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Stephanie Brina-Herres, MS, RD, CDN
Stephanie is an American Heart Association award winning Registered Dietitian (RD) and NY State credentialed Certified Dietitian-Nutritionist (CDN).
With solid expertise built over more than three decades of practice and spanning six states, Stephanie's background includes being a seasoned clinician, consultant, educator (including full-time professor), presenter, author, researcher, program coordinator, consumer scientist (including recipe developer), advocate, counselor, coach, and mentor.
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Stephanie grew up in an Italian family and Italians are passionate about life! Every aspect of life is important to them: living, loving, family, food, and all things cultural. Stephanie is an American Heart Association award winning Registered Dietitian (RD) and NY State credentialed Certified Dietitian-Nutritionist (CDN).
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Ramadan daylight fasting is one of the five pillars of the Islamic faith.
This June, our blog site Guest Author is Teba Abdul Lateef, a Registered Dietitian from Pakistan who is contributing to a two-part blog series on Ramadan. Teba is sharing some of her expertise as a devout Muslim when it comes to Islamic traditions. Please see Part 1 of this two-part blog series for links to Teba’s background. (Grand Mosque picture courtesy of barunpatro at rgbstock).
Part 1 covers some background from Teba concerning Ramadan as well as some reported culinary trends during Ramadan for Muslims living in various parts of the world. This Part 2 includes some thoughts from Teba for devout Muslims to consider when it comes to maintaining their health during Ramadan.
Remember that this blog site only provides infotainment. We respect each person’s right of choice.
We urge each devout Muslim who is considering practicing daylight fasting during the month of Ramadan to please check with his or her personal physician. Each devout Muslim should carefully weigh the individualized health care advice received from that health professional before making any decision regarding personal fasting.
Please note that a health care professional personally working with any devout Muslim who chooses to fast from dawn to dusk during Ramadan may suggest the taking of specific dietary aka nutrient supplement(s). Such supplement(s) may contain particular levels of minerals and/or vitamins designed to promote wellness and protect health considering the circumstances of daytime fasting and the consumption of fewer meals during Ramadan. Any such recommendation should be personalized for each devout Muslim’s unique individual needs.
Please see Part 1 of this blog series for more details on Islamic religious doctrine regarding those Muslim faithful who may be considered exempt from fasting during Ramadan.
We hope that you enjoy this two-part series with a unique perspective on Ramadan.
Dining Considerations for a Healthier Ramadan
Original Article Draft by Teba Abdul Lateef; Content Editing and Formatting by Stephanie
Intermittent fasting during daylight hours of Ramadan, which is considered a religious duty for non-exempt mentally and physically fit adult Muslims, has been reported to be accomplished safely when reasonable precautions are taken when eating and drinking during allowed meals of Ramadan.
Many healthy adult Muslims firmly believe fasting during daylight hours of Ramadan can be beneficial for their health. Health Care Professionals urge that all healthy adult Muslims take great care to consume food items from all of the food groups during allowed meals along with adequate clear fluid intake in order to best protect their health during Ramadan.
Muslims are concerned that non-Muslims may have a misconception about prolonged intermittent daylight hour fasting during the month of Ramadan. Non-Muslims may incorrectly believe that prolonged intermittent fasting is the same as non-stop continuous fasting aka starvation.
Starvation is an unhealthy state in which the body is not getting enough food to produce sufficient energy to meet its energy needs and thus the body is forced to use its own protein sources for energy. Breaking down muscle tissue and later organ tissue occurs in starvation in an attempt to meet the body’s most critical needs for energy.
Starvation is NOT the same as intermittent fasting.
People throughout the world at times must engage in overnight intermittent fasting prior to having blood work drawn the following morning. In such instances, the fasting period lasts for 8-12 hours including while one sleeps. The body typically enters into a fasting state approximately eight hours or so after completion of the last meal. After such an overnight intermittent fast, liver glycogen, a storage form of the sugar glucose, can be broken down to release glucose into the blood stream to provide energy to the body of a healthy person. Muscle glycogen can also be available to the body.
