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The holy month of Ramadan – which this year is expected to begin on the evening of Tuesday 17 February – has great religious and cultural importance for Muslims.
It is a time for communal prayer, spiritual reflection and meals with extended family and friends to break daily fasts, concluding with the community celebration of Eid-Ul-Fitr.
Ramadan fasting (sawm) is one of the Five Pillars of Islam, considered by believers to be the foundation of Muslim life. Fasting entails abstinence from food, liquid and oral medications between sunrise and sunset.
Who should fast?
All healthy individuals who have passed puberty are expected to fast, unless it would be detrimental to their health.
Guidelines from the British Islamic Medical Association (BIMA) say those who are exempt from fasting at Ramadan include frail and elderly people, children, pregnant and breastfeeding women, and people with comorbidities.
“Ramadan is a time of spiritual reflection, but it’s also important to take care of your health while fasting,” says Dr Manisha Kumar, chief medical officer at NHS Greater Manchester. She suggests some simple tips to help people stay well during the holy month:
- Stay hydrated
Drink plenty of water between Iftar (breaking the fast) and Suhur (the pre-dawn meal) to prevent dehydration, and avoid caffeinated drinks like coffee and tea, as they can increase the risk of further dehydration
- Choose nutrient-rich foods
Opt for slow-releasing energy foods such as whole grains, lean proteins like chicken, turkey and tofu, and fibre-rich vegetables such as Brussels sprouts, carrots, broccoli and peas
- Eat a balanced Suhur
The pre-dawn meal of Suhur provides fluids and energy for the day of fasting ahead, so include carbohydrates like oats or wholemeal bread, along with protein sources such as eggs or yoghurt, to keep you fuller for longer
- Pace yourself at Iftar
Break your fast with dates and water, followed by a light soup or salad before moving on to a balanced main meal. Avoid fried and sugary foods, which may leave you feeling tired and sleepy
- Get enough rest
With late night prayers and early morning meals, sleep patterns can be disrupted. Try to maintain a consistent sleep routine and take short naps if needed to stay refreshed
- Keep moving
Energy levels may be lower than usual, but gentle activity such as walking or stretching can help to maintain fitness.
Observing Ramadan in the pharmacy
“If you’re not all that familiar with Ramadan customs, you may be anxious about getting it wrong,” says Hussain Kayani, principal employment law solicitor at WorkNest, a human resource consultancy in London.
“The basic legal principle is simple: you must make sure employees participating in Ramadan are not treated less favourably based on their religion or belief.”
Hussain’s advice for pharmacy employers wanting to support colleagues observing Ramadan is to:
Accommodate fasting – fasting can lead to fatigue, so allow more rest breaks, modify the employee’s duties or allow them to work through lunch.
Consider allocating a room for prayer – enforcing a ‘no prayer in the workplace’ rule may constitute indirect discrimination.
Grant time off requests – while there is no automatic right to time off in this context, try to be as reasonable, fair and accommodating as possible.
Foster a culture of respect – circulate a company-wide email or put up a notice in communal areas to make everyone aware of Ramadan, and ensure that any events held during this time accommodate Muslim staff as well, where possible.
Taking medicines
Patients may ask about whether they can take medicines during Ramadan, or fast while they are on medication.
General advice is that fasting on medication is allowed during Ramadan, but anyone who takes medication regularly should be assessed by a doctor before fasting – especially people with diabetes or chronic conditions.
It is okay not to fast if a medical professional advises against it for health reasons. Similarly, it is permissible to take essential medication when fasting.
Managing diabetes
Worldwide, approximately 116 million people with diabetes fast during Ramadan.
Pharmacy teams can advise patients living with diabetes to talk to their doctor or healthcare team about how to manage the condition while fasting to avoid the risk of hypoglycaemia, hyperglycaemia, dehydration and thrombosis, diabetic ketoacidosis and other problems.
Their doctor or diabetes team will advise them if it is safe to fast, and give them advice about blood glucose monitoring several times a day, as well as at any time they experience symptoms of hypo- or hyperglycaemia, or feel unwell.
They may also make medication adjustments for the duration of the fast.
Further information
- Videos aimed at supporting patients to use their medicines and promote wellbeing during Ramadan can be found here: bit.ly/4c2Nxrd
- International Learning Movement (ILM) offers guidance on taking medication during Ramadan here: bit.ly/4alF2Vk
- For British Islamic Medical Association (BIMA) and Diabetes UK guidance on deciding to fast or not and how to fast safely, visit: bit.ly/3Owf2iP
- Information about how to support colleagues who are fasting can be accessed through the NHS Employer’s webpage: bit.ly/3ZZQtNM
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