Ramadan fasting involves alternating periods of fasting and feasting where Muslims do not eat or drink during daylight hours. Certain groups like travelers, pregnant women, the elderly, and those with medical conditions should not fast. Diabetic patients should consult their doctors before Ramadan to adjust medications. During non-fasting periods, people should stay hydrated by drinking water and eating water-rich foods to avoid headaches and tiredness.

1. Short report about fasting Ramadan
Samir Morcos Rafla, MD, PhD
FACC, FESC, FHRS, member EHRA
Emeritus professor of Cardiology,
Alexandria University, Egypt
smrafla@yahoo.com
01001495577

2. Ramadan fasting is not a prolonged or continuous fasting, but consists of
alternate fasting and feasting periods (i.e.: intermittent feeding).
Every healthy Muslim should fast except those who are:
- traveling long distances
- pregnant women or those in menstruation
- elderly or minor (under the age of puberty)
People with wasting diseases or malnutrition.
Those with a history of cardiac arrhythmias.
People with hepatic or renal insufficiency. although they may participate if they
would like to.

3. Other health problems as renal insufficiency, if creatinine is above 2 mg/dl,
should not fast because the kidney needs fluids and should not be subjected to
dehydration. Those with creatine 1.4 to 1,9 mg may fast and repeat creatinine
after 3 days, if it rises, then they should not fast.
Diabetic patients should consult their doctors 15 days before Ramadan not three
days to adjust the dose of treatment according to severity of diabetes. There are
many roles in this context that is included in special lecture. If blood sugar drops
to 70 mg, you should break fasting. In general, in Ramadan, observe to drink lot
of fluids during the time of no fasting, take care not to exceed the normal amount
of proteins whether animal protein or plant protein as Fool (Beans).

4. Drink lots of water and eat water-rich foods when you are not fasting to keep
hydrated avoiding headaches & tiredness.
Avoid walking in the sun or hot weather not to get dehydrated and tired.
If you don’t drink sufficiently before a fast your risk of dehydration is increased.
This risk is higher in older people and in those taking tablets such as diuretics.
•If you are unable to stand up due to dizziness, or you are disoriented, you should
urgently drink regular, moderate quantities of water–ideally with sugar and salt.
Impact on nutrition: Decreased time available for eating
Decreased Gastric filling Capacity
With my best wishes. Prof. Samir Rafla