Effects of Ramadan intermittent fasting on middle-distance running performance in well-trained runners

Effects of Neuromuscular Training Applied During Ramadan on Physical Fitness and Injury Prevention in Highly-Trained Male Youth Soccer Players

BACKGROUND

The intermittent fasting period of Ramadan is associated with reductions in training volumes and intensities to maintain physical fitness levels and reduce injury occurrence. Accordingly, it might be beneficial to include neuromuscular training (NMT) applied during Ramadan to avoid detraining and promote injury prevention in soccer players. This study aimed to analyze NMT effects on physical fitness and injury prevention during the Ramadan fasting period in young soccer players.

METHODS

Forty young highly-trained male soccer players (U17/U19) were randomly assigned to a NMT (n = 20) or a traditional soccer-specific training group (TT, n = 20). NMT was conducted during Ramadan, lasted four weeks, and included two weekly sessions with exercises to promote muscle strength, power (plyometrics), speed, balance. TT contents were similar to the training period before Ramadan and comprised two weekly sessions including endurance and sprint-based exercises. The training volume was similar between groups. Body composition (body fat), linear sprint (5-m, 10-m, 30-m sprint), and change-of-direction (CoD) speed (T-test with and without ball), muscle power (squat [SJ], countermovement jump [CMJ]), peak isokinetic torque of the knee flexors, extensors, and soccer-specific performance (Loughborough soccer passing test [LSPT], Yoyo intermittent test level 1 [YYIRT L1], repeated-shuttle-sprint ability test [RSSA]) were determined before and after the Ramadan period. The overall injury rate per 1000 h of exposure (training, match) was carried out during and after the four-week Ramadan period and until the end of the soccer season (overall 8 weeks).

RESULTS

No significant between group baseline differences were noted. Group-by-time interactions were significant for most assessed variables (0.001 < p < 0.004, 0.22 < d < 0.76) in favor of NMT. Variations in body mass, body fat, and BMI determined by post-hoc tests indicated significant decreases in NMT but not TT (0.026 < p < 0.047, 0.65 < d < 0.73). Moreover, post-hoc tests showed that NMT provided linear and COD speed improvements, enhanced muscle power (SJ, CMJ) and improved soccer-specific performance (p < 0.001, 0.71 < d < 2.53). Additionally, post-hoc tests revealed significant isokinetic strength increases in favor of NMT for all peak torque variables (0.015 < p < 0.049, 0.64 < d < 0.81). The overall injury rate was significantly lower in NMT (8.00/1000 h exposure) compared to TT (13.33/1000 h exposure) (p = 0.049; d = 0.66).

CONCLUSIONS

Findings suggest that a four-week NMT conducted during Ramadan fasting helped to maintain or even improve measures of physical fitness including isokinetic strength. In addition, significant NMT-related reductions in injury occurrence were noted in highly-trained young male soccer players.

Effects of intermittent fasting combined with physical exercise on cardiometabolic outcomes: systematic review and meta-analysis of clinical studies

CONTEXT

Different intermittent fasting (IF) protocols have been proven to be efficient in improving cardiometabolic markers, but further research is needed to examine whether or not combining IF regimens plus physical exercise is superior to control diets (ie, nonfasting eating) plus physical exercise in this setting.

OBJECTIVE

The aim of this study was to determine whether or not combining IF plus exercise interventions is more favorable than a control diet plus exercise for improving cardiometabolic health outcomes.

DATA SOURCE

PubMed, Scopus, and Web of Science were comprehensively searched until April 2023.

DATA EXTRACTION

Electronic databases were searched for clinical trials that determined the effect of IF plus exercise vs a control diet plus exercise on body weight, lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol), and systolic and diastolic blood pressure (SBP and DBP, respectively). Analyses were conducted for IF plus exercise vs a nonfasting diet plus exercise to calculate weighted mean differences (WMDs).

DATA ANALYSIS

The meta-analysis included a total of 14 studies, with a total sample of 360 adults with or without obesity. The duration ranged from 4 to 52 weeks. IF plus exercise decreased body weight (WMD = -1.83 kg; P = 0.001), LDL (WMD = -5.35 mg/dL; P = 0.03), and SBP (WMD = -2.99 mm Hg; P = 0.003) significantly more than a control diet plus exercise. HDL (WMD = 1.57 mg/dL; P = 0.4) and total cholesterol (WMD = -2.24 mg/dL; P = 0.3) did not change significantly for IF plus exercise vs a control diet plus exercise, but there was a trend for reducing triglycerides (WMD = -13.13 mg/dL; P = 0.07) and DBP (WMD = 2.13 mm Hg; P = 0.05), which shows clinical magnitude.

CONCLUSION

IF plus exercise improved some cardiometabolic outcomes (body weight, blood pressure, and lipid profile) compared with a control diet plus exercise.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42023423878.

