The science of nutrition and sleep during fasting

Yvonne Taylor: Can we just ask everybody if they can mute themselves, please? That would be great, before we begin. I’ll just let – when I can see who’s waiting, let everybody in. [Silence 00:00:26-00:00:37]. There we go. OK, so, we’re all good to go, I think everybody’s muted and we’ve got record going, so we’re ready.

So, welcome everyone to this wellbeing webinar on fasting, where we’re going to take a look specifically at nutrition and sleep around fasting. For those that haven’t attended one of these webinars before, I’m Yvonne Taylor and I lead on the health living portfolio for Oscar Kilo. This morning’s webinar is slightly different to our normal format, as we have three experts with us this morning.

So, we’ve got Anna Earl, who’ll talk about nutrition, Sophie Bostock, who will cover the sleep aspect, and we’ve got Zahid Aziz, who will speak to us about his own experiences of fasting and take some questions if we’ve got some questions. So, I won’t say more than that, as I’ll let each of them introduce themselves. We are recording the webinar, so, it will be available to revisit or to signpost to colleagues, it will be saved in the protected area of the website, an account is needed to access that area, but it’s very easy to set that up and you will then have access to a lot more resources on different topic areas too.

So, if I can just recheck that everyone is on mute, please? If you’re not on mute, can you please put yourself on there now so that our speakers aren’t interrupted? And I will hand over to you guys.

Anna Earl: Thank you very much. Good morning everybody, my name is Anna Earl and this morning we’re going to be covering, first of all, general fasting, what fasting is, the pros and cons of non-religious fasting. We’ll talk about the different types, the benefits and the challenges to do with fasting, and then I’m going to hand over to Sophie, who’s going to talk about what fasting has to do with sleep. And then we have Zahid Aziz with us, who’s going to talk specifically about Ramadan, his experiences of observing Ramadan whilst being a serving police officer. And hopefully some very helpful strategies that helped him through his career in policing.

And then we, hopefully, will have a nice period at the end for some questions and answers, so we hope to have a nice interactive period with you then. So, by all means, pop any questions in the chat box throughout the period that we’re talking or you can save those until the end, as well. OK, so, my name is Anna Earl, I’m a former police officer and I’m a nutritional therapist specialising in nutrition to support shift workers.

And this is a really fascinating area of biochemistry called chrononutrition, and it looks at the relationship between our natural internal body clock, food timing and choices, digestion and our health. And ignoring these biological rhythms can be a driver of many chronic diseases. Sophie’s going to look at this in more detail, when we look at the obvious time for a break in eating food, which is when we are asleep.

So, if we’ve not met before, sorry, let’s come back, if we’ve not met before, I’ve created the Oscar Kilo Nutrition for Wellbeing programme, including a series called Feed Your Body Clock. And I’ll direct you at the end to those resources if you’re not familiar with them already. So, we’ve invited you to this collaborative talk today, approaching it from two different angles. The timing of the talk is significant as we approach Ramadan, which will be staring this weekend. And if you work in policing and will be observing Ramadan you may have the additional challenge of fitting shift work around both your period of fasting and the opportunities to break your fast.

And that can have a knock on effect on your sleep pattern and your energy levels. So, Zahid is going to share his personal experiences and insights of that and offer some helpful recommendations. But alongside raising awareness of those challenges we’re also going to look at the reported benefits of fasting. Not only in terms of the spiritual cleansing, as with the period of Ramadan and other religious practices, such as Christians observing Lent, which we’re in now up until Easter. But also the potential physical and mental benefits on our health.

So, what is fasting? We’re looking at chunks of time where we’re abstaining from food and this is increasingly uncommon practice. Where, instead, we have become very much a nation of grazers, we are in a constantly fed state. Three meals a day, plus snacks in between most, if not all meals, certainly when we’re talking about feeding – even starting with weaning and feeding our young children and preschoolers. There’s that obsession with having to carry snacks with you everywhere so we can be constantly feeding little ones.

And even though they might need that little and often energy, sometimes we’re now never breaking that habit, we continue that right through adulthood and it’s really not necessary. I’ve spoken before about the significance of food timing and choices and how shift work can disrupt the ability to eat three regular main meals at regular times. Which is now recommended to promote health. And the impact of food timing is due to very strong biological cycles that mean that our body is designed to digest and process food when it’s light and to sleep when it’s dark.

So, what are different types of fasting? There is the abstinence for religious and spiritual reasons side of fasting, in Ramadan Muslims won’t eat or drink between the hours of sunrise and sunset. They will break the fast twice a day at dawn and after sunset. With Lent it may be that people restrict the intake of certain foods and drink. Then we have time-restricted eating or intermittent fasting, and this observes a period of usually around 12 hours, though some people do extend that further to maybe 14-16 hours, it can be quite a challenge.

But there is some data to suggest that a period of around 12 hours is optimal, a few times a week, to give our bodies a rest from constantly digesting. And then we have the 5:2 fasting practice, where we eat normally for five days a week and then have very restricted intake for two days. And, again, some people extend this to eating normally for four hours and then fasting or restricted food intake for three days. And this can be an effective weight loss tool.

However, one fast does not suit all, every person’s body reacts differently to eating and fasting. So, when we eat our body uses the glucose from our food to produce energy and after 10 to 12 hours of not eating our body enters a fasting state and starts to break down our energy reserves from fat cells. And this can lead to some weight loss, that period of darkness gives our body essential time to have a rest and repair, including allowing the brain a detox.

It can’t do that as efficiently whilst we are still feeding. Fasting can also help to regulate our blood sugar and insulin levels, which can reduce our risk of type II diabetes. When we constantly graze we don’t give our insulin production much of a rest, as it works tirelessly to keep our blood sugar within a healthy balance. And rather than feeling constantly hungry, provided our fuel is good-quality when we do eat, fasting can, in fact, result in our energy and mood levels improving.