The same principle of drawing upon body stores of energy applies to daylight intermittent fasting with the exception that one is typically active during daylight hours and that activity places a greater demand upon one’s body to draw upon energy stores of liver and muscle glycogen. It is typically closer to 24 hours of fasting when the body can draw on fat stores and break them down so that fat can be used as an energy source once liver and muscle glycogen stores have been used up.
Fast durations during daylight hours of Ramadan will vary depending upon the time of year in which Ramadan occurs and the country in which the Muslim faithful are living. Fast durations can potentially extend to 15-16 hours or more in length in peak summer months in both Eastern & non-Eastern countries. Extremes of the “midnight sun” in certain parts of the world where the sun is visible for up to 24 hours such as north of the Arctic Circle or South of the Antarctic Circle (no human settlements exist in the latter location) can pose difficulties for the Muslim faithful during Ramadan, however, the majority of Muslims do not live or travel in such places. Guidelines are available for when devout Muslims may eat at “Sehr” (Suhoor aka Suhour aka Suhur) and Iftar if they happen to be in “midnight sun” areas during the time of Ramadan.
Making Better Halal Food Choices During Ramadan
Beyond consuming water as a beverage*, it is typically suggested that Halal food choices from each food group should be consumed in the two allowed meals of Suhur and Iftar (plus any snacking after Iftar) in order to obtain a sufficient array of nutrients from one’s diet to promote health. For information on Halal, please see a publication from the Institute of Food Technologists (IFT) titled The Kosher and Halal Food Laws (you can download a full pdf from the abstract link page) and/or a publication from the Islamic Food and Nutrition Council of America (IFANCA) Halal Foodservice Kit.
Suhur* (pre-dawn meal eaten at Sahar) should be composed of more wholesome food choices to provide energy to last through the daylight fasting hours. Iftar (breaking the fast after sunset) should be a complete meal to contribute to replenishing a person’s energy levels during the following overnight hours. Snacking judiciously late evening/at night (preferably 2-3 hours prior to bedtime) to obtain needed nutrients during Ramadan is another strategy Muslims can utilize.
Suggested Meal Patterns for Iftar and Suhur
- Fruits and vegetables: Servings per meal of vegetables (2-3) and fruits (1-2) should be consumed. These carbohydrate-rich food sources should be consumed especially during suhur as they give a person a feeling of fullness because each contains fiber. *The water content of vegetables and fruits can also help keep a person hydrated during the rest of the day during fasting hours of Ramadan. Total vegetable and fruit consumption for a 24 hour period can typically range between 5-9 normal size servings.
- Whole grains: Serving(s) per meal of whole grain bread and whole grain alternatives (1-2-3) should be consumed. Whole grain bread or brown rice are often preferred. Whole grains contain complex carbohydrates which release glucose slowly (glucose is a form of sugar the body uses for energy) and help to sustain more even energy levels for the body for longer periods of time than refined grains do. Total whole grain consumption for a 24 hour period can range between 3-6 oz aka 3-6 normal size servings.
- Meat, fish and alternatives (such as cooked legumes/beans/pulses): One serving per meal of leaner meat (2-3 oz cooked) or its alternatives can be desirable. As rich sources of protein, they can help repair body tissues and contribute to maintaining the immune system. Cooked legumes/beans/pulses can contribute valuable fiber intake helping to prevent constipation during times of intermittent fasting. Total meat and alternatives consumption for a 24 hour period is typically adequate at 5 oz cooked meat equivalent.
- Dairy products: Serving(s) per meal from lower fat or non-fat dairy products (1-2) may reduce the incidence of joint and bone pain which are among frequent complaints voiced by Muslims during Ramadan. Total dairy products consumption for a 24 hour period is typically adequate at 3 normal size servings each equivalent to 7-8 grams of protein).
Dining Choices that are Discouraged in Many Countries During Ramadan
Foods to avoid during Ramadan include highly processed foods and refined carbohydrates (such as refined white flour, high sugar content items, refined flour made cakes, refined flour made biscuits), as well as other food items high in fat (even if they don’t appear fatty) along with food items high in sodium (even if they don’t taste salty). It is fine to use white whole wheat flour as it is made from a whole grain and is NOT refined white flour.
