Ramadan 2026: hydration, balanced meals and health during fasting

01Ramadan fasting: a unique physiological experience#

Ramadan, the ninth month of the Hijri calendar, imposes on more than one and a half billion Muslims worldwide an exceptional period of strict daytime fasting: neither water nor food, from sunrise to sunset, for 29 or 30 consecutive days. In Morocco, depending on the season in which Ramadan falls, this fasting period lasts between 14 and 16 hours per day, with a peak of about 15-16 hours of continuous deprivation when the holy month occurs in summer. This prolonged duration makes Muslim Ramadan the most physiologically demanding religious fast in the world, requiring the body's adaptation and particular vigilance on dietary and hydric levels.

When properly conducted, Ramadan can bring real metabolic benefits documented by several quality scientific studies. Research published in The Lancet in 2019, in several French Inserm journals, and by Moroccan teams (especially the Moroccan Society of Nutrition) has demonstrated that a well-balanced Ramadan typically results in a moderate weight loss of 2 to 4 kg in the majority of subjects, a significant improvement in insulin sensitivity (with positive effect on pre-diabetes), a measurable decrease in LDL cholesterol, a reduction in systemic inflammatory markers, and a relative rest of the digestive system sometimes perceived as beneficial. These effects are similar to those observed with intermittent fasting regimens which have been the subject of intense research in recent years.

Conversely, a poorly conducted Ramadan can be accompanied by significant deleterious effects. Severe dehydration, particularly dangerous in summer or for workers exposed to heat (farmers, construction workers, street vendors, deliverers), can cause hypotension, cognitive disorders, syncope, even renal complications. Hypoglycaemia, particularly in diabetics on insulin or sulfonylureas, can be severe and require immediate fast-breaking. Intense fatigue and headaches are frequent, particularly during the first week of adaptation. Constipation through dehydration and modified eating rhythm is very common. Nocturnal gastric reflux and digestive disorders are aggravated by copious and late meals. And paradoxically, many people gain weight during Ramadan due to massive caloric excess at F'tour and Shour, particularly through excessive consumption of very caloric traditional pastries.

Physiologically, the body progressively adapts to fasting. The first three days are the most difficult: rapid use of hepatic glycogen reserves, slight dehydration, caffeine withdrawal for regular consumers, frequent fatigue and headaches. From the fourth to seventh day, the body enters metabolic adaptation mode: increased production of ketone bodies from fats, improvement in hunger and thirst sensation. From the second week, balance is generally reached and the majority of people feel better than in the first days.

02Hydration, the major Ramadan challenge#

The adult human body is composed of approximately 60% water in men and 55% in women. Dehydration of only 2% of body weight already significantly impairs cognitive performance, mood, concentration, physical performance. Dehydration of 5 to 10% becomes dangerous to health. This shows the capital importance of hydration during Ramadan, when the available window for drinking is reduced to about 8 to 10 hours per 24 hours.

The daily target is to drink at least 1.5 to 2 litres of water between F'tour (fast-breaking at sunset) and Shour (last meal before dawn), more in case of heat or physical activity. This quantity must be progressively distributed rather than drunk all at once, because absorption of too large a hydric volume in a short time causes rapid renal elimination without true tissue rehydration.

Here is an optimal distribution of hydric intake over the Ramadan evening and night.

Several drinks to favour during Ramadan. Plain water remains the reference drink — prefer low-mineral water for main consumption. Milk simultaneously provides hydration, calcium and proteins, particularly useful at Shour. Warm herbal teas (mint, verbena, lime, chamomile) without added sugar contribute to hydration and favour digestion. Clear soups (notably traditional harira, rich in water and nutrients) combine hydration and nutritional intake. Fresh water-rich fruits (watermelon, melon, oranges, strawberries, grapes, peaches) provide water, vitamins and fibres — an ideal dessert at F'tour.

Conversely, several drinks to limit or even avoid. Coffee and strong tea are diuretics which increase urinary water elimination and paradoxically worsen dehydration. If you are used to them, moderate (1 to 2 light cups in the evening rather than multiple strong coffees). Sodas and industrial sugary drinks cause a rapid glycaemic peak followed by reactional hypoglycaemia, gas-related bloating, and provide empty calories. A single can contains the equivalent of 7 teaspoons of sugar. Industrial or homemade concentrated fruit juices are also too sugary — prefer whole fruits. Very cold drinks at F'tour can cause digestive shocks after a long day of fasting — prefer drinks at room temperature or slightly cool.

