The month of Ramadan is a special month for Muslims around the world. In Ramadan, Muslims are obliged to observe fast worship with restraint from indulgence and everything that can cancel fasts such as eating and drinking from sunrise to sunset. Not only spiritual, but fasting can also have a physical effect. A study carried out in Saudi Arabia indicates that when a person fasts, the individual will also experience some changes in his daily life, such as eating habits, sleeping habits, and even metabolism in his body may change (Bahammam, 2010 in Norhasanah & Salman, 2021).

Food intake decreases while someone is fasting, as a result of a reduction in meal frequency and amount ingested, as well as a reduction in fat metabolism in the body (Norhasanah & Salman, 2021). Lower food intake during fast can result in weight loss as a result of unmatch caloric needs. Nevertheless, it is not uncommon to lose weight after a fast but also to gain weight. The phenomenon is known as the Yoyo effect (muhammad, et al., 2018). Similar to yoyo, weight loss during the fast can be restored to previous levels or even beyond their previous weight.

A study by Ismail et al. (2015) suggests that post-fasting food consumption settings can prevent yoyo effects. Food consumption arrangements need to be made so that the amount of food a person eats does not exceed his or her needs. The study also shows that motivation also plays a crucial role in preventing yoyo’s effects after fasting. Thus, it may be concluded that to prevent the yoyo effect after fasting, the frequency and amount of food consumed should be considered to suit the need, and that effort should be accompanied by strong motivation in order to produce results as expected.

References

Ismail, S. et al., 2015. Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women. Sultan Qaboos University Medical Journal, 15(1), pp. 96-104.

Muhammad, H. F. L., Latifah, F. N. & Susilowati, R., 2018. The yo-yo effect of Ramadan fasting on overweight/obese individual in Indonesian: A prospective study. Mediterannean Journal of Nutrition and Metabolism, Volume 11, pp. 127-133.

Norhasanah & Salman, Y., 2021. Penyuluhan Gizi Online dengan Media Video Audio Visual “Tetap Fit Saat Puasa dan Pasca Puasa dengan Gizi Seimbang”. Jurnal Abdimas Kesehatan (JAK), 3(1), pp. 33-40.

In Ramadan month, Muslims across the world will fast during the hours of daylight and can not eat or drink until the sun sets. Fasting can be challenging since our body does not get any food and fluid intake for around 13 hours. During fasting, the body uses carbohydrate that is stored up in liver and muscles (1,2). Once all has been used up, it uses fat as an energy source (3). Meals must contain adequate carbohydrate and fat to prevent muscle breakdown. Hence, balanced diet is very important. There are some things to consider so that you will be in a good condition during fasting and worship remains smooth.

1.Stay hydrated

Most people who are fasting during Ramadan will experience mild dehydration that can cause headache, tiredness, and difficulty on concentrating (2). To prevent feeling thirsty during fasting, you can divide your fluid intake into: 1 glass after wake up before sahur,  1 glass after sahur, 1 glass after fast break, 1 glass after Magrib prayer, 1 glass after diner, 1 glass after Isya’ prayer, 1 glass after Tarawih prayer, and 1 glass before going to bed.

In addition, it is better to avoid drinking tea or coffee as they contain caffeine which is diuretic and stimulates faster water loss. Eating fluid-rich food such as fruits and vegetables is also recommended since those also contain minerals for your body.

2.Eat moderately and choose well-balanced diet

Eating mindfully and slowly will make you more satisfied since it gives your brain time to register what you are eating (1). Having just enough portion size and well-balanced diet are also important. Your body needs good nourishment to compensate the stress during fasting. There must be good-quality carbohydrate, protein, and fat (ideally unsaturated fat) on the plate. You can choose high fibre starchy carbohydrates such as wholegrain bread, oatmeal, rice, potato, pasta, and cereals to keep you feel full longer and reduce cravings for simple carbohydrates such as biscuit, chocolate, and cake (4). Put extra effort into including foods from five groups (such as breads, cereals; fruit and vegetables; meat, fish, and poultry; milk, cheese, yogurt; and unsaturated fat) to ensure your body is well-nourished.

