Medical experts share advice on fasting safely during Ramadan for people with heart conditions and the symptoms that require immediate attention
As Muslims across London and worldwide prepare for the holy month of Ramadan, which is expected to begin on a date between Tuesday (February 17) and Thursday (February 19) depending on moonsighting reports, it is important to know who should and shouldn’t take part in a period of fasting for health reasons.
While Ramadan is a time to fast, pray and reflect via abstaining eating food and drinking to strengthen their faith, medical guidance suggests fasting should be avoided by individuals who are frail and in poor health, or those currently battling infections including flu or Covid.
Additionally, exemptions apply to people managing conditions such as diabetes, kidney disease, or heart disease, as well as cancer patients undergoing treatment. Pregnant and breastfeeding women are also exempt, as well as those who are on their menstrual cycle at the time.
Medical professionals emphasise that whilst Ramadan fasting can be undertaken safely by numerous individuals with heart conditions, this varies significantly on a case-by-case basis. Heart Research UK’s Chief Medical Advisor, Dr Roy Jogiya, has offered guidance on maintaining health throughout Ramadan, whilst the charity’s qualified nutritionist, Amie Leckie, shares practical advice for managing nutrition during the fasting period, reports Birmingham Live.
Who is usually safe to fast
Dr Roy explained: “Many people with stable heart conditions can fast safely, including those with well-controlled blood pressure, stable coronary heart disease, previous heart attacks with good recovery, or mild, stable heart valve disease. If you feel well and your condition is controlled, fasting is often possible with the right planning.”
Before embarking on a fast, individuals with heart conditions are strongly advised to consult their doctor. Particularly, if you’ve had symptoms of heart failure, significant valve disease, a recent heart attack or heart surgery, it’s crucial to see a GP first.
Even if your heart condition has been relatively stable, any sudden change in symptoms should prompt a visit to a doctor, as Dr Roy suggests. Those who require multiple daytime medications or diuretics (water tablets) may also need tailored advice.
It’s important not to stop or alter heart medications without medical guidance. Some medicines can be adjusted to fit the pre-fasting meal of suhoor and post-fasting feast of iftar, but others require careful timing. Staying hydrated between sunset and dawn is especially crucial, he emphasised.
Warning signs to watch for
Dr Roy advises those who are fasting to seek medical help if they experience chest pain, worsening breathlessness, dizziness or fainting, palpitations, or unusual fatigue. These symptoms should not be ignored while continuing with the fast. Following Dr Roy’s advice, expert nutritionist Amie Leckie shares key steps for maintaining a heart-healthy Ramadan:
1. Prioritise a balanced, nutrient-dense suhoor
A well-planned suhoor helps maintain energy and nutrient levels throughout the day. Opting for a balanced mix of lean proteins, complex carbohydrates and fibre slows digestion, keeps you feeling fuller longer, and aids in maintaining stable blood sugar.
The suhoor meal should include a sufficient amount of lean proteins such as chicken, eggs, and legumes. Amie has encouraged individuals to opt for heart-healthy fats like olive oil, avocados, nuts, and seeds, and while this advice isn’t specific to Ramadan, it’s a good habit for maintaining long-term heart health.
To keep energy levels steady during fasting hours, Amie emphasises the significance of high-fibre foods, as they slowly release energy throughout the day, helping to curb hunger pangs.
2. Break your fast with hydration and electrolytes before your main meal
Dehydration can put pressure on the cardiovascular system, particularly during extended fasts without water consumption. Keeping hydrated aids blood volume, blood pressure regulation and optimal cellular function.
Amie offers these three tips to ensure that those fasting can stay adequately hydrated throughout the day:
- At iftar, start with water and electrolytes (e.g., coconut water, homemade broths).
- Spread fluid intake throughout the evening and before suhoor.
- Include water-rich foods like cucumbers, watermelon, and soups.
3. Avoid excessive sugar, salt and ultra-processed foods
Diets rich in sugar and salt can lead to increased blood pressure, blood sugar spikes, and unfavourable changes in lipid (cholesterol) levels, negating the potential benefits of fasting. Steer clear of high-sugar, refined carbohydrates (biscuits, sweets, pastries, etc.) and sugary drinks, as they can cause rapid blood sugar spikes.
4. Maintain overall energy balance and mindful eating
Studies have shown that fasting during Ramadan can lead to better lipid (cholesterol) levels, lower blood pressure and weight loss – all of which support cardiovascular health. That said, eating too much once the sun goes down can undo these positive effects. To keep your energy steady whilst fasting, it’s crucial to stick to these guidelines:
- Eat mindfully, slowly and stop when satisfied.
- Listen to hunger cues rather than eating large portions immediately when breaking the fast.
- Spread meals over the evening to avoid digestive strain.
5. Choose light exercise
Gentle movement during Ramadan helps keep your heart fit, aids blood flow, and keeps blood sugar in check without leaving you overly tired or parched.
6. Focus on sleep and recovery
Shifting meal times and late-night worship during Ramadan can throw off your sleep routine, which may impact your energy, blood pressure, and heart health. Making quality rest a priority supports your wellbeing and helps your body recuperate whilst fasting.
Amie suggests: “Aim for consistent sleep and wake times where possible and take short daytime naps if night time sleep is reduced.”
Concluding, Dr Roy adds: “For those whose health may be affected by fasting, Islamic teachings recognise flexibility, where fasting is not possible.”
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