holiday season

Acknowledgment: Reviewed by Riham Albalbisi, Atef Al Taher, Wisam AlBadr, MD the Council on Renal Nutrition (02/2020)

The Holy month of Ramadan

Patients on hemodialysis are encouraged to discuss with their physician whether or not they should fast during the holy month. If you have other chronic diseases such as diabetes, high blood pressure or complications of heart disease these can add to ptential complications during fasting.

If you decide to go ahead with fasting it is extremely important to follow a plan in order to ensure you get good nutrition and stay healthy all through this blessed month.

1.    Reduce the physical effort during the month of Ramadan

2.    Avoid exposure to elevated temperatures during fasting

3.    Your dialysis session dates will be arranged in advance

4.    You should save the new schedules of your medicines

Did you know that Allah has relieved Muslims with illnesses, which includes CKD patients, and permitted them to break their fast during Ramadan?

Sleep for 6-8 hours a day to get sufficient mental and physical rest. Less sleep means you will feel tired during the day which in turns leads to less productivity and activity.

While you should follow health guidelines during the month of Ramadan, you should make sure to enjoy the time you spend with family and friends. Ramadan is a time to focus on spirituality, including attention to your health.

Diet and nutrition tips during Ramadan

• Eat three meals a day (Iftar, midnight, and Suhoor).
• To avoid weakness and fatigue, do not skip Suhoor or delay your Suhoor meal to Fajir time, as permitted.
• Consume slow-digesting, fiber-rich foods (such as whole-wheat bread, legumes, salads and vegetables) that will help you stay satisfied longer.
• Reduce your intake of sweets (such as sweetened gelatin, jam, honey, pudding and sugary drinks). Sweets do not keep you feeling satisfied for long.
• Remember the need to control foods high in potassium and phosphorous.
• Increase your protein intake after dialysis, adding healthy proteins such as egg whites and chicken to your meals.
• You may experience loss of appetite after receiving dialysis, and it is important that you don’t skip Suhoor or Iftar, even if you are not feeling hungry.

Salt and fluid intake

• Keep to your advised fluid intake per day to include water, juices, ice cream and soups.
• Beverages should be cool in order to reduce the sense of thirst.
• When you are feeling thirsty, try to take some ice cubes or small slices of frozen apple or pear, instead of drinking water, to minimize the amount of fluid intake.
• Remember controlling your salt intake will help you avoid feeling thirsty throughout the day.
• Avoid adding salt to your meals or eating salty food.
• Avoid fast food and fried meals, because they contain a high amount of salts.

Iftar

Eat your Iftar meal at sunset, as permitted.

Have a balanced varied diet in Iftar which includes all healthy foods.

Make sure the meals are grilled, and choose natural juices free of additives and sugar.

Beverages and Dessert

• Replace caffeinated drinks (tea, cola and coffee) with decaffeinated ones, as caffeine is a diuretic and depletes the body of its fluids.
• Reduce Vimto intake or replace it by apple juice. But you still need control the amount very closely.
• Replace dry sweets such as baklava and lugaimat with small amounts of custard and puddings. These are less sweet and will help you manage thirst.

Stop Smoking

Ramadan is the perfect time to try to stop smoking for a better life. Talk with your doctor about the best way you can do it. You can distract yourself from smoking by focusing on the Ramadan activities and prayer.

Eid al-Fitr Celebration

The Eid season is the opportunity to have a fresh start with the health and lives of joy and pleasure. Some people may experience undesirable disturbances, like indigestion, heartburn and weight gain when they return to their regular meal times. Overeating during the holiday is very common. Like the other holidays, you need to pay special attention to what you eat during this period. However, you can still enjoy and participate in many of the traditional activities with your family and friends. Be sure to check with your doctor, nurse or your dietitian about which foods you should eat or avoid during this period.

Some Eid dietary advice:

•    Before Fajir prayers, be sure to have a snack.

•    After the prayer, it is preferable to eat or drink something light, such as a cup of milk.

•    For breakfast try a healthy meal with proteins, carbohydrates and vegetables

•    Try to adjust main meals times progressively according to the new schedules (Eid to Iftar and then normal mealtimes). This will help your body to gradually adapt to the new routine.

•    Eat small meals to avoid heartburn and indigestion.

Some Tips To Celebrate Eid Al-Fitr 

Desserts

Although you may enjoy dessert, you must pay attention to the ingredients used, many of which may contain excess fat and add-ons that may be harmful for you. Cakes and pies often contain dates, nuts and dried fruits, which may raise your potassium and phosphorus to unhealthy levels. You may eat some of them, but try to limit the portion. And always prefer fresh fruits such as apples, berries, cherries red grapes as much as possible. To reduce calorie intake, change your preparation of special dessert recipes by reducing the amount of fat, and replace sugar with honey which increases the nutritional value and taste.

Meals

Many ceremonial meals are composed of meat, potatoes and rice; these are all good options for you if you eat limited portions. Try to eat a balanced diet and avoid fried foods, or foods that contain a lot of fat and/or sugar and drinks that contain caffeine. Try to eat healthy proteins, such as egg whites, poultry, small portions of fresh fish (salmon, trout, tuna), as well as vegetables such as cabbage, broccoli, garlic, onion and sweet red pepper.

Treatment plan

During this time, you might be eating with less restrictions than before. So it is very important that you follow strictly your medication and dialysis treatment, according to your doctor’s prescriptions. If you have fasted during Ramadan, you may have noticed that you felt some differences and some of the results of laboratory analysis have changed. Now is the time to stay in close contact with the “care crew” to experience Ramadan in the safest way. Make sure to consult your dietitian in order to know the diet you need depending on your lab results. Don’t forget to do some physical activity.

Some Tips to Celebrate Eid Al Adha

Happy occasions like the Eid al-Adha contribute to excessive intake of food, especially meat and sweets.

It is necessary to control the quantity of what you eat: make sure you follow your dietitian’s instructions so that you do not feel unwell.

So we give you the most important tips to avoid weight gain in the Eid al-Adha:

•    Reduce as much as possible the intake of red meat, preferably grilled or boiled.

•    Do not start the meals with Eid candy.

•    Eat more salad before meals.

•    Avoid overeating at dinner, and don’t sleep immediately after it.

•    Stay away from salty foods and foods high in fat.

•    Try to drink tea or coffee without cardamon.

Make sure to prepare a large platter of salad. Include types of vegetables rich in minerals, vitamins and fiber, such as cucumber, parsley, lettuce, cold pepper.

With best wishes for you, your family and your loved ones, live a happy and healthy Ramadan and Eid, accompanied by a healthy diet.

References:

https://www.davita.com/

كتاب المرشد الشامل لمرضى الفشل الكلوي  تاليف د.عبد الكريم السويداء_ الطبعة ألاولى_2010  - 1431