Ramadan and Sport: Minimizing Effects Upon the Observant Athlete

Abstract

The intermittent fasting of Ramadan could affect various aspects of body physiology and biochemistry important to athletic success. Much of the available information on this subject has been collected from sedentary subjects or low-level competitors, often without well matched controls. Other issues requiring clearer definition include the duration of fasting, the local environment, the timing of observations, and changes in training, diet and sleep patterns. Sleep may be shortened or made good with daytime naps. Circadian rhythms of temperature, metabolism, hormonal secretions and physical performance may be disrupted and incidental activities curtailed. Disturbances of psychomotor performance include daytime sleepiness, impaired vigilance and slower reactions. Food intake is limited to night-time meals. Sedentary individuals sometimes exploit Ramadan to reduce body fat stores. Well disciplined athletes usually maintain energy balance unless daily energy expenditures are very high. Protein intake must allow for gluconeogenesis, and provide quality protein ingested around training times. Blood sugar levels are likely to fall over a long and active day, even if morning glycogen reserves are maximized. Metabolism of fat should be encouraged, beginning prior to Ramadan; inclusion of fat in the pre-dawn meal also slows gastric emptying. Daytime fluid depletion is inevitable if athletes exercise in the heat, but the immediate deficit can usually be made good at night. Some studies show an initial fluid depletion, with recovery as Ramadan continues, possibly reflecting changes in urine and sweat production. Top athletes can maintain training throughout Ramadan, although coaches sometimes reduce demands through a pre-competitive tapering of effort. Late night or early morning training requires negotiation with players who are not observing Ramadan, and dietary adjustments to maintain optimal plasma amino acid levels when training. Performance of repeated anaerobic exercise is impaired, but aerobic power and muscular strength show little change during Ramadan. Ratings of fatigue are increased, and vigilance and reaction times are impaired, particularly during the afternoon. Medical issues during Ramadan are few. Athletes with diabetes mellitus should seek a medical exemption from fasting, and prescribed drug schedules should be carefully maintained. There is no major increase of injury rates, but competitors may have difficulty in producing urine for doping controls. Logical measures to minimize the effects of Ramadan include the optimization of mood state, maintenance of training, minimization of sleep loss, appropriate adjustments of diet, and the monitoring of competitors for chronic dehydration. Future research should concentrate on the changes observed in top athletes, particularly women, with data collected in the late afternoon after a known period of fasting in a well defined environment. It will be important to ensure that the lifestyle of those studied has been optimized. Implications of chronic dehydration for...

Effects of Ramadan Observance on Dietary Intake and Body Composition of Adolescent Athletes: Systematic Review and Meta-Analysis

“…The contradictory findings of our meta-analysis and those conducted on sedentary individuals [ 27 , 28 , 29 , 30 , 31 ] could be explained by differences in the quantity and quality of food intake, water intake, age, gender and energy expenditure. Moreover, some sedentary individuals use Ramadan in an attempt to reduce body fat content [ 25 ].…”

“…To date, most literature reviews synthesizing the effect of Ramadan observance on body mass and body composition of athletes are narrative in type [ 24 , 25 , 26 , 27 ] and require updating. The only systematic reviews and meta-analysis conducted on this topic have focused on sedentary individuals [ 28 , 29 , 30 , 31 ].…”

Poorer Intermittent Sprints Performance in Ramadan-Fasted Muslim Footballers despite Controlling for Pre-Exercise Dietary Intake, Sleep and Training Load

“…Players in the present study have been observing Ramadan fast annually for many years. The individual’s prior experience as to how he feels when exercising in the Ramadan-fasted state (presumably negative experience since exercise in the Ramadan-fasted state is physiologically challenging [ 1 , 2 ]) would have played a contributory role or even reinforced the nocebo response. Thus the players’ own expectations of a poorer performance is deemed as the primary cause of the relatively slower sprints in the RAM trial.…”

“…The recent reviews on the effects of Ramadan fasting and exercise performance indicated mixed findings [ 1 , 2 ], with some studies indicating an adverse impact and while some investigations indicating no differences in the exercise performances performed in Ramadan-fasted vs. performed in the non-fasted state. A potential reason for the diverse findings is that in many of these studies there was the lack of control for variables such as the subjects’ pre-exercise dietary intake, sleep hours, and training load.…”

The effect of fasting during Ramadan on parameters of the haematological and steroidal modules of the athletes biological passport – a pilot study

“…[6,7] The mentioned restrictions in fluid uptake could possibly affect athletes' performance but could also lead to a significant concentration of blood and urine and subsequently to an increase of the concentration-based variables. [8] While training times usually change to the evening hours (after Iftar), Doping controls, especially by international federations, are mostly taken during the day (morning to evening) which would be exactly in the time of fasting. Thus the diurnal variation of anti-doping parameters could be disturbed by the change in the timings of food and fluid uptake and could affect the haematological and steroid parameters of the ABP.…”