What We’ll Cover:

• An introduction to Ramadan
• Roczen protocol adaptations for Ramadan 
• When to seek medical attention

Introduction: 

With Ramadan approaching, we want to support you in managing your Roczen journey alongside this important period in the Islamic calendar. The Holy Qur’an requires fasting from sunrise (suhoor) to sunset (iftar) during Ramadan, which in the UK means that fasts can last from 10–21 hours a day, depending on the season Ramadan falls within. 

The annual observance of Ramadan is a time for prayer, reflection and community in the Muslim calendar. We hope this guide supports you during this important time whilst you’re on the Roczen programme.

Exemptions:

• The elderly 
• Illness (physical or mental) 
• Menstruating 
• Pregnancy, breastfeeding

Risks:

• Dehydration 
• Overeating leading to weight gain
• Reduced activity levels
• Problems with sleep
• For individuals living with diabetes,  low blood sugar levels (hypoglycaemia) or high blood glucose levels(hyperglycaemia). There are exemptions for fasting and this can include people living with diabetes. Please always speak to your clinical team to understand if it is safe for you to fast. This can depend on the type of medication you take, the type of diabetes you have, your HbA1C levels or if you live with any diabetes complications.  

What to eat and drink at iftar and suhoor- Roczen protocol considerations

Whilst you will be prioritising and following the rules of Ramdan, we encourage you to follow the Roczen principles wherever possible, aiming for a diet rich in protein, high in fibre, low in carbohydrates and with a range of healthy fats. Remember to look back on the nutrition guidelines if unsure, or ask your group mentor for more tips.

Have a Roczen-friendly meal at the start of Iftar (when the sun goes down), and consider adding lentils, beans, quinoa or pulses to the meal. The meal should remain a meal and not become a feast.

1. Consider whole grain oats eggs before Sahoor (the start of the fast, sunrise)  
2. Yoghurt – this can be a good food to include at suhoor as it provides nutrients like protein, calcium, iodine, B vitamins and contains fluids. 
3. Try to limit fruits that are not recommended in the plan, such as melon, grapes, prunes, and sultanas.
4. Drink 2-3 litres of water once Iftar has started

Movement

• Be kind to yourself and listen to your body - it's okay to lower the intensity of your exercises and stop if you don't feel well.
• Plan your workouts carefully and don't overdo it - consider just maintaining your current level (or even dropping slightly for a few weeks) rather than pushing to improve.

Things to be mindful of:

Headaches: This is a common problem and there are many causes. Headaches during a fast could be due to dehydration, hunger or even a lack of rest. A moderate and balanced diet, especially not missing the pre-dawn meal and consuming adequate fluid quantities, should help to avoid this. Despite the above measures, you should speak to a doctor if you have a persistent or worsening headache.

‍Constipation: This can be challenging for someone undertaking a fast. Maintaining good hydration outside the fast, eating plenty of vegetables in your diet and increasing the fibre content of your food should help.

Important considerations if you are living with diabetes

• The information below is adapted from Diabetes UK. It is available to order and download in multiple languages on their website and has been developed in partnership with the British Islamic Medical Association (BIMA). 
• Fasting carries the risk of low blood sugar (or hypoglycaemia) if you take certain tablets or insulin for diabetes
• Make sure you monitor your blood sugars more often during the fast (with a blood sugar monitor or a continuous glucose monitor, CGM) and are familiar with your signs and symptoms of low blood sugar.
• If your blood sugar drops below 4mmol/L, you must break the fast and treat the hypoglycaemia
• If you are feeling unwell or have a high glucose level (your diabetes team or GP can help determine what is a high level for you), you must break the fast, drink fluids and seek urgent medical advice. 

When to seek urgent medical attention:

• Severe dehydration that can present as confusion, fainting, and seizures.
• Uncontrolled high or low blood sugar which can cause symptoms such as excessive thirst, frequent urination, confusion, weakness, and seizures.
• Chest pain or discomfort which can be a sign of a heart attack or other serious heart condition.

Please speak with your clinician if you have any questions or need additional advice. We are here to support you.