Adolescents have an important role in the development of a nation, because healthy adolescents are an investment in the future. One of the health problems that become a burden on adolescents, especially young women, is anemia. Anemia is a condition characterized by a lack of red blood cells in the body, causing fatigue, tiredness, lethargy and impacting the patient’s productivity. In addition, young women who experience anemia are at greater risk of giving birth to low birth weight (LBW) babies and stunting (Sartika et al., 2021). The prevalence of anemia in adolescents in Indonesia is quite high, at 32% (Riskesdas, 2018). Therefore, the prevention and control of anemia in young women is a health problem that is focused on by the government.

Iron deficiency is one of the main causes of anemia. This is caused by the lifestyle of adolescents including inadequate nutritional intake habits (especially sources of iron), the habit of drinking tea and coffee while eating, and lack of physical activity (Kemenkes, 2018). On the other hand, young women need more iron during growth and when blood loss occurs, such as menstruation. Therefore, young women are more at high risk of anemia due to iron deficiency.

Prevention of anemia in adolescents can be done with the following things: 1) increasing the intake of iron-rich foods; 2) iron supplementation by taking blood-added tablets (TTD); 3) increasing consumption of fruits and vegetables as a source of vitamin C; 4) increasing the consumption of animal protein sources; 5) avoiding the consumption of tea and coffee when eating or when consuming iron tablets; and 6) exercising or doing physical activity regularly (Ministry of Health, 2018 and Wouthuyzen et al., 2015). In preventing and overcoming anemia conditions, cooperation from the government and the community is needed. Therefore, teenagers are expected to be able to apply anemia prevention measures in their daily life.

References: 

Kementerian Kesehatan RI. 2018. Hasil Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian RI.

Kementerian Kesehatan RI. 2018. Pedoman Pencegahan dan Penanggulangan Anemia pada Remaja Putri dan Wanita Usia Subur. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian RI.

Sartika AN, Khoirunnisa M, Meiyetriani E, Ermayani E, Pramesthi IL, Nur Ananda AJ. Prenatal and postnatal determinants of stunting at age 0-11 months: A cross-sectional study in Indonesia. PLoS One. 2021 Jul 14;16(7):e0254662.

Wouthuyzen Bakker, M., & van Assen, S. (2015). Exercise-induced anaemia: a forgotten cause of iron deficiency anaemia in young adults. The British journal of general practice : the journal of the Royal College of General Practitioners, 65(634), 268–269. https://doi.org/10.3399/bjgp15X685069

Anemia is a blood disorder condition defined by a lack of red blood cells in the body or the red blood cells can not function properly. This condition causes the body not getting enough oxygen. Anemia is a serious global health problem. Based on WHO, anemia still affects 42% of children aged <5 years and 40% of pregnant women. Symptoms that are often experienced by people with anemia are easily tired, easily drowsy, dizziness, and pale face. The most common cause of anemia is a lack of nutrients, such as vitamin B12, folate, vitamin A, and iron.

There are various types of anemia which can be classified into nutritional anemia and non-nutritive anemia. Nutritional anemia is an anemia condition that can be prevented or corrected with proper nutritional intake. While non-nutritional anemia is not caused by a lack of nutrients, but from abnormalities in body conditions. If you experience symptoms of anemia, it is important to know which type of anemia is experienced so that it can be treated appropriately.

The following are some types of non-nutritional anemia:

1. Aplastic anemia

This anemia occurs due to the inability of the bone marrow to produce enough red blood cells. Aplastic anemia occurs due to genetic causes, usually a hereditary disease. To establish the diagnosis of aplastic anemia, it is necessary to perform a complete blood count and bone marrow examination.

1. Sickle cell anemia

Red blood cells are normally round and flexible, but in people with sickle cell anemia the shape of the red blood cells are sickle-like and stiff, so those can easily clog small blood vessels. Sickle cells can be damaged faster than normal cells and cause oxygen circulation in the body hampered. This type of anemia is a genetic disorder. Until now there is no cure for sickle cell anemia, but blood transfusions can be done to prevent complications.

