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

Effects of Ramadan on cognitive functions in young boys

Fasting during Ramadan involves abstaining from food and drink from dawn to sunset, potentially influencing cognitive functions essential for the intellectual development of the youth. Therefore, understanding the effects of fasting on these functions in children/adolescents provides valuable perspectives to enhance education and promote mental well-being. However, studies on children/adolescents in this context are still limited. To evaluate the impact of Ramadan fasting on cognitive functions, including information processing speed, inhibition, decision-making, and auditory attention processes among children and adolescents aged 11 to 15 years. This study was conducted with 24 healthy children/adolescents (aged 12.84 ± 0.69 years). The experimental protocol consisted of two sessions: Before-Ramadan (BR) and at the beginning of the second week of Ramadan (R2). At each session, the boys were randomly tested on simple reaction time (SRT), choice reaction time (CRT), negative priming reaction time (NPRT), and auditory discrimination (P300). The tests were administered and scored by the same person in the different sessions. The study found that Ramadan fasting did not have an effect on various reaction times or on electro-physiological data, including P300 amplitude and latency. The current study, conducted with healthy children/adolescents, indicates that Ramadan fasting had no impact on various reaction times (SRT, CRT, NPRT), suggesting the preservation of information processing speed and decision-making, even in the face of increased task complexity. This is evident, on the one hand, through the maintenance of the ability to react to unexpected events, and, on the other hand, through the mastery of resistance to automatism, thus reflecting the preservation of inhibitory function (NPRT). Regarding P300 data, the absence of changes in latencies and amplitudes suggests that Ramadan fasting did not alter either the evaluation time of auditory stimuli or auditory attention processes.

Effects of Caloric Restriction and Intermittent Fasting and Their Combined Exercise on Cognitive Functioning: A Review

PURPOSE OF REVIEW

The impact of dietary habits on cognitive function is increasingly gaining attention. The review is to discuss how caloric restriction (CR) and intermittent fasting (IF) can enhance cognitive function in healthy states through multiple pathways that interact with one another. Secondly, to explore the effects of CR and IF on cognitive function in conditions of neurodegenerative diseases, obesity diabetes and aging, as well as potential synergistic effects in combination with exercise to prevent cognitively related neurodegenerative diseases.

RECENT FINDINGS

With age, the human brain ages and develops corresponding neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and epilepsy, which in turn trigger cognitive impairment. Recent research indicates that the impact of diet and exercise on cognitive function is increasingly gaining attention. The benefits of exercise for cognitive function and brain plasticity are numerous, and future research can examine the efficacy of particular dietary regimens during physical activity when combined with diet which can prevent cognitive decline.

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 .

Aspetar clinical guidelines: Ramadan fasting and exercise for healthy individuals

Healthy adult Muslims who practice Ramadan fasting (RF) follow strict religious rules regarding their lifestyle. RF influences several parameters, including nutrition, hydration, and sleep habits, and can potentially reduce physical performance. It seems that RF prevents athletes from training and participating in competitions, and prevents the general community from engaging in physical exercise. This places practicing Muslim athletes at a competitive disadvantage. Therefore, the goal of this guide was to provide practical recommendations, based on expert panel consensus, for healthy athletes and their support staff on how to adopt appropriate behavioral, social, and psychological strategies to cope with the changes and constraints resulting from RF. The recommendations developed in this guide are not limited to prescribing appropriate exercise during the month of Ramadan (ie; schedule, frequency, intensity, duration, type of exercise, and training load), but cover different aspects of lifestyle such as nutrition, hydration, and sleep, and address psychosocial and cognitive aspects related to RF. These recommendations are intended for healthy individuals. Patients with chronic illnesses should refer to their doctor to ensure an eventual safe practice.