We don’t have the feelings of fatigue, cravings and irritability that we can have, that’s driven by blood sugar crashes from overeating, particularly high-sugar foods. And then there are other reported metabolic benefits, including reduced blood fats, our lipids and cholesterol and blood pressure levels.

Fasting has the potential to reduce chronic inflammation and this drives many diseases, such as heart disease, inflammatory bowel disease, multiple sclerosis and some cancers. Certain foods can be pro-inflammatory. I talk about that in much greater depth in one of the recorded webinars on the OK Nutrition pages, called Food for Mood. And here is a really good example where both food choices and food timing can really impact your health.

If you haven’t considered fasting before, or if you are a constant grazer and would like to see how fasting might present some health benefits for you, I would say listen to your body. Experiment and see what works for you, but start small, just reducing snacks between meals, for example, and then observe your hunger and energy levels. If you want to take that a bit further, can you delay breakfast without feeling lightheaded or nauseous? Or do you need to bring your evening meal forward to allow for that 12-hour window, at least a few times a week, before your next meal of the day?

If, for example, the time-restricted eating fasting pattern might appeal to you, to give your body that opportunity to use up some reserves and initiate some repair. I highly recommend that you schedule some time to plan your meals, your meal times and meals. Maybe just set aside 15 minutes per week to fit around your shift pattern, your activity levels, when you might need to adjust your fuel intake. It really can be time well spent, and remember that food is to be enjoyed and celebrated, fasting doesn’t have to be punished and anti-social. Adopt practices within a manageable level so as not to add additional layers of stress to an already demanding lifestyle in policing.

OK, and now I’m going to hand over to Sophie to talk to you about the impacts of fasting with sleep.

Sophie Bostock: Amazing, thank you so much. I have to say I think I’m finding – can you see my screen?

Anna Earl: Yeah.

Sophie Bostock: Is it working? OK, marvellous. No, I’ve found this research on fasting really compelling and I think some of my reticence around fasting potentially is because I wasn’t sure what it would actually do your sleep. So, why am I here? Well, really to think about both the impacts of fasting on sleep, but also potentially sleep on our ability to fast and to make healthy food choices. So, when we think about lack of sleep we tend to think about being tired and we’re all pretty familiar with that. But whenever we feel tired we’ve, kind of, got to remember that this may just be the tip of the iceberg. Because that’s what we experience, but under the surface there are all sorts of other impacts on our physiology, including increased insulin resistance, chronic inflammation, potential weight gain, appetite disruption and impacts on emotional health, as well.

So, all of those benefits that Anna was talking about, if that fasting goes on to mess with our sleep then it could actually be counterproductive. So, I think it’s important to, kind of, consider that. And I’m really just going to look at three questions today, how do you know if you’re getting good quality sleep? How does the time of eating affect sleep and circadian rhythms? And how does non-religious fasting affect sleep? And then we’ll go onto Zaheed and talk specifically about Ramadan.

But I’m very much just thinking about just generally fasting for health reasons, perhaps. OK, so, how do we think about quality of sleep? Some of you may well wear sleep trackers, I often say that the best way to measure how well you’re sleeping is how well you feel during the day. And if you can get through the day, waking up feeling refreshed, not relying on caffeine or sugar to keep you going through the day, not catching up on weekends, then probably you are getting enough sleep. But those wearables will sometimes give us more granular data on what’s actually happening during the night.

So, we typically sleep in a number of different stages and we cycle through these stages during the night. And this pattern that I’m showing you on the screen, this is called a hypnogram, and I’d say this is for an average, kind of, middle-aged adult. And what you can see is there are periods of wakefulness that happen during the night, so, if you wake up once or twice during the night it doesn’t mean that you have a sleep problem. This is very often a natural part of sleep and provided that you’re not too worried about it you probably roll over, go back to sleep, and you may not even remember it in the morning.

But often when we think about sleep quality we’re thinking about reducing the number of wakenings, but also making it easier to fall back to sleep afterwards. So, a little bit more about the detail of these different sleep stages, which is the most valuable? That’s what people often ask, well, the reality is they are all important. So, we start off in a very light stage, stage one sleep, not particularly restorative, but after about five or 10 minutes we will slip into stage two sleep, which is where we start to consolidate memories, we start to be able to improve learning and focus. And then after about 40 minutes or so, if we’re lucky, if we’re relaxed and the environment is nice and dark and cool, we’ll slip into slow wave sleep, which is particularly important for our physical energy levels.

It’s also a little bit like the fasting that Anna mentioned, it detoxifies the brain, because if we’re not constantly bringing in external stimuli, while we’re unconscious and asleep, the brain is better able to process our memories, but also to suck out some nasty toxins like beta amyloid and tau, which have been implicated in Alzheimer’s disease.

So, there’s a real interest in slow wave sleep being protective for our brains, but in recent years it’s also been shown that slow wave sleep is very helpful for insulin sensitivity. So, our ability to suck blood glucose, sugars out of the bloodstream and, kind of, store them safely in our cells. So, when we disrupt deep sleep we tend to see an imbalance in that management of blood sugar and that’s one of the things that, as Anna said, leads to increased risk of diabetes.

The final stage of sleep that we swing through maybe four or five times during the night is REM sleep, rapid eye movement sleep. This is the type of sleep that’s usually associated with dreaming and it’s thought to be particularly important for creativity, also for memory, and also for emotional regulation. So, balancing our emotions. So, in an ideal world we want all of these stages of sleep and we want enough time, ideally between seven to nine hours, to get through sufficient sleep cycles. And what you’ll find is that from day-to-day patterns of sleep will be slightly different, so don’t read too much into the reading from a wearable that says your slow wave sleep was only 10% today. It will probably rebound the following day.