1. Thalassemia anemia

Thalassemia is a genetic disorder in which the protein that forms hemoglobin can not be formed or insufficient so that red blood cells break easily. Treatment for this disease depends on the severity of the condition, usually requiring regular blood transfusions.

In addition, the following are some types of anemia caused by nutritional deficiencies:

1. Iron deficiency anemia

Hemoglobin functions to transport oxygen which will later be circulated throughout the body. The body needs iron to produce hemoglobin. Lack of hemoglobin causes the body to lack oxygen supply. Initial screening for nutritional anemia can be done by assessing hemoglobin level. The healthy range for hemoglobin in men is 14-18 g/dL and in women is 12-16 g/dL In addition, if iron deficiency anemia occurs in pregnant women, it can interfere with fetal growth, increase the risk of premature birth, and even death of the mother and baby. Iron deficiency can be corrected by eating foods that are high in iron, especially those of animal such as meat, liver, milk, and eggs. In addition, increasing vitamin C intake can help the process of iron absorption.

1. Megaloblastic anemia

Deficiency of vitamin B12 and folic acid can cause megaloblastic anemia. This type of anemia is a condition in which red blood cells are larger than normal or produce immature red blood cells. This condition reduces the amount of oxygen that can be carried in the blood. Vitamin B12 and folate have roles in the red blood cell regeneration process called erythropoiesis. If the body lacks these two nutrients, the formation of new red blood cells can be disrupted. Anemia can be prevented by meeting balanced nutritional needs. Vitamin B12 is found in eggs or fortified foods such as cereals, milk, cheese, and yogurt. Folic acid is found in beef liver, green vegetables, and beans.

Anemia that happens in the long term can cause damage to organs, such as the heart and lungs, since these organs have to try harder in carrying out their duties. If you experience regular symptoms such as fatigue, constant tiredness, and pale face, it is best to consult a doctor to get the right diagnosis and treatment.

References:

• Centers for Disease Control and Prevention. 2021. Thalassemia. [online]. Available at https://cdc.gov.ncbddd/thalassemia/facts.html
• Hariz A, Bhattacharya PT. 2022. Megaloblastic Anemia. StatPearls Publishing.
• National Institutes of Health. 2021. Dietary Supplement Fact Sheets: Folate. [online]. Available at https://ods.od.nih.gov/
• National Institutes of Health. 2021. Dietary Supplement Fact Sheets: B12. [online]. Available at https://ods.od.nih.gov/
• World Health Organization. 2017. Nutritional Anaemias: Tools for Evective Prevention and Control. [online]. Available at https://www.who.int/publications/

Eid Al-Fitr or Lebaran is a day that is highly awaited by Muslims, not only in Indonesia, but also all around the world. Eid is identical with a family gathering and also the tradition of eating together with family. Many types of food and drinks are served during Eid. In Indonesia, the usual menus are lontong opor ayam, rendang, meatball soup, Eid cakes, snacks, and sweet drinks.

Some people make Eid or Lebaran as a time of revenge to eat as much as they want, after having fast for about 30 days in the month of Ramadan, within 13-14 hours every day. However, this phenomenon cannot be justified. Why? Because it can cause an unfavorable impact for the body, for example: increasing weight drastically, and also increasing blood sugar and cholesterol levels in our bodies.

There are four tips for maintaining a healthy diet that we need to consider and apply during Eid:

• Limit the Amount of Food Intake and Limit High Calorie Food: Foods Containing Coconut Milk and High in Fat

During Eid, we often feel like we want to taste all the food that is served at the table. It is okay to try all the foods served, but remember to limit the number of the portions. Use small plates to limit the amount of your food intake.

