Dr. Mohammed Alo's Blog

Cardiologist Toledo Ohio

Surviving the most brutal Ramadan ever

This year's Ramadan will be the most brutal and taxing Ramadan ever! Find out what you can do to survive and avoid common mistakes.
Surving Brutal Ramadan  

This year's Ramadan will be the most brutal and taxing Ramadan ever! Ramadan has been getting harder and harder, but this year, it will be especially tough on US Muslims. Muslims in some parts of the United States will be fasting close to 17 hours day. That's no food and no drink for 17 hours. This will be a very difficult Ramadan, but there are steps you can take to avoid disaster and survive.

What is Ramadan?
Ramadan is a Muslim holy month. Muslim are more generous, nicer, more giving and generally more spiritual. Muslims are required to fast from before sunrise to sunset.  No food or drink. People living in the western most parts of each time zone will fast the longest, but it will be especially difficult on people in the Eastern time zone. As an example, Muslims in Detroit will be fasting from 4:30am to 9:15pm. While people in Chicago may start earlier, but be able to eat around 8:30pm.

Why does this happen?
Ramadan is on a lunar calendar. Every year, it moves up by 11 days. If Ramadan begins on August 12th this year, it will begin on August 1st the following year. Every 33 years it makes it way completely back around the calendar. Fasting in December is easy for Chicagoans, who could eat as early as 3:30pm. But is it fair to everyone else? By having Ramadan on a lunar calendar, you assure that it moves around the calendar in your lifetime, and no one will be stuck fasting in June (the longest days of the year) or December (the shortest days). Everyone gets a fair shake.

Why do you get tired and fatigued?
The first few days of Ramadan your body will live off your glucose and water stores in your muscles and organs. After about three days, you will run out of that readily available glucose and will become very dehydrated. That's when the fatigue, tiredness, and lack of energy will really set in. Your body will shut down metabolism and try to lull you to sleep to avoid burning energy. It's a protective mechanism in your body to help protect it from famine and starvation. 

While you are fasting throughout the day, your glucose stores will run out, and your body will switch to relying on ketones to survive. Ketones are made from fat. Your body will burn fat, to make energy. This is called ketosis and is the concept behind high protein diets like the Atkins diet. It also can help you lose weight in Ramadan. 

Surviving Ramadan
The most important step this year for US Muslims will be to hydrate appropriately and load up on carbohydrates leading up to Ramadan and throughout Ramadan. Marathon runners and competitive athletes always go through a phase of "carb loading" as their competition approaches and this will be important to increase your muscle stores of glucose. You will also have to drink plenty of water to help hydrate your muscles and organs. When your muscles fill up with glucose, they will also fill up with water. Water follows glucose.

When it's time to eat, you will have to make sure you get enough carbohydrates in the form of complex carbohydrates (fruits, vegetables, nuts, beans) as well as a small amount of simple carbohydrates (bread, rice, pasta, baked goods, juices, sweetened tea/coffee). You should try to eat throughout the night and divide your calories up into smaller servings. If you are still feeling fatigued, tired and dehydrated, you will have to increase the amount of simple carbs you eat until you begin storing them for later use. You will figure this out as you try varying amounts.

Load up on Salt
You have to increase your salt intake to increase you water storage and avoid dehydration. Our bodies are very good at eliminating salt, so you are fighting a losing battle, but excessive salt intake can cause water retention.

Won't I gain weight?
Unfortunately, most Muslims gain weight during Ramadan because they gorge and binge on food. Eating one or two large meals a day causes weight gain. You get a large spike in blood sugar, which causes a huge amount of insulin secretion, which leads to weight gain. The key to avoiding weight gain will be avoiding simple carbs, eating frequent small meals, and trying not to binge eat. For each person it will be different. One person may be able to eat two slices of bread without gaining weight, for others half a slice may cause weight gain. It's also important to balance carbohydrate intake with ketosis if you are trying to lose weight. You want to eat enough to be able to get through the day, but not so much that you put on tons of weight. Your body shuts down your metabolism in an effort to protect itself, you are fighting this protective mechanism as well.

Losing weight in Ramadan
I've written about this extensively, and it is possible. You have to avoid large spikes in blood sugar. Try to eat small, frequent meals and avoid large simple carbohydrate meals. When you first break your fast and start eating, work your food in gradually. You can read the full length article on weight loss in Ramadan. Eat a small amount of fruit with a tall glass of water, take a break, have soup and salad. Take a another break, then eat a little bit more if you are still hungry. Drink, even if you aren't thirsty. Save your big meal to the morning meal before sunrise. You will need that meal to get you through the day. But be smart about what you eat. Don't gorge, eat small sensible, meals. Your morning meal before sunrise should consist of good mix of simple and complex carbohydrates. The simple ones to get you through the next few hours, and the complex ones to power you through the rest of the day. Eat 20% simple carbs and 80% complex carbs for your morning meal.

Prophetic Wisdom
Fifteen hundred years ago, the prophet Muhammad encouraged Muslims to break their fast gradually. He taught us to eat a small piece of fruit (a date) and drink a tall glass of water. This starts the digestive process early. It takes 20 minutes for your stomach to tell your brain that it is full, this starts the satiety process. Then go pray the sunset prayers, then have soup or something simple. Then go pray the special Ramadan night prayers, then you can go back and eat another small snack and sleep. He also heavily encouraged waking up early, before sunrise, and eating a healthy breakfast meal to get you ready for the day ahead. If you follow this prescription, you will do really well and avoid these pitfalls. The prophet taught us this nearly 1500 years ago, long before anyone knew about insulin or simple carbohydrates.

If you follow the above guidelines, you should be able to not only survive this Ramadan, but also thrive in it. Ramadan is supposed to be hard. You are supposed to empathize and feel what poor people go through. But if you take the appropriate steps, you can be less miserable and hopefully enjoy Ramadan.

Click on the Ramadan tag below to read more. I have plenty of articles on Ramadan and weight loss, cardiology, research studies, how it affects your blood pressure and cholesterol and much more!

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