Fasting: A Purifying Practice—But Not for All Chronic Patients
La Presse — While fasting is traditionally viewed as a religious and spiritual act, it also serves a detoxifying function for the body—except for certain chronic illnesses. In many cases, fasting can harm health and disrupt a medication‑based therapeutic regimen that also relies on a healthy lifestyle and a proper schedule.
Why Many Chronic Patients Should Skip Fasting
For a large number of chronic patients, abstaining from fasting is the wise choice, and even religious authorities permit it. However, this decision must not be made arbitrarily. Only the treating physician—whether a primary‑care doctor or a specialist—can determine if fasting is safe, based on the patient’s metabolic and mental state and the results of clinical examinations.
“The right to fast varies from one chronic patient to another and from one disease to another,” explains Dr. Olfa Brigui, a geriatrician, to La Presse.
Key point
- Renal failure patients (especially those on hemodialysis) are strictly prohibited from fasting.
- For other conditions, the decision rests with the treating doctor and is evaluated case‑by‑case.
Because the list of chronic diseases is extensive, this article focuses on the three most prevalent conditions in our country: diabetes, hypertension, and cardiovascular disease.
General Recommendation for All Chronic Patients
“One month before Ramadan, every chronic patient must consult their treating physician and undergo a clinical assessment that clarifies the disease’s evolution and the patient’s ability to control metabolic and pathological parameters.
Seniors, in particular, often cannot manage their health on their own. Only well‑informed patients who properly manage their illness may be allowed to fast,” adds Dr. Brigui.
Diabetes: Watch Out for Hypo‑ and Hyper‑glycemia
Fasting is only permissible for diabetics who have their disease under control, maintaining blood‑glucose levels close to normal and strictly following the physician’s instructions.
- Carry a glucometer at all times to test blood sugar whenever needed.
- Break the fast immediately if any warning signs appear: dizziness, sweating, tremors, dry mouth, etc.
- Interpret the reading:
- < 0.70 g/L → severe hypoglycemia → stop fasting at once.
- > 3 g/L → hyperglycemia → also requires immediate interruption of the fast.
The “Suhoor” (pre‑dawn meal) Must Not Be Neglected
Beyond constant glucose monitoring, a fasting diabetic must adhere to strict dietary hygiene both at Iftar (breaking the fast) and Suhoor.
“Avoid foods high in salt, sugar, and fat,” stresses Dr. Brigui. “Suhoor is an essential meal; it should contain a dairy product and whole‑grain bread to prevent hypoglycemia. Hydration is crucial—prefer water and steer clear of sugary drinks.”
Hypertension: Keep Salt and Fat in Check
For hypertensive patients, the same careful approach applies to ensure a complication‑free fast.
- Consult the doctor to confirm fitness for fasting and to adjust medication timing to Ramadan’s schedule.
- Blood pressure is considered balanced when it stays between 12 and 13 cm Hg (i.e., 120‑130 mm Hg).
- Values above this range indicate poor control, disqualifying the patient from fasting.
“A hypertensive’s diet must be low in salt, fried foods, and fat,” notes Dr. Brigui. “If, while fasting, the patient experiences an unbearable headache, dizziness, or ringing in the ears, they must stop fasting immediately and have their blood pressure measured.”
Cardiovascular Disease: No Dietary Lapses Allowed
For patients with heart failure, fasting is only allowed when the condition is mild and well‑controlled.
- A pre‑Ramadan consultation is mandatory.
- Patients must demonstrate vigor and avoid any dietary excesses.
- The diet should be low in salt, sugar, and fat, with adequate hydration.
“Both chronic patients and healthy individuals should aim to drink 1.5–2 liters of water per day, including during Ramadan,” advises the specialist. “Choosing a low‑salt, low‑sugar, low‑fat diet is a key preventive habit and part of a healthy lifestyle.”
Bottom Line
Fasting can be a spiritually rewarding practice, but safety comes first. Chronic patients—especially those with renal failure, diabetes, hypertension, or heart disease—must obtain medical clearance, monitor their health closely, and follow strict dietary guidelines to avoid serious complications during Ramadan.