The Impacts of Ramadan Intermittent Fasting on Saliva Flow-Rate and Metabolic Data: A Systematic Review

The aim of this systematic review was to report the impacts of Ramadan intermittent fasting (RIF) on salivary flow-rate (SFR) and metabolic parameters. A thorough literature search was carried out using the databases PubMed and Scopus from their inception up to 15 July 2021. The Boolean connectors used in PubMed were (Saliva [Mesh] AND Fasting [Mesh]). The same keywords were used in Scopus. Inclusion criteria were defined using PICOS. The research included all original studies involving “healthy” adults and published in English. Methodological quality assessment was performed utilizing the Joanna Briggs Institute Critical Appraisal Tool, which allows attributing scores from 1 to 11 to the selected studies. Two authors carried out the literature search, study selection, and data extraction. Differences on issues were resolved by a third author if necessary. The systematic review protocol was registered within the “Open Science Framework” (Doi: 10.17605/OSF.IO/DE7BH). Six articles met the inclusion criteria. All studies were heterogeneous and had a high score of bias and several methodological differences. The following parameters were collected: SFR, melatonin, cortisol, glucose, immunoglobulin A (IgA), uric-acid, alkaline phosphatase (ALP), and aspartate aminotransferase (AST). The SFR decreased by 10% during Ramadan in fasting subjects. The circadian pattern of melatonin remained unchanged during Ramadan, but melatonin levels dropped significantly from baseline. The salivary cortisol levels were unchanged or increased during Ramadan. The salivary glucose levels were decreased. ALP increased significantly, whilst uric-acid and AST decreased significantly. Salivary IgA decreased during the last week of Ramadan. To conclude, there is a trend toward a decrease in SFR and the content of the majority of the biomarkers investigated, with the exception of ALP and uric-acid. These changes cannot be easily attributed to any single factor (hydration status, dietary habits, physical activity, or hygiene habits).

Systematic Review Registration: [https://osf.io/de7bh/], identifier [Doi: 10.17605/OSF.IO/DE7B].

Anthropometric, Psychosocial, Physiological, and Postural Observances During Ramadan in Men With Chronic Obstructive Pulmonary Disease

This study aimed to carry out a Ramadan observance (RO) on anthropometric, psychosocial, physiological, and postural characteristics of patients with chronic obstructive pulmonary disease (COPD). Twenty COPD patients were evaluated. Tests performed 1 week before Ramadan (C), and during the second (R-2) and the fourth weeks of Ramadan (R-4) included standard anthropometry, spirometry, a quality of life questionnaire (VQ11), a 6-minute walking test (6MWT), measurement of maximal voluntary contraction force of the quadriceps (MVC), Timed Get Up and Go (TUG), Berg Balance Scale (BBS), and Unipedal Stance (UST). During R-2, there were significant decreases in forced vital capacity and forced expiratory volumes, 6MWT distance, MVC, BBS, and UST, with significant increases in TUG and significant changes in VQ11. During R-4, there was some recovery, but all variables remained significantly different from initial control data. To conclude, RO adversely affects pulmonary function, exercise performance, postural balance, and quality of life in COPD, with some recovery by the R-4. Although a number of functional consequences remain to be elucidated, functional losses were insufficient to limit daily living in our sample, but further studies are recommended in those with more severe COPD, paying particular attention to postural disturbances and a possible increase in the risk of falls.

Time-Restricted Feeding and Aerobic Performance in Elite Runners: Ramadan Fasting as a Model

A distance runner's performance is generally limited by energy availability when competing or training. Modifying meal frequency and timing by abstaining from eating or drinking, from dawn to dusk, during Ramadan fasting is hypothesized to induce hypohydration and reduced caloric and nutrient intake. The purpose of this study was to investigate the impact of Ramadan fasting on runners' performances. Fifteen trained male distance runners who observed Ramadan participated in this study (Age = 23.9 ± 3.1 years; Peak VO₂ = 71.1 ± 3.4 ml/kg/min). Each participant reported to the human performance lab on two testing occasions (pre-Ramadan and the last week of Ramadan). In each visit, participants performed a graded exercise test on the treadmill (Conconi protocol) and their VO₂, Heart Rate, time to exhaustion, RPE, and running speed were recorded. Detailed anthropometrics, food records, and exercise logs were kept for the entire period of the study. Repeated measure ANOVA, paired t-test, and Cohen's effect size analysis were carried out. Results indicated no significant influence for Ramadan fasting on body mass (p = 0.201), body fat (p = 0.488), lean body mass (p = 0.525), VO₂max (p = 0.960), energy availability (p = 0.137), and protein intake (p = 0.124). However, carbohydrate (p = 0.026), lipid (p = 0.009), water (p < 0.001), and caloric intakes (p = 0.002) were significantly reduced during Ramadan Fasting. Daily training duration (p < 0.001) and exercise energy expenditure (p = 0.001) were also reduced after Ramadan. Time to exhaustion (p = 0.049), and maximal running speed (p = 0.048) were improved. Overall, time to exhaustion and maximal running speed of the distance runners was improved during Ramadan fasting, independent of changes in nutrients intake observed during the current study. With proper modulation of training, distance runners performance can be maintained or even slightly improved following the month of Ramadan fasting.

