As if fasting for 12+ hours during the day and getting up in the middle of the night wasn't challenging enough, this year, like the last, Muslims have the added challenge of keeping their immune systems at optimum function amid the COVID-19 pandemic.

Dietary specialist and clinical psychologist Merve Öz shares her tips and advice to make sure you have the healthiest Ramadan possible while maintaining your weight and keeping your immune system strong.

To sahur or not to sahur?

Reiterating that the two systems for which the body needs the most energy are the immune system and the digestive system, Öz said fasting allows the body to focus its energy on one at a time, and thus stopping digestion for a specific period allows the immune system to be more active. This will allow the body to repair cells and fight off germs better. Öz says between sahur and iftar is when the immune system will be most active but to ensure this, she emphasized the necessity of getting up to eat a wholesome sahur meal, no matter how inclined you may be to go back to sleep.

"If you don't get up for sahur, your body will be stressed due to a prolonged period of hunger, which may lower your immunity," she says.

What foods to pick

When it comes to building a healthy diet during Ramadan, the key is to go for lighter but filling foods that will help your body replenish all the nutrients you may lose throughout the day. Try to set your table to include all the essential food groups – grains, vegetables and fruit, legumes, nuts, dairy or alternatives and your protein sources.

"A nutritious soup, eggs, cheese, olives, greens, cucumbers, tomatoes would be ideal (or sahur). Oatmeal lovers can also consider it as an option," says Öz.

However, she recommends consuming eggs, "one of the most beautiful sources of protein," alongside oatmeal or einkorn wheat porridge to increase satiety and stave off hunger for longer.

Go for soups and salads

As hard as it may feel to pace yourself as soon as you hear the adhan for the sunset prayers that signal iftar, being mindful of your bites and the foods you eat will help you stay as healthy as possible during this month.

"After you break your fast and eat your soup, take a break for 15 minutes, and then move on to the main course," says Öz.

Since your brain won't register the signal that you are getting full until after 20 minutes, taking a break before eating again helps you slow down and give you more control over your portions. Soup is a particularly great choice for starters as it helps your body slowly adjust to the feeling of satiety and prevents a sudden increase in blood sugar.

Öz also recommends having a good helping of salad as a side to your main meal at iftar. Not only will the greens and vegetables in the salad fill your stomach up with their volume but salads also prevent you from consuming too many calories at once.

"The fiber you get from salads will help relieve your intestinal laziness," she adds.

Stock up on antioxidants

Antioxidants in foods, especially colorful fruits and vegetables, can help prevent cell damage, therefore boosting the immune system. That's why consuming fruits as a snack in between iftar and sahur is highly recommended.

"Fruits are also high in fiber which facilitates the functioning of the digestive system and creates a suitable environment for beneficial bacteria to flourish in the intestines. And the more beneficial bacteria we have in the gut, the stronger our immunity will be," says Öz.

When it comes to desserts, try to go for fruits as much as possible, she adds.

Not all carbs are created equally

Öz says you should try to refrain from fried goods and pastries as much as possible during this month.

Calling bread "the best quality carbohydrate" over rice, pasta, bulgur and the classic "Ramadan pide," the dietary specialist said you should always choose wholegrain, sourdough or einkorn wheat bread over white flour.

As tasty and addictive as the Ramadan pide is, it is made from white flour, which causes spikes in blood sugar. Öz, however, admits that it is hard to stop once you get a taste.

Gaining weight rapidly and being overweight can also make you susceptible to many diseases, including heart disease and diabetes and may mean worse outcomes from COVID-19. Hence, dieticians place the utmost importance on staying at a healthy weight, especially during Ramadan.

Drink at least 1.5 liters of water

Underscoring that water is a must for a strong immune system as it keeps all systems in the body functioning properly, Öz said, "Water also helps to remove toxins from the body, transport nutrients to our cells and neutralizes bacteria and viruses."

She also cautioned against not consuming enough water when drinking tea, coffee or other caffeinated beverages. These drinks may give you the false impression that you are meeting your daily water intake, however, caffeine dehydrates the body and acts as a diuretic, meaning it speeds up water excretion from the body. Some doctors recommend drinking a cup of water for every cup of coffee you drink to offset this effect.

Revisit probiotics

If there is one drink Öz recommends people add to their diets during Ramadan, it is kefir. Thanks to the probiotics it contains, kefir has a very profound effect that strengthens immunity, she says.

"Kefir, which regulates the intestinal flora, also helps to alleviate constipation, a problem widely experienced in Ramadan. In addition, kefir has a low glycemic index and high protein content, making you feel fuller for longer."

The question of exercise

Although exercise may be the last thing you want to do when fasting, doctors recommend at least 30 minutes of activity to keep your body in tip-top shape, aid digestion and strengthen your immune system.

Reiterating that keeping active was one of the most important factors to build immunity, Öz said it does so by supporting both physical and mental health. If you have no physical conditions that prevent you from doing so, at least try to walk 30 minutes every day without overexerting yourself, she said.

Most doctors recommend refraining from high-intensity workouts during the fasting window and exercising an hour or two after eating to prevent indigestion. A brisk walk is the most recommended exercise, with doctors recommending it either an hour or two before iftar or after the iftar meal.