Specially for Yom Kippur – How to Have a Good Fast

 

Can diabetes sufferers fast? How best to break the fast? All you need to know on how to get through the fast. Mrs. Einat Badihi-Nahum, Director of the Nutrition and Dietary Service at the Shaare Zedek Medical Center, offers a list of recommendations and tips not only for diabetes sufferers but for the general public as well.

 

Nutritional Tips before the Fast
•    A day before the fast it is recommended to eat complex and simple carbohydrates every three hours: bread, pasta, fruit, etc., in order to fill up the glycogen stocks in your body.
•    Drink lots of water, at least 2-3 liters.
Tips for the Meal before the Fast
•    Best to integrate complex carbohydrates into the menu. Because they are digested slowly, they give you a feeling of being full and comfortable. Choose wholewheat bread, wholewheat pasta, sweet potato, etc.
•    Recommended to add foods rich in protein and fats, which contribute to a feeling of satiation for a longer time.
•    Best to forego spicy and salty foods, which make you thirsty, and fried food.
•    It is preferable to avoid legumes, and vegetables like broccoli, radish and cauliflower which cause bloating and wind.
•    It is preferable to avoid fizzy drinks which can also cause a feeling of bloatedness. 
Tips for Breaking the Fast
•    Break the fast with a drink at room temperature and even something light such as a slice of bread with a spoonful of jam.
•    About an hour later, it is recommended to eat a normal meal, for example – bread, cheese, tuna, eggs, salad, or chicken soup, etc.
•    It is important to drink in moderation but still to restore the liquids lost during the day.
•    Remember! There is no need to make up for all the meals you didn’t eat during the day! The body doesn’t need that now! On the contrary, too much food – particularly carbs – can upset your sugar levels and make you feel bad.
Can Diabetes Sufferers Fast?
Many have discussed this issue and there are many opinions. We do not intend to take a stance on the halachic aspects of this topic.
The approach taken by the Pediatric Diabetes Clinic at the Shaare Zedek Medical Center is to give the child and his or her family the option of choosing for themselves after consulting with their doctor and a rabbi. We respect their decision and guide the patients accordingly. If you do decide to fast, here are a few suggestions:
Nutritional Tips for Diabetes Sufferers before the Fast
•    A day before the fast it is recommended to eat complex and simple carbohydrates every three hours: bread, pasta, fruit, etc., in order to fill up the glycogen stocks in your body.
•    Drink lots of water, at least 2-3 liters.
Tips for the Meal before the Fast
•    Best to integrate complex carbohydrates into the menu. Because they are digested slowly, they give you a feeling of being full and comfortable. Choose wholewheat bread, wholewheat pasta, sweet potato, etc.
•    Recommended to add foods rich in protein and fats, which contribute to a feeling of satiation for a longer time.
•    Best to forego spicy and salty foods, which make you thirsty, and fried food.
•    It is preferable to avoid legumes, and vegetables like broccoli, radish and cauliflower which cause bloating and wind.
•    It is preferable to avoid fizzy drinks which can also cause a feeling of bloatedness. 
•    In this meal, it is important to inject less insulin than the normal ratio (as directed by your medical team in the clinic.)
During the fast, it is important to:
•    Measure blood sugar levels frequently or use a blood sugar sensor for constant measurement, so as to prevent extreme movement in blood sugar levels.
•    Have a sweet drink and a carbohydrate on hand at all times.
•    Change the drug treatment as instructed by your doctor, on the day before the fast and during the fast itself.
•    (One usually needs to significantly reduce long-term basal insulin, to 40-60% from the regular dosage).
•    In cases of hypoglycemia, one should stop fasting and eat and drink as normal. We recommend stopping the fast when blood sugar reaches approximately 80 mg/dl.
•    In the event of a prolonged extreme blood sugar level rise, stop the fast and drink a lot of water. Take insulin as you need so as not to become dehydrated or get acidosis.
Remember! Fasting causes duress to the body, particularly a diabetes-stricken body, and if you don’t pay close attention to the instructions, the child with diabetes could be at risk!
Tips for Stopping the Fast
•    Check sugar levels and inject according to what you’re eating at your normal ratio.
•    Break the fast with a drink at room temperature and even something light such as a slice of bread with a spoonful of jam.
•    About an hour later, it is recommended to eat a normal meal, for example – bread, cheese, tuna, eggs, salad, or chicken soup, etc.
•    It is important to drink in moderation but still to restore the liquids lost during the day.
•    Remember! There is no need to make up for all the meals you didn’t eat during the day! The body doesn’t need that now! On the contrary, too much food – particularly carbs – can upset your sugar levels and make you feel bad.
•    Check blood sugar levels two hours after the meal and correct as needed.
•    Restore the basal insulin level that was reduced at the start of the fast. Those treated with injections should raise the basal insulin level to the regular dosage.