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Marzban A. The Role of Hydration and Nutrition in Preventing Heat Exhaustion among Arbaeen Pilgrims. JNFS 2025; 10 (4) :484-485
URL: http://jnfs.ssu.ac.ir/article-1-1327-en.html
URL: http://jnfs.ssu.ac.ir/article-1-1327-en.html
Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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The Role of Hydration and Nutrition in Preventing Heat Exhaustion among Arbaeen Pilgrims
Ameneh Marzban; PhD*1
1 Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Ameneh Marzban; PhD*1
1 Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| ARTICLE INFO | ||
| EDITORIAL ARTICLE | *Corresponding author amenemarzban@yahoo.com Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. Postal code: 1449614535 Tel: +98 9172458896 |
|
| Article history: Received: 25 Apr 2025 Revised: 18 Jun 2025 Accepted: 21 Jul 2025 |
Dear Editor
The Arbaeen pilgrimage, one of the largest religious gatherings, exposes millions of participants to extreme physical and environmental challenges (Yousefi and Hasani, 2024). Among the most pressing health concerns is heat exhaustion, caused by prolonged exposure to high temperatures, physical exertion, and inadequate fluid intake. While environmental factors contribute to this condition, proper hydration and nutrition play a crucial role in mitigating risks (Moulaei et al., 2024). This letter highlights the importance of hydration and nutrition in preventing heat exhaustion among Arbaeen pilgrims and proposes practical interventions to enhance their safety.
Hydration and heat exhaustion
Hydration is essential for thermoregulation and endurance during long-distance walking. Many pilgrims, due to the rigorous nature of the journey, neglect adequate water intake (Lee et al., 2022). Dehydration reduces sweating efficiency, leading to increased core temperature, dizziness, muscle cramps, and even heatstroke. Additionally, dehydration impairs cognitive function, Heightening risks to fatigue and confusion in crowded pilgrimage routes (Kolivand et al., 2025).
To combat dehydration, hydration stations should be strategically placed along pilgrimage routes (Alfiah et al., 2023). Water distribution efforts, supported by volunteers and health organizations, can significantly reduce dehydration risks. Educating pilgrims on the importance of consuming electrolyte-rich beverages, such as oral rehydration solutions, can further enhance their ability to withstand extreme heat and physical exertion (Kolivand et al., 2025).
Nutrition and heat stress management
Proper nutrition maintains optimal energy levels and minimizes physiological strain caused by heat. Many pilgrims rely on processed, high-calorie foods due to convenience, but such choices can worsen hydration status and increase susceptibility to heat exhaustion (Moulaei et al., 2024). Salty foods contribute to excessive sodium intake, leading to increased thirst and fluid imbalance. Conversely, consuming nutrient-dense foods rich in water content, such as fruits and vegetables, supports hydration and improves stamina (Alfiah et al., 2023).
A well-balanced diet during the pilgrimage should include
Water-rich fruits and vegetables such as cucumbers, oranges, and watermelons (Yousefi and Hasani, 2024). Whole grains and lean proteins to maintain energy levels without excessive metabolic strain (Moulaei et al., 2024). Electrolyte sources such as bananas and yogurt to support muscle function and cramps prevention (Alfiah et al., 2023). Avoidance of high-sugar and caffeine-containing beverages that may contribute to dehydration (Yousefi and Hasani, 2024). Community-based food distribution programs should incorporate healthier meal options rather than relying on traditional high-fat and carbohydrate-heavy foods (Lee et al., 2022). Public health initiatives should promote awareness regarding dietary choices that positively impact physical endurance and heat tolerance (Moulaei et al., 2024).
Implementation strategies
Preventing heat exhaustion through hydration and nutrition requires collaboration among religious organizers, health authorities, volunteers, and local governments (Lee et al., 2022). Key strategies include:
The Arbaeen pilgrimage, one of the largest religious gatherings, exposes millions of participants to extreme physical and environmental challenges (Yousefi and Hasani, 2024). Among the most pressing health concerns is heat exhaustion, caused by prolonged exposure to high temperatures, physical exertion, and inadequate fluid intake. While environmental factors contribute to this condition, proper hydration and nutrition play a crucial role in mitigating risks (Moulaei et al., 2024). This letter highlights the importance of hydration and nutrition in preventing heat exhaustion among Arbaeen pilgrims and proposes practical interventions to enhance their safety.
Hydration and heat exhaustion
Hydration is essential for thermoregulation and endurance during long-distance walking. Many pilgrims, due to the rigorous nature of the journey, neglect adequate water intake (Lee et al., 2022). Dehydration reduces sweating efficiency, leading to increased core temperature, dizziness, muscle cramps, and even heatstroke. Additionally, dehydration impairs cognitive function, Heightening risks to fatigue and confusion in crowded pilgrimage routes (Kolivand et al., 2025).
