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Weight Gain, Health Issues Threaten Muslim Fasters


Now we want to take a different look at the Muslim holy month of Ramadan. As you might imagine, health issues arise for just about anybody who is not drinking or eating from sunrise to sunset, whether you're a world-class athlete or not. Dehydration and indigestion are just two concerns, but you might be surprised to hear that Ramadan is also a month when people can end up eating too much, even wind up in the hospital.

We wanted to talk more about the best ways to eat during the month, so we've called upon Nour Zibdeh. She is a practicing Muslim and a registered dietician. She owns her own practice called Nourition in Northern Virginia, but she joins us on the line from Amman, Jordan, where she's visiting friends and family.

Nour Zibdeh, welcome to the program, and Ramadan Mubarak to you.

NOUR ZIBDEH: Thank you. Thanks for having me on the show.

MARTIN: So what pressure - what physical pressure does fasting put on the body, even if you are eating early in the day and late in the day?

ZIBDEH: Well, you know, the days - Ramadan rotates throughout the year. So now, in the summer, the days are long, and fasting is from dawn to sunset, no food or drink. So, definitely for someone who is not used to - hasn't done it before, it's - you know, there's hunger, there's thirst and just managing meals and meal structure, as well.

MARTIN: You were telling us that there's a difference between how people tend to experience it in the United States - where perhaps people within your own community might be celebrating or observing Ramadan - and perhaps in the Middle East and other parts of the country, where Islam is the dominant religion. Do people kind of change their whole day overseas...


MARTIN: ...like where you are?

ZIBDEH: Yes. Right now, I'm in Jordan. So I can speak of Jordan, and not other Muslim or other Arab countries. Pretty much, life changes. It's a different lifestyle. Work hours are cut short. And sometimes some businesses open at night after the sun sets, and they're open till 1:00 or 2:00 in the morning. So you have a lighter workload during the day, which is a blessing, especially for those who work under the sun or even, like, construction workers.

In my neighborhood, there is a construction site, and they're working at 11:00 p.m. because they're not working at 3:00 in the afternoon. So there is accommodation in these terms. Other things, it's the general atmosphere. You barely see anybody eat during the day in public. Also, there's, like, special marketing and products and events for Ramadan. So it's a different - it's kind of like more people are doing it if - when you're in an Arab or a Muslim country.

Whereas, in the U.S., life is kind of the same, but then you have Muslim-Americans observing their own holiday. So it's a little bit different. Well, I would say it's a lot different.

MARTIN: We've heard that some people actually put on weight during Ramadan. I just think it's hard for people to imagine who haven't - who aren't observing it. How is it possible that people are putting on weight? And then we've also heard that, you know, in a couple of places, there were reports this year that - in Qatar, for example - went to the hospital, like, in the first couple of days of Ramadan because of overeating. That's hard for some of us to imagine. How is that possible?

ZIBDEH: Yeah. Well, I mean, you know what? If - think about it. If you're not eating all day and you can think of all the yummy things that you can have at night and, you know, the sun goes down and you can have anything you want, it is easy for some people to overeat, especially if they're not concerned about their health. So, definitely, that happens a lot.

Some people give themselves the green light to eat unlimited amounts of fried foods and desserts all 30 days. And a lot of appetizers and desserts are fried, and a lot of them are drenched in syrup. And if you think that you can have your dessert in unlimited amounts every day, then I can see how the calories can pile by the end of the month.

Also, some people kind of switch their days. So if you're continuously grazing at night with snacks, desserts, nuts and chips and pretzels and traditional - even like traditional, like, beans and lentils are part of appetizers. And then you have sodas, sugary drinks and desserts. All of these can add the calories.

MARTIN: Are we making you crazy, making you talk so much about food while you're fasting, by the way?

ZIBDEH: No, no. You know what? It's hard. Like, personally, for me, it's hard the first day or two, but then, you know, it just becomes - it becomes normal.

MARTIN: OK. We're speaking with registered dietician Nour Zibdeh about eating during Ramadan. Now we want to talk about what are the better ways to eat during Ramadan to avoid some of those unpleasant side effects that we were just talking about here.

Now, you've previously talked about the fact that because of the huge diversity of the Muslim community - especially in the United States - that there's really no one typical Iftar meal. That's the meal you eat after sunset. But is there a best way to break the fast?

