The fact that Ramadan coincides with hot weather brings with it the risk of increased fluid loss with the long fasting process. Stating that with the slowing down of the metabolic rate during prolonged fasting periods; conditions such as weakness, slow stomach emptying and low sugar occur, Uzm. Dr. Güzin Oğuz pointed out that people with chronic diseases should have their doctor's checks before Ramadan.
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Dr. Güzin Oğuz, Internal Medicine Specialist at Üsküdar University NPISTANBUL Hospital, made important warnings just days before Ramadan.
"In our country, the number of chronic diseases is gradually increasing due to the increase in the average life expectancy to 78 years and the increase in the proportion of people over the age of 65, which is called the 'geriatric population', to 8.5 percent," said Uzm. Dr. Güzin Oğuz,
"Children, pregnant women, the elderly and those with chronic diseases are more sensitive to prolonged fasting and dehydration. Since our metabolic rate will slow down during prolonged fasting periods such as summer fasting, fatigue, slow gastric emptying and low sugar levels occur; this situation negatively affects those with chronic diseases."
Those with chronic diseases should fast under the supervision of a doctor
Stating that those with chronic diseases should regularly go to the doctor's control, Uzm. Dr. Güzin Oğuz,
"Check-ups should be reviewed before Ramadan. Those with some diseases such as chronic thyroid can fast under the control of their physicians, provided that they take their medication at sahur time. Fasting can be practiced in chronic diseases where prolonged hunger and thirst will not cause problems."
Which patients can fast with the permission of their doctor?
Uzm. Dr. Güzin Oğuz gave the following information about patients who can fast with the permission of their doctors:
- "Diabetes patients who use insulin or medication that lowers blood sugar (oral antidiabetic),
-Those with severe heart failure,
-Pregnant women
-Those whose blood sugar frequently falls below normal,
-Active ulcers in the stomach or duodenum,
-Chronic liver and chronic kidney diseases,
Patients who have undergone surgery for a difficult-to-treat or serious illness and need to be fed regularly,
-Those with diseases (febrile illnesses) where there is concern that an existing disease may be aggravated by fasting or that health may be impaired should not fast, and if they insist on fasting, they should obtain the necessary approval from their attending physician."
How should those with gastrointestinal problems eat?
Üsküdar University NPISTANBUL Hospital Internal Medicine Specialist Dr. Güzin Oğuz said, "Most of the patients with gastrointestinal problems have to apply to health institutions with stomach complaints after iftar or towards the end of Ramadan. Eating fast, drinking plenty of water during meals, and eating a lot of food that stretches the stomach cause gastrointestinal complaints to increase." and listed their suggestions as follows:
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- "Do not drink too much water during meals. Spread water drinking over hours.
- Eat a Mediterranean diet with fiber, water, olive oil and vegetables.
- Do not eat fast, do not swallow food without chewing it well, do not go to bed immediately after eating.
- Avoid excessive fatty, spicy foods and sweet desserts.
- If you have bloating and gas in your abdomen, eat a diet low in milk, dairy products and gluten."
People with diabetes, beware!
"All patients with Type 1 diabetes and Type 2 diabetes patients who use multiple insulins are not allowed to fast," said Dr. Güzin Oğuz, Internal Medicine Specialist:
"Those who use oral sugar medication; If their fasting-fasting blood sugar levels and blood sugar averages for the last three months are at appropriate levels, they can fast in consultation with their doctor. Due to the risk of hypoglycemia in diabetic patients who take medication on an empty stomach in the morning, the fasting sugar pill should be changed under the supervision of a doctor. In some recent studies, there have been studies on fasting and follow-up of Type 2 diabetes patients who use insulin, and it is ensured that they can keep it under strict doctor control with the necessary appropriate changes. For this, it is very important to consult a doctor, treatment plan management by the right specialists and physician-patient compliance.
Some general recommendations for diabetic patients:
- Do not eat a diet rich in carbohydrates and fats during iftar and sahur,
- Eat foods with a low glycemic index such as eggs, milk and unsalted cheese, which give a feeling of satiety because they are digested slowly and prevent blood sugar from dropping because they are released slowly into the bloodstream,
- Avoid foods such as pita bread, pasta and rice, which raise and lower blood sugar rapidly,
- Drink at least 2 liters of water between iftar and suhoor, spread over hours,
- Wait at least 1 hour after Iftar when you feel the urge to eat dessert. Avoid syrupy desserts. Prefer milk desserts with reduced sugar.
People with respiratory diseases should not go out in the midday heat
Breathing sprays and vapor treatments do not invalidate fasting since they cannot enter the systemic circulation from the lungs. When asthma and COPD patients do not follow the recommendations against reflux, dry cough and shortness of breath attacks may increase.
Some general recommendations for those with respiratory system diseases:
- Do not go out of the house in the midday heat, wear light-colored and spacious clothes,
- Do not tire yourself. Take a shower with warm water when you get home; cool your neck, wrists, forehead and neck with water during the day,
- Do not go to bed immediately after sahur and iftar as lying down increases reflux,
- Since fast and large meals increase reflux, eat slowly and chew your food well, do not fill your stomach with water,
- Since the water lost through sweating will thicken the phlegm, make sure to drink 2-2.5 liters of water between iftar and sahur.
Heart and high blood pressure patients should not neglect their medication!
Hypertension patients should avoid fasting. Those whose blood pressure is under control and who do not have additional complications can fast by rearranging their medication hours under the supervision of a doctor. If your doctor has given approval, blood pressure can even be regulated with the peace of mind of fasting, provided that you follow the rules.
Some recommendations for heart and high blood pressure patients:
- Check your blood pressure more frequently during the day and consult a healthcare provider if you feel any discomfort,
- Don't forget to take your medicine,
- Avoid going out in the sun at noon and wear a hat when going out,
- Drink at least 2 liters of water between iftar and sahur,
- Avoid foods such as salty cheese, salty olives, pickles, mineral water and white bread.
People with kidney disease should pay attention to fluid intake
Summer fasts are important for kidney health due to high water loss due to heat and inadequate water intake into the body with long fasting. Patients with stage 1-2-3 renal failure can fast if they can get enough fluids between iftar and sahur and if they do not have concomitant diseases, provided that kidney function control is closely monitored. However, stage 5 patients on dialysis and stage 4 patients undergoing dialysis preparation should not fast.
Some general recommendations for kidney patients:
- Pay attention to fluid intake, drink at least 2 liters of water between iftar and sahur,
- Try not to go out in the midday heat when dehydration will be intense,
- Avoid salty foods."
