tar, nicotine, and carbon and much more than cigarettes:
http://www.kansan.com/photos/2009/oct/08/6925/

The numbers on smoke volume come from "The Hookah Lounge":
http://www.thehookahlounge.org/2006/06/30/is-smoking-a-hookah-bad-for-your-health/

Which is actually a website that actually advocates the use of hookah as well as others who have connected hookah to machines and measured smoke volume. Those numbers are from a World Health Organization study. You can view the WHO advisory here:

http://www.who.int/tobacco/global_interaction/tobreg/Waterpipe%20recommendation_Final.pdf

Which is where most of the research comes from.

The Mayo Clinic also has a resource on Hookah:
http://www.mayoclinic.com/health/hookah/AN01265

and demonstrates hookah to cigarette equivalency.

An article here also shows that hookah smoke is just as bad, if not worse based on a JAMA article:
http://health.usnews.com/usnews/health/healthday/080103/hookah-smoking-as-tough-on-lungs-as-cigarettes.htm

and here:
http://www.reuters.com/article/lifestyleMolt/idUSTRE57O2RZ20090825

and:
http://www.washingtonpost.com/wp-dyn/content/article/2006/07/03/AR2006070300774.html