Most of the food served during Eid are identical with coconut milk (santan) and rich in fat. Even though it has such a delicious taste, but we need to limit the portions. If it’s too much consumed, there can be an increase in body weight, cholesterol and blood sugar levels, so that it can increase the risk of cardiovascular disease (1). 

• Increase the Consumption of Vegetables and Fruits

Try to keep consuming vegetables and fruits during Eid. Besides choosing protein-rich foods, don’t forget to tuck in vegetables and fruits on your plate, to meet your micronutrient needs. The World Health Organization (WHO) recommends consuming vegetables and fruits at least 400 grams/person/day (2).

Vegetables and fruit are known to be rich in vitamins, minerals, carotenoids, phytosterols, flavonoids, phenolic compounds, dietary fibers, and antioxidants that have so many benefits for the body (3,4). One of the benefits is that it can maintain our health and also reduce the risks of several diseases (3), such as:

• Cancer
• Cardiovascular diseases: hypertension and chronic health failure
• Diabetes Mellitus
• Arthritis
• Skin diseases
• Overweight and Obesity
• Neurodegenerative diseases: Alzheimer’s and Parkinson’s disease

In addition, consuming enough vegetables and fruits also helps maintain lung function in adults, and also increases bone health to avoid the risk of osteoporosis (3).

• Limit Sugar Intake

Oftentimes, sweet foods and drinks are served during Eid. It’s okay if you want to try various types of Eid cakes or sweet drinks served on the table, but keep an eye on the numbers of the portions. Eating too much sugar increases the risk of dental caries, diabetes, and obesity (5).

Don’t forget to drink enough water after consuming sweet foods and drinks. The Ministry of Health Republic of Indonesia recommends drinking 2 liters of water or 8 glasses every day (6).

• Do Moderate Exercise

Last but not least, take your time to do some exercises. The Ministry of Health Republic of Indonesia recommends exercising for about 30 minutes/day or 150 minutes/week in moderate intensity (7). You don’t have to do sports using special equipment or go to the gym with a personal trainer, but you can do your exercises independently at home. Choose a type of exercise that you can enjoy, so that you don’t feel overwhelmed while doing it.

References:

1. Astrup A, Mangkos F, Bier DM, Brenna T, Otto M, Hill JO, et al. Saturated Fats and Health: A Reassessment and Proposal for Food-Based Recommendations. JACC State-of-the-Art Review. 2020; 76(7).
2. WHO. Healthy Diet. [Online]; 2020 [cited 2022 April 23. Available from: https://www.who.int/news-room/fact-sheets/detail/healthy-diet.
3. Yahia EM, García-Solís P, Celis MEM. Contribution of Fruits and Vegetables to Human Nutrition and Health. In Postharvest Physiology and Biochemistry of Fruits and Vegetables. Cambridge: Woodhead Publishing; 2019. p. 19-45.
4. Varadaraju R, Patel P. Health Benefits of Vegetables. International Journal of Chemical Studies. 2019; 7(2): p. 82-87.
5. WHO. Taxes on sugary drinks: Why do it? (No. WHO/NMH/PND/16.5 Rev. 1): World Health Organization; 2017.
6. Kemenkes RI. Berapa Takaran Normal Air Agar Tidak Kekurangan Cairan dalam Tubuh? [Online]; 2018 [cited 2022 April 23. Available from: http://p2ptm.kemkes.go.id/preview/infografhic/berapa-takaran-normal-air-agar-tidak-kekurangan-cairan-dalam-tubuh.
7. Kemenkes RI. Ayo Bergerak, Lawan Obesitas Jakarta: Kementerian Kesehatan RI; 2017.

The food pattern during fasting is certainly changing. The changes occur when food consumption is limited so that the frequency of eating and the amount of food consumed are more limited. In general, people consume a portion of food three times a day but during fasting it changes to two times a day. Although eating patterns change during fasting, people must maintain optimal and balanced nutritional intake so that their body condition remains healthy and can undergo fasting properly. Therefore, the foods fulfillment with carbohydrates, fiber, vitamins and minerals, fats, and proteins must be considered accordingly.