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.

Intermittent Fasting and Its Effects on Athletic Performance: A Review

Intermittent fasting (IFast) has been around for most of human history, and its proposed health benefits have been mentioned in ancient civilizations. However, recently, there has been a renewed public interest in IFast. Given the importance of nutrition in optimizing athletic performance, there is a concern about the effects of IFast on athletics. Most of the studies looking at performance and fasting are regarding athletes who observe Ramadan. Looking at high-intensity, endurance, and resistance exercises, studies have been varied but are uniform in showing that there is no benefit to athletic performance while fasting. More long-term studies need to be done to evaluate specific fasting protocols during sport.

Does Ramadan Fasting Affect Spirometric Data of Healthy Adolescents?

Purpose:

Several studies raised the effects of Ramadan fasting on healthy adults spirometric data, but none was performed in children. The aim of this study was to compare the spirometric data of a group of faster adolescents (n = 26) with an age-matched non-faster one (n = 10).

Methods:

This comparative quasi-experimental study, including 36 healthy males aged 12 to 15 years, was conducted during the summer 2015 (Ramadan: June 18 to July 16). Three sessions (Before-Ramadan [Before-R], Mid-Ramadan [Mid-R], After-Ramadan [After-R]) were selected for spirometry measurements. Spirometry was performed around 5.5 to 3.5 h before sunset and the spirometric data were expressed as percentages of local spirometric norms.

Results:

The two groups of fasters and non-fasters had similar ages and weights (13.35 ± 0.79 vs 12.96 ± 0.45 years, 46.8 ± 9.2 vs 41.7 ± 12.6 kg, respectively). There was no effect of Ramadan fasting on forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), FEV₁/FVC, peak expiratory flow, and maximal mid-expiratory flow. For example, during the Before-R, Mid-R, and After-R sessions, there was no significant difference between the fasters and non-fasters mean FVC (101 ± 11 vs 99 ± 14, 101 ± 12 vs 102 ± 14, 103 ± 11 vs 104 ± 13, respectively) or FEV₁ (101 ± 13 vs 96 ± 16, 98 ± 11 vs 97 ± 16, 101 ± 10 vs 98 ± 16, respectively).

Conclusions:

Ramadan fasting had no interaction effect with the spirometric data of Tunisian healthy male adolescents.

The Impacts of Ramadan Intermittent Fasting on Oxidant/Antioxidant Stress Biomarkers of Stable Chronic Obstructive Pulmonary Disease Male Patients

No prior study has evaluated the impacts of Ramadan intermittent fasting (RIF) on oxidant/antioxidant stress (OS/AOS) biomarkers in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to assess the impacts of RIF on some OS/AOS biomarkers measured in male patients with stable COPD. Fifteen COPD patients (mean age: 71 ± 6 years) fasting Ramadan in 2017 volunteered to take part in the study. Three sessions (before Ramadan [BR], end Ramadan [ER], after Ramadan [AR]) were selected. Blood samples of OS (homocysteine [μmol/L], thiobarbituric acid reactive substances [TBARS, μmol/L]) and AOS (catalase [U/ml], ceruloplasmin [g/L], superoxide dismutase [SOD, ng/ml], zinc [µmol/L], albumin [g/L]) biomarkers were consistently taken 4.5 to 2.5 hr before the iftar. Findings were analyzed by applying Friedman or Kruskal-Wallis ANOVA. Comparisons of the number of patients with high OS [high homocysteine and/or TBARS] and low AOS (low catalase and/or ceruloplasmin and/or SOD and/or zinc and/or albumin) blood values between the three sessions were performed using the Cochran test. The median ± interquartile of homocysteine (BR: 21.48 [18.98-24.49], ER: 23.15 [21.77-26.45], AR: 24.87 [21.91-37.12]), ceruloplasmin (BR: 0.27 [0.24-0.30], ER: 0.28 [0.26-0.33], AR: 0.28 [0.25-0.32]), SOD (BR: 288.00 [112.00-400.00], ER: 182.00 [152.00-386.00], AR: 234.00 [190.00-420.00]) and the mean ± SD of TBARS (BR: 5.66 ± 1.26, ER: 4.59 ± 0.78, AR: 5.29 ± 1.69), catalase (BR: 120.97 ± 54.62, ER: 106.73 ± 50.92, AR: 137.39 ± 40.88), zinc (BR: 11.85 ± 2.01, ER: 12.47 ± 2.34, AR: 12.21 ± 2.58) and albumin (BR: 39.78 ± 3.19, ER: 40.74 ± 2.26, AR: 40.56 ± 2.38) were not significantly affected by RIF. The number of patients with high OS (BR [ n = 13], ER [ n = 15], AR [ n = 14]) or low AOS (BR [ n = 12], ER [ n = 13], AR [ n = 13]) statuses were not significantly influenced by RIF. In conclusion, RIF did not induce any significant statistical or clinical changes in OS/AOS biomarkers or statuses in COPD patients.

