Avoiding excess is key to good health

Finally Ramadan has arrived. The city bears a festive look and the level of activity after dusk has increased significantly. In the last few days, our sleeping habits have changed, as have our eating patterns. These changes have affected even those of us who are not fasting, due to a reduction in work hours, as well as the altered meal times along with a limited availability of food during the daytime.

As most of us would agree, we have not started feeling anything remarkably different as yet from how we felt before the start of Ramadan. Normally, given the built up energy stores in the human body as well as our natural resilience, we generally do not start to feel any significant difference for the first few days. However, shortly thereafter, early signs of fatigue start showing up if the proper precautions are not taken from the very beginning.

The key to having a successful and healthy Ramadan lies in properly planning your daily routine with the key principle of avoiding excess. That includes excess of anything such as diet, activity or inactivity. These issues get compounded over the weekends with iftar and suhour parties tempting us to indulge. Indeed, a large number of people end up gaining weight at the end of Ramadan, much like the holiday season in the West. The similarity is remarkable in the sense that the weather is extreme at that time of the year, leading people to stay indoors with abundance of food, mostly sweets. The natural conclusion is the weight gain. This Ramadan will put a lot of people in a similar predicament. Losing these extra pounds is always an uphill battle afterwards. A balanced schedule of a proper diet and regular physical activity goes a long way in avoiding this unwanted weight.

As we know there is always an exception to the rule. For example, in terms of activity, a lot of our young friends do go out and play sports at the tail end of the day, prior to iftar. Given the heat and the duration of the fast this year, dehydration is indeed a major concern. My advice would be to choose your sport wisely and avoid excessive loss of fluid. If that happens, the fast might need to be broken, defeating the whole purpose of this core tenet of Islam.

For patients with diabetes, these last few days would have allowed them to gather enough data to see how the adjustment to their medication as well as their eating habits is working out. The most objective data will come from the results of their own blood sugar monitoring. We at the Dubai Diabetes Centre at DHA have instructed our patients to forward us their readings by now, so that we can evaluate them and make any necessary adjustments. I am certain that other health care providers would do the same. However, if someone has already noticed significant changes such as very high or very low readings, it might be necessary to get in touch with their doctor right away. The issue that stands out well above everything else is an inability to know when the sugar is dropping to dangerously low levels. In that instance, one should definitely refrain from fasting. Imagine someone driving on the road and suddenly losing consciousness, leading to grave danger not only to self but also to the others around them.

Another important group comprises women who are pregnant. There is no definitive scientific data proving whether fasting is harmful or beneficial during this time in terms of women who have no medical problems. In reality, a significant number of pregnant women do fast without any obvious immediate problems. However, if we limit ourselves to women who have diabetes, whether it pre-existed prior to their pregnancy or they developed gestational diabetes (which is diabetes diagnosed only during pregnancy), extreme caution is advisable. They should proceed with fasting only under medical supervision, provided their doctor agrees with that decision. Clearly, diabetes is a disease and that, as such, exempts these individuals from fasting as per our religious teachings. Certainly, Allah knows best. However, as physicians, our guiding principle remains: First do no harm.

With schools being closed, it is much easier for the children to fast. I have not heard much grumbling from either Shayan or Shehryar, my children who generally have no qualms about airing their opinions. However, it is a quite an effort to get them to remain active during Ramadan. As a majority of parents would agree, children move into a "nocturnal" mode during Ramadan with a reverse sleep cycle. This has to be discouraged. No doubt, in addition to being unhealthy, schools will start immediately after Ramadan and they will have to adjust very rapidly to their normal routine. But in all honesty, good luck with that.

Dr M. Hamed Farooqi is the Director of the Dubai Diabetes Centre at the Dubai Health Authority. He is US Board Certified in Internal Medicine as well as Endocrinology and is a Fellow of both the American College of Physicians and Endocrinologists. (This article is the second in a five-part weekly series.)