The do’s and don’ts of fasting, according to a cardiologist

Dr Michael MacDonald

With the holy month of Ramadan in full swing, Muslims all over the world are fasting from sunup to sundown. And while fasting for up to 21 hours may seem drastic to non-Muslims, this routine is actually similar to the intermittent fasting (IF) diet, which in recent years has gained much attention due to its effectiveness in promoting weight loss, in addition to benefits for the brain and heart.

In this article, we draw parallels between Ramadan and IF by speaking to Dr Michael MacDonald from the Harley Street Heart and Vascular Centre, who shares the upsides of timed caloric restriction, as well as the dos and don’ts of fasting to maximise its health effects.

What are the similarities between Ramadan and intermittent fasting?

During Ramadan, Muslims abstain from food and drink for 10 to 21 hours per day, depending on where they are in the world. According to an article in Nutrients, IF has two main variants including the 5:2 diet – in which individuals abstain from food two days a week – or daily time-restricted eating (TRE). Ramadan fasting and daily TRE are nearly identical because people who practise the latter only eat at specific times, ranging from a 16-hour fast and eight-hour feed to a 20-hour fast and four-hour feed. The only difference between these routines is that TRE allows for you to drink water during fasting windows.

What are the benefits of fasting?

According to Dr MacDonald, IF is becoming a popular diet option because it is less restrictive than traditional weight loss regimens. It also offers several health benefits including improved cardiovascular health and brain function, reduced risks of cancer and diabetes, and potentially a longer lifespan.

“When we abstain from food for more than 8 hours, the body’s fasting mode kicks in. This prompts the liver to break down fats to use as fuel, promoting weight loss. IF also reduces inflammation and cholesterol/triglyceride levels, thereby preventing atherosclerosis and its associated conditions such as heart attacks and strokes, according to studies,” says Dr MacDonald.

“Other research also shows that IF reduces blood pressure, enhances brain function, and increases insulin sensitivity of cells, which helps to mitigate cancer cell proliferation and type-2 diabetes. This is in addition to reduced oxidative stress, which according to free radical theory, are the main culprits of ageing and degeneration,” adds Dr MacDonald.

Now that we understand the benefits of IF, what are the dos and don’ts when fasting in our everyday routines? 

Do start slow: Dr MacDonald says, “While Muslims are obligated to abstain from food and drink from sunup to sundown, those interested in trying IF for weight loss or health reasons should do so gradually. Start with the least restrictive forms of IF, such as the 16 hours fast and 8 hours feed or the 5:2 diet, and slowly expand your fasting periods over several months. If you are on medication, talk to your doctor about a food or medication plan that will allow you to undertake this routine.”

Do not binge eat: While it is tempting to end your Ramadan or IF fast with a large meal, this can leave you bloated, tired and with a tummy ache. The best way to break your fast is by eating normally or returning to your regular eating routine.

Do eat healthfully: While the IF diet does not specify what you can or cannot eat during feeding periods, it is still wise to consume less refined sugars, processed foods, red meat and salty foods, as these promote weight gain, cardiovascular disease and metabolic syndrome. If you’re unsure about what foods to incorporate in your IF or Ramadan fasting routines, try sticking to a Mediterranean diet (vegetables, fruits, fish, and whole grains) as it is rich in cardio-protective and fat-inhibiting substances.

Whether you are fasting for Ramadan or intermittent fasting, a Mediterranean diet (vegetables, fruits, fish, and whole grains) is recommended as it is rich in cardio-protective and fat-inhibiting substances.

Do stay hydrated: While Ramadan fasting prohibits drinking during fasting periods, non-Muslims who wish to try IF should consume plenty of sugar-free drinks during non-eating windows. If Muslims would like to practise IF outside the holy month, they are of course welcome to take as many unsweetened drinks as possible during non-feeding hours, as staying hydrated staves off hunger.

Do not over-exercise: High-intensity workouts during fasting will make you hungrier, thirstier, and more irritable than you already are. To counter this, try sticking to light exercises such as brisk walks or a stroll around the park.

Sleep early!

Do sleep early: If adults are putting their kids to bed at 8pm or 9pm every day, why not sleep when they do? Not only will you get more beauty sleep, you’re also less likely to consume more calories than you actually need during eating windows.

All photos by Shutterstock