Ramadan remains a period of intense spirituality, but after 45 years, the physiology changes. While fasting remains possible for the majority, it requires more attentive listening to your body.
“The metabolism slows down, muscle mass decreases (sarcopenia), the feeling of thirst diminishes and the kidneys retain water less well, increasing the risk of dehydration and imbalances. confirms Dr Gérald Kierzek, emergency doctor and medical director of True Medical.
Vigilance on dehydration
The main challenge after age 45 is fluid management. The kidneys’ ability to concentrate urine diminishes, making water loss faster and less noticeable.
According to Dr. Kierzek, dehydration is the “main threat” for this age group. It is imperative to watch for signs like dark urine, constipation, unusual drowsiness or tachycardia.
To compensate, drink more than 2 to 3 liters between Iftar (evening meal) and Fajr. By favoring water and broths.
In women, perimenopause or menopause complicates this picture. “Low estrogen promotes osteoporosis and hot flashes are often amplified by dehydration” specifies the doctor, recalling the importance of calcium and vitamin D in the diet.
Chronic illnesses and medication management: the role of the physician
The appearance of pathologies such as high blood pressure (hypertension), type 2 diabetes or hypercholesterolemia radically modifies tolerance to fasting. The risk of hypoglycemia, thrombosis or falls due to fatigue becomes a concrete reality.
A crucial point of vigilance concerns treatments. “The accumulation of medications is longer in those over 45 years old. It is imperative to adapt the times and doses with medical advice, because the risk of poisoning is multiplied by three” calls back the doctor.
For the three main chronic diseases, here is the procedure to follow:
- Hypertension: monitor headaches and avoid diuretics in case of severe dehydration;
- Diabetes : “Fasting is authorized if blood sugar is balanced by tablets, but remains strictly prohibited under insulin or if HbA1c is greater than 8%.” underlines our expert;
- Cholesterol: Statins are generally well tolerated, provided the dosing schedule is adjusted.
Trim and effort, the importance of structure
To counter muscle wasting, the organization of meals must be rethought. Dr Kierzek recommends avoiding excess fat and sugar at Iftar and suggests a three-step structure:
- A light Iftar, composed of soup or broth;
- A dinner 3 hours later, rich in protein (lean meats, legumes) and fiber (fruits and vegetables).
- A substantial Sahur (meal taken in the morning, before dawn) to last the day.
In terms of activity, total sedentary lifestyle is a mistake. “A moderate walk of 15 to 30 minutes per day, coupled with an afternoon nap and regular sleep, helps maintain muscle tone without depleting energy reserves.
he finally advises.
Finally, fasting after 45 requires a prior consultation, ideally one to two months before the start of the holy month, to carry out a complete assessment (blood pressure, blood sugar, creatinine, even ECG).
It is essential to remember that health comes first. As Dr. Kierzek reminds us, “en cases of chronic illnesses, religious exemption is often recommended“to preserve the physical integrity of the faithful.