03F'tour: breaking the fast healthily#

F'tour (from Arabic "iftar", fast-breaking) is the most awaited moment of the day during Ramadan, but also the one where dietary errors are most frequent. A poorly conducted fast-breaking can cause bloating, reflux, drowsiness, and compromise all potential benefits of fasting. Here is how to physiologically optimally structure your F'tour.

Initial gentle fast-breaking

The first 5 to 10 minutes should be devoted to progressive fast-breaking. Prophetic tradition recommends starting with 1 to 3 dates accompanied by a large glass of water or warm milk. This choice is not trivial: dates provide a fast sugar that restarts blood glucose after a day of fasting without causing too brutal a glycaemic peak thanks to their fibre richness. Water or milk start rehydration. This prophetic model is now scientifically validated as the best way to break a prolonged fast.

Avoid starting F'tour with sweets, pastries or sugary drinks which cause a major insulin peak followed by reactional hypoglycaemia a few hours later, source of nocturnal cravings and chaotic food intake.

The soup and starter phase

After initial fast-breaking and ideally after Maghrib prayer, comes the soup and light starter phase over 15 to 20 minutes. Traditional Moroccan harira is an excellent nutritional choice: it combines legumes (lentils, chickpeas) sources of vegetable proteins, wheat for complex carbohydrates, vegetables for vitamins and fibres, meat in moderate quantity. Traditionally prepared (without excess fat or added salt), it is one of the most balanced dishes of Moroccan cuisine, perfectly adapted to fast-breaking. A chorba (clear broth with vegetables and meat) is also an excellent alternative. Limit the quantity of traditional pastries served at F'tour (chebakia, almond and honey briouates, sellou) — keep them for pleasure but in reasonable quantity (1 to 2 pieces maximum).

The complete main meal

After a 20 to 30-minute pause (allowing the stomach not to be overloaded), comes the complete main meal which should be balanced and of reasonable size rather than gargantuan. Proteins must be present in adequate portion (150 to 200 g): fish, chicken without skin, lean lamb, eggs, legumes such as lentils or chickpeas. Complex carbohydrates provide energy: whole or barley bread rather than industrial white bread, brown rice, whole semolina, steamed potatoes. Vegetables should be abundant, in the form of raw salads and/or cooked vegetables in tagine, steamed, or as accompaniment. Extra virgin olive oil (1 to 2 tablespoons) is the recommended main fat. A light dessert based on fresh fruits closes the meal — reserve traditional pastries for occasional occasions rather than daily.

Classic mistakes to avoid

Several frequent eating behaviours at F'tour deserve correction. Eating too quickly after a long day of fasting causes bloating, gastric reflux, sensation of heaviness. Take time to chew, make pauses between dishes. Consuming fried foods in excess (fried briouates, sfenj, sellou rich in fats) causes digestive disorders and provides considerable caloric excess — limit to 1 to 2 pieces and prefer oven or steam cooking. Eating sweets before proteins and complex carbohydrates causes a major glycaemic peak — respect traditional order (dates, soup, complete meal, dessert). Very sweetened mint tea just after F'tour inhibits iron absorption and poses a particular problem in women of childbearing age often deficient in iron.

04Shour: an essential and strategic meal#

Shour (or Suhoor) is the meal taken before dawn, just before the start of daytime fasting. It is mandatory according to medical recommendations (and strongly encouraged by prophetic tradition). However, a Moroccan Society of Nutrition survey shows that 70% of Moroccans skip Shour to gain sleep, which is a mistake with significant consequences.

Skipping Shour exposes to several problems during the day. Major daytime fatigue, particularly in the second part of the day, which impairs professional performance and increases accident risk. Hypoglycaemia in predisposed subjects (diabetics, athletes, pregnant women), sometimes severe. Increased dehydration as the last hydric intake then dates from F'tour the day before. Cognitive disorders (concentration, memory) particularly marked for those who must think intensively (intellectual professions, students in exams). Chaotic food intake at F'tour by extreme craving, conducive to excesses and paradoxical weight gain.