Ramadan fasting alters food patterns, dietary diversity and body weight among Ghanaian adolescents

BACKGROUND

Ramadan is a monthlong fast for healthy adolescents and adult Muslims. The quality of foods eaten and eating patterns in Ramadan may be different from other months of the year. Food intake of adolescents is a concern as energy and nutrient requirements are higher and needed to support the growth spurt of this stage. The objective of the present study was to describe the food patterns, dietary diversity and body weight changes among adolescents during Ramadan.

METHODS

A prospective cohort study design with four measurement points (baseline, midline, endline and post endline) was conducted among 366 adolescents in Junior High Schools. Food pattern was assessed with a food frequency questionnaire, a 24-h dietary recall was used to assess dietary diversity and body weight was measured using an electronic scale. A repeated measures ANOVA was used to compare changes in dietary diversity scores (DDS) and weight of pupils.

RESULTS

Half of the pupils (50.3%) were female and average age was 15.9 ± 1.8 years. Pupils fasted for an average of 28.3 ± 4.0 days and 14.3 ± 0.5 h a day (dawn to dusk) during Ramadan. The number and types of dishes taken at meal times differed substantially between Ramadan periods and outside Ramadan. Consumption of vitamin A-rich fruits, other fruits, and milk and milk products increased markedly during Ramadan. However, fasting came with a reduction in consumption of foods from roots and tubers, legumes and nuts, and dark green leafy vegetables while other food groups remained unchanged. Mean DDS increased significantly during Ramadan (F (2.933, 1070.573) = 7.152, p < 0.001) while mean daily meal frequency decreased (F (2.936, 1071.623) = 51.653, p < 0.001). There was significant body weight loss (-1.5 kg (95% CI: -1.1 kg to -1.6 kg)) among adolescents (F (2.656, 958.95) = 304.90, p < 0.001). Weight loss was short-lived; regained one month after Ramadan.

CONCLUSION

In this prospective cohort study among schooling Ghanaian adolescents who fast during Ramadan, fasting was characterised by marked changes in usual food patterns, increased dietary diversity and significant body weight loss.

The Effects of Ramadan Intermittent Fasting (RIF) on Spirometric Data of Stable COPD Patients: A Pilot Study

No previous study has raised the effects of RIF on lung function data of chronic obstructive pulmonary disease (COPD) patients. The objective of the present study was to assess the effects of RIF on spirometric data measured in male patients with a stable COPD. Sixteen patients with stable COPD (mean ± SD of age: 64 ± 7 years) who fasted during Ramadan volunteered to the study. Three sessions (Before-R, End-R, and After-R) were selected for spirometry tests that were consistently performed 2.5-4.5 hr before fasting break. Assessment sessions comprised: forced vital capacity (FVC), 1st s forced expiratory volume (FEV₁), FEV₁/FVC, peak expiratory flow (PEF), maximal mid-expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEFx%). A reversibility test was performed only during the Before-Ramadan session. Spirometric data were expressed in percentages of local reference values. Findings were analyzed by applying repeated measures analysis of variance. The mean ± SD of the postbronchodilator FEV₁/FVC ratio and the FEV₁ were, respectively, 0.52 ± 0.14 and 48 ± 19%. The mean ± SD of FEV₁ (Before-R: 47 ± 19, End-R: 45 ± 18, After-R: 44 ± 19%), FVC (Before-R: 73 ± 18, End-R: 71 ± 16, After-R: 69 ± 17%), FEV₁/FVC (Before-R: 67 ± 16, End-R: 66 ± 16, After-R: 65 ± 16%), PEF (Before-R: 46 ± 19, End-R: 47 ± 22, After-R: 45 ± 21%), MMEF (Before-R: 19 ± 10, End-R: 18 ± 8, After-R: 18 ± 9%), FEF_25% (Before-R: 16 ± 6, End-R: 16 ± 5, After-R: 15 ± 5%), FEF_50% (Before-R: 21 ± 14, End-R: 20 ± 12, After-R: 20 ± 12%) and FEF_75% (Before-R: 27 ± 19, End-R: 27 ± 19, After-R: 27 ± 19%) were not significantly influenced by RIF. RIF did not bring about any significant changes in the spirometric data of stable COPD male patients fasting the 2016 holy month of Ramadan.