To combat dehydration, hydration stations should be strategically placed along pilgrimage routes (Alfiah et al., 2023). Water distribution efforts, supported by volunteers and health organizations, can significantly reduce dehydration risks. Educating pilgrims on the importance of consuming electrolyte-rich beverages, such as oral rehydration solutions, can further enhance their ability to withstand extreme heat and physical exertion (Kolivand et al., 2025).
Nutrition and heat stress management
Proper nutrition maintains optimal energy levels and minimizes physiological strain caused by heat. Many pilgrims rely on processed, high-calorie foods due to convenience, but such choices can worsen hydration status and increase susceptibility to heat exhaustion (Moulaei et al., 2024). Salty foods contribute to excessive sodium intake, leading to increased thirst and fluid imbalance. Conversely, consuming nutrient-dense foods rich in water content, such as fruits and vegetables, supports hydration and improves stamina (Alfiah et al., 2023).
A well-balanced diet during the pilgrimage should include
Water-rich fruits and vegetables such as cucumbers, oranges, and watermelons (Yousefi and Hasani, 2024). Whole grains and lean proteins to maintain energy levels without excessive metabolic strain (Moulaei et al., 2024). Electrolyte sources such as bananas and yogurt to support muscle function and cramps prevention (Alfiah et al., 2023). Avoidance of high-sugar and caffeine-containing beverages that may contribute to dehydration (Yousefi and Hasani, 2024). Community-based food distribution programs should incorporate healthier meal options rather than relying on traditional high-fat and carbohydrate-heavy foods (Lee et al., 2022). Public health initiatives should promote awareness regarding dietary choices that positively impact physical endurance and heat tolerance (Moulaei et al., 2024).
Implementation strategies
Preventing heat exhaustion through hydration and nutrition requires collaboration among religious organizers, health authorities, volunteers, and local governments (Lee et al., 2022). Key strategies include:
- Establishing hydration stations along pilgrimage routes (Yousefi and Hasani, 2024).
- Distributing electrolyte-rich beverages and educating pilgrims on hydration needs (Kolivand et al., 2025).
- Encouraging the availability of nutrient-dense food options (Alfiah et al., 2023).
- Launching awareness campaigns on dietary choices that enhance heat tolerance (Yousefi and Hasani, 2024).
By prioritizing hydration and nutrition, Arbaeen pilgrims can significantly reduce the risk of heat exhaustion, ensuring a safer and more fulfilling spiritual journey.
References
Alfiah A, Hapsari RAF & Wulandari E 2023. Analysis of food consumed by Indonesian moslem Hajj Pilgrims: Complete and incomplete nutrition. Avicenna medical journal. 4 (2): 31-40.
Kolivand P, Moslehi S, Marzban A, Bastami M & Sayadi H 2025. Investigating the risk perception of Arbaeen Pilgrims regarding heat stroke. Trauma monthly. 30 (1): 1346-1352.
Lee JK, Tan B, Ogden HB, Chapman S & Sawka MN 2022. Exertional heat stroke: nutritional considerations. Experimental physiology. 107 (10): 1122-1135.
Moulaei K, Bastaminejad S & Haghdoost A 2024. Health challenges and facilitators of arbaeen pilgrimage: a scoping review. BMC public health. 24 (1): 132.
Yousefi M & Hasani M 2024. Nutrition in Arbaeen and mass gatherings. Quran and medicine. 9 (1): 131-140.
References
Alfiah A, Hapsari RAF & Wulandari E 2023. Analysis of food consumed by Indonesian moslem Hajj Pilgrims: Complete and incomplete nutrition. Avicenna medical journal. 4 (2): 31-40.
Kolivand P, Moslehi S, Marzban A, Bastami M & Sayadi H 2025. Investigating the risk perception of Arbaeen Pilgrims regarding heat stroke. Trauma monthly. 30 (1): 1346-1352.
Lee JK, Tan B, Ogden HB, Chapman S & Sawka MN 2022. Exertional heat stroke: nutritional considerations. Experimental physiology. 107 (10): 1122-1135.
Moulaei K, Bastaminejad S & Haghdoost A 2024. Health challenges and facilitators of arbaeen pilgrimage: a scoping review. BMC public health. 24 (1): 132.
Yousefi M & Hasani M 2024. Nutrition in Arbaeen and mass gatherings. Quran and medicine. 9 (1): 131-140.
Type of article: letter to the editor |
Subject:
public specific
Received: 2025/04/25 | Published: 2025/11/19 | ePublished: 2025/11/19
Received: 2025/04/25 | Published: 2025/11/19 | ePublished: 2025/11/19
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