The ideal Shour composition

For an optimal Shour, several nutritional principles should guide choices. Low glycaemic index slow carbohydrates are the basis: rolled oats with milk, whole or barley bread with topping, whole semolina, brown rice. These slow-release carbohydrates provide continuous energy throughout the fasting day. Proteins are essential to prolong satiety: soft-boiled or poached egg, plain yoghurt, fresh cheese like lben, cottage cheese, almonds or other oilseeds, cold chicken breast, sardines. Fibres from fruits and vegetables slow digestion and prolong the feeling of satiety: apple, banana, dates in moderate quantity, raw vegetables as accompaniment. Hydration must be generous: 2 large glasses of water minimum, possibly complemented by a glass of milk or herbal tea.

What to avoid at Shour

Several common food choices at Shour should be avoided or limited. Very spicy or very salty dishes increase daytime thirst sensation — prefer mild cuisine. Strong coffee or concentrated tea are dehydrating by diuretic effect and disrupt late-night sleep. Isolated rapid sugars (dry cakes, sweet biscuits, pure jams) cause hyperglycaemia followed by reactional hypoglycaemia 3-4 hours later, in mid-day — a critical moment. Heavy and fatty dishes (mechoui, dishes in sauce with lots of oil) slow digestion and disrupt sleep. Avoid eating Shour 2 or 3 hours before dawn and immediately returning to lie down — instead favour 30 to 60 minutes of semi-seated digestion before sleep.

05Dietary mistakes to avoid throughout Ramadan#

Beyond the specifics of F'tour and Shour, several common dietary errors during Ramadan compromise benefits and can even harm health.

Systematically skipping Shour is probably the most frequent error, as mentioned above. Make Shour a non-negotiable habit, even light. Eating oriental pastries in excess is the most impactful caloric error — Moroccan traditional pastries are delicious but very calorie- and added-sugar-dense (a chebakia or makrout can reach 500 to 700 kcal each). Limit to 1 to 2 pieces occasionally rather than making it a daily dessert. Consuming fried foods at every meal provides excess saturated fats, potentially harmful frying compounds, and significantly contributes to digestive disorders. Limit fried foods to 1 or 2 times a week, favouring oven, steam, simmering cooking.

Adopting total sedentariness through fatigue is tempting but harmful: Ramadan should not be a period of total inactivity. Light physical activity (30-45 minute walk 1-2 hours after F'tour, ideally outdoors) is beneficial for digestion, mood and prevention of weight gain. Conversely, avoid intense efforts during the fasting day, particularly in strong heat, which expose to risk of hypoglycaemia and dehydration. Significantly reducing sleep quality is a frequent trap: between long Tarawih evenings and morning Shour, many people sleep less than 6 hours per night, which impairs recovery, increases inflammatory markers, disrupts satiety hormones and favours weight gain. Make 20-30 minute naps during the day if possible, and try to maintain at least 6 to 7 hours of cumulative sleep over 24 hours.

06Ramadan in the presence of chronic pathologies#

Several chronic pathologies require specific management during Ramadan, ideally prepared several weeks before the holy month.

Diabetes

Diabetes is probably the pathology requiring the most adaptations. A medical consultation 6 to 8 weeks before Ramadan is essential to assess risk according to IDF-DAR 2021 classification, adapt treatments (reduction of sulfonylureas at risk of hypoglycaemia, adjustment of insulin doses, shifting metformin intake), educate on multi-daily glycaemic self-monitoring (4 to 6 measurements per day during Ramadan), define fast-breaking thresholds. Type 1 diabetes is generally classified as very high risk and fasting is discouraged. Type 2 diabetes on insulin is at high risk but fasting remains possible with reinforced medical follow-up. Type 2 diabetes on oral antidiabetic agents can generally fast with therapeutic adjustments. The Islamic Fiqh Academy and several fatwas explicitly authorise breaking the fast in case of vital risk, without religious guilt — which medically legitimises stopping the fast when it becomes dangerous.