Several things need to be considered in implementing a healthy diet while fasting. Three tips for maintaining a healthy diet during fasting are:

• Limit Salty Foods Consumption During Suhoor

Consuming salty foods will increase the intake of sodium that enters the body. It can increase urination after consuming drinks during the suhoor (Juraschek et.al., 2020). In addition, it also causes dry mouth and thirst. It is caused when the body improves the ratio of sodium and fluid balance to respond to the sodium increase (Agócs et al., 2020). Therefore, try to limit salt consumption or other high-sodium foods such as sauces, soy sauce, and canned foods during the suhoor.

• Consume Complex Carbohydrates and High Fiber

Consuming food sources of complex carbohydrates and high fiber are recommended at suhoor. Foods such as sweet potatoes, corn, cassava, oatmeal, whole wheat bread, and brown rice will provide a full effect for more than 6 hours. It happens because fiber can slow down the gastric emptying process, so that food absorption takes longer (Akbar et al., 2021). In addition, consuming enough fiber can also maintain a healthy digestive tract and prevent constipation (McRorie et al., 2016).

• Eat Sufficiently and Limit Sweet Foods During Iftar

When breaking the fast, you should consume food gradually. Avoid consuming heavy food immediately, because it can put an extra burden on digestion (Sanvictores et al., 2021). In addition, directly consuming a lot of food can make the stomach feel tight. Therefore, eat gradually, starting with water, then a little sweet food, and main food after an interval of half or an hour are recommended. When breaking the fast, it is also necessary to pay attention to the consumption of sweet foods, but people often consume drinks with high sugar and sweet foods when breaking the fast. Sweet foods have benefits in increasing low blood sugar levels while fasting. However, you need to be careful not to consume excess sugar.

References:

Akbar A, Shreenath AP. High Fiber Diet. [Updated 2021 May 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559033/

Agócs R, Sugár D, Szabó AJ. Is too much salt harmful? Yes. Pediatr Nephrol. 2020 Sep;35(9):1777-1785. doi: 10.1007/s00467-019-04387-4. Epub 2019 Nov 28. PMID: 31781959; PMCID: PMC7384997.

Juraschek SP, Miller ER 3rd, Chang AR, Anderson CAM, Hall JE, Appel LJ. Effects of Sodium Reduction on Energy, Metabolism, Weight, Thirst, and Urine Volume: Results From the DASH (Dietary Approaches to Stop Hypertension)-Sodium Trial. Hypertension. 2020 Mar;75(3):723-729. doi: 10.1161/HYPERTENSIONAHA.119.13932. Epub 2020 Jan 20. PMID: 31957521; PMCID: PMC7278848.

McRorie JW Jr, McKeown NM. Understanding the Physics of Functional Fibers in the Gastrointestinal Tract: An Evidence-Based Approach to Resolving Enduring Misconceptions about Insoluble and Soluble Fiber. J Acad Nutr Diet. 2017 Feb;117(2):251-264. doi: 10.1016/j.jand.2016.09.021. Epub 2016 Nov 15. PMID: 27863994.

Sanvictores T, Casale J, Huecker MR. Physiology, Fasting. [Updated 2021 Jul 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534877/

Certainly it is not an easy thing to hold thirst for more than 12 hours per day. Under normal circumstances, adult body requires ± 2 liters of fluid every day. Lack of fluids can cause disturbances in brain function such as difficulty thinking, headaches, fatigue, and impaired muscle function. Therefore, in this article, we will discuss tips that can be done to keep the body hydrated during fasting.