So, provided we allow enough time the brain is really good at knowing which stage of sleep you, kind of, need. But, in general, to optimize sleep quality we think about three different systems. I’m going to mainly focus on circadian rhythms today, because that’s what’s particularly relevant when we’re thinking about intermittent fasting and times of eating. But over the course of 24 hours our alertness typically follows a pattern like this. So, we become gradually more alert through the morning, we often have a little bit of a lull after lunch, alertness picks up around 4:00 or 5:00pm, which coincides with a peak in our core body temperature, and then we feel sleepy, we sleep, and the cycle begins again.

So, this mechanism, this pattern, is influenced by these three systems. The first are your body clocks, also called your circadian rhythms, and I’m going to go into a bit more detail about those. The second is sleep pressure, and this is pretty straightforward, the more hours you’ve been awake the more you build up a pressure to sleep. So, the later you go to bed, potentially, the easier you find it to fall asleep and actually the more likely you are to sleep through the night.

But this can be messed up by the third sleep system, which is our stress balance. So, your stress system is the thing that evolved to protect you from danger, from threats. So, if you feel overwhelmed or you feel in danger or even if you’re in a new environment we tend to dial up levels of adrenaline, cortisol, which interfere with the process of falling asleep.

So, the way that we sleep from night to night is always a, kind of, balance of these, all three of these systems. But the good news is you can actually focus on any single one of these to improve the quality of your sleep. So, today I’m going to focus mainly on circadian rhythms, but if you feel like you’re not in as much control of your cycadean rhythms, for example, if you work shifts, you are still able to focus on the other two systems to optimize the quality of your sleep.

But let’s have a look at circadian rhythms and what influences them and how we control them and why they’re so important. So, circadian rhythms actually live in every single cell in our body. If you take any little cell and you put it in a petri dish it would oscillate on a 24-hour rhythm and that’s because we have evolved to be more active and alert, to interact socially during daylight hours and to rest and recover at night.

So, things like this hormone melatonin, many of you will have heard of, if you have a consistent rhythm from day-to-day then about an hour-and-a-half before your normal sleep time, provided that it gets dark, then melatonin will be produced by the brain, which helps to prepare the body for sleep. Similarly, if you wake up at the same time every day you’ll get this peak in cortisol, the stress hormone. Now, cortisol often gets a bad name, but is actually a really energising hormone and we want a nice peak first thing in the morning to give us energy.

And so consistency is one of the key factors which improves sleep quality, so, this chart here just shows a pattern of average sleep consistency and the amount of slow wave sleep over the course of a typical night. And you can see that in general there’s this direct correlation and actually there was a paper that was published a couple of weeks ago that suggested that the regularity or consistency of your sleep patterns is potentially even more important for our health than how long we sleep for.

So, in an ideal world we would have a consistent rhythm, of course in policing that is very often not possible. And if we experience shift work or something like jet lag or we just have very haphazard rhythms, for any other reason, then our body experiences this thing called circadian desynchrony. And what that means is that our internal clocks are out of sync with the outside world, the light cycle of the sun, but they may also be out of sync with each other. Because you may find that the clocks in your stomach are actually adjusting at a different pace to the clock in your liver. So, they’re not talking to each other as efficiently as they might.

And lots of experiments have been done to, kind of, work out how this actually impacts on your body and this is just one example where they pushed people from a 24-hour rhythm onto a, kind of, 28-hour clock. Just to see what happens. And pretty much it disrupted all of the, kind of, metabolic hormones. It’s not that we can’t perform and operate under conditions of circadian desynchrony, of course we can, but it puts more stress on the body. And this chart just shows one example, this is the, kind of, natural rhythm of the hormone leptin. Now, leptin makes us feel full, and what they found was that when they pushed people’s circadian rhythms out of line with the light-dark cycle around them, you’ve got this disruption to leptin levels.

So, leptin levels fell by at least 20%, so, if you imagine that signal to your brain that’s making you feel full is reduced when you’re in this state of circadian desynchrony, which is one of the reasons that for some people, for some shift workers, they can find it a bit more difficult to make healthy choices. Because their brain is telling them that they’re still hungry under conditions that actually perhaps they’re not.

And it’s not just appetite, it’s high blood pressure, insulin sensitivity, and reduced sleep proficiency, all of these things can be symptoms of circadian desynchrony. So, if you’re sitting there going, “Well, what am I supposed to do then? Because I have no choice but to work lates, to work nights.” Well, the good news is that we can use these signals called zeitgebers or time givers to influence the timing of these internal clocks. And the most powerful is light, which, kind of, lands on receptors on the back of the eye, it tells the rest of the body that it’s time – that it’s daytime, it’s time to be alert.

But our body also listens to external signals, temperature, the eating of food, and movement. And all of these things can influence the master clock in the brain to tell it whether or not it’s time for sleep. So, this is why you’ve probably heard the advice to try and keep your bedroom cool, to avoid eating at least two, if not three hours before you get into bed. And also to try and avoid very vigorous exercise in the last hour before bed. It’s because those signals can delay your body clocks. And this is important when we think about, as Zaheed will go on to say, what actually happens during Ramadan, because it can cause confusing messages for the brain.

