Mahmoud Natty, Naheen Shah and Thushara Dassanayake introduce a new patient information leaflet for Muslim adults living with CKD, aligning clinical nutrition advice with Islamic principles.
Chronic kidney disease (CKD) is a significant and growing public health challenge in the UK. An estimated 3.5 million adults – around 7.2% of the population – live with CKD, and as many as one million more remain undiagnosed. Often silent in its early stages, CKD is frequently detected late, particularly in communities facing barriers to healthcare access.
These burdens are not shared equally. Individuals from Black, Asian and minority ethnic backgrounds face a disproportionately high risk of CKD, primarily due to increased prevalence of hypertension and type 2 diabetes. Socioeconomic disadvantage, cultural and linguistic barriers and a well-documented history of mistrust between underserved communities and healthcare services further compound disparities in diagnosis, management and outcomes.
As specialist renal dietitians working in diverse parts of London, we’ve seen these challenges first-hand. Standard dietary advice, however well evidenced, often overlooks the cultural and spiritual context in which people live, eat and heal. For people living with CKD of Muslim faith in particular, typical CKD resources may ignore deeply held beliefs, important traditional foods and key religious practices like Ramadan fasting.
In this context, culturally tailored dietary resources are not simply helpful – they are essential. They support:
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Relevance – reflecting real lives, cultural foodways and religious practices
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Empowerment – enabling self-management grounded in faith and identity
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Equity – addressing disparities in access to trusted, appropriate guidance
Why the Sunnah Diet Information Leaflet is needed
For many Muslims, food and faith are inseparable. Islam offers specific teachings – through the Sunnah (way and practices) of the Prophet Muhammad (peace be upon him) – that encompass how, what and even why one eats. Foods like dates, olives, barley, honey, black seeds and figs are frequently referenced in hadith (Prophetic actions and sayings) and are commonly consumed during religious observances.
However, these foods can raise nutritional concerns in CKD management, particularly regarding potassium, phosphate or fluid content. Without sensitive and respectful communication, Muslim patients may feel forced to choose between medical advice and religious devotion – a choice one would prefer not to make.
Additionally, fasting during Ramadan presents challenges. For many people living with CKD, prolonged fasting without hydration or medication can be risky. But a generic ‘do not fast’ message often lacks empathy or theological nuance, leading to distress and disengagement.
Our patients needed a tool that not only provided accurate renal dietary guidance but also honoured their beliefs. Thus, the Sunnah Diet Sheet for Renal Patients was born.
This patient information leaflet can be used all throughout the year and not exclusively for Muslim or renal patients, but it was created with a Muslim renal patient in mind.
What is the Sunnah Information Leaflet?
The Sunnah patient information leaflet is designed for Muslim adults living with CKD. It aligns clinical nutrition advice with Islamic principles, creating a bridge between best practice and personal belief.
What does it include?
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Nutritional guidance on key Sunnah foods
Including potassium and phosphate content, appropriate portioning and religious context
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Faith-sensitive advice for fasting
Covering exemptions, safety considerations and spiritual alternatives if fasting is medically unsafe
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Culturally relevant information on hydration, salt and physical activity
Grounded in both renal guidelines and Prophetic teachings about moderation and wellbeing
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Spiritually affirming messages
Reassuring patients that they can follow their faith while managing their condition safely
This isn’t a resource that tells patients what they can’t do. Instead, it helps them understand how they can live well with CKD while honouring their faith.
The resource was conceptualised by Mahmoud Natty and Naheen Shah, together setting out to design something that felt both professional and personal.
As practising Muslims, we had an insider’s understanding of the cultural and spiritual significance of the foods and practices we were discussing. This lived experience shaped not only the content but also the tone of the resource – respectful, inclusive and empowering.
We were guided by several key pillars during development:
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Faith leader consultation
We engaged with Imams and researched hadiths to ensure every reference to Sunnah foods was grounded in sahih (authentic) sources. This ensured spiritual integrity alongside clinical accuracy
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Patient and public involvement
We invited input from Muslim people living with CKD and community members. Though engagement varied, the feedback we received helped refine the language and emphasis of the leaflet – particularly around the emotional and spiritual complexities of Ramadan
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Professional review
Colleagues from the renal dietetics community reviewed the draft versions, offering both clinical and cultural insights. Their feedback affirmed the value of the resource in practice and strengthened its utility across diverse settings
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Kidney Dietitian Specialist Group (KDSG) endorsement
The KDSG supported the project throughout its journey by inviting Muslim dietitians to join the project at various stages, reviewing draft versions and endorsing, promoting and hosting the final leaflet on their BDA webpage to maximise accessibility. This endorsement was a key step in ensuring the resource’s national visibility and credibility
Faith and food: a complementary approach
A common misconception is that faith and clinical advice are in tension. The Sunnah Diet Information Leaflet demonstrates the opposite: faith can enhance health engagement and dietary advice can honour faith.
Consider these examples from the resource:
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Dates – often eaten for breakfast – are explained as spiritually valuable but potassium-rich. Patients are guided on portion size and frequency
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Salt intake – patients are shown how Islamic teachings already promote moderation, reinforcing clinical advice using familiar language and shared values
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Fasting – rather than simply advising against it, the sheet includes references to exemptions and offers spiritual alternatives such as feeding the poor – options patients found emotionally and religiously fulfilling
In feedback, patients shared that the leaflet “finally speaks our language” – not only in words, but in spirit.
Outcomes and impact
Since its endorsement, the Sunnah Diet Information Leaflet has been positively received by both patients and professionals. Our multidisciplinary teams (MDTs) report greater confidence in discussing fasting and traditional foods with Muslim patients. Patients express relief and appreciation for having their values acknowledged in their care.
A model of EDI in practice
This project is a tangible example of how equity, diversity and inclusion (EDI) can be realised in clinical practice. It illustrates the value of embedding EDI in recruitment, leadership and resource design across the NHS.
When dietitians reflect the communities they serve, they are more likely to bring community capital and natural cultural competence to their roles. This can facilitate deeper empathy, greater trust and more culturally sensitive care. In our case, it enabled us to translate years of professional knowledge into a resource that truly resonates with our patients.
Healthcare needs to move beyond the one-sizefits- all approach. Identity – including religious identity – matters in health behaviour, health beliefs and health outcomes.
Looking forward: next steps for inclusive dietetics
The Sunnah Diet Information Leaflet is more than a leaflet – it’s a blueprint for culturally responsive care. It reminds us that true patient-centred practice means more than tailoring nutrient targets; it means understanding the full picture of a person’s life.
We hope this project will inspire others to:
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Develop similar resources for other faiths, cultures and dietary needs
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Engage communities in resource design from the outset
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Advocate for more inclusive tools and training within dietetics
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Recruit and empower diverse voices in healthcare leadership
This is not the work of tomorrow — it is the work of now. Health inequalities are real, present, and addressable. Dietitians are uniquely placed to make an impact to change this.
Final reflections
Creating this resource has been one of the most rewarding projects of our careers. It combined everything we value in our profession: evidencebased practice, community engagement, cultural humility and advocacy for health equity.
When culture meets clinical, the result is more than better patient information leaflets. It’s better care, better relationships and, ultimately, better health.