At sundown on Friday, Sept. 29, Jews across the Baltimore-metro region and the Diaspora will begin a day-long fast as part of observing Yom Kippur. But what are the best ways to prepare, the best ways to break the fast on Saturday night, and when should a rabbi be consulted about how to fast while taking medications or living with certain heath conditions?
Much of preparing for and observing the fast relies on common-sense nutritional and health advice, said Nina Goldberg, registered clinical dietician at Levindale.
“The day before, a lot of the [preparation] is things we should be doing all the time, but we just want to be more conscious to prepare ourselves for our day of not eating or drinking,” Goldberg said. “A big one is we want to stay hydrated, so I would definitely encourage drinking throughout the day. Focus more on water, not sugared beverages.”
In addition to drinking plenty of water and other non-sugary drinks the day before, Goldberg said soups and fruits and vegetables with a high water content are good choices.
“But I would be cautious with soups, because you don’t want to have things that are too salty,” she said. “You want to focus more on the complex carbohydrates; whole grains in particular are good because they are high in fiber. They slow digestion, so it keeps you full longer.”
She advises staying away from simple sugars, including candy and sugary beverages because they can stimulate hunger, and eating a balanced diet throughout the day and not a large meal right before the fast.
The day of the fast, because there is no energy intake from food, people should avoid too much exertion and gauge how they feel as the day progresses. Taking a nap in between services may work for some people if they are feeling fatigued.
When the time comes to break the fast, don’t do it all at once, and make sure to get rehydrated first, Goldberg said. She recommends using sports drinks to replenish electrolytes or orange juice to return sugars to the system, then return to eating a balanced diet. Don’t gorge.
“Obviously, people tend to want to eat a lot at one time, but that would probably make you feel sick later,” she said. “Eat slowly, have a balanced diet; proteins will get you full. Go back to the fiber and the complex carbs, but people have to make sure they’re hydrated. And even though they may not be thirsty, they want to make sure to drink a lot.”
While there are people exempt from fasting, including young children, women who have given birth recently and people who are seriously ill, consulting a rabbi is necessary to learn who is exempt and how to break the fast, if necessary for medical reasons.
“There are certain criteria,” said Rabbi Mitchell Ackerson, director of the department of pastoral care at Levindale. “If you’re taking a heart medication, you have to take your medication. It’s non-negotiable. I don’t know any rabbi in town, and I mean none, I don’t care how far left or how far right, who would tell someone [not to take their medication].
However, nonessential medications, such as vitamins, may not be necessary on a fasting day.
“But if you’re taking [prescriptions] because you’ve had a stent or you’ve had bypass or you’ve had a heart transplant or you’ve had any transplant and you’re taking your anti- rejection medication, the answer is: You need to take your medication,” Ackerson said. “The key is to make sure it’s a prescription of something that clearly needs to be taken every day, that would cause you harm if you didn’t take it.”
Then comes the issue of whether medication needs to be taken with water or food, both of which are not allowed during the Yom Kippur fast.
“If you can swallow a pill without drinking water, that’s often preferable. Some medications require certain amounts of food. So, [rabbis] have to explain to a person how to eat, if they have to eat on Yom Kippur,” he said. “What amounts you’re allowed to eat, how often you’re allowed to eat.”
And if people start to feel poorly during the fast, Ackerson said using common sense and, again, consulting with a rabbi is the best course of action.
“It’s a matter of how ill are you? Do you have other underlying medical issues? If I have a headache, that’s not necessarily grounds for breaking fast. But if I have underlying medical issues and that headache may be a symptom of something more serious, then you need to ask someone,” he said.
Ackerson said an important aspect of talking with a rabbi about fasting with a medical condition is making sure to be honest and tell the rabbi the full extent of the medical issues.
“The rabbi will make the individual decision based on what medical facts the patient tells the rabbi, which is always a key element in this because we don’t always get told all the facts,” he said. “If you only give me part of the story, it’s very hard to give you a legitimate religious decision.”