Although many different kinds of dessert items are frequently available in various Muslim cultures during Ramadan, higher saturated fat intake is usually discouraged.
It would be worth avoiding caffeine as much as possible in the diet during Ramadan. Caffeine is a known diuretic and stimulates more rapid body loss of needed water, which is a serious concern in extremely hot weather when Ramadan occurs during peak summertime heat. Caffeine is present in tea, coffee, certain carbonated soft drinks, energy drinks, chocolate, etc.
Cooking Method Awareness During Ramadan
Deep fat frying, and excessive sautéing should be avoided during Ramadan. Although some limited fat intake is reasonable, sufficient fiber and water intake may help to ameliorate potential episodes of constipation. High fat intake should also be avoided because in the process of slowing down digestion it can lead to prolonged acidity in the stomach and a sense of indigestion after a meal.
Tips For a Healthier Ramadan
- Drink adequate clear water and other fluids, but avoid caffeinated beverages as much as possible especially since Ramadan falls during a peak time of heat and humidity this year in many parts of the world and concerns for dehydration are thus increased.
- Break your fast at iftar with a little fruit which has a high content of fructose (a form of sugar) such as 2-3 dates (for almost “instant energy”).
- Avoid fried foods as much as possible and be judicious when consuming high sugar content items other than some fruit (avoid excessive dessert intake temptation despite the offering of so many high sugar and high fat dessert items popular in each culture during Ramadan).
- Include adequate real, wholesome food intake from each food group as much as possible in each allowed meal.
Since one’s diet plays an important role in one’s observation of Ramadan, it is hoped that faithful Muslims will practice healthier eating when they dine during Ramadan.
Ramadan Mubarak! (May your Ramadan be blessed!)
*Suhur is also known by other spellings (including, but not limited to) Sahari, Sahur, Sehri, Sehur, Suhoor and Suhour
2014Ramadan is considered the holiest of the four holy months observed by ~ 1.6 billion Muslims worldwide. In 2014, Ramadan is observed from June 28th – July 27th.
Once again, we have invited Teba Abdul Lateef, a Registered Dietitian (RD) certified by the Pakistan Nutrition and Dietetic Society, to contribute as a Guest Author for this month. Teba was last featured as a Guest Author back in March for National Nutrition Month. During the academic year, Teba serves as a Lecturer in the Department of Nutrition and Dietetics at the Ra’ana Liaquat Ali Khan Govt. College of Home Economics in Karachi. (Grand Mosque picture courtesy of barunpatro at rgbstock).
When it comes to this important Islamic tradition of Ramadan, Teba is contributing to a blog series sharing her insights as a devout Muslim and her expertise as a RD. Collaborating with Stephanie, Teba provides some valuable insights into the food and nutrition culinary trends during Ramadan as celebrated by the Muslim faithful around the globe in this Part 1 and then in Part 2 she shares some suggestions for enjoying a healthier Ramadan.
Please keep in mind that this blog site only provides infotainment. We respect each person’s right of choice.
We urge each devout Muslim who is considering practicing daylight fasting during the month of Ramadan to please check with his or her personal physician and carefully weigh the individualized health care advice received from that health care professional before making any decision regarding personal fasting.
Please enjoy this two-part series with a unique perspective on Ramadan.
The Culinary Trends of Ramadan
Original Article Draft by Teba Abdul Lateef; Content Editing and Formatting by Stephanie
Beginning with either the physical sighting or calculated time of the first crescent of a new moon, Ramadan lasts for 29-30 days encompassing the ninth month of the Islamic lunar calendar. Ramadan is preceded by the month of Sha’aban and followed by the month of Shawwal.
Since the Islamic lunar calendar is ~11 days shorter than the Gregorian calendar (used in the West), the exact time period on the Gregorian calendar for observance of Ramadan will shift every single year per Ramadan Facts published by the Council on Islamic-American Relations (CAIR).
