It’s that time of year again, fall is in the air, Yom Tov preparations have begun, and all the local publications are filled with delicious recipes for the many, many different dishes that will be prepared in the coming weeks. With all this excitement and distraction, it’s easy to lose sight of the imminent approach of the most important day of the Jewish calendar, Yom Kippur. A day that is so important, it supersedes even Shabbos. A day so important that Sandy Koufax, the secular Jewish pitcher for the LA Dodgers, refused to pitch in Game 1 of the 1956 World Series. We know why Yom Kippur is so important to us; it is the day on which our entire fates for the coming year are sealed. To mark the gravity of the day, we deprive ourselves of physical pleasures and focus on the metaphysical and spiritual aspects of our beings. However, without proper preparation, one may end up feeling so ill, he or she cannot focus on the importance and gravity of the day. Fasting is often considered even more important than davening (prayer) on the day of Yom Kippur (source). One must always keep in mind, though, that the life of an individual must never be placed in jeopardy for the sake of keeping this mitzvah.
There’s a famous story regarding Rav Yisrael Salanter, one of the leading rabbis in Lithuania in the 19th century. In the fall of 1848, a devastating cholera epidemic was blazing its way through Europe. The day of Yom Kippur fell as the disease was at its peak. Rav Salanter decreed that nobody in his community of Vilna fast for Yom Kippur that year, for fear that the people, already weakened by cholera, would become dangerously ill with additional depravation of food and water. To this day, we must remember how important it is to fast safely.
One of the main causes of discomfort while fasting is dehydration. In fact, Hatzolah gets many calls for dehydration on Yom Kippur, and often need to start IV lines for hydration, or transport people to the hospital for further care. These calls are preventable, and ensuring proper and adequate hydration days prior to Yom Kippur is of utmost importance. Of course, drinking plain water is the best way to hydrate, but our bodies also need electrolytes, like sodium, to be able to retain fluid. Drinking Powerade, Gatorade, Smart Water, or some other electrolyte solution, along with your increased water intake during the days before the fast, is a great way to hydrate your body in preparation. Too much salt can be counterproductive, and cause increased thirst, so limiting excessive salt intake is wise. Proper hydration is particularly important for pregnant women and nursing mothers, as they are providing fluid for their own bodies as well as their babies!
It’s important to make the proper food choices the day before the fast; try to eat foods that will provide long term energy, avoid sugar heavy foods, and don’t overindulge! Foods with a lot of sugar will cause a spike in insulin and eating large amounts of food will both make you feel hungry sooner. Try sticking to healthy fats, proteins and complex carbohydrates to provide the long term energy you’ll need. Examples of healthy, fast friendly options include whole grains, beans, raw fruits (unpeeled), and lean proteins. Eating carbs like whole grain toast or oatmeal for breakfast, and pasta or potatoes for lunch, will help build up glycogen stores for energy during the fast. The immediate pre-fast meal should be lighter, smaller portions, than usually consumed, with minimal spice.
Another major source of discomfort while fasting, for those coffee drinkers, is caffeine withdrawal. The main symptoms of caffeine withdrawal are headache, nausea, fatigue and irritability. Additionally, caffeine has a diuretic effect, which causes the body to lose more fluid. To mitigate the side effects of withdrawal, you can try to cut back on caffeine consumption during the days preceding the fast. Try drinking half caffeinated coffee, or switching to green teas which have less caffeine content. If these are not options for you, you can buy slow release caffeine products, which can be taken before the fast, although this may interfere with your sleep the night of Yom Kippur!
There are, of course, situations in which it is detrimental or even life threatening for someone to fast for a prolonged period of time. The same Torah which commands us to “afflict our souls” on this day, also commands that we should “choose life.” Pregnant women who are close to their due date, recently postpartum women, insulin dependent diabetics, people with eating disorders or severe malnourishment, or anybody taking strictly scheduled medications, to name a few, should consult their doctor and rabbi to ensure that their health is not in danger.
Wishing everybody an easy and meaningful fast and G’mar Chasimah Tovah!
by Perel Schneid, DO
Perel Schneid, DO, is a Primary Care Physician at Crystal Run Healthcare and is seeing patients in the practice’s West Nyack facility.