Conversely, if you want a really great sleep, then you want to dim the lights, sorry, you want to dim the lights, sort of, last thing at night, but you want plenty of natural light in the morning and actually you want to move your body in the morning to tell the body that it’s daytime and it’s going to boost alertness. So, a lot of research has looked at this data and been like, well, some people have no choice but to work shifts, so could we use the timing of food to actually help people’s bodies to reduce this circadian desynchrony? So, there was a well-known study that was published in 2022 and what they did is they took some firefighters who were working 24-hour shifts and they invited 150 people into this trial. And they randomized them, so half of them were just told, they were advised to try and eat a health, Mediterranean style diet. So, avoiding unprocessed foods, pretty much, lots of fruit and vegetables.

The other group were invited to try intermittent fasting, a time-restricted eating pattern, and what they were recommended to do was to try and only eat during daylight hours. And to try and compress that eating window to 10 hours. So, for example, from 9:00am in the morning to 7:00pm at night. Now, not suggesting that this is easy for a night shift worker, but actually part of the reason for the trial was to work out is this feasible? Is this something that shift workers can actually do and can they maintain it for three months?

So, what were the results of the study? Well, at baseline they tended to find that most people, most shift workers, were eating, on average, for 14 hours out of the 24. And after the trial or during the trial most people actually did manage to stick to that time-restricted eating pattern. I think on average they actually had an 11-hour eating window, which is really not bad considering all the, sort of, stresses and strains. But after three months they found that blood sugar and blood pressure had improved in those people who had unhealthy, less healthy metabolic levels at the start.

Interestingly, no impact on their experience of sleep, but actually people found that they were starting to reduce alcohol intake as a result of consequence reducing that eating window. So, overall this was seen as a pretty marked success of time-restricted eating for shift workers. But, you know, I’m supposed to be talking about the impacts of fasting on sleep and, to be honest with you, there’s not a lot of data on it.

So, of course, if you are starving hungry or dehydrated that’s probably going to mess with sleep quality. But actually a number of trials have found that fasting, intermittent fasting, even doing a 24-hour fast, doesn’t seem to have any impact on sleep quality. A couple of trials suggest that it may improve sleep quality. So, the overall conclusion from the research is don’t let actually worries about sleep put you off trying fasting, if that’s something that you want to do. You just want to ideally avoid going to bed when you’re really hungry, really full, because that’s going to delay your circadian rhythms, or thirsty, or dehydrated.

And finally, just a very short thing about what you eat, how the nature of the food impacts on your sleep quality. Again, a surprising, kind of, absence of good-quality research on this, but there are some lab studies which have tested different types of meals and found that those with lower fibre and higher saturated fat and high sugar, so less healthy meals, tend to be associated with less of that deep, slow wave sleep. So, the messages that come through the research very much reinforce the fact that a natural, unprocessed, Mediterranean style diet are typically better for sleep.

Another recent study actually found that high fat and high sugar before bed didn’t have a massive impact on sleep duration, but did seem to reduce that slow wave sleep. In the real world a big study published last year suggested that on average what people were eating was not having a massive impact on their sleep.

So, overall, in terms of sleep diet isn’t one of the most important factors, I think if we think about circadian rhythms and sleep pressure and the stress system those are probably much more important. But to err on the side of caution, ideally we’re looking at unprocessed food and that Mediterranean style diet. So, sleep may not be the most important factor, but certainly when you eat, when you move, when you’re social, and your exposure to light can have an impact on sleep. Which I think feeds us quite nicely into introducing Zaheed, who’s actually going to tell us the realities of what it’s like during Ramadan. Because it’s not just about not eating, Ramadan is so much wider than that.

So, I’m going to stop sharing my slides so that you get a full view of Zaheed, just let me do that. Zaheed, do you want to just introduce yourself and your role? Because you’ve had some absolute brilliant experiences from the perspective of policing.

Zaheed Aziz: Thank you, Sophie, and good morning to everybody online. I’m pleased to be here and to share my experience on fasting. I’m over 55, so, I’ve been fasting for over 40 years and so I will try and explain how I manage my fasting month. In terms of my policing experience, 30 years police service, retired last September and since then I’ve been an employee at the college, as a civil servant, in the international policing advisor role.

During my policing career I’ve done everything from shift work, 24/7, seven days a week, through to operational units where you’re having to work long hours sometimes on the back of no rest, you know, maybe 14-16 hour days, doing fasting. Operational deployment, so, public order commitments and other, kind of, operational responsibilities that you might have. Working through the ranks, as an inspector, for example, it’s very challenging, sometimes, when you are fasting, and you manage a critical incident, making those high-end, high-risk decision-making and directing officers, directing activity. When perhaps your energy levels are low, etc., so I can touch on that as we go forward.

And then, as a superintendent, long hours as a senior commander, sometimes a very short [unintelligible 00:31:20] work, you know, beyond your fasting time, when you’re expected to be home and having your normal routine of food, and going beyond until maybe 9:00, 10:00, 11 o’clock at night. So, having those experiences what I can perhaps share with you.

Sophie Bostock: That is brilliant. I mean I have to say, not to oversell Zaheed, but if you’ve joined this call looking for specific recommendations I think he’s probably experienced every pressure that policing can throw at you. So, we can have a chat about that and please be brave and share your questions for him in the chat, we’ll come onto open questions. But if we can just start, Zaheed, with for those of us who’ve never experienced Ramadan, don’t know very much about it, could you just explain, in a simple way, what it actually means for the Muslim community? What do you do? Why is it so important?

Zahid Aziz: Yeah, so, Ramadan is one of the 12 months of the Arabic calendar, so, during which Muslims are required to fast. It’s an obligatory act for Muslims, it’s one of our five pillars of Islam, of our beliefs in terms of belief in God, praying five times a day, obligatory charity and then the pilgrimage to Mecca. So, fasting is one of the five key elements of our belief that we have to fulfil.