3.Do light exercise

Although fasting can be physically exhausting, it is still important not to be too sedentary. During fasting we naturally become less active as the reduced energy we are getting from food. Therefore rather than doing high impact exercise, try to do small walks, doing errands, or a few stretches which places less stress on your body but still keep it actives. If you need to work out at gym, consider exercising after iftar.

References:

1. British Nutrition Foundation (2022). A Healthy Ramadan. [online] Available at: https://www.nutrition.org.uk [Accessed 18 Mar. 2022].
2. Khuraaki (2022). A Guide on Healthy Eating and Hydration During Ramadan. [online] Available at: https://khuraaki.co.uk/ [Accessed 18 Mar. 2022].
3. Shadman Z, Akhoundan M, Poorsoltan N (2016). Nutritional Education Needs in Relation to Ramadan Fasting and Its Complications in Tehran, Iran. Iran Red Crescent Med J. 18(8):e26130.
4. UCLA Health (2019). Healthy Tips for Ramadan. [online]. Available at: https://connect.uclahealth.org/2019/05/01/healthy-tips-for-ramadan/ [Accessed 18 Mar. 2022].

Nowadays, the rapid development of science and technology is felt in various sectors, including nutrition and health. The concept of a medical paradigm through a predictive, preventive, personal, and participatory approach can manage and support a specific health status for individuals. Personalized nutrition is a basic concept that shows everyone has a different metabolism, genetics, biochemistry, and microbiota that contribute to the body’s response to nutritional intake. Therefore, the concept of personalized nutrition applies multidisciplinary, such as nutrition, medicine, biology, epigenetics, and genomics to demonstrate the relationship of individual variation to a disease risk.

Nutrigenetics and nutrigenomics play an important role in genetically based nutrition recommendations or personalized nutrition. Individuals have different genetic variations that can affect the body’s response to nutrients. Nutrigenetics describes the interaction of genetic variation with the environment, including the nutrients contained in food. While nutrigenomics consider the impact of nutrient intake (macronutrients, micronutrients, and bioactives) on gene expression, where nutrients can activate or silence certain genes. Thus, nutrigenetics plays a role in providing an overview of the individual’s response to the environment and nutrigenomics will provide appropriate dietary recommendations.

One example of the application of nutrigenetic to describe the interaction of genes and nutrients is the activity of methylene-tetra-hydro folate reductase (MTHFR) enzyme. MTHFR enzyme involved in folic acid metabolism and maintenance of homocysteine ​​levels. A particular MTHFR gene SNP (C677T and A 1298C) were associated with an increase in blood homocysteine ​​levels, especially in conditions of deficiency folic acid intake. In addition, individuals with low MTHFR enzyme activity are usually accompanied by elevated homocysteine ​​levels, which have been associated with inflammation and heart disease, difficulty conceiving, birth defects, and potentially impaired detoxification abilities. For this reason, intake of micronutrients including folic acid, vitamin B6, and B12 is very important to maintain homocysteine ​​levels.

Based on nutrigenomics, an example of nutritional intake that affects gene expression can be known through phenylketonuria disease. Phenylketonuria or PKU is an inherited metabolic disorder caused by mutations in a single gene, thus patients should avoid foods containing the amino acid phenylalanine. High levels of phenylalanine in the body can interfere with brain function, mental retardation, and seizures.

Currently, research in nutrigenetics and nutrigenomics related to the prevention and treatment of diseases is increasing, including chronic diseases such as obesity, type 2 diabetes mellitus, cancer, and cardiovascular disease. Personalized nutrition is certainly useful for a nutritionist or dietitian in providing appropriate nutritional recommendations according to the genetic characteristics of individuals. By knowing the role of nutrigenetics and nutrigenomics in personalizing nutrition, hoped this knowledge will develop as the basic concept to provide nutritional recommendations.

Archibald, A. and Joffe, Y., 2021. The Role of Nutrigenetics and Nutrigenomics in Clinical Nutrition Practice. ADCES in Practice, 9(2), pp.34-40. 

Bush, C.L., Blumberg, J.B., El-Sohemy, A., Minich, D.M., Ordovás, J.M., Reed, D.G. and Behm, V.A.Y., 2020. Toward the definition of personalized nutrition: a proposal by the American Nutrition Association. Journal of the American College of Nutrition, 39(1), pp.5-15.