The Effect of Ramadan Fasting on the Coping Strategies Used by Male Footballers Affiliated with the Tunisian First Professional League

This study aimed to discover coping strategies among professional male Tunisian footballers during the Ramadan 2021 fast. One hundred and eighty footballers who belong to twelve Tunisian professional clubs (age: 25.54 ± 4.41 years, weight: 77.19 ± 5.99 kg; height: 180.54 ± 7.28 cm; BMI: 23.67 ± 0.58) were tested during three sessions: one week before Ramadan, during the last week of Ramadan, and one week after Ramadan 2021. The footballers completed the Arabic version of the Inventory of Coping Strategies for Competitive Sport (ICSCS) scale in each session. Responses were recorded retrospectively one hour after a competition. The analysis of variance revealed a significant effect of Ramadan fasting on the adaptation profile of footballers (F = 3.51; p-value = 0.0001). Before and after Ramadan fasting, active coping dominates the adaptation profile of Tunisian professional footballers. During Ramadan, footballers use an irregular and unbalanced coping profile. The lifestyle change induced by the Ramadan fast significantly and negatively affected the adaptation profile of Tunisian professional footballers. Under the effect of the month of Ramadan, footballers developed a different coping profile from that of normal months.

Dietary Intake and Body Composition During Ramadan in Athletes: A Systematic Review and Meta-Analysis With Meta-Regression

The aim of this research was to evaluate the effect of Ramadan observance on dietary intake and body composition in adult athletes. This was a systematic review and meta-analysis. Data sources used were PubMed, Web of Science, Scopus, and Taylor and Francis. Eligibility criteria for selecting studies were as follows: single-group, pre-/post-Ramadan, with or without control group, conducted in athletes aged ≥19 years training at least twice a week, and published in any language before August 25, 2021. Studies assessing dietary intake and/or body composition were deemed eligible. The methodological quality of studies was assessed using QualSyst. Nine studies evaluated dietary intake; 4 of these were rated as strong quality and the remaining as moderate. Of the 17 selected studies evaluating body composition, 7 were of strong quality and the remaining 10 were rated as moderate. Compared to pre-Ramadan, energy (number of studies, K = 7; number of participants, N = 78; g = -0.781; 95% confidence interval [CI], -1.416 to -0.145; p = 0.016), carbohydrate (K = 5; N = 50; g = -1.643; 95% CI, -2.949 to -0.336; p = 0.014), and water (K = 4; N = 39; g = -1.081; 95% CI, -1.371 to -0.790; p = 0.000) intakes decreased during Ramadan. However, fat (K = 5; N = 50; g = -0.472; 95% CI, -1.085 to 0.140; p = 0.131) and protein (K = 5; N = 60; g = -0.574; 95% CI, -1.213 to -0.066; p = 0.079) intakes remained unchanged. Compared to pre-Ramadan, body mass (K = 16; N = 131; g = -0.262; 95% CI, -0.427 to -0.097; p = 0.002) and body fat percentage (K = 8; N = 81; g = -0.197; 95% CI, -0.355 to -0.040; p = 0.014) decreased in the fourth week of Ramadan. Lean body mass did not change during Ramadan (K = 4; N = 45; g = -0.047; 95% CI, -0.257 to 0.162; p = 0.658). Carbohydrate and total water intake decreased with the observance of Ramadan, but fat and protein intake were unchanged. Continued training of athletes during Ramadan was associated with a decreased body mass and body fat percentage, but not lean body mass, toward the end of the fasting month. Key pointsRamadan fasting decreases body mass and body fat percentage of athletes, but not lean body mass.Longer durations of fasting could provoke more pronounced decrements in body mass.Carbohydrate and total water intake decreased during Ramadan in athletes.Future studies, with greater methodological rigor, are required to better discern changes in dietary intake and body composition during Ramadan. Supplemental data for this article is available online at https://doi.org/10.1080/07315724.2021.2000902 .

Longer Nap Duration During Ramadan Observance Positively Impacts 5-m Shuttle Run Test Performance Performed in the Afternoon

It is well-documented that changes in the rhythm of life during Ramadan affect sleep schedules (i.e., interruption of night sleep patterns) and are likely to have negative effects on physical and cognitive performances. The aim of the present study was to examine the effect of different naps opportunities' durations during Ramadan on performance of short-duration repetitive maximal exercise and perception of effort. Fifteen physically active men (age: 21 ± 3 years, height: 177 ± 6 cm, body-mass: 73 ± 10 kg) performed a 6 × 30-s shuttle run test after a 25-min nap (N25), a 45-min nap (N45), and in a no-nap condition (NN) during three experimental periods: ∼2 weeks before Ramadan (BR), the last ten days of Ramadan (ER), and ∼3 weeks after Ramadan (AR). During the shuttle run test performed in the late afternoon, the greatest distance (GD), the total distance (TD) and a fatigue index (FI) were assessed. Rating of perceived exertion (RPE) was determined after each 30-s effort. Dietary intake and sleep quality were assessed in each of the three periods. Compared to BR, GD and TD were lower in the ER testing period (p = 0.005; d = 0.54) but returned to BR levels in the AR period. During ER, carbohydrate intake was lower (p = 0.04; d = 0.2), and sleep duration and sleep quality were reduced (d = 0.27 and 0.54, respectively), although other aspects of dietary intake and sleep pattern were not affected. Compared to NN, GD and TD were higher after N25 (d = 0.57 and 0.34, respectively) and N45 (d = 0.93 and 0.88 respectively). RPE was lower in N45 (p = 0.035, d = 0.84). N45 resulted in higher TD (p = 0.021, d = 0.13) and lower RPE (p = 0.004; d = 0.57) compared to N25 during ER. Taking a daytime nap benefits subsequent performance in a shuttle run test, whether sleep the previous night was normal (as in BR) or compromised (as in ER). The benefits of napping were greater after a 45-min nap opportunity than after a 25-min nap opportunity.