Ramadan is of great importance to all Muslims as the followers of Islam. Throughout the world, Muslims observe Ramadan by fasting from sunrise to sunset, although there are total exemptions for children below the age of puberty, as well as those who are sick, elderly, mentally incapacitated, or not otherwise considered mentally and physically capable as noted in Ramadan Begins (The Practice of Fasting) from the Academy of Nutrition and Dietetics.
Other persons may have temporary exemptions from dawn to dusk fasting such as menstruating women or females who are pregnant or breastfeeding, as well as travelers, however, missed days of fasting must then be made up later as each one of these individuals is able (in some situations acts of charity may be substituted).
General guidance when it comes to food and nutrition matters during Ramadan is available from healthcare professionals. An example includes the Healthy Eating During Ramadan Survival Guide from the Muslims in Dietetics and Nutrition (MIDAN) member interest group (MIG) of the Academy of Nutrition and Dietetics (formerly the American Dietetic Association). Another example is Achieving Good Nutrition During Ramadan or Understanding Muslim Fasting Practices by Registered Dietitian Nour El-Zibdeh. Still another example comes from Communities in Action which has published a Ramadan health guide .
Note that although having a condition such as diabetes mellitus can indeed fall under the exemptions from fasting, many Muslim faithful persons with diabetes refuse to have themselves so categorized, even at the risk of their own health, as noted by the international health care professional members of the Diabetes and Ramadan (DAR) Forum. Best practice guidelines for health care professionals and teachers, etc., who may work with the Muslim faithful, including persons with diabetes who insist upon observing fasting times during Ramadan, are available. Please see the end of this blog post for details.*
During Ramadan, even foreigners who are not Muslims are required to fast from dawn to dusk in Saudi Arabia. This is true in other primarily Muslim faithful countries as well, which non-Muslims need to consider and plan accordingly for prior to traveling to such locations. It should be noted that in a number of instances, periodic fasting has also been included as a ritual among the practices of the faithful of other religions around the world.
During Ramadan, the Islamic faithful also engage in intense worship, recite the Qur’an, and give to others through acts of charity (zakah or zakat which means giving alms from one’s wealth to those who are less fortunate).
Fasting is a religious obligation of Islam as it was a practice of the Prophet Muhammad. Fasting during daylight hours of the month of Ramadan is the third of five “pillars” of Islam. The purpose of fasting is to learn self-control/self-restraint and discipline. Muslims can neither eat nor drink nor chew gum nor take oral medication during daylight hours of fasting (unless they are exempt).
Muslims believe that fasting in this manner leads to a higher level of spirituality, which in turn means a faithful follower of Islam becomes closer to Allah (the Muslim God). A secondary purpose of fasting in this manner is to control hunger, which causes a faithful person to think about the needs of others who lack adequate food the rest of the year because they are poor.
Faithful Muslims believe that Ramadan raises awareness of and highlights ideas/thoughts of healthy eating and a healthy life style as mentioned in Ramadan and fasting: An opportunity to improve health. Such a perspective is along the lines of “mindful eating” which is promoted in many cultures. Because of this heightened awareness of self and increased sense of spirituality, even those Muslims who may be exempt from participating in fasting during Ramadan may engage in it.
Non-Muslims should be aware of the importance of Ramadan to all Muslims and demonstrate cultural sensitivity respecting the right of choice of Muslims to follow their faith regardless of where they live.
Ramadan Typical Halal Meals
There are a total of two Halal** meals which the Muslim faithful can consume during each 24 hour period during Ramadan. The first meal is called “suhoor” or “suhur” which translated from the Arabic means “pre-dawn meal” and thus would be eaten prior to sunrise. After suhur, Muslims fast during daylight hours until sunset after which the second meal known as “iftar” can be eaten to break the daytime fast. Thus the word “iftar” means “breakfast”. In winter months, the fasting period during daylight hours of Ramadan will be shorter than in the summer months when the daylight hours are longer.
Reported Ramadan Halal Food Trends in Different Countries
Every country has its own unique foods trends and culinary patterns including those observed during the month of Ramadan. Following are some reported food trends which may be observed during Ramadan around the world. [Editor's Note: the online articles which Teba is aware of and has verified such as one from thekitchn.com written by a freelance writer, etc., are the source of some of these reported culinary trends during Ramadan which are being mentioned here for infotainment purposes only.]