And the fast starts from the first light of dawn, so not sunrise, but an hour-and-a-half, approximately, before sunrise, until the sun sets. And it’s a set of 28 to 30 days, depending on the lunar calendar month of that month. As to how many days you would fast. So, it’s a consecutive period of fasting from the first light of dawn until sunset. So, there are people who are exempt from fasting, the very young ,people who are elderly and find it difficult to fast, those who have reasons based on ill health, they’re taking medication, for example, they have a level of diabetes where they can’t manage because of fasting. Children, pre-puberty, are not required to fast, and those who are travelling distances, or long distances are exempt, as well. And then we have nursing mothers and during menstruation, as well. So, under those circumstances people are not required to fast.

As [unintelligible 00:33:39] lunar calendar and so therefore the calendar moves back every 10 days, because the lunar calendar extends to 355 days and the Gregorian calendar obviously 365 days. So, we find that Ramadan rotates backwards from winter to autumn to summer to spring and that cycle of 35 years goes round the calendar and we start back again from the winter again. The consequence of that is that the hours are very long in the summer and much shorter in the winter.

So, for example, December-time we could be fasting for eight or nine hours and in the summertime, when I was in Scotland before I moved south, it was 21 hours long. So, you had a three-hour window of eating, breaking your fast, going to do your night prayers, coming back home, having your early meal and then going to bed. So, it’s a very challenging –both are challenging, actually. For the summer it’s obviously the length of time, sometimes the thirst kicks in, and for the winter actually you’d be surprised, it's the cold, because you’re not taking hot fluids, your body temperature, kind of, drops quite quickly. And it’s very cold, it can feel very cold for you.

So, what is fasting? It’s the prohibition of not consuming food or drink and abstaining from sexual activity during the daytime, obviously. And your focus is on worship and remembrance of God and doing good deeds. Charity, for example, helping people out, giving funds for good causes, etc. And you’re also required to avoid acts of things which we class as being forbidden, so backbiting, and other being toxic, etc.

So, it’s a behavioural exercise, as well as a physical exercise in terms of your food intake, and so it covers both aspects, yeah.

Sophie Bostock: And for somebody who’s never fasted before, I’m going to hold up my hand here, I am inspired to try. But I think when we spoke before you, kind of, said actually Muslims welcome this time. For me it would sound incredibly daunting, particularly the 18, 19, 20 hours without eating, but actually for you and your community actually this is a really important and potentially positive time that you look forward to.

Zahid Aziz: Yeah, it is, Sophie, it’s welcomed because we consider this as a month of blessings and by blessings I mean any act that we do in this month, which is for the sake of God. So, abstaining from food, doing charity work, etc. Its reward we believe is multiplied tenfold or more, depending on which act you do. So, people look upon the month of Ramadan as a, kind of, welcomed arrival of a time when you can break the cycle of what you normally do, refocus yourself on your relationship with God. It’s very much a social time, as well, social space where you’re in amongst family, you are sharing food, you are engaging the community, you are doing night prayers where you’ll meet other people in the community, as well, which ordinarily you probably won’t.

So, it’s very much a social, as well as a spiritually rewarding time.

Sophie Bostock: Anna, do you want to ask some questions about the nutrition aspect specifically?

Anna Earl: Yeah, certainly, I’m interested to know what your main challenges were as a police officer observing Ramadan and what were your coping strategies to develop when you were either on call, when you were working longer than just your regular eight or 12-hour shift. Were there conflicts with your energy levels and how did you cope with that, Zahid?

Zahid Aziz: I mean that’s a really good question, and I think over time as you start to begin your fasting life you start to design your own tricks, shall we say, or activities that help you cope. So, your energy levels change because you’re not eating as you normally would. Your meal, for example, this coming week we’ll start Ramadan, your first meal will be at 4:30 in the morning and then you won’t have anything for the rest of the day, no water, no drink. So, your energy levels tend to drop at some point during the day.

It’s difficult to scientifically say how, but you’ll have different experiences on different days. So, some days you’ll feel thirsty, you could have the same amount of food intake, the same amount of fluid intake, but some days you’ll feel thirsty. Other days you might feel hungry, other days you won’t feel anything and it’s quite a smooth day. As a general trend, as you, kind of, move towards through Ramadan, the first five, six, seven days are difficult because you’re adjusting. The next 10 to 15 days are reasonably OK, if I can use that term, and then the last five to 10 days before a bit more challenging, because at that point your energy levels, etc., and your tiredness kicks in.

So, lack of sleep is a big issue for us , as Muslims we engage in worship at night, a lot of people do because it’s encouraged within our faith. So, your sleep pattern is disrupted, ordinarily I go to bed about 10:30-11 o’clock, Ramadan I’ll probably go to bed about 11:30-12:00 and wake up at 4 o’clock in the morning, for example, for my first food during this period. In the summer it might be 1 o’clock I’ll be awake and then half-past-2o’clock I’ll go back to bed again. And it’s that, kind of, adjustment you would have to make in terms of your – the food that you take, for example.

So, my food intake in the morning will generally be along the lines of some porridge, some eggs, some hot milk, and maybe some dates. But keeping the quantity of the food relatively light in the morning because, in effect, what you’re going to do is you’re going to go back to sleep, wake up at 7:00 and then get to work, so you can’t have a full stomach as you move into your fast day.

Sophie Bostock: That’s really interesting. Sorry, just listening, Zahid, because obviously you’ve got to compromise, your need to take in enough to see you through the day, but also you want to be able to fall back to sleep. And I’ve just said taking in food can delay sleep and interfere with that process of falling asleep. So, really good point that actually you want food that’s going to sustain you, but not too much of it.