The effect of Ramadan fasting on the morning-evening difference in team-handball-related short-term maximal physical performances in elite female team-handball players

The combined effect of Ramadan fasting and the time of theday on the physical performance of team-handball players has not yet been fully investigated. This study investigated the effects of Ramadan fasting on the morning-evening difference in team-handball-related short-term maximal physical performance. With acounterbalanced study design, 15 elite female team-handball players underwent the hand grip (HG), ball throwing velocity (BTV), modified agility T-test (MAT), and repeated shuttle-sprint and jump ability (RSSJA) tests at 07:00 h and 17:00 h, one week before Ramadan (BR), and during thesecond (SWR) and fourth week of Ramadan (4WR). The oral temperature (OT) was monitored prior to exercise and the ratings of perceived exertion (RPE) scale were obtained after RSSJA. The results showed that the time of theday had an effect on OT under all conditions. The HG, BTV, and MAT test performances were higher in the evening than in the morning BR (P< .001, P< .05, and P< .001, respectively). However, the diurnal variation noted in the HG and MAT tests was reversed during the SWR and 4WR, while the BTV variation was blunted during the SWR and reversed during the 4WR. The best RSSJA performance was observed in the evening BR. However, for the best and mean sprint times, areversal of this diurnal variation was observed, which was blunted for the mean jump height and sprint time decrement during Ramadan. Moreover, RPE were influenced by the time of theday and the month of Ramadan. These findings suggest that the diurnal variation of team-handball-related short-term maximal physical performance may be reversed and/or blunted during Ramadan fasting.

Effects of Ramadan Fasting on Physical Performance: A Systematic Review with Meta-analysis

BACKGROUND

It is common that several athletes will fast while training or competing during Ramadan. There is currently no consensus on if or how this might affect physical performance.

OBJECTIVE

The aim was to conduct a systematic review combined with a meta-analysis to determine what are the effects of fasting during the month of Ramadan on physical performance.

METHODS

Three electronic databases were searched: PubMed, ScienceDirect, and Web of Science between from the earliest available date to May 2019. Two authors identified studies that evaluated the effects of Ramadan fasting on physical performance. Risk of bias was assessed using the Downs and Black methodological quality checklist. Pooled effects were reported as standardized mean differences (MDs) and 95% confidence intervals (CIs) using a random effects model.

RESULTS

A total of 11 studies met the inclusion criteria. Results revealed that Ramadan fasting had a deleterious effect on mean power and peak power during a Wingate and/or a repeated sprint test. In the morning, sprint performance was negatively affected by Ramadan fasting. Aerobic performance, strength, jump height, fatigue index, and total work were not affected by the intermittent fasting during the month of Ramadan.

CONCLUSIONS

The majority of physical performance parameters were not influenced by Ramadan fasting when tested either in the morning or in the afternoon. Athletes appear able to participate in competition in a fasted state with little impact on physical performance. Sleep and nutrition opportunities should be optimized to minimize likelihood of accumulating fatigue.

Efficacy of Popular Diets Applied by Endurance Athletes on Sports Performance: Beneficial or Detrimental? A Narrative Review

Endurance athletes need a regular and well-detailed nutrition program in order to fill their energy stores before training/racing, to provide nutritional support that will allow them to endure the harsh conditions during training/race, and to provide effective recovery after training/racing. Since exercise-related gastrointestinal symptoms can significantly affect performance, they also need to develop strategies to address these issues. All these factors force endurance athletes to constantly seek a better nutritional strategy. Therefore, several new dietary approaches have gained interest among endurance athletes in recent decades. This review provides a current perspective to five popular diet approaches: (a) vegetarian diets, (b) high-fat diets, (c) intermittent fasting diets, (d) gluten-free diet, and (e) low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diets. We reviewed scientific studies published from 1983 to January 2021 investigating the impact of these popular diets on the endurance performance and health aspects of endurance athletes. We also discuss all the beneficial and harmful aspects of these diets, and offer key suggestions for endurance athletes to consider when following these diets.