Afghanistan: Main dish (protein) is served with “naan”, an oven baked flat bread. Iftar is considered incomplete without naan.
Bangladesh: Two famous dishes commonly served at iftar are “piyaji” and “begun”. Piyaji is a spiced lentil and onion fritter. Bejuni is slices of eggplant dipped in a gram flour batter and deep fat fried.
Brunei: Iftar is referred to as “sungkai” and the breaking of the fast is observed at a restaurant buffet.
China: “Paomo” is a bread and mutton soup which is consumed at the time of iftar.
Egypt: “Fried kaftan” is a minced meat ball which is deep fried. Egyptian “Fattah” is a baked dish consisting of varied ingredients as bread, rice, sauce and meat.
India: “Haleem” is served during iftar. Haleem is a spiced porridge prepared by using a slow cooking method. It consists of lentils, meat (either chicken or beef) and broken wheat.
Indonesia: The dessert “kolak” is served during iftar. Kolak is made with palm sugar, coconut milk and pandan leaves.
Iran: “Zolbia” and “Bamieh” are served together at the time of iftar. Zolbia is made of yogurt and starch which is then fried by being poured into oil to create long thin swirls. Bamieh is oval-shaped, deep fried dough. Both are dipped in honey or rose syrup.
Jordan: Stuffed lamb is a traditional dish of Jordan, also served at iftar. “Mansaf” is lamb dish served with rice at iftar.
Lebanon: “Fatayer” is a common dish usually eaten during Ramadan. This dish consists of pastry with a cheese filling. “Stuffed green chillies” locally called “Filfil Mahshi” (type of stuffed peppers) is also served at iftar.
Malaysia: “Babur Lambuk” is the special stew served at iftar. It has varied ingredients including aromatic spices, herbs, meat, coconut milk, ghee and coconut oil.
Morocco: “Chorba” is a famous traditional dish. It is a lamb stew made with tomatoes and chickpeas. A dessert, called “chabbakia” is also served at iftar. It is made of a fried dough flavored with orange blossom water and coated with sesame seeds and honey.
Pakistan: Fruit salad, chickpeas, salad, “dahi baray” (made of lentil flour which is deep fat fried, then mixed into buffalo milk yogurt). Deep fat fried items are always part of iftar.
Saudi Arabia: “Qataef” is often served at iftar. It is a type of Arabic pancake filled with sweet cheese and nuts.
Singapore: “Kueh Lapis” is a layered glutinous steamed cake. The popular rainbow colored dessert is made from tapioca starch, coconut milk, pandan leaves and white sugar.
Syria: “Shish Kebab” is served at the time of iftar.
Turkey: Iftar is considered incomplete without Sherbet. Sherbets are made by combining fruit juices, extracts of flowers or herbs, water and white sugar. “Ramazan kebab” is a dish made with lamb, onions, yogurt and pita bread.
Please see Part 2 of this blog series for details of Ramadan Dining Considerations to help maintain health during Ramadan.
Ramadan Mubarak! (May your Ramadan be blessed!)
*Some links for best practice guidelines when working with persons with diabetes who wish to observe intermittent daylight fasting during Ramadan: One example is Diabetes and Ramadan (How to achieve a safer fast for Diabetics) by the Pakistan Academy of Family Physicians. Another example is Recommendations for Management of Diabetes During Ramadan Update 2010 as published by the American Diabetes Association (ADA). Still another example is Diabetes and Ramadan: how to achieve a safer fast for Muslims with diabetes by Mohammed M Hassanein MB CHB, FRCP, FRCP, MPhil, who also presented a webinar for the Johnson & Johnson Diabetes Institute in June 2014 titled Diabetes and Ramadan fasting; a challenge or an opportunity. Mohammed Hassanein is a member of the previously mentioned Diabetes and Ramadan (DAR) Forum whose members seek to raise awareness of potential increased health risk “for hypoglycemia, hyperglycemia and dehydration” for those persons with diabetes who choose to fast during Ramadan.