Di Renzo, L., Gualtieri, P., Romano, L., Marrone, G., Noce, A., Pujia, A., Perrone, M.A., Aiello, V., Colica, C. and De Lorenzo, A., 2019. Role of personalized nutrition in chronic-degenerative diseases. Nutrients, 11(8), p.1707. 

Marcum, J.A., 2020. Nutrigenetics/nutrigenomics, personalized nutrition, and precision healthcare. Current nutrition reports, 9(4), pp.338-345.

Sharma, P. and Dwivedi, S., 2017. Nutrigenomics and nutrigenetics: new insight in disease prevention and cure. Indian Journal of Clinical Biochemistry, 32(4), pp.371-373.

Uthpala, T.G.G., Fernando, H.N., Thibbotuwawa, A. and Jayasinghe, M., 2020. Importance of nutrigenomics and nutrigenetics in food Science. MOJ Food Processing & Technology, 8(3), pp.114-119.

Recently people are familiar and connected with the science and technology development especially in the health area. In health area, technology has been widely used in such areas as communication, education, and health management. Besides that, technology has also been widely used for diet management, food nutrition database, and anthropometrics measurements. Technological applications in the field of nutrition have now entered a “genomic era” that relates to the development of nutrigenetic. Nutrigenetic is science that studies the interaction between the genetic impact and nutrition in specific individuals. The relationship between genes and individual nutrition intake is specifically known by the term personalized nutrition. The term has broken the old approach called “one size fit all” which means the nutritional needs are united for everyone.

Based on the concept of the personalized nutrition, each individual has a unique gene in its own to adapt to nutrition intake, environment, and risk of illness. The genetic factors of each individual are also linked to physical activity, health status, and eating habits. Today, the personalized nutrition is thriving because it has the benefit of predicting the prevention of certain infectious diseases or malnutrition through a genetic approach. The personalized nutrition can also contribute to the continuation of dietary plans. Application of genetic examination of nutrition can be performed in both vulnerable individuals (such as the elderly and pregnant mothers) as well as in healthy groups of individuals who wish to prevent disease and promote health status. The samples used for genetic screening can be biological samples such as blood and saliva.

One example of a widely studied personalized nutrition application is at the risk of obesity. According to some studies, single nucleotide polymorphism (SNPS) represents a genetic variant commonly used to predict diet interactions related to obesity. The study included a personalized nutrition application for the prevention of non-communicable diseases. The interaction of SNPS and diet can be seen at table 1.

Table 1. SNPS and diet interactions

Source: Ramos-lopez and martinez (2020)

Despite its many benefits, the utilization of nutrigenetic for the personalized nutrition in Indonesia is still quite expensive today. Additionally, it requires much further research on the scale of laboratories, clinical trials, and populations. However, it is not expected that this does not hinder the potential for development and utilization of the long-term development of health-care technology in Indonesia.

References

Aji, A. S. 2020. Personalized Functional Foods: Masa Depan Penerapan Personalized Nutrition Advice. Prosiding Seminar Nasional Online: Peran Pangan Fungsional dan Nutraseutikal dalam Meningkatkan Sistem Imun Mencegah Covid – 19, Juni 2020, Bogor, pp. 303 – 310.

Caradonna, F. et al. 2020. Science and Healthy Meals in the World: Nutritional Epigenomics and Nutrigenetics of the Mediterranean Diet. Nutrients. Multidisciplinary Digital Publishing Institute, 12(6), pp. 1–23.

Freitag L. M., H. 2021. Mengenal Konsep Personalized Nutrition [Internet]. Tersedia dalam: <https://gizigama.com/2021/12/13/mengenal-konsep-personalized-nutrition/> [Diakses 6 Maret 2022]

Jayasinghe, M. 2020. Importance of Nutrigenomics and Nutrigenetics in Food Science. MOJ Food Process Technols, 8(3), pp. 114–119.

Ordovas, J. M. et al. 2018. Personalized  Nutrition and Health. BMJ (Online). BMJ Publishing Group, 361, pp. 1–7.

Prasanti, D. dan Fuady, I. 2018. Pemanfaatan Media Komunikasi Dalam Penyebaran Informasi Kesehatan Kepada Masyarakat. Reformasi, 8(1), pp. 8–14.