Ramadan Fasting During the COVID-19 Pandemic; Observance of Health, Nutrition and Exercise Criteria for Improving the Immune System

Fasting is one of the religious rituals of Muslims worldwide who refrain from eating foods and liquids every year during Ramadan. This year (2020), Ramadan is very different from previous years due to the outbreak of a terrible microscopic giant called coronavirus disease 2019 (COVID-19). The pandemic COVID-19 has made Ramadan very important this year because the virus has infected millions of people around the world and killed thousands, especially people with immunodeficiency. In dealing with COVID-19, maintaining good hygiene and supporting the immune system are effective, preventive approaches. Moderate exercise training and proper nutrition are the most important factors to support immune function. Lack of facilities, poor health and many traditions that lead to public community gatherings have made many Islamic countries susceptible to this dangerous virus. In such an unprecedented situation, there are many Muslims who doubt whether they can fast or not. Therefore, the proposal of usable exercise programs and effective nutritional strategies is imperative. In this study, we will look at the proposed health effects of fasting and its impact on the immune system, the effects of Ramadan intermittent fasting on resting values and responses of immunological/antioxidant biomarkers in elite and recreational athletes, together with the important health, nutrition, and exercise advice that fasting people need to follow in the event of a COVID-19 outbreak.

Does Ramadan Observance Affect Cardiorespiratory Capacity of Healthy Boys?

Studies raising the issue of the effects of Ramadan observance (RO) on boys' 6-min walk test (6MWT) data are rare. The studies, which did not include control groups of non-fasters, presented contradictory results. This study aimed to compare the 6MWT data (6-min walk distance [6MWD; m, %predicted], heart rate [HR; bpm, % of maximal predicted HR]), oxy-hemoglobin saturation (Oxy-sat; %), systolic and diastolic blood pressures (SBP and DBP, respectively; mmHg) determined at rest (_Rest and at the end _End of the test) of a group of 22 healthy fasting boys (age: 12 to 15 years) with an age-matched non-fasting group (n = 10). The 6MWTs were performed during three experimental conditions (ECs): Pre-Ramadan, Mid-Ramadan, and Post-Ramadan. The two groups' 6MWT data for each EC were compared, and repeated factorial analysis of variance (2 groups vs. 3 ECs) was performed. Both groups had similar values of 6MWD (m, %predicted), HR_Rest or HR_End (bpm, % of maximal predicted HR), Oxy-sat_Rest, Oxy-sat_End, SBP_Rest, and DBP_Rest during the three ECs. Compared to the non-fasting group, the fasting group had significantly higher SBP_End (121 ± 10 vs. 130 ± 11) and DBP_End (72 ± 6 vs. 78 ± 7) determined during the Mid-Ramadan EC. No significant interactive effects of the groups (2) vs. ECs (3) was found for the 6MWD (%predicted; p = .809), HR_Rest (%, p = .555), HR_End (%, p = .964), Oxy-sat_Rest (p = .336), Oxy-sat_End (p = .389), SBP_Rest (p = .708), SBP_End (p = .548), DBP_Rest (p = .277), and DBP_End (p = .096). To conclude, in boys, RO does not impact the 6MWD, HR, or Oxy-sat, but it has minimal impact on the SBP_End and DBP_End.

Mendonca G. Effects of Intermittent Fasting on Specific Exercise Performance Outcomes: A Systematic Review Including Meta-Analysis

Intermittent fasting (IF) has been studied in athletes during Ramadan and in those willing to decrease adiposity while maintaining or increasing lean body mass. The purpose of this systematic review was to summarize the effects of IF on performance outcomes. We searched peer-reviewed articles in the following databases: PubMed, Web of Science and Sport Discus (up to December 2019). Studies were selected if they included samples of adults (≥18 years), had an experimental or observational design, investigated IF (Ramadan and time-restricted feeding (TRF)), and included performance outcomes. Meta-analytical procedures were conducted when feasible. Twenty-eight articles met the eligibility criteria. Findings indicated that maximum oxygen uptake is significantly enhanced with TRF protocols (SMD = 1.32, p = 0.001), but reduced with Ramadan intermittent fasting (Ramadan IF; SMD = −2.20, p < 0.001). Additional effects of IF may be observed in body composition (body mass and fat mass). Non-significant effects were observed for muscle strength and anaerobic capacity. While Ramadan IF may lead to impairments in aerobic capacity, TRF may be effective for improving it. As there are few studies per performance outcome, more research is needed to move the field forward.

Exercise Training and Fasting: Current Insights

Fasting is defined as the abstinence from consuming food and/or beverages for different periods of time. Both traditional and modern healthcare systems recommend fasting as a therapeutic intervention for the management of several chronic, non-infectious diseases. Exercising during a fasting state increases lipolysis in adipose tissue while also stimulating peripheral fat oxidation, resulting in increased fat utilization and weight loss. A key focus of this review is to assess whether endurance training performed while fasting induces specific training adaptations, where increased fat oxidation improves long-term endurance levels. Fasting decreases body weight, lean body and fat content in both trained and untrained individuals. Several studies indicate a broader impact of fasting on metabolism, with effects on protein and glucose metabolism in sedentary and untrained subjects. However, there are conflicting data regarding the effects of fasting on glucose metabolism in highly trained athletes. The effects of fasting on physical performance indicators also remain unclear, with some reporting a decreased performance, while others found no significant effects. Differences in experimental design, severity of calorie restriction, duration, and participant characteristics could, at least in part, explain such discordant findings. Our review of the literature suggests that there is little evidence to support the notion of endurance training and fasting-mediated increases in fat oxidation, and we recommend that endurance athletes should avoid high intensity training while fasting.

