As millions of Muslims across the country get settled into the Ramadan rhythm of fasting during the daylight hours and all the difficulties it entails, a range of health concerns abounds.
Those concerns have never been more pertinent to Sari Pratiwi than during this year’s month-long event. The 26-year-old is five months pregnant and says she has decided to do the fast.
“I consulted my obstetrician before I decided to fast because I’m aware that my baby needs constant nutrition for its development,” she said. “After the examination, the doctor said the baby was healthy so I could fast.”
But given her condition, she acknowledges the need for a change in her regular eating habits.
“The doctor advised me to always eat nutritious food three times a day: once during sahur [the predawn meal], again when breaking the fast at magrib [sundown] and the third time after tarawih,” she said, referring to the extended evening prayer that takes place every night during Ramadan.
As part of the change, Sari plans to drink milk twice a day — at sahur and magrib — to ensure she gets enough nutrition.
Titi Sekarindah, a clinical nutritionist from Jakarta’s Pertamina Hospital, said it was fine for women in the second trimester of their pregnancy (four to six months) to fast, because by then the fetus was relatively strong.
“As long as the mothers are healthy and they can maintain a good intake of nutrition — especially proteins because the fetus needs that for its tissue development — then fasting is fine for them,” she said.
She adds that during Ramadan, it was advisable for pregnant women to double their regular intake of protein, found in fish, eggs, meat or tofu.
Titi stressed that it was also important that pregnant women consult their doctors regularly to monitor their pregnancy for advice on whether it was safe to continue fasting.
“We don’t advise women in the first trimester of pregnancy to fast because this is a crucial stage for the fetus,” she said. “Fasting can harm both the fetus and the mother.”
What fasting does, she said, is lower the red blood cell and iron levels in the mother’s blood, thereby affecting the development of the fetus.
Ma’ruf Amin, head of edicts at the Indonesian Council of Ulema (MUI), the country’s highest Islamic authority, says pregnant and breast-feeding women can be exempted from fasting.
“Fasting is compulsory for them unless they fear that it will harm them or the baby,” he said. “If they opt not to, they can make up for it by fasting another time or by donating food to the poor.”
He adds that others who may be exempted from fasting, which constitutes one of the five pillars of Islam, include those traveling long distances, the elderly and those in poor health.
“This is confirmed in a hadith,” Ma’ruf said, referring to the testaments attributed to the Prophet Muhammad’s disciples. “Islam is a religion that is tolerant.”
Pregnant women are not the only ones who need to make sure they eat healthy during the fasting month, Titi said.
“Don’t forget to eat fruits and vegetables during your predawn meal and when breaking the fast, because the fiber helps suppress hunger during the day and keeps the digestive system functioning smoothly,” she says. Many people, she adds, experience constipation during Ramadan because they don’t eat enough fibrous foods.
She also says fatigue and dehydration during the day can be minimized by drinking plenty of water during the predawn meal. “Drink at least eight glasses of water a day when you fast, three or four of them at sahur,” Titi says.
She warns against the Indonesian penchant for drinking sugary iced or hot tea during sahur, pointing out that tea makes people thirstier and should only be consumed at magrib, when it is important to replenish the blood sugar level.
“Fresh fruit juice and milk are advisable for sahur because they’re more nutritious than tea and you need them to stay healthy,” she says.
As for exercise during the month, Titi recommends a light regime such as walking for 20 to 30 minutes in the afternoon, at around 4 p.m., rather than giving up exercising altogether.
Done wisely, she says, fasting during Ramadan can be beneficial to the health. The right combination of a balanced diet and light exercise keeps the body fit, while the fasting serves to flush out toxins.
“And for those who suffer light gastritis, fasting acts as a cure because it helps the gastrointestinal system rest,” she says.
Her final tip for Ramadan, and one that applies to most of those who fast, is on how to prevent the bad breath that comes with not eating or drinking for hours on end.
Brush three times a day, Titi says, and use mouthwash regularly to keep your breath fresh.
Just make sure it doesn’t contain any alcohol.