Zahid Aziz: Yeah, it’s that fine balance of having enough that you’ve got enough energy, but, by the way, your energy will wane over the day, that’s a given. The exercise of fasting in Islam is meant to be a challenge, it’s not meant to be something like a walk in the park, so you are meant to be physically challenged, so that you are more mentally aware of the purpose of the fast. And then you [unintelligible 00:41:12] God, etc., and do good deeds.

So, it’s a change in your behaviour, it’s a change in your normal activities which is a big factor. The other thing is that preparation for fasting is really key, as well, so for myself I tend to fast ahead of Ramadan, maybe two or three days. So, the shock factor of not having fluids, not having food for such a long period of time isn’t such an impact on your body and your mental health, as well.

One of the biggest factors in mental capacity, to, kind of, sustain 30 days and, again, the preparation coming into fasting is quite key. My son, for example, who he’s been fasting – he’s 21, fasting since he was 13 years of age, he tends to reduce his food. He doesn’t fast, but he tends to reduce his food intake. So, he might skip lunch one day, he might have less of a meal in the evening just in preparation. So, that preparatory work is really key and makes your 30 days of fasting a lot easier to accept.

Sophie Bostock: That’s also really interesting. From a sleep perspective I think – I mean this is the scientific perspective would be rather than starting sleep deprivation early. Because we know that sleep debt builds my advice, as a scientist, would be actually bank sleep, so in that preparatory phase if you can start well rested, from a mindset perspective and emotional control perspective, you should be actually better able to cope with then the sleep debt. But from your perspective personally I don’t know whether you also compress sleep leading into it or actually you would go with that more rested approach?

Zahid Aziz: I think because it’s a 30-day exercise you can’t really bank sleep, if I can use that term.

Sophie Bostock: Yeah, I mean before, yeah, so, in the preparatory phase, leading up to.

Zahid Aziz: Yeah, I haven’t tried that, to be honest, but what I will say is that you have to adjust yourself. So, in Ramadan, for example, there’s a general practice where we try and have some sleep during the day, during the part of the Ramadan period. So, whether it’s lunchtime, a lunch break, for example, I’ve a colleague who’s an accountant who works for a large company in Maidenhead. So, he will go into the mosque and occupy a corner in the room and spend an hour-and-a-half just catching up on sleep and then has an extended working day towards the end.

For myself, as a working officer, I would tend to finish my work and then go home and then have at least an hour’s nap. And that’s your bank, shall I say, of sleep, so when it comes to the night you then have that banked already for the remainder of that day or evening and then you can bolster that with your general night sleep.

Sophie Bostock: Yeah, and I think there’s sometimes some controversy in the literature about, you know, napping, and it’s really only come from people who’ve experienced insomnia and then start napping at random times of day and night. And actually if you have very long naps during the day that can interfere with your sleep at night. But for Ramadan you are so sleep deprived that I would absolutely encourage naps, wherever it is safe and viable and feasible to do so, and I’m sure like in policing that sometimes has its challenges. But hopefully, yeah, just raising awareness of the importance of napping when you are sleep deprived I think can really help with cognition and mood and all those things.

Zahid Aziz: Yeah, the thing with Ramadan, it’s a social community exercise. So, we collectively are in the same space, so, if you’re in the Muslim world, for example, even the working day, for example, is adjusted, schools close because obviously – you know, to enable children to fast, etc. But in the UK, you know, Muslims here are a minority, the social gatherings, the evening events, the family get togethers, the night prayers, for example, all help you embed yourself into that environment where it becomes normal.

So, it’s the socialisation of fasting which I think helps you get through some of the challenges and sustains you, shall we say, to the 30 days.

Anna Earl: Zahid, I’ve got one final question before we perhaps think about the nutrition considerations and then open up for any questions and answers. So, I’m, sort of, hearing from you that maybe in preparation for Ramadan preparing yourself and maybe some food preparation, as well, might be key for any Muslims that are new to shift work for Ramadan, as well. If they’re on a period of a set of nights they may miss out on a lot of that social aspect, that you get, that support that you get, and the prayer times during the night, if they’re having to work.

So, are there any other tips or bits of advice that you can offer to any Muslims who are perhaps shift working for the first time during Ramadan?

Zahid Aziz: I mean I think planning ahead is absolutely key. So, setting up your routine, or building yourself into a routine where the arrival of Ramadan isn’t a shock factor, as best you can. If you’re working shifts, obviously lates, earlies, nights, it’s a bit more difficult, but you can adjust your regime to catch up on your sleep, to manage your food intake, to make sure you’re getting enough energy to sustain you for the day.

So, for example, if I was being deployed on a 12-hour cycle operation, which I have been during Ramadan, at Reading Rock Festival, I’ve adjusted my food in the morning to sustain me for that day. It’s not always possible to predict what’s going to happen in policing, but if you can at all then you really plan ahead to know what you’re going to be facing over the course of the day and make sure you have enough intake of fluids and energy, as well.

The other issue I think is sleep, and, again, you’ve really got to try and adjust yourself so your sleeping patterns work. But planning ahead, as I said, is one thing, focusing on the spiritual aspect for Muslims is really key, so that helps you get through the difficult challenges. Because ultimately your aim is to obviously try and gain your reward and that ultimate goal is what you’re aiming to get.

And the other thing which I think most Muslims tend to do is have the personal goal for achieving 30 days of fasting. So, you’re constantly focused on the end line, to get over the end line, and therefore you, kind of, keep yourself motivated, particularly in the mid to late end of the fasting element. And my advice to people in general is that if you are fasting have a think about your role, have a think about what you’ll be doing. And if there’s something that’s particularly challenging, so, whether it’s something to do with a difficult, complex decision making day, for example, and it’s a deployment that perhaps will exhaust you. Make you enabled to do the best that you can within that role, then seek some adjustments, speak to your line management, suggest that perhaps somebody else maybe is more suited to be deployed to that particular responsibility.