The effects of Ramadan intermittent fasting on the underlying mechanisms of force production capacity during maximal isometric voluntary contraction

The aim of the present study was to investigate the effects of Ramadan intermittent fasting (RIF) on the underlying mechanisms of force production capacity during maximal voluntary isometric contraction (MVIC) using the superimposed twitch technique. Ten healthy male physical education students performed three MVIC of the knee extensor superimposed with nerve electrical stimulation during four testing phases: one week before Ramadan (BR), at the end of the first week of Ramadan (R-1), during the fourth week of Ramadan (R-4) and two weeks after Ramadan (AR). This study was performed during Ramadan 2016. MVIC values, voluntary activation level (VAL), potentiated resting twitch and electromyography signals were recorded during each MVIC. The French version of the Profile of Mood States questionnaire (POMS-f) was used to evaluate the subjective mood states in each testing session. The results showed that MVIC values (890.57 ± 67.90 vs. 816.46 ± 54.72 N) and VAL (87.73 ± 3.27 vs. 77.32 ± 7.87%) decreased at R-1 compared to BR (p < 0.001). However, the neuromuscular efficiency and the potentiated resting twitch remained unchanged during Ramadan (R). Results showed that depression (p < 0.01; 6.3 ± 1.57 vs. 4.7 ± 1.25), fatigue (p < 0.001; 9.2 ± 1.93 vs. 4.6 ± 2.01) and anxiety (p < 0.001; 6.4 ± 1.51 vs. 11.8 ± 1.23) scores of POMS-f were higher during R-1 compared to BR. In conclusion, RIF-related impairment of maximal muscle force seems to be related to nervous alterations of the VAL, whereas the RIF did not adversely affect peripheral mechanisms. Abbreviations' List: ANOVA: Analysis of variance; AR: After Ramadan; BMI: Body-mass index; BR: Before Ramadan; EMG: Electromyography; ER: End of Ramadan; MF: Mean frequency; M_max: Peak-to-peak M-wave amplitudes; MVIV: Maximal voluntary isometric contraction; NES: Nerve electrical stimulation; NME: Neuromuscular efficiency; POMS-f: French version of the Profile of Mood States questionnaire; R: Ramadan; R-1: First week of Ramadan; R-4: Fourth week of Ramadan; RF: Rectus femoris; RIF: Ramadan intermittent fasting; RMS: Root mean square; VAL: Voluntary activation level; VL: Vastus lateralis; VM: Vastus medialis.

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

This study examines the effects of Ramadan fasting on sprint performance during prolonged intermittent exercise in trained Muslim footballers, under controlled pre-exercise conditions. A within-group, cross-over study design with two non-fasted or Control trials performed before (i.e., CON1) and after (CON2) the Ramadan month, and with the Ramadan-fasted (RAM) trials performed within the Ramadan month. After familiarization, 14 players completed a modified 60-min (4 × 15-min exercise blocks interspersed with 3-min intervals) of the Loughborough Intermittent Shuttle Test (mLIST) of fixed speeds of walking, jogging, running, but with all-out effort sprints. During the interval periods, capillary blood glucose and blood lactate measures were taken, rectal and skin temperatures were recorded and maximal voluntary isometric contractions (MVIC) of the dominant leg and hand-grip were performed to provide some indication to the cause(s) of ‘fatigue’ during exercise. Players were provided with standardized 24-h pre-packed meals prior to all trials. Sleep hours were objectively assessed and perceived training loads were monitored and these were equivalent between RAM and CON trials. Sprint times throughout mLIST were significantly faster in both CON1 and CON2 as compared to RAM trials (all P < 0.017; d = small to moderate), and this poorer performance in RAM was observed as early as during the first 15-min of the mLIST. Blood markers, MVIC and thermoregulatory results were not substantially different between both CON and RAM trials. In conclusion, despite similarities in dietary intake, sleeping hours and training loads between conditions, results still indicate that Ramadan fasting had an adverse effect on prolonged intermittent performance. Nocebo effects plays a dominant role during exercise in the Ramadan-fasted state.

Effects of Ramadan intermittent fasting on North African children's heart rate and oxy-haemoglobin saturation at rest and during sub-maximal exercise

Aim:

To examine the effects of Ramadan intermittent fasting (RIF) on the heart rate (HR) and oxyhaemoglobin saturation levels (oxy-sat) of boys at rest and during a six-minute walking test (6MWT).

Methods:

Eighteen boys (age: 11.9 ± 0.8 years, height: 153.00 ± 8.93 cm, body mass: 55.4 ± 18.2 kg), who fasted the entire month of Ramadan in 2012 for the first time in their lives, were included. The experimental protocol comprised four testing phases: two weeks before Ramadan (pre-R), the end of the second week of Ramadan (R-2), the end of the fourth week of Ramadan (R-4), and 10 to 12 days after the end of Ramadan (post-R). During each phase, participants performed the 6MWT at approximately 15:00. HR (expressed as percentage of maximal predicted HR) and oxy-sat (%) were determined at rest and in each minute of the 6MWT.