ZIBDEH: Yes. So, Muslims in America are diverse. So, definitely, a lot of people ask me, well, what is Iftar like? And the only thing I can say, it depends from one household to another. And even people from the same background, they may have different preferences. Generally, there is - the fast is usually broken with dates and water. That would be, like, mainstream, across the board.

MARTIN: Is there a health reason why? Is there a health reason why it's a good idea to break the fast with dates and water?

ZIBDEH: Definitely. If you've seen dates, they have sugar. It's natural sugar. If you haven't been eating all day and then you have a little bit of sugar and then water, we know that water is absorbed better with a little bit of glucose. So I see that a way of hydrating the body very quickly. And so, two or three dates, and then a glass of water or two. And when I - I really recommend that people start with soup or a small appetizer or a salad and then take a break.

There's usually a prayer right after breaking the fast. And I always tell people, get up and perform your prayer, and then go and have your main meal. And this way, it helps you pace yourself. And, you know, let your body get adjusted that - OK. There's food coming. And let your satiety signals start to work instead of, you know, indulging in a very huge meal and, before you know it, you've eaten too much and you're overstuffed and uncomfortable.

MARTIN: So pace yourself...

ZIBDEH: Yes, absolutely.

MARTIN: ...is what you're saying. What about the predawn meal of Suhur? How do you usually eat for that, or how would you recommend people handle that meal?

ZIBDEH: I leave it up to people to decide what they prefer. However, general guidelines, I recommend giving yourself time to eat. Let's say you have - we have to stop eating at 4:15, like today in Jordan. You know, we had to stop eating at 4:15. I tell people, give yourself 30 to 45 minutes so that you can get up, get some fluids, eat slowly instead of trying to, you know, chug down water and everything in 10 minutes, and that would cause un-comfort.

MARTIN: Finally, before we let you go - and I understand that you're an authority on nutrition and you're not a religious authority, per se. But it is the case, is it not, that there are some people who simply should not fast for reasons of health?


MARTIN: Who fits into those categories?

Well, I mean, I - as you said, I'm not a religious - I cannot give a ruling. But, I mean, there are people with chronic conditions. You have diabetes, whether it's Type I or Type II, kidney disease, heart disease, pregnant or nursing women, anybody with a condition that may make fasting a challenge. I highly recommend that they consult with their doctor. There are different severities of, you know, each diseases, and sometimes, doctors can adjust their medication schedule so that they can fast.

ZIBDEH: So, definitely, they should check with their physician and, you know, get the OK from them, as well. You know, Islam gives - if a person has a condition, they are allowed to not fast, and then they can make up for not fasting by giving charity and other - or making it up later if the condition can - you know, for a pregnant woman, she can eat during Ramadan and then make the days up later.

So, definitely, if there's a condition. The point of fasting is to not cause harm. So if fasting for that person can be harmful, then by all means, consult with a religious figure in their community and also with their physician to make sure they're taking care of their health.

MARTIN: And, finally, again, before we let you go, I think many non-Muslims see Ramadan as a time of penance, but you're saying it really is not that. In fact, many people actually quite enjoy it. Could you talk about that?

ZIBDEH: Yes. You know what? It's one month of the year. It's like 29 or 30 days in the year. It has its own atmosphere. Families gather, communities gather. There's a lot of charity work going on in Ramadan. There's a lot of spirituality in Ramadan, so it is really a time of joy, a time of reflection on, you know, yourself and your life. And it is a joyful time of year.

So, sometimes, I feel like, from the outside, it feels like, poor Muslims. They're not eating or they're not drinking. But, you know, we do enjoy that time of year and, you know, after Ramadan, there's Eid, or when we break the fast, and it's a big holiday. So - yeah. No. It's - we're happy with Ramadan - about Ramadan.

MARTIN: Nour Zibdeh is a registered dietician. She runs her own practice called Nourition, based in Northern Virginia, but we caught up with her in Jordan, where she is visiting with friends and family, as she told us. And she joins us on the line from Amman.

Thank you so much for speaking with us and, once again, Ramadan Mubarak to you.

ZIBDEH: Thank you. Thank you for having me. Transcript provided by NPR, Copyright NPR.