Fasting during the holy month of Ramzan

Not much data is available on the effects of fasting beyond implications on food intake and energy metabolism. While it might be expected that there would be an impact on the functioning of the pancreas and on arteries,there isn’t a lot to test that assumption against.

A study by Iranian researchers published in The Lancet noted headaches (perhaps because of the daytime withdrawal of fluids),dehydration and sleep deprivation as some of adverse transient effects of a month’s fasting. There was a reduction in the concentrations of blood glucose and HDL (good) cholesterol,and increase in LDL (bad) cholesterol in healthy individuals during the period of fasting.

In the 12-15 hours that the Ramzan fast lasts every day,the liver’s stored glycogen — a complex carbohydrate molecule — is broken down. For fat to break down,the fast needs to last longer. Nutritionists suggest making small alterations in the traditional menu of qormas,fried snacks and sewaiyan to make it less of a metabolic disaster.

“Small alterations may be done to the dinner menu. Make it low fat and low carbohydrate. Instead of frying the sewaiyan in ghee,simply boil them in low fat milk with less sugar,” says Dr Nilanjana Singh,nutritionist at Pushpawati Singhania Research Institute.

An estimated 40-50 million people with diabetes mellitus observe roza,according to an article in the journal Diabetes Care. Dr Anoop Misra of Fortis-C-DOC Centre of Excellence for Diabetes,Metabolic Diseases and Endocrinology,says,“The key is to switch to shorter acting insulin and anti-diabetes drugs. Exercise is important. We advise patients to split the evening meal into two. The drug schedule is altered so that there are more drugs in the evening. Patients with hypertension need to switch to long-acting varieties of drugs,and ones that can be taken on an empty stomach.”