Results:

R-4 HR values were lower than those of (1) pre-R (in the second minute), (2) R-2 (in the first and second minutes), and (3) post-R (in the first, second, fourth, fifth and sixth minutes). R-2 oxy-sat values were higher than those of pre-R (in the third minute) and those of post-R (in the fifth minute). Post-R oxy-sat values were lower than those of pre-R and R-4 in the fifth minute. These oxy-sat changes were not clinically significant since the difference was less than five points.

Conclusion:

In non-athletic children, their first RIF influenced their heart rate data but had a minimal effect on oxy-sat values.

Knowledge, beliefs and attitudes of Muslim footballers towards Ramadan fasting during the London 2012 Olympics: a cross-sectional study

OBJECTIVES

Muslims observe fasting during the month of Ramadan by abstaining from eating and drinking from dawn to sunset. Available literature shows that although several studies have been conducted on athletes to determine the effects of Ramadan fasting in terms of physical fitness and performance, little data are available regarding the knowledge, beliefs and attitudes of athletes (particularly footballers) towards Ramadan fasting during high-level competitions. This study explored the knowledge, beliefs and attitudes towards Ramadan fasting among football players participating in the London 2012 Olympics football tournament.

DESIGN

Cross-sectional study.

SETTINGS

Team training facility.

PARTICIPANTS

54 Muslim footballers participating in the London Olympics, 2012 OUTCOME MEASURES: Each participant was asked to complete a pre-validated structured questionnaire to assess knowledge, beliefs and attitudes regarding Ramadan fasting and their intention to fast during London 2012.

RESULTS

Of the 54 participating athletes, 21(39%) reported that they intended to fast during Ramadan, but not on a match day. This attitude differed across three teams interviewed -83%, 15% and 0%-showing cross-cultural variation. Overall, there was a lack of knowledge among footballers regarding the effects of Ramadan fasting on sleep and performance; around 30% of athletes gave incorrect responses. This knowledge was independent of their decision to fast on non-competition days (p>0.05).

CONCLUSIONS

This is the first study to describe the knowledge, beliefs and attitudes towards Ramadan fasting among athletes from Muslim-majority countries participating in a high-level competition. Appropriate knowledge can ensure optimum performance for athletes during Ramadan fasting. Coaches, family members and friends also in possession of this knowledge can provide moral support to the players.

Ramadan fasting does not adversely affect neuromuscular performances and reaction times in trained karate athletes

Background

The present study aimed to investigate the concomitant effects of Ramadan intermittent fast (RIF) and muscle fatigue on neuromuscular performances and reaction times in young trained athletes.

Methods

Eight karate players (17.2 ± 0.5 years) were tested on three sessions: during a control period (S1: one week before Ramadan), and during the first (S2) and the fourth week of RIF (S3). Dietary intake and anthropometric measurements were assessed before each session. During each test session, participants performed maximal voluntary isometric contractions (MVC) and a submaximal contraction at 75 % MVC until exhaustion (T_lim) of the right elbow flexors. Surface electromyography was recorded from biceps brachii muscle during MVC and T_lim. Simple (SRT) and choice (CRT) reaction times were evaluated at rest and just after T_lim in a random order.

Results

The total daily energy (S2: +19.5 %, p < 0.05; S3: +27.4 %, p < 0.01) and water (S2: +26.8 %, p < 0.01; S3: +23.2 %, p < 0.05) intake were significantly increased during RIF. However, neither body mass nor body mass index was altered by RIF (F_(2,14) = 0.80, p = 0.47 and F_(2,14) = 0.78, p = 0.48, respectively). In addition, T_lim (F_(2,14) = 2.53, p = 0.12), MVC (F_(2,14) = 0.51, p = 0.61) and associated electrical activity (F_(2,14) = 0.13, p = 0.88) as well as neuromuscular efficiency (F_(2,14) = 0.27, p = 0.76) were maintained during RIF. Moreover, neither SRT nor CRT was affected by RIF (F_(2,14) = 1.82, p = 0.19 and F_(2,14) = 0.26, p = 0.78, respectively) or neuromuscular fatigue (F_(1,7) = 0.0002, p = 0.98 and F_(1,7) = 3.78, p = 0.09, respectively).

Conclusions

The present results showed that RIF did not adversely affect the neuromuscular performances and anthropometric parameters of elite karate athletes who were undertaking their usual training schedule. In addition, neither RIF nor neuromuscular fatigue poorly affects reaction times in elite karate athletes.

Effects of Ramadan on physical capacities of North African boys fasting for the first time

INTRODUCTION

Most of the literature related to the effects of Ramadan fasting on physical performance has focused on adults, and only three studies have examined its impact on children's physical performance.

