How to have a healthy Ramadan when you have a heart condition

What's on this page:

• I have a heart condition is it safe to fast during Ramadan?
• Can I change the time I take my medicines when I’m fasting?
• Can I exercise when I’m fasting?
• What should I eat and drink during Ramadan?
• How can I stop smoking?

I have a heart condition is it safe to fast during Ramadan?

Many people with a heart or circulatory condition can fast safely from dawn until sunset during the month of Ramadan.

But if your heart condition could worsen, making you unwell, because of fasting, you are not required to fast. This may apply to you if you have a serious heart condition. Or if you have recently had a change in your condition, such as a heart attack or stroke, or had a heart procedure like a stent or bypass surgery, which put you at higher risk of having more heart problems if you do not eat and drink as usual.

If you have a heart condition, make sure you discuss your plans to fast with your doctor or nurse before going ahead.

You may also want to try fasting for a few days before the month of Ramadan to see how well you cope. You can also try fasting for a shorter period in Ramadan to see how your body copes and have breaks if you need them, such as fasting on every other day or a few days in a row.

You can make up any missed days later in the year and may wish to do this during the winter months when the length of fasts is the shortest.

If you cannot fast at all due to poor health or are unable to make up the fasting days you miss, consider speaking to your local Imam or scholar about the fidya, a charitable donation made in place of your fasting.

Can I change the time I take my medicines when I’m fasting?

If you have a heart or circulatory condition you are likely to have been prescribed regular medicines to help you stay healthy.

Because fasting involves not eating or drinking from dawn to sunset, it may interfere with your normal medication routine.

Pharmacists can be a valuable source of information about medicines, so seek out their advice before changing your routine.

For some medicines it is safe to change the time you take them. For example, if you take a medicine once a day in the morning, you may be able to switch to taking it in the evening when you are eating and drinking. 

If a medicine needs to be taken on an empty stomach, you could take it just before opening your fast.

However, some medicines for conditions such as heart failure, diabetes, high blood pressure and some arrhythmias need to be taken regularly. Not taking them at the right time could make your symptoms more severe.

If you experience any of the below symptoms, it could be a sign you need to return to your normal medication routine, and you should seek medical attention immediately:

• fluid building up in the ankles
• breathlessness and fatigue
• passing more urine than normal
• dizziness or fainting spells
• rapid heartbeat or pounding in the chest
• chest pain or pressure.

Can I exercise when I’m fasting?

It’s a good idea to keep active during Ramadan, but you may need to adapt the activity you do to make it more gentle than usual, depending on your energy levels.

Try to find a time of day that works best for you to exercise. For instance, you could fit it into your Ramadan activities by walking to the mosque, or doing some stretching when you get up at dawn.

The motions involved in salah (Islamic prayer) can also be good for your heart, as any physical movement helps the heart stay healthy.

Exercise can also boost your mental wellbeing and help you feel less tired. Being spiritually engaged during Ramadan may boost your feeling of wellbeing too.

If you have recently had a serious event such as a heart attack, or a heart procedure, then you will likely be taking part in cardiac rehabilitation classes (either online or in person). If this is the case, it may not be safe for you to fast during this period.

This is because you are at higher risk of becoming dehydrated due to lack of water. Or you may have low blood sugar levels as a result of eating less, or not having the right levels of medicines in your body.

Talk to your cardiac rehab specialist about the best approach for you. 

What should I eat and drink during Ramadan?

It's important to continue to eat healthily during Ramadan.

At suhoor (pre-dawn meal), make sure you have a meal which is filling and gives you plenty of slowly released energy. Include wholegrain starchy carbohydrates such as oats, bulghur wheat, wholegrain bread or brown rice, fruits and vegetables, and some protein.

Traditionally, many Muslims open their fast by eating dates with water, which will provide fibre and energy from the natural sugars they contain.

Make your evening meal filling by including slowly digested carbohydrates. And include plenty of fruit and vegetables, and some lean or low-fat protein sources. Bake or grill your food instead of frying it.

Try to avoid overeating by eating slowly and paying attention to your feelings of fullness. Keep an eye on your portion sizes too, and limit fatty and sugary foods, so you do not gain weight unintentionally during Ramadan.

Drink plenty of sugar-free drinks like water or sugar-free squash at iftar and suhoor to make sure you do not become dehydrated.

If it’s particularly hot, or you have an active job that means you sweat a lot, you may be at higher risk of dehydration, so bear these things in mind.

Also, try to avoid salt and salty foods which can make you thirstier, as well as not being good for your blood pressure.

If you have been told to restrict your fluids as part of treatment for your heart condition, ask you medical team for advice on what you should do during Ramadan.

Drinking enough water and including fruit, vegetables and high-fibre foods in your diet will also help to keep your digestion healthy.

How can I stop smoking?

Like eating and drinking, smoking and vaping are not allowed when you are fasting during Ramadan.

Smoking is very harmful for your heart. So, if you smoke or use tobacco products, try using Ramadan to quit for good.

You can get help to do this by contacting the free NHS smoking cessation service. Your local service may be in a GP surgery, pharmacy, high-street shop, or mobile bus clinic, depending on where you live.

You can speak to an advisor who can give you tips and prescribe patches, chewing gum, nasal sprays, or medicines to help you cope with nicotine cravings. You can do this any time before, during, or after Ramadan.

Many Muslim scholars are also of the opinion that nicotine patches which go on your skin do not break the fast. If you are unsure, you can use any of these products outside fasting hours.

•  Find your nearest free NHS smoking cessation service.

Contributors:

• Chloe Macarthur, Senior Cardiac Nurse, British Heart Foundation
• Dr Mohammed Khanji, Consultant Cardiologist at Barts Health NHS Trust, Honorary Associate Professor of Cardiology at Queen Mary University of London and member of the British Islamic Medical Association (BIMA) Ramadan Compendium Team
• Dr Salman Waqar, Academic GP in Berkshire and President of the BIMA
  

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