• Drink enough water

During fasting, our bodies can experience mild dehydration which is characterized by headaches, fatigue, and difficulty concentrating. To prevent excessive thirst, we can divide the time to drink water with the following pattern: 1 glass when breaking the fast, 1 glass after dinner, 1 glass after Isha’ time, 1 glass after Tarawih time, 1 cup before bed, 1 cup after wake up, 1 glass at dawn, and 1 glass before Fajr. The volume of water that is drunk at one time should not be excessive (only about 250 – 300 mL / glass) because the body will not be able to absorb large amounts of water at once. Dairy products such as milk and yogurt are also high in water content so they are good for supplementing daily fluid needs.

• Consumption of fruits and vegetables

Eating fruits and vegetables is also highly recommended, because in addition to containing high water content, they also contain vitamins and minerals that are good for the body. Examples of fruits that contain a lot of water are watermelon, strawberries, oranges, melons, and pineapples. In addition, vegetables that are high in water content include spinach, broccoli, tomatoes, and carrots.

• Avoid caffeine consumption

You should avoid drinking tea or coffee before fasting because the caffeine contained in it is a diuretic. Consumption of tea and coffee will increase the frequency of urination and make our bodies thirsty faster. This will make dehydration worse.

• Take a cold shower

Hot temperatures can increase the release of fluid through the skin pores. Taking a cold shower will keep your body from excreting a lot of fluids. In addition, showering with cold water can also help reduce stress and improve mood.

References:

1. Enhance (2022). Cold Showers and Intermittent Fasting: The Benefits to Your Health. [online]. Available at: enhancenaturals.co.uk
2. Khuraaki (2022). A Guide on Healthy Eating and Hydration During Ramadan. [online]. Available at: https://khuraaki.co.uk.
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.

Because of the negative effects, intermittent fasting is not recommended for pregnant women and nursing mothers, children and adolescents under the age of 18, those at risk of hypoglycemia, diabetes, or people with certain chronic diseases. If you have side effects like headaches, nausea, or other symptoms after practicing intermittent fasting, you should consult a doctor. There are several methods that can be used by those who want to start intermittent fasting, including:

1. The 5:2 Diet

This method is used twice a week and involves eating only one portion of food (about 500-600 calories). To keep calories low when fasting, it is highly recommended to eat foods high in fiber and protein. On the other five days of week, you are free to eat normally. If you choose to eat normally every day of the week except Sunday and Monday, for example.

1. The 16/8 method

You have choice of eating for 8 hours and fasting for 16 hours. For example, you may eat from 10 a.m. until 6 p.m. and then fast for the next 16 hours. Some people find it simple to maintain this method over time.

1. Eat-Stop-Eat

This method involves fasting for a full 24 hours once or twice a week. You can fast from breakfast till breakfast the next day, then continue after one day of not fasting. The negative effects of this method might be severe, including weariness, headaches, and hunger.

Reference:

1. Cleveland Clinic (2022). Intermittent Fasting: How It Works and 4 Types Explained. [Online] Available at: https://health.levelandclinic.org/ [Accessed April 6, 2022]
2. Dong, TA, Sandesara, PB, Dhindsa, DS, Mehta, A., Arneson, LC, Dollar, AL, … & Sperling, LS (2020). Intermittent fasting: a heart healthy dietary pattern?.The American journal of medicine,133(8), 901-907.
3. Johns Hopkins Medicine (2022). Intermittent Fasting: What is it, and how does it work? [Online] Available at: https://www.hopkinsmedicine.org/ [Accessed April 6, 2022]
4. Mohamed, AI, Abdi, AM and Abilahi, MM (2020). Ramadan Intermittent Fasting and Its Beneficial Effects of Health: A Review Article. Central African Journal of Public Health, 6(5), 288-292.

Stunting is one of the chronic nutritional problems in Indonesia. The prevalence of stunting in Indonesia is quite high, ranked number 2 in Southeast Asia (1). Based on Riskesdas 2018, the prevalence is 30.8% and it is estimated to decrease to 26.92% in 2020 (2, 3). However, this figure is still within the upper threshold for stunting prevalence which is 20% set by WHO. This is an important problem that needs to be addressed together either by the government or by the community.