The Effects of Ramadan Fasting on the Spirometric Data of Healthy Adult Males

The few studies carried out on the effects of Ramadan fasting (RF) on spirometric values present contradictory conclusions. This study aimed at assessing whether RF affects healthy adults' spirometric values. Twenty-nine nonsmoking healthy males ( M ± standard error of mean [ SEM] of age: 27 ± 1 years) who fasted during Ramadan (June 29-July 28, 2014) volunteered to the study. Three periods (before-Ramadan [June 23-25], mid-Ramadan [July 14-16] and after-Ramadan [August 11-14]) were selected for spirometry measurements that were consistently performed 5.5 to 3.5 hours (between 15:00 and 17:00 hours) before fasting break. Assessment sessions comprised following: weight (kg), forced vital capacity (FVC), first second expiratory volume (FEV₁), FEV₁/FVC, peak expiratory flow (PEF), maximal mid expiratory flow (MMEF), and forced expiratory flow rate at the x% of FVC to be exhaled (FEF _x%). Spirometric data were expressed in percentages of reference values. Results were analyzed by applying repeated measures analysis of variance. The M ± SEM of weight (before-R: 81.6 ± 2.8 kg, mid-R: 80.8 ± 2.9 kg, after-R: 81.2 ± 2.9 kg), FEV₁ (before-R: 99 ± 2%, mid-R: 98 ± 2%, after-R: 98 ± 2%), FVC (before-R: 103 ± 2%, mid-R: 101 ± 2%, after-R: 101 ± 2%), PEF (before-R: 112 ± 3%, mid-R: 113 ± 2%, after-R: 114 ± 3%), MMEF (before-R: 83 ± 3%, mid-R: 83 ± 3%, after-R: 82 ± 3%), FEF_25% (before-R: 90 ± 5%, mid-R: 89 ± 6%, after-R: 87 ± 6%), FEF_50% (before-R: 94 ± 4%, mid-R: 91 ± 4%, after-R: 93 ± 3%), and FEF_75% (before-R: 108 ± 3%, mid-R: 111 ± 2%, after-R:111 ± 3%) were not significantly influenced by RF. To conclude, RF did not bring about any significant changes in the spirometric values of nonsmoking healthy adult males.

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.

Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: a pilot study

This study assessed selected measures of cognitive function in trained cyclists who observed daylight fasting during Ramadan. Eleven cyclists volunteered to participate (age: 21.6±4.8 years, VO2max: 57.7±5.6 ml kg(-1)·min(-1)) and were followed for 2 months. Cognitive function (Cambridge Neuropsychological Test Automated Battery (CANTAB), Reaction Time index (RTI) and Rapid Visual Information Processing (RVP) tests) and sleep architecture (ambulatory EEG) were assessed: before Ramadan (BR), in the 1st week (RA1) and 4th week of Ramadan (RA4), and 2 weeks post-Ramadan (PR). Both cognitive tests were performed twice per day: before and after Ramadan at 8-10 a.m. and 4-6 p.m., and during Ramadan at 4-6 p.m. and 0-2 a.m., respectively. Training load (TL) by the rating of perceived exertion (RPE) method and wellness (Hooper index) were measured daily. If the TL increased over the study period, this variable was stable during Ramadan. The perceived fatigue and delayed onset muscle soreness (DOMS) increased at RA4. Sleep patterns and architecture showed clear disturbances, with significant increases in the number of awakenings and light sleep durations during Ramadan (RA1 and RA4), together with decreased durations of deep and REM sleep stages at PR. RTI (simple and multiple reaction index) reaction and movement times did not vary over the study period. The RVP test showed reduced false alarms during Ramadan, suggesting reduced impulsivity. Overall accuracy significantly increased at RA1, RA4 and PR compared to baseline. At RA4, the accuracy was higher at 0-2 a.m. compared to 4-6 p.m. Despite the observed disturbances in sleep architecture, Ramadan fasting did not negatively impact the cognitive performance of trained cyclists from the Middle East.

