Staying Hydrated this Ramadan
Written by Dr. Ishtiaq Ahmed, Founder of Legeci Health
Staying Hydrated this Ramadan. “Did you drink your EIGHT glasses of water today?” Most of us have heard this statement before, emphasizing the importance of consuming at least 8 glasses of water every day for hydration and healthy skin. Ever wonder where this recommendation came from? Is it really true? The Institute of Research made recommendations for hydration back in 2012 where they suggested a healthy adult male should consume 3 Litres of fluid (approximately 12 cups) a day and female 2.2 Litres of fluid (9 cups) per day for health. Notice that the recommendation doesn’t really say how many glasses of water to drink, but instead suggests how much total fluid to consume in the form of beverages and foods. Many foods we consume have fluid content, especially foods like fruits and vegetables are very high in fluid composition. For example, oranges, watermelons, apples, and cucumbers are composed of 90% fluid as are most other fruits and vegetables. Other foods such as soups, cooked pasta, rice and grains are composed of approximately 90% fluid also. You need to combine all these sources of fluid towards the total fluid intake for the day. So where did the 8 glasses of water misnomer come from? It is “catchy” and simple to remember and roughly in the range of 2.2 L (9 cups) of fluid recommended by the guideline. In reality, figuring out how much fluid someone really needs is a bit more complex with multiple factors at play.
The water balance in your body depends on how much you are TAKING IN and how much the body is LOSING. Typically we consume 60% of our fluids from beverages, 39% from foods, and 10% comes from metabolism in our bodies (oxidation of carbohydrates, protein and fat). The way we lose fluid from our bodies is 20% from skin, 5% sweating, 60% in urine and waste, and 15% from breathing. People who lose fluid more would require more replacement. Those who exercise regularly, play sports, get exposed to hot temperatures tend to lose lot more fluids than those who do not. On average, we lose 5% of fluid as sweat or perspiration, and this increases to 90% during prolonged exercise. Studies have demonstrated that even a 1% loss in body weight from dehydration can negatively impact an athletes performance- this would mean as little as 0.7 kg weight loss in a 70 kg person. Despite aggressive hydration during hockey games, a goalie can lose up to 7 kg of weight at the end of a single game from pure dehydration. In this case the goalie would need to replenish over 1.5L of fluids. Similarly, outdoor workers in the summer need to be much more vigilant about hydrating regularly compared to someone working indoors in an air conditioned room.
These factors are compounded even more when someone is fasting from all food and drink. Intermittent fasting as in the month of Ramadan precludes one from consuming any fluids or food from dawn till dusk. In the summers of North America, this can mean over 17 hours of fasting. Our bodies are composed of 70% water, much like the Earth’s surface is composed of 70% water, subhanallah! Our bodies need water more than food to sustain. During the non-fasting hours, it is imperative that we consume enough amount of fluids to replenish and top-up our bodies with fluid. Many times when we break our fast at Iftar we neglect hydration. By making sure we consume a good amount of water and other fluids between iftar and suhoor, we can prevent the chances of getting low on fluids, which is dehydration.
What are the signs of dehydration?
When our bodies fall behind on fluids and feel “dry”, we are approaching the state of dehydration. Often dehydration is a direct result of not consuming enough fluids. Dehydration can lead to dizziness, light-headedness, fainting, racing heart beat (palpitations), and decreased kidney function as a direct result of low blood pressure. People can feel parched or dry mouth, dry eyes, dry skin, and low energy in the form of fatigue. Often positional changes will bring on the dizziness, for example standing up after lying or sitting. This sudden drop in blood pressure can be dangerous, particularly in diabetics and elderly, putting them at risk for falls and injuries. If someone is feeling unwell during a fast, seek medical attention right away. Checking your blood pressure and blood sugars will help determine if those factors are causing the weakness or dizziness. Most importantly, consult your local physician and scholar to determine if it would be safe to continue fasting.
Beware of drinking too much plain water as well. Overhydration with only water can cause “Water Toxicity” where your electrolytes such as sodium and potassium can get too low. That is why it is important to get your fluid from other sources of beverages and foods rather than just water.
Tips on Staying Hydrated this Ramadan
Take enough fluids: Make sure before starting and after breaking your fast, you consume foods rich in fluids and drink adequate healthy beverages to hydrate yourself. Keep a water bottle with you from iftar to suhoor so that you are sipping on some water regularly. Also try to consume 1 glass of water before each meal.
Reduce salt: This includes highly processed foods that have a high salt content and foods made at home that are high in salt. Watch out for canned products that are usually laden with salt. Salt typically causes thirst and also forces your body to get rid of excess salt by making more urine. You are more likely to feel thirsty and get a dry mouth with high salt foods. Especially avoid salty foods at Suhoor.
Reduce sweets: Resist taking that extra piece of gulab jamun or another piece of cake. Instead, go for some whole fruits or nuts. Alternatives include less sweet items such as figs, apricots or dates.
Be mindful of fiber: Take adequate fiber in your diet by consuming fruits and vegetables. Along with enough hydration, these foods are also rich in water and will help maintain hydration. The fiber will also help prevent constipation. High fiber foods will help better control sugar spikes. It is good to start your dinner with a healthy salad before moving on to the main course.
Focus more on protein and complex carbohydrates: Much like athletes rely on carbohydrate foods for prolonged energy, foods that are complex carbohydrates such as rice, pasta, grains and oatmeal tend to be better at providing energy for longer. Protein also provides a good source of lean energy.
Control your portions: After fasting for a long day, the cravings get the better of you! Indulgence in some sweets and your favourite iftar items is inevitable, but make sure you control your amounts. Much like how real estate is about “location, location, location” eating healthy begins with “portion, portion, portion!”
Keep it simple: Too much variety at the iftar table often will lead you to consume more food. Try limit to a smaller quantity and less variety of items for each day, but feel free to make different items on different days. This way you can still enjoy all your favorite Ramadan foods but not all at once!
Remain physically active: It is best to stay active during fasting as in your usual routine, however be careful when it comes to intense sports activity while fasting. Your risk of dehydration, injury and fatigue is much higher if not able to replenish your fluid loss, salt, and energy. Fluid loss from sweating goes up from 15% to 90% with prolonged sports activity.
Limit heat exposure: Sweating is a natural way our bodies cope with heat. Exposure to hot temperatures will cause more fluid loss and dehydration through increased sweating. This is important for people who spend lot of time working outdoors, particularly in the heat of the long summer days. It is advisable to seek some shade and cool temperatures to recover.
Keep that glucometer handy: People with diabetes must take extra precautions if fasting to control their blood sugar levels. If your diabetes is well controlled, and you are safe to fast, make sure you carefully track your blood sugars through the day. Diabetics are at risk of experiencing low blood sugar (HYP O-glycemia) or high blood sugar (HYP ER-glycemia) levels around fasting. Keep your glucometer within reach in case you feel unwell at any time. For emergencies, always carry some glucose tablets or juice with you in case your blood sugar drops during the fast, and you need to take some sugar immediately.
Compensate for health problems: Low salt and reduced fluid intake is important for patients with heart or kidney disease. These patients are very prone to retaining fluid if salt and fluid intake is not balanced. Swelling in the body, often called edema, happens when excess fluid collects in the tissues. If you suffer from heart, kidney or other similar diseases, consult with your physician to discuss what salt and fluid restrictions to follow when fasting.
Dr. Ishtiaq Ahmed, Founder of Legeci Health is our health expert. For more medical information from an Islamic perspective, please visit: www.legeci.com