AIMS

To examine the effects of Ramadan fasting on first-time fasting boys' performance in short-term explosive exercises [vertical and horizontal jump tests (VJT and HJT), 20-m and 30-m sprints and medicine-ball throw (MBT)], as well as in sub-maximal endurance [6-min walking distance (6MWD) measured during the 6-min walk test (6MWT)].

METHODS

Eighteen Tunisian boys [mean±standard deviation (SD) of age and body mass (BM): 11.9±0.8 y and 55.4±18.2 kg, respectively] were included. The experimental design comprised four testing phases: 2-weeks before Ramadan (BR), the end of the second week (R2) and the fourth week (R4) of Ramadan, and 10-12 days after the end of Ramadan (AR). At each phase, boys performed two test sessions in the afternoon (15:00-17:00 h) interrupted by 48 h of recovery (first test session: BM, VJT, HJT, and 20-m and 30-m sprint tests; second session: MBT and 6MWT). The study was conducted during the summer of 2012 from July 5 to August 29.

RESULTS

6MWDs (m) were significantly shorter during R2 (652±101) and R4 (595±123) compared to BR (697±86) and came back to baseline values AR. BM (kg) mean±SD did not significantly change during R2 (52±15) and during R4 (53±15) compared to BR (55±17), and short-term explosive performances were unchanged throughout the study.

CONCLUSION

In non-athletic children, first-ever Ramadan fasting impairs sub-maximal aerobic capacity but has no effect on BM or short-term explosive performance.

Effects of ingesting low glycemic index carbohydrate food for the sahur meal on subjective, metabolic and physiological responses, and endurance performance in Ramadan fasted men

PURPOSE

To investigate the effect of low glycemic index (LGI) carbohydrate meal on subjective, metabolic and physiological responses, and endurance performance in the Ramadan fasted state.

METHODS

During Ramadan, 12 Muslim men, in a randomized and crossover design, ingested for the sahur meal (i.e., last meal before commencement of the day's fast), either LGI (glycemic index = 37) or mixed (CON; ∼57) meal of equivalent macro-nutrient. At ∼12 h post-prandial, subjects completed a 60 min continuous run.

RESULTS

There were no significant differences between the two meals for ratings in perceived satiety, fullness, appetite and mood states. During steady-state exercise, there were no significant differences in metabolic and physiological measures. In the time-trial, distance ran was significantly lower in LGI versus CON meal trial, but with a corresponding lower perceived exertion in the LGI trial.

CONCLUSION

Compared to CON, ingesting LGI as the sahur meal did not provide any metabolic, physiological or performance benefits during endurance run performed 12 h post-prandial in Ramadan fasted state.

Mouth rinsing improves cycling endurance performance during Ramadan fasting in a hot humid environment

This study examined the effect of mouth rinsing during endurance cycling in a hot humid environment (32 °C and 75% relative humidity) on athletes in the Ramadan fasted state. Nine trained adolescent male cyclists completed 3 trials that consisted of a carbohydrate mouth-rinse (CMR), a placebo mouth-rinse (PMR), and a no-rinse (NOR) trial during the last 2 weeks of Ramadan. Each trial consisted of a preloading cycle at 65% peak rate of oxygen consumption for 30 min followed by a 10-km time trial (TT10 km) under hot humid condition. During the CMR and PMR trials, each cyclist rinsed his mouth with 25 mL of the solution for 5 s before expectorating the solution pre-exercise, after 5, 15, and 25 min of the preloading cycle, and 15 s prior to the start of TT10 km. Time to complete the TT10 km was significantly faster in the CMR and PMR trials compared with the NOR trial (12.9 ± 1.7 and 12.6 ± 1.7 vs. 16.8 ± 1.6 min, respectively; p < 0.017). Ratings of perceived exertion taken at the end of the TT10 km was lower in both CMR and PMR trials compared with the NOR trial, although the difference was significant only between CMR and NOR (p < 0.05). In conclusion, mouth rinsing with either carbohydrate or placebo solution provided ergogenic benefits compared with a no-rinse condition on TT10 km performance in acute Ramadan fasted subjects during endurance cycling in a heat stress environment.

Effect of Ramadan observance on maximal muscular performance of trained men

OBJECTIVE

To assess the influence of Ramadan fasting on maximal performance of moderately trained young men using various tests of muscle performance.

DESIGN

Comparison of Ramadan fasting (n = 10) versus control group (n = 10) over 3 test sessions, before Ramadan (B), at the end of the first week of Ramadan (R-1), and during the fourth week of Ramadan (R-4).

SETTING

At each 2-day test session, 4 tests were performed in the same order: measurement of vertical jump height (VJH) and a force-velocity test using the arms on day 1, and measurement of handgrip force (HGF), and a force-velocity test using the legs on day 2.

PARTICIPANTS

Twenty trained men.

MAIN OUTCOME MEASURES

Maximal power of the arms and of the legs (force-velocity testing), vertical jump performance, HGF, anthropometric data, dietary intake, hemoglobin, and hematocrit.

