Eating Well on a Budget, in Ramadan, Hajj and Travel

Plan ahead for food, water, heat, medicines and rest.

• Wash hands with soap and water, or use an alcohol-based hand rub (at least 60% alcohol), before eating and after the toilet.
• At Hajj and Umrah, stay in shade where you can, rest during the hottest hours, wear light clothing and carry an umbrella and a water bottle.
• Check your urine: pale yellow means you are drinking enough; dark yellow means drink more (unless your doctor limits fluids).
• Keep a regular medicine routine with phone alarms; time zone changes and crowds make missed doses common.
• Get vaccines and travel advice before you go (the Saudi Ministry of Health lists requirements for pilgrims; hepatitis A and typhoid vaccines are often recommended for food- and water-borne disease). Immune-suppressed people should ask before any live vaccine.
• Do not rely on a travel plan alone if your health is fragile; ask your doctor whether the trip is advisable, and for a letter in English and Arabic listing your diagnosis and medicines.

Four situations, with the main principles for each.

• Healthy eating on a budget: build meals around legumes (foul, lentils, chickpeas, white beans), which are cheap sources of protein and fibre; eggs, laban or plain yoghurt, and canned or fresh fish; seasonal local vegetables and fruit; frozen vegetables (nutritionally similar to fresh and with less waste); rice, bread and oats with some wholegrain; and cooking oil in small amounts. Cook in batches and freeze portions, plan the week, and use leftovers.
• Smart shopping: write a list, compare unit prices, buy staples in bulk when you can store them, choose canned fish in water or oil and canned beans, rinse canned beans and vegetables to cut salt, and limit sugary drinks, sweets, chips and fried fast food, which cost more per nutrient. If you follow a special diet (gluten-free, low-salt, or low-lactose), build it on naturally suitable foods such as rice, legumes, eggs, fruit and vegetables rather than costly specialty products.
• Ramadan principles (details in our Ramadan article): at iftar, break the fast with water and a few dates and a light soup, then a balanced meal; at suhoor eat slow-digesting foods (oats, eggs, ful, yoghurt, vegetables, fruit) and do not skip it; drink water steadily between iftar and suhoor; limit fried, sugary and very salty foods, tea, coffee and cola; take medicines only on the plan agreed with your doctor; and break the fast if you feel unwell. Check with your doctor first if you have cirrhosis, IBD, ulcers, diabetes, a transplant or take time-critical medicines.
• Hajj and Umrah food and water safety: eat food that is freshly cooked and served hot; avoid food that has sat out in the heat for hours (especially rice, meat, dairy, salads, and anything with mayonnaise or cream); eat fruit you wash and peel yourself; use sealed bottled or properly treated water, and avoid ice of unknown origin; be careful with street vendors and with free food packs, checking they are sealed, dated and have been kept hot or cold; and do not eat raw or undercooked meat, eggs or shellfish. Keep your own water and safe snacks in a small cool bag when possible.
• Heat and dehydration: drink fluids regularly before you feel thirsty, and replace salts with ORS sachets if you are sweating a lot or have diarrhoea. If you take water tablets (diuretics), laxatives, or have cirrhosis, kidney disease or heart failure, ask your doctor beforehand how much to drink and what to do on hot days. Learn the signs of heat exhaustion (heavy sweating, headache, dizziness, nausea, cramps) and of heat stroke (confusion, collapse, very high temperature).
• Preventing travellers’ diarrhoea: safe food and water, hand hygiene, and avoiding risky foods are what work. Routine antibiotics for prevention are not recommended, and the evidence for probiotics is inconsistent.
• If you get diarrhoea: keep eating small bland meals as tolerated, and drink oral rehydration solution (ORS) made from a pharmacy sachet, mixed with safe water exactly as the packet says. Do not make it stronger or weaker. Sugary drinks, juice, and sports drinks are not a substitute for ORS, especially in children. Seek care for red flags above.
• Travelling with diet restrictions: tell the airline, hotel or Hajj campaign in advance if you need gluten-free, low-salt, diabetic or soft meals; carry a card in Arabic and English describing your restrictions; pack safe snacks for delays; and ask how food is prepared. For coeliac disease, watch for cross-contamination in buffets and shared kitchens. For cirrhosis, avoid raw shellfish and salty foods and keep up protein. Tube-feed or supplement users should carry enough supplies.
• Snacks to carry: plain biscuits or crackers, dates (if suitable), unsalted nuts (if tolerated), dried fruit, rice cakes, tinned tuna or sardines with a key-opener, sealed juice boxes, and sealed water. Avoid snacks that spoil in heat.

Carry medicines carefully and use them as prescribed. No doses are given here.

• Carry all regular medicines in original labelled packaging in your hand luggage, plus extra for a few days in case of delay, and a doctor’s letter and prescription listing generic names. Some strong painkillers, sedatives and other controlled medicines are restricted when travelling, so check the rules of the country you enter (for Saudi Arabia, see the SFDA guidance).
• If you use injectable or refrigerated medicines (such as biologics or insulin), carry them in an insulated bag with ice packs, never in checked luggage, and ask your doctor or pharmacist for the storage limits and a travel letter.
• Consider carrying: oral rehydration sachets, a thermometer, an antacid if you already use one, paracetamol (not anti-inflammatory painkillers such as ibuprofen if you have ulcers, IBD, cirrhosis or kidney problems), sunscreen, plasters and hand sanitiser. Ask your doctor or pharmacist before taking antibiotics, loperamide or herbal remedies.
• Do not use loperamide if you have blood in the stool, a high fever, or active colitis; and do not start antibiotics without medical advice.
• Keep taking IBD, liver, transplant and other long-term medicines even if you have diarrhoea or vomiting, unless your doctor says otherwise, and call them if you cannot keep them down.

Help to know about if you become unwell during a trip.

• In Saudi Arabia, call 997 for an ambulance in an emergency; during Hajj and Umrah, health centres and hospitals are available near the holy sites, and the Ministry of Health information line is 937.
• Intravenous fluids may be needed for severe dehydration, and stool tests or blood tests are done if you are very unwell.
• Travel insurance and a copy of your medical summary help with care abroad; carry the contact of your own gastroenterologist.
• Elective endoscopy or procedures should be planned for after, not just before, a major trip; ask your doctor.