Ask for reasonable adjustments, as a chair of the Muslim Police Association in Thames Valley Police, we often got requests for reasonable adjustments. And it was more around people’s personal preferences, around how they would adjust themselves for their sleep and their food intake. So, my advice is plan ahead and make some adjustments and if you have any particular needs and challenges then speak to your supervisors and request those things.

Sophie Bostock: Brilliant, I’m going to cheekily, while Anna puts her slides up, because she’s going to give a little summary from a nutrition perspective. But if you are napping, reach over for my ultimate sleep enhancing device. This is very low-tech, ladies and gentlemen, but if you do have to nap, you know, carry a sleep mask with you. Because just hiding exposure from light, from your eyes, will actually improve the depth of your sleep. So, even if you’ve only got 15 minutes to nap, it’s still worth it, I’m sure Zahid will probably back me up on this. But, you know, you might ideally have an hour-and-a-half to try and catch up from maybe a couple of hours of lost sleep at night. But there’s really good evidence that even 10 to 20 minutes can actually improve your alertness, your mood, for the subsequent two or three hours.

So, it’s potent stuff, a nap.

Zahid Aziz: Yes, definitely.

Anna Earl: It is, thank you, Sophie, and if anyone’s been to an Oscar Kilo roadshow you may well have an Oscar Kilo eye mask that hopefully you’re carrying around in your kit bag with you, as well. So, thank you, Zahid, that was really, really interesting and so many practical messages there, as well, for people to hopefully assist with Ramadan. So, here just to finish off with some food considerations when breaking your fast. And this is practical, hopefully, for people observing Ramadan, but also just general nutrition guidelines for that first meal of the day when we’re breaking our fast.

So, first of all thinking not to go overboard on the, sort of, calorific intake when we’re first waking up, particularly with Ramadan if you are looking to go back to sleep again. But certainly think this is your opportunity to get the fluid into you for the rest of the day. So, thinking of fluids that are high in fluid, so lots of high fluid fruits such as watermelon and mangos, berries and so on, will be able to hydrate you as much as also having fluid intake from tea, coffee, water and so on.

Also thinking about the fluid that you can add through different soups and sauces. But, as I said, we’re looking to minimize foods that are really high in sugar, that are very rich, deep-fried foods. These may contribute ultimately to some weight gain, especially if you’re eating those foods at night before you go to sleep.

So, reserving those kinds of foods for the occasional treats and perhaps for at the end, for the more festival type celebrations at the end of fasting, rather than regular daily intake. We’ll be looking to get some fibre in for that first meal of the day, to encourage digestion. Constipation can be quite an issue, if you have really reduced your food intake, so getting some fibrous foods in at the start of the day can help to get everything moving and really help support your gut health. And that’ll be food like your whole grain foods, so whole grain and granary bread and pasta, brown rice, rather than the simple carb, the processed versions of that, the white wheat versions of those.

Lots of vegetables and fruit, again, they’re going to be giving you the fibre, the vitamins and minerals for your energy, as well as that hydration, as well, the fluid from those foods. And then thinking about nuts and beans, lentils and chickpeas, with those fibrous foods you’re also getting some lovely plant protein. And they can really help with sustaining your appetite throughout the day. They can really help with that, triggering that hormone leptin that Sophie talked about, they can help with feeling full and can help you feel much fuller for longer.

And then with protein and healthy fats, they also can really help sustain your appetite. So, we’re going to feel less likely to want to be snacking and feeling hungry. And so those foods, if you’re a meat eater, will be your meat and your fish, some dairy, so some natural yogurt, some kefir, perhaps, which is a probiotic yogurt, and eggs, as well, lovely and sustaining, wholesome protein from eggs.

And then we get our plant protein, as I said, from beans and pulses, from nuts and tofu, and healthy fats will be things like avocado and hummus and lots of lovely extra virgin olive oil. And these are lovely, sustaining, nourishing foods that hopefully can help you to then carry out the daily activities that are required from you in your role in policing.

As I mentioned earlier, from a non-religious perspective, one fasting method does not suit all people and fasting is not recommended for people who are underweight. If you have a medical condition such as type II diabetes or if you’re pregnant then I would advise that you seek medical advice before fasting. Many people do observe Ramadan with type II diabetes, but managing the medication timing is really important to avoid a hypo or a hyperglycaemic event. And healthcare providers should help you to schedule that safely.

So, finally I’ve got here some resources, I’m going to copy the links and put them in the chat as soon as I hand over to Sophie. And so hopefully if you want to seek any further information on the topics that we’ve spoken about today then you can click on those links before we finish. So, thank you for listening to me, I’m going to stop sharing now, I’ll hand over to Sophie to finish and then we’ll open up for anyone who’s got any questions.

Sophie Bostock: Brilliant, I have nothing else to say, I definitely want to allow anyone to ask questions if they’re curious. A question from Richard who said, “Whey protein shake with 30g of protein to break a fast, yay or nay?” What do you think, Anna?

Anna Earl: So, I would always says food first, but if you’ve got your food intake, if you’ve got your protein intake from those good protein sources. Because with those protein sources, if you’re going to have food with protein, you’re not just having a lump of protein, you’ve got the benefits of lots of other nutrients in there, particularly with meat and fish and dairy you’re going to have all your B-vitamins that are going to really help with triggering energy levels, as well. And lots of your key minerals.

So, I wouldn’t just rely on protein powder, but adding that perhaps to a shake or a smoothie can give you that added sustaining food to help with the appetite. So, a good addition, rather than relying on that solely.