RESULTS

Two-way analyses of variance (group × time) showed Ramadan fasters with decreased maximal anaerobic power of the arms (Wmax-A) and legs (Wmax-L) at R-1, with a partial return of arm data to initial values at R-4. Vertical jump height and HGF remained unchanged throughout. Other changes in Ramadan observers were a decreased energy intake and a decrease of plasma volume at R-1.

CONCLUSIONS

These results suggest that Ramadan observance initially had detrimental effects on Wmax-A, and Wmax-L, with a tendency to recovery by week 4 of Ramadan. Reductions of total energy intake and intramuscular glycogen may contribute to the reduced Wmax-A and Wmax-L during Ramadan fasting.

Conducting an acute intense interval exercise session during the Ramadan fasting month: what is the optimal time of the day?

This study examines the effects of Ramadan fasting on performance during an intense exercise session performed at three different times of the day, i.e., 08:00, 18:00, and 21:00 h. The purpose was to determine the optimal time of the day to perform an acute high-intensity interval exercise during the Ramadan fasting month. After familiarization, nine trained athletes performed six 30-s Wingate anaerobic test (WAnT) cycle bouts followed by a time-to-exhaustion (T(exh)) cycle on six separate randomized and counterbalanced occasions. The three time-of-day nonfasting (control, CON) exercise sessions were performed before the Ramadan month, and the three corresponding time-of-day Ramadan fasting (RAM) exercise sessions were performed during the Ramadan month. Note that the 21:00 h session during Ramadan month was conducted in the nonfasted state after the breaking of the day's fast. Total work (TW) completed during the six WAnT bouts was significantly lower during RAM compared to CON for the 08:00 and 18:00 h (p < .017; effect size [d] = .55 [small] and .39 [small], respectively) sessions, but not for the 21:00 h (p = .03, d = .18 [trivial]) session. The T(exh) cycle duration was significantly shorter during RAM than CON in the 18:00 (p < .017, d = .93 [moderate]) session, but not in the 08:00 (p = .03, d = .57 [small]) and 21:00 h (p = .96, d = .02 [trivial]) sessions. In conclusion, Ramadan fasting had a small to moderate, negative impact on quality of performance during an acute high-intensity exercise session, particularly during the period of the daytime fast. The optimal time to conduct an acute high-intensity exercise session during the Ramadan fasting month is in the evening, after the breaking of the day's fast.

The effects of Ramadan intermittent fasting on athletic performance: recommendations for the maintenance of physical fitness

The behavioural modifications that accompany Ramadan intermittent fasting (RIF) are usually associated with some alterations in the metabolic, physiological, and psychological responses of athletes that may affect sport performance. Muslim athletes who are required to train and/or compete during the month-long, diurnal fast must adopt coping strategies that allow them to maintain physical fitness and motivation if they are to perform at the highest level. This updated review aims to present the current state of knowledge of the effects of RIF on training and performance, focusing on key-factors that contribute to the effects of Ramadan on exercise performance: energy restriction, sleep deprivation, circadian rhythm perturbation, dehydration, and alterations in the training load. The available literature contain few studies that have examined the effects of RIF on physical performance in athletes and, to date, the results are inconclusive, so the effects of RIF on competition outcomes are not at present wholly understood. The diverse findings probably indicate individual differences in the adaptability and self-generated coping strategies of athletes during fasting and training. However, the results of the small number of well-controlled studies that have examined the effects of Ramadan on athletic performance suggest that few aspects of physical fitness are negatively affected, and where decrements are observed these are usually modest. Subjective feelings of fatigue and other mood indicators are often cited as implying additional stress on the athlete throughout Ramadan, but most studies show that these factors may not result in decreases in performance and that perceived exercise intensity is unlikely to increase to any significant degree. Current evidence from good, well-controlled research supports the conclusion that athletes who maintain their total energy and macronutrient intake, training load, body composition, and sleep length and quality are unlikely to suffer any substantial decrements in performance during Ramadan. Further research is required to determine the effect of RIF on the most challenging events or exercise protocols and on elite athletes competing in extreme environments.

The impact of Ramadan observance upon athletic performance

Ramadan observance requires a total abstention from food and drink from sunrise to sunset for a period of one month. Such intermittent fasting has only minor effects upon the overall nutrition and physiological responses of the general sedentary population. Larger meals are consumed at night and in the early morning. Body mass usually remains unchanged, the total energy intake remains roughly constant, and there is little alteration in the relative consumption of protein, fats and carbohydrates. However, Ramadan observance may be of greater consequence for the training and performance of the competitive athlete, particularly when the festival is celebrated in the hotter part of the year and daylight hours are long, as is the case for the 2012 Summer Olympic Games in London, England. The normal sleeping time then tends to be shortened, and blood sugar and tissue hydration decrease progressively throughout the hours of daylight. Some limitation of anaerobic effort, endurance performance and muscle strength might be anticipated from the decrease in muscle glycogen and body fluid reserves, and a reduced blood glucose may cause a depressed mood state, an increased perception of effort, and poorer team work. This review considers empirical data on the extent of such changes, and their likely effect upon anaerobic, aerobic and muscular performance, suggesting potential nutritional and behavioral tactics for minimizing such effects in the Muslim competitor.