**For information on Halal, please see a publication from the Institute of Food Technologists (IFT) titled The Kosher and Halal Food Laws (you can download a full pdf from the abstract link page) and/or a publication from the Islamic Food and Nutrition Council of America (IFANCA) Halal Foodservice Kit.
In Part 2 of 2 of this latest two-part series referencing Pakistani cuisine, we focus in on a glimpse of a typical Pakistani cultural dietary pattern. Once again, for National Nutrition Month (NNM), we feature our Guest Author, Pakistani Registered Dietitian, Teba Abdul Lateef.
Teba shares details of her observations of some of the traditional food ingredients utilized in preparing Pakistani cuisine. She compiled the listing based on her experience living in Karachi, thus it is not meant to be all-inclusive. In Part 1, Teba shares details about the wonderful nuances of some of the better known cultural dishes and spices that help to bring out the distinctive flavors of Pakistani cuisine which can dazzle your senses.
Pakistani cuisine which will dazzle your senses is being featured in this next two-part blog series during March 2014. This Part 1 includes details about a number of the wonderful nuances of some of the better known cultural dishes and spices that help to bring out the distinctive flavors of Pakistani cuisine. Part 2 focuses on a glimpse of a typical Pakistani cultural dietary pattern.
Earlier this month, we introduced our Guest Author for 2014 National Nutrition Month (NNM), Pakistani Registered Dietitian, Teba Abdul Lateef, who recently accepted a college lecturer position in Karachi.
Tasty recipes from Pakistan are being featured this March, courtesy of our Guest Author, as we go global in our effort to promote eating right during National Nutrition Month® (NNM).
In Part 1 of 2 in this blog series, our Guest Author shared some useful tips to consider when making your meal/snack choices. For Part 2 of 2 in this blog series, our Guest Author shares some personal recipes to prove tasty food can indeed be both delicious and nutritious!
Read on for all the details.
Tasty and nutritious food can contribute to better health no matter where you live, so let’s go global in promoting eating right as we celebrate National Nutrition Month® (NNM)!
This March 2014 marks the 41st anniversary of the Academy of Nutrition and Dietetics’ month long promotion of National Nutrition Month®.
We’re featuring a Guest Author on the blog this month. Read on for all the details and some new Pakistani cuisine recipes.
2013As part of First Lady Michelle Obama’s signature “Let’s Move” initiative to end childhood obesity in America, on Tuesday, July 9, 2013 the second annual White House “Kids’ State Dinner” as a formal luncheon is scheduled to celebrate the winners of the 2013 Healthy Lunchtime Challenge.
Selected healthy focus recipes have been scheduled to be featured at the luncheon. (Image of Kids’ State Dinner graphic property of Let’s Move and shown for identification purposes only).
2013Plans are underway for the year 2013 (2nd annual) Kids’ State Dinner aka celebration of the Healthy Lunchtime Challenge promoted by Let’s Move.
Winners of the recipe contest are scheduled to be announced sometime around late June 2013, although apparently per press information on the www, winners are already receiving some local celebrity in their home town locations.
(2012 Kids’ State Dinner Official White House photo by Sonya N. Hebert)
Part 1 of this blog series began some discussion of factors to consider when buying a dishwasher, zeroing in on noise or sound level as measured in a logarithmic decibel (dB) acoustic scale for sound or dB level.
Now we’d like to focus on other considerations including cycle and option choices.
2013Anyone who cooks and/or bakes at home from scratch winds up having a lot of preparation equipment, etc. to deal with when it comes to washing and sanitizing those items. Since this blog site encourages home food preparation, we thought we would share some points to ponder when it comes to home model dishwashers. Few folks can have anything professional when it comes to major appliances in their kitchen, so we’ll stick to home retail models only.
Hidden dishwasher control image used with permission ©KB/Quirky KimUS10
If you have been thinking about possibly buying/replacing a dishwasher, a useful kitchen major appliance that can help make kitchen clean up a tad easier, then you might want to think about some factors that could influence the decision you ultimately make.