Sophie Bostock: Great point, someone also – Anisa’s asked, “Thoughts on exercising whilst fasting?” And I’ll turn to Zahid on this one, but certainly from the research perspective it’s hard. I mean there’s been a number of studies which have looked at professional athletes who observe Ramadan and they have found that, you know, they do tend to feel more fatigued, unsurprisingly. And so supplementing their nighttime sleep with naps is one of the strategies that they’ve used to try and improve performance.

But most people will feel lower in energy and as Zahid has said that might change very much over the period of Ramadan. I think something I’ve really learned from Zahid is just how changeable it can be from day-to-day. And I think there’s definitely an element of listening to your body, but Zahid, have you got any kind of experiences around exercise in particular?

Zahid Aziz: Yeah, my personal approach was light exercise towards the end of the fasting day, or perhaps after the fasting day, but obviously a gap between when you have your food, after you open your fast, to the time you exercise. But certainly you can’t go at the same pace, at the same intensity as you probably would ordinarily, but just to keep yourself going. I tend to walk now more than do physical weight training or physical running, it’s just easier on your body. And your metabolism then doesn’t, kind of, go miles high the next day and you feel really hungry very quick. So, that’s the approach I normally take.

Sophie Bostock: Yeah, that sounds very sensible, there’s going to be so much natural variation and if you’re a pretty serious athlete you can’t afford to not train at all for a month. But I think there’s definitely some variation of perhaps pushing your exercise period back a little bit, because you’re going to find it harder to take in obviously any energy to recover. Wonderful, let me just see, what else have we got coming in? Lisa says, “Should you not have any liquids if fasting for health benefits?” OK, so, this is a non-Ramadan question, but Anna, what would you say about, sort of, intermittent fasting, does it include liquids?

Anna Earl: Yes, so, intermittent fasting, if you’re looking to finish your last meal of the day, say by 7 o’clock in the evening and you’re looking to have a 12-hour window until breakfast 7:00-ish the next morning, that would mean no liquid unless it’s just water or herbal teas. So, if you want to have something in the evening just to try and curb those munchies, for example, just drinking some herbal tea or water would be fine. But certainly no alcohol, no milk in tea, no juices, so yes, that would be within the guidelines of intermittent fasting.

Zahid Aziz: Can I just say, just from a fasting experience over 30 days, it’s amazing how your body adjusts to your actual intake, whether it’s food, whether it’s the rhythm of food, whether it’s the fluid intake. You start to use less fluids as your body realises that it’s not having the intake as you normally would. So, the body’s an amazing machine.

Sophie Bostock: Yeah, I think I’m learning that more as I listen to you. Sally’s also asked, “Any tips for operational officers when Ramadan falls during the hotter months and they’re out in the heat wearing body armour, etc.?” I mean I guess it’s all the obvious things of avoiding any non-essential full exposure to the sun, but I don’t know if you’ve had experience of that, Zahid?

Zahid Aziz: Yeah, I mean I have, and I think that the best thing to do is, to be honest, if you have a deployment like that have a conversation with your line manager to say, “This may not be the best deployment.” Ultimately you’re there for the safety of the public and if you can’t perform that role as best as you should then have that conversation.

But having a sensible approach, not exerting yourself too much over the course of the day, if you can, and keeping yourself out of the sunlight, if it’s really hot. Yeah, I mean operational policing is operational policing. Ultimately if you come to a point that it’s detrimental to your health Islam allows you to break your fast, because, you know, the intention was to have the fast, you’ve done the best you can and you’ve come to the point where perhaps you’re so exhausted that you can’t sustain yourself anymore. Then you’re allowed to break your fast to sustain yourself, yeah, so that’s what I’d say.

Sophie Bostock: That’s a really, really important point. We are at time and I want to let people go, I know everyone’s short of time. One little question that I will respond to, somebody just asking, “I have two black coffees every morning, how do I cope with caffeine withdrawal and the headaches that go with it? What can I do beforehand?” And it really is just a case of tapering down. If you’re consuming caffeine on a regular basis going cold turkey sometimes is associated with extra fatigue and headaches, which can add to the burden. So, just I would recommend perhaps a week beforehand just start to reduce your dose by half each day, if you can, or just, sort of, cut down a little bit, or delay your first cup of coffee. Those things are all going to help with reducing that dependence.

Any final words? Anna? Zahid? That you want to add? Then we’ll wrap it up.

Anna Earl: I’m mindful of the time so I’m good, thank you. Zahid, final words over to you.

Zahid Aziz: No, just likewise, just conscious of time. But I would say for colleagues who are managing Muslim staff, for example, or they have colleagues working the same office, etc., just be mindful of potential mood swings. Because you’re adjusting to your new regime and environment. Not that it’s any excuse, but sometimes people are just not as they normally seem to be. So, just be conscious that it does affect people’s behaviours and appearances, shall we say, as opposed to simply just fasting.

Sophie Bostock: Brilliant and I’ve just posted, a little bit earlier on, the guidance from the National Association of Muslim Police Officers, I think, which people might find helpful. And Anna’s added some other links. Yvonne, any word from you to just wrap us up?

Yvonne Taylor: Just a thank you, really, from me, it’s a fascinating topic, we’ve heard some great advice today, so thanks to all of you for that. I can’t thank you enough. Do visit the Oscar Kilo website for lots of resources on sleep and fatigue and all the other areas that we work in. And, as Sophie’s said, she’s also added a link to the Muslim Police Association. So, thank you to those that have joined us today, to those that are fasting, good luck and best wishes for that period. Thanks everyone.

Zahid Aziz: Thank you.

Sophie Bostock: Thanks everyone.

Anna Earl: Thank you, bye-bye.