Effect of Ramadan intermittent fasting on selective fitness profile parameters in young untrained Muslim men

Background

The present study was aimed at investigating the effects of sleep deprivation and dietary irregularities during Ramadan intermittent fasting (RIF) on selective fitness profile parameters in young untrained male Muslim individuals.

Methods

77 untrained Muslim men were recruited in the study. They were divided into the experimental group (EG; n=37, age: 22.62±1.77 years) and the control group (CG; n=40, age: 23.00±1.48 years). EG was undergoing RIF while CG abstained. Aerobic fitness, anaerobic capacity or high-intensity efforts (HIEs), agility, flexibility, vertical jump height and handgrip strength were measured on 8 separate occasions—15 days before RIF, 7 days before RIF, 1st day of RIF, 7th day of RIF, 15th day of RIF, 21st day of RIF, last day of RIF and 15 days after RIF.

Results

Aerobic fitness and HIE showed a significant difference (p<0.05) during RIF in EG. Agility and flexibility score showed a significant decrease in EG during RIF, whereas changes in the vertical jump score (VJT) and handgrip strength were statistically insignificant. Studied parameters showed an insignificant variation in CG during RIF. Aerobic fitness, HIEs, agility and flexibility showed a significant intergroup variation during different experimental trials.

Conclusions

The present investigation revealed that RIF had adverse effects on aerobic fitness, HIEs, agility and flexibility of young untrained Muslims of Kolkata, India. VJT, waist-hip ratio and handgrip strength were not affected by RIF in the studied population. Mild but statistically insignificant reduction in body mass was also reflected after the mid-Ramadan week.

A Prospective Study of the Physiological and Neurobehavioral Effects of Ramadan Fasting in Preteen and Teenage Boys

BACKGROUND

Intermittent fasting during the month of Ramadan, although not obligatory, is commonly practiced by Muslim children.

OBJECTIVE

Our aim was to describe the effects of Ramadan fasting on various physiological and neurobehavioral measures in preteen and teenaged boys.

DESIGN

We conduced a prospective cohort study during Ramadan, observed from August 9 to September 11, 2010.

PARTICIPANTS

Eighteen healthy Muslim boys (mean age±standard deviation 12.6±1.5 years) were recruited and assessed before, during (1st and 4th weeks), and after Ramadan. Subjects were classified as preteens (aged 9 to 12 years) or teens (aged 13 to 15 years).

INTERVENTION

On each clinic visit, participants completed a match-to-sample test, a spatial planning and working memory task, and a working memory capacity test using the Cambridge Neuropsychological Test Automated Battery. Participants were also assessed for their sleep patterns, daily energy expenditure, and dietary intake. Body composition was determined using a dual-energy x-ray scan. Complete blood count, lipid profile analysis, and iron indices were conducted.

MAIN OUTCOME MEASURES

We measured morphologic, metabolic, and neurobehavioral parameters.

STATISTICAL ANALYSES

A linear mixed model was used to assess changes in outcome measures. Post hoc pairwise comparisons were performed as necessary with Bonferroni adjustment.

RESULTS

Within 1 week of fasting, there was a drop in body fat only in preteens (P=0.001). Reported fat (P=0.004) and protein intake (P=0.037) was higher during Ramadan, but energy expenditure did not change. By the end of Ramadan, there was a significant reduction in hemoglobin (mean±standard error -0.48±0.4 mmol/L) and serum iron (-25.7±31.8 μg/dL [-4.6±5.7 μmol/L]) levels. During week 4, total sleep duration decreased by 1.8 hours. At week 4, performance on the spatial planning and working memory task and working memory capacity test increased significantly (P=0.002), while match-to-sample test performance declined in preteens only (P=0.045).

CONCLUSIONS

Ramadan fasting was associated with significant changes in body composition, dietary intake, and sleep patterns. Reductions in attention and iron indices were observed in preteens only.