Ramos-lopez, O. and Martinez, J. A. 2020. Nutrigenetic Approaches in Obesity and Weight loss in Precision Medicine for Investigators, Practitioners and Providers. Elsevier Inc., pp. 409–415.

Rankin, A. et al. 2018. Food Choice Motives, Attitude Towards and Intention to Adopt Personalized  Nutrition. Public Health Nutrition. Cambridge University Press, 21(14), pp. 2606–2616.

Sugar-sweetened beverages (SSB) are any type of drinks that are sweetened with added sugars, such as brown sugar, corn sweetener, corn syrup, dextrose, fructose, glucose, high-fructose corn syrup, honey, lactose, malt syrup, maltose, raw sugar, and sucrose (1,6). This includes, but are not limited to, regular soda, fruit drinks, sports drinks, energy drinks, sweetened waters, also coffee and tea beverages with added sugars (1). SSB usually contains high calories but it will not make you feel as full as if you had eaten the same calories from solid food. There is a research (2) that explained about sugar content of SSB per serving of product in Indonesia by sampling 91 SSB products from a popular convenience store. On an average, the amount of sugar per serving was 22.8 g or 86.3 g/1000 ml. Sugar in sports drinks had the highest contribution to energy of products (93.33%).

Many researches have explained consuming SSB frequently is associated with weight gain or obesity, type 2 diabetes, heart disease, kidney diseases, non-alcoholic liver disease, tooth decay, cavities, and gout (3,4,5,7). People who consume sugary drinks regularly—1 to 2 cans a day or more—have a 26% greater risk of developing type 2 diabetes than people who rarely have such drinks (3). A study that tracked the health of nearly 90,000 women over two decades, found that women who drank more than two servings of sugary beverage each day had 40% higher risk of heart attacks or death from heart disease than women who rarely drank sugary beverages (5). A study of 33,097 individuals showed that among people with a genetic predisposition for obesity, those who drank sugary drinks were more likely to be obese than those who did not (4). This study is important because it suggests genetic risk for obesity does not need to become a reality if healthy habits, like avoiding sugary drinks, are followed.

Indonesian Health Ministry recommends that daily sugar intake does not exceed 50 grams or 4 tablespoons. In fact, based on previous research mentioned (2), the content of sugar alone in carbonated beverages per serving has reached 33.6 grams or 67.2% of the daily intake. It means that only 32.8% of sugar could be obtained from other foods. Another example is that ice cream contains 22 g sugar per serving or 44% of daily intake. Therefore, it is necessary for consumer to read nutrition label before purchasing the product.

 Knowing the bad effects of consuming SSB, plain water is always the best option to choose or beverages with few or no calories. If you are willing to contribute to society, asking schools or workplaces to provide filtered water or water fountain is a good move. You can also help yourself by not stocking soda, fruit punch, or other sugary drinks in the house and making them an occasional treat rather than a daily beverage.

1. CDC (2021). Get the Facts: Sugar-Sweetened Beverages and Consumption. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/nutrition/data-statistics/sugar-sweetened-beverages-intake.html [Accessed 26 Feb. 2022].
2. Haning, Mohamad Thahir & Arundhana, Andi Imam & Muqni, Asry. (2016). The government policy related to sugar-sweetened beverages in Indonesia. Indian Journal of Community Health. 28. 222-227.
3. Malik VS, Hu FB. Sugar-sweetened beverages and cardiometabolic health: An update of the evidence. Nutrients. 2019;11(8):1840.
4. Qi Q, Chu AY, Kang JH, Jensen MK, Curhan GC, Pasquale LR, Ridker PM, Hunter DJ, Willett WC, Rimm EB, Chasman DI. Sugar-sweetened beverages and genetic risk of obesity. New England Journal of Medicine. 2012 Oct 11;367(15):1387-96.
5. Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, Willett WC, Hu FB. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA. 2004 Aug 25;292(8):927-34.
6. The Nutrition Source. (2013). Sugary Drinks. [online] Available at: https://www.hsph.harvard.edu/nutritionsource/healthy-drinks/sugary-drinks/ [Accessed 26 Feb. 2022].
7. Valenzuela MJ, Waterhouse B, Aggarwal VR, Bloor K, Doran T. Effect of sugar-sweetened beverages on oral health: a systematic review and meta-analysis. Eur J Public Health. 2020.