Food Choices during Ramadan

Document Type: Letter to the Editor

Authors

1 Diet and Education Department, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan

2 Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan

Abstract

Few studies have assessed the dietary Practices of people with diabetes during Ramadan (1). A sub study of Ramadan prospective diabetes study (2) which was conducted at the outpatient department of Baqai Institute of Diabetology and endocrinology, Karachi Pakistan in 2009 analyzed the food choices of patients with diabetes during Ramadan. Several irregularities regarding dietary intake and food choices were noted among the study participants. Although, the patients were counseled regarding diet before Ramadan, many did not follow the dietary advice. All patients had taken food at Iftar but majority of them preferred fried items like samosas, pakoras (fried snack), chicken rolls etc. these deeply fried items can lead to post Iftar hyperglycemia. Patients were also opted for fruit chat, dahibara and chanachaat at Iftar, higher load of these items can also worsen glycemic control. The striking finding was almost absence of meat (protein) intake at Iftar but study from India showed increment of all three macronutrients during Ramadan (3). This may result in higher intake of items from carbohydrate and fat groups resulting in hyperglycemia after iftar. Intake of vegetables at Iftar was also negligible and hence the diet was not well balanced. The food choices at sahoor included roti, paratha (fried bread), slices, khajla, pheni, meat, egg and milk. Though it is advisable to take complex carbohydrates, protein and fat at sahoor as these are slowly digestible and can prevent hypoglycemia during fasting but khajla pheni are extremely rich in fat and carbohydrate content and should be avoided (4). However, paratha in 2 teaspoon of oil can be taken at sahoor.Patients with diabetes who fast during the month of Ramadan should have pre Ramadan dietary guidance and counseling session in order to modify their food preferences and choices during the holy month of Ramadan (4).

Keywords


  1. Azizi F, SiahkolahB. Ramadan fasting and diabetes mellitus. Arch Iranian Med. 2003;6:237-42.
  2. Ahmedani MY, Haque MS, Basit A, Fawwad A, Alvi SF. Ramadan Prospective Diabetes Study: the role of drug dosage and timing alteration, active glucose monitoring and patient education. Diabet Med 2012, 29:709–715.
  3. Vasan SK, Karol R, Mahendri NV, Arulappan N, Jacob JJ, Thomas N. A prospective assesstment of dietary patterns in muslims subjects with type 2 diabetes who undertake fasting during Ramadan. Indian J Endocrinol Metab. 2012;16(4):552-7.
  4. Salti I, Benard E, Detournay B, Bianchi-Biscay M, Le Brigand C, Voinet C, et al. A population based study of diabetes and its characteristics during the fasting month of Ramadan in 13 countries: results of the epidemiology of diabetes and Ramadan 1422/ (EPIDIAR) study. Diabetes Care. 2004;27(10):2306–2311.