Arterial hypertension

For hypertensive patients, several adaptations are necessary. Medication intake schedules must be shifted to F'tour and Shour to respect therapeutic intervals without breaking the fast. Salt consumption must be moderated (traditional harira, olives, salted cheeses, industrial bread provide enormous salt). Diuretics pose a particular problem as they aggravate dehydration already induced by fasting — they are sometimes temporarily replaced or administered at F'tour with compensatory hydration. Regular blood pressure measurement at home allows detecting drifts.

Pregnancy and breastfeeding

Pregnant or breastfeeding women are religiously dispensed from fasting when it risks harming their health or their baby's, with possible later catch-up. If the woman wishes to fast despite this, enhanced medical surveillance is essential: weight and fetal growth on ultrasounds, blood pressure, blood glucose in women at risk of gestational diabetes, surveillance of diuresis and dehydration. Fast-breaking is essential at the slightest warning sign (decreased fetal movements, dehydration, hypoglycaemia, contractions).

The elderly

Elderly people are particularly vulnerable during Ramadan. They have lower hydric reserves, less efficient thermal regulation, often several cumulative chronic pathologies, and are at increased risk of falls through orthostatic hypotension and dehydration. Maximum hydration between F'tour and Shour, medication adaptation by the treating physician, surveillance by entourage are essential. In case of cognitive disorders (early dementia), fasting can worsen confusion and is often discouraged.

Gastro-oesophageal reflux

For patients with gastric reflux (GORD), Ramadan can be problematic due to copious and late meals. Several adaptations help: fractionate meals into 3 mini-meals spaced between F'tour and Shour rather than 2 copious meals, avoid classic triggers (mint, coffee, chocolate, fatty dishes, citrus, acidic foods), do not lie down within 2-3 hours following a meal, raise the head of the bed by 15-20 cm, maintain habitual PPI treatment by adapting to schedules (generally 30 minutes before F'tour). If GORD becomes disabling despite these measures, do not hesitate to break the fast.

07Children and Ramadan#

Ramadan fasting is not a religious obligation before puberty (generally 12-15 years according to the moment of pubertal maturation). For younger children who wish to participate in the family experience, several principles apply.

Gradual progression is recommended from age 10-12: start by fasting half a day (until noon), then progressively increase, then attempt one or two complete days at the weekend before fasting an entire month. This gentle transition allows the child and the body to adapt without undergoing brutal deprivation.

Attentive surveillance is essential for children who fast. Monitor hydration (nappies, urine, dehydration signs), energy and mood, behaviour (excessive irritability, unusual fatigue), school performance. Any warning signal should lead to interrupting the fast without hesitation. A child who faints, becomes pale, presents apathy, must have the fast immediately interrupted.

Several situations formally contraindicate fasting in children: insulin-dependent diabetes, severe asthma, epilepsy, chronic disease requiring strict treatment, recent dehydration, weak growth, severe anaemia. In case of doubt, the paediatrician's opinion is essential before the start of Ramadan.

For a child who fasts, the ideal eating rhythm includes two complete meals (F'tour and Shour) well balanced and nutritious, with if necessary an additional snack around 10 PM for children with weak appetite who cannot eat everything at once. Insist on proteins, complex carbohydrates, fruits, vegetables, and dairy products. Limit pastries, sweets and sugary drinks which provide empty calories and disrupt balance.

08Good practices for a healthy Ramadan#

To conclude, here are the essential principles of a balanced and beneficial Ramadan for health. Hydrate generously between F'tour and Shour (1.5 to 2 litres minimum, more in summer). Never skip Shour, even light. Favour lean proteins, complex carbohydrates, fruits and vegetables, olive oil, plain dairy products. Limit traditional pastries (1 to 2 pieces occasionally), fried foods, sweets, sugary drinks. Practise moderate physical activity daily (walking after F'tour). Preserve your sleep (6-7 cumulative hours per 24h, possible naps during day). Adapt your chronic treatments with your doctor before the start of Ramadan. Listen to your body's signals and do not hesitate to break the fast in case of medical problem. Enjoy the spiritual, social and family dimension of Ramadan, which is largely as important as the nutritional dimension.

With these principles, Ramadan can be lived not as a constraint or a risk, but as a beneficial experience for physical and mental health, in addition to its fundamental religious dimension.