Stunting or short toddlers is a condition of failure to thrive that occurs in children under five due to chronic malnutrition, especially in the period of the First 1,000 Days of Life (HPK) (4). Stunting conditions are generally caused by low nutritional intake and health status for a long time, lack of access to sanitation and clean water resulting in repeated infections, and inadequate parenting (4).

Early detection of stunting can be done by monitoring the child’s growth curve regularly. Mothers should regularly monitor their child’s growth and development by visiting the nearest Posyandu in the neighborhood. The cadre will explain how the child’s weight and length/height are based on their age category. Toddlers are categorized as stunted when the Body Length index for Age (PB/U) or Height for Age (TB/U) with a z-score is in the range of less than -2 SD (short) to -3 SD (very short) (4).

Stunting prevention needs to be done as early as possible. Similar to what has been said by Prof. Dr. dr. Nila Djuwita F. Moeloek, SpM(K), that “If we prevent it earlier since we are young girls, the better results will be. Behavior change is needed because preventing stunting is important!”. The government together with the Ministry of Health has also compiled stunting prevention programs to reduce stunting prevalence in Indonesia, such as (5):

1. Giving 90 pieces blood supplementation during pregnancy
2. Providing additional food for pregnant women
3. Handling pregnant women with an expert doctor or midwife
4. Implementation of breastfeeding early initiation
5. Exclusive breastfeeding for babies up to 6 months old
6. Complementary feeding for 2 years old children (from 6 months to 24 months)
7. Immunization and vitamin A supplementation
8. Monitoring growth and development of toddlers through Posyandu activities in the neighborhood
9. Implementing clean and healthy living behavior

If not prevented and handled properly, stunting can have a negative impact on the quality of human resources. 

• Short-term impact: stunting can cause stunted growth in children, impaired brain growth, cognitive and motoric disorders of children, metabolic disorders, and physical size of children’s bodies do not develop optimally according to their age (4,6).
• Long-term impact: stunting can cause children intellectual capacity which has an impact on decreasing learning concentration and difficulty understanding the material presented at school, so that it can affect learning achievement and productivity as an adult, decreased immunity/immune, and the risk of developing degenerative diseases (4,6).

References:

1. Asian Development Bank (ADB). Prevalensi Stunting Balita Indonesia Tertinggi ke-2 di Asia Tenggara. [Online].; 2020 [cited 2022 April 3. Available from: https://databoks.katadata.co.id/datapublish/2021/11/25/prevalensi-stunting-balita-indonesia-tertinggi-ke-2-di-asia-tenggara.
2. Sekretariat Wakil Presiden. Angka Prevalensi Stunting tahun 2020 Diprediksi Turun. [Online].; 2021 [cited 22 Desember 21. Available from: https://stunting.go.id/angka-prevalensi-stunting-tahun-2020-diprediksi-turun/.
3. Kemenkes RI. Hasil Utama Riskesdas 2018. Jakarta; 2018.
4. Kementerian PPN/Bappenas. Pedoman Pelaksanaan Intervensi Penurunan Stunting Terintegrasi di Kabupaten/Kota Jakarta: Kementerian Perencanaan dan Pembangunan Nasional/Badan Perencanaan dan Pembangunan Nasional; 2018.
5. Kemenkes RI. Warta Kesmas: Cegah Stunting itu Penting. [Online].; 2018 [cited 2021 April 3. Available from: https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Warta-Kesmas-Edisi-02-2018_1136.pdf.
6. Adistrie F, Lumbantobing VBM, Maryam NNA. Pemberdayaan Kader Kesehatan Dalam Deteksi Dini Stunting dan Stimulasi Tumbuh Kembang pada Balita. Media Karya Kesehatan. 2018 Desember; 1(2).

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].