Written by: : Laura Gosine, Shannan Grant, Memoona Khalid, Registered Dietitians, Nephrology Program, Queen Elizabeth II Hospital, Nova Scotia Health
Photo by Kasem Sleem on Unsplash
Ramadan is the ninth month of the Islamic calendar and is observed by Muslims around the world. It is considered the holiest month of the year and begins when the new crescent moon is sighted. The month lasts 29 or 30 days, ending with the sighting of the next new moon, which marks the celebration of Eid.
During Ramadan, Muslims fast from sunrise to sunset no food, no drink (including water). The fast is traditionally broken at sunset with water and dates, followed by the evening meal, known as Iftar. Ramadan is a month of self-reflection, self-control, balance, and intention. Its key purpose is to fortify moderation, not only in eating, but in life. The self-control practiced during the day is meant to carry into the evening and beyond the month.
For individuals living with chronic kidney disease (CKD), moderation is especially meaningful and the basis of their nutrition care. Following nutrition recommendations, especially serving and portion sizes, is challenging during Iftar. After several hours of fasting, appetite is strong, and traditional foods are shared in celebration. Moreover, as the month ends, Eid brings joyful gatherings and festive meals that may include favourite dishes and sweet treats.
In this blog, we have addressed three common questions we get leading up to and during this auspicious time.
Dates are high in potassium. Does this mean I can no longer have dates?
Dates have about 650 mg of potassium a serving. To help people understand what these numbers mean, we often compare this to commonly known potassium rich foods, like potatoes and bananas. One baked Russet potato contains about 925 mg of potassium per serving, while 1 medium banana has 425 mg potassium. Another strategy we use is to create a table that compares different types of dates.
Potassium Content in Dates (Per Serving) :
- 1/2 Cup (88g) Dried Dates: 584mg
- 100g Deglet Noor: 656 mg
- 5 fruits (medium, average size) dates: 270 mg
- 100g Dates: 660mg
- 1 fuit Mejdool date: 167mg
During meals and celebrations, I have a hard time keeping track of what I eat. Do you have a strategy to help me do that?
The Balanced Food Plate illustrates a meal composed of 1/4 protein foods, 1/4 protein foods like tofu and yogurt, 1/2 servings of non-starchy vegetables and fruits, and 1/4 whole grains, accompanied by a fork and a glass of water.
With a thoughtful and moderate approach, it is possible to honour traditions and celebrations. One strategy we recommend is to use the plate method to guide meal choices. The Plate Method (learn more in this blog post) includes:
Lower-Potassium Vegetables (½ plate or 50%)
Include vegetables such as cucumber, cabbage, lettuce, carrots, or bell peppers. Vegetables add fibre, Vitamin C and B-vitamins and balance to the meal while helping to moderate overall potassium intake.
Fiber-rich vegetables help you feel full while nourishing your body with essential vitamins.
Lean Protein (¼ Plate or 25%)
Choose sources of high-quality protein such as tofu and other soy foods (tempeh, edamame), as well as plant-based options like lentils, chickpeas, black beans, quinoa, and nuts or seeds.
Animal-based options may include grilled chicken, baked fish, or lean beef kebabs.
Prepare protein foods with minimal added salt and keep portions moderate, about the size of a deck of cards or the palm of a hand (3 oz / 90 g) see Handy-Servings-Guide.
Protein helps promote fullness and stabilize appetite after fasting.
Grains or Starches (¼ plate or 25%) Foods, Nutrient, Tip (Example below)
Include a moderate portion of rice (1 cup cooked), roti (6inch), pita bread(6inch). Keeping portions consistent (for example, about ½ cup of cooked rice) helps avoid stacking multiple starches on one plate especially when comfort foods are also included. Use the following guide to learn more about portion sizes Phosphorus Foods Pictorial.
Grains and starchy vegetables provide carbohydrates, including starch, fibre, and sugar, all part of a moderate and healthy diet. It is important to apply moderation with carbohydrates, as many people have 2-4 times the recommended serving sizes in a sitting.
Higher-fibre, lower-sugar choices support longer satiety during fasting and promote long-term health beyond Ramadan.
Beyond the Plate – One Small Traditional Portion
Carbohydrate foods often provide comfort, and many traditional foods are higher in carbohydrates and sodium. These foods can still fit into a balanced meal with mindful portions.
Instead of filling the plate with several fried foods, which are often breaded and count toward grains and starches, choose one small portion rather than several. Examples include a mini pakora, a small samosa, or a small falafel.
Traditional foods should replace part of the grain portion rather than being added on top of it. For example, enjoy one small samosa instead of part of a rice or roti serving.
Portion Tip: Traditional fried foods count as part of the grain or starch portion of the plate.
Remember, the goal is not perfection, it is moderation. A balanced plate allows room for enjoyment while supporting kidney health.