Achieving optimum sports performance during Ramadan: some practical recommendations

Timing of Resistance Training During Ramadan Fasting and Its Effects on Muscle Strength and Hypertrophy

PURPOSE

During Ramadan month, Muslims often continue training to maintain their muscle performance. However, trainers should stress the importance of the time of day chosen for practicing resistance training (RT) during Ramadan fasting to avoid health and performance alteration. Thus, this study aimed to investigate the effects of the timing of RT during Ramadan intermittent fasting (RIF) on muscle strength and hypertrophy in healthy male adults.

METHODS

Forty men were randomly allocated to 2 matched groups: 20 practicing whole-body RT in the late afternoon in a fasted state and 20 training in the late evening in a fed state (FED). Both groups performed 4 days per week of whole-body RT (∼75%-85% 1-repetition maximum, 12 repetitions/3-4 sets) during RIF. Anthropometric measurements and 1-repetition-maximum test for the squats, deadlift, and bench press were measured. A cross-sectional area of the quadriceps and biceps brachii was examined using ultrasound scans. All measurements were taken at 4 time points: 24 hours before the start of Ramadan, on the 15th day of Ramadan, on the 29th day of Ramadan, and 21 days after Ramadan.

RESULTS

Post hoc tests indicated significant preimprovement to postimprovement in FED at the 29th day of Ramadan for the 1-repetition-maximum test for the squats (P = .02; effect size = 0.21) and deadlift (P = .03; effect size = 0.24) when compared to 24 hours before the start of Ramadan. No significant changes were observed in the fasted-state group or for cross-sectional area for both groups.

CONCLUSIONS

Practicing RT during RIF appears not to have adverse effects on muscle hypertrophy and strength no matter whether it is practiced in FED or fasted state. However, RT had greater effects on muscle strength when applied in FED. Our findings suggest that training sessions should be scheduled after breaking the fast during Ramadan.

Effect of Time-Restricted Feeding on Anthropometric, Metabolic, and Fitness Parameters: A Systematic Review

Time restricted feeding (TRF) as a form of intermittent fasting (IF) has gained popularity because its ability to reduce body mass (BM) without an emphasis on caloric restriction. However, how this dietary protocol may affect health, fitness, and performance in a relatively healthy cohort remains less clear. The purpose of this article was to systematically review the current literature concerning the effect of TRF on anthropometric, metabolic, and fitness parameters in normal-weight adults and overweight and obese individuals. A systematic search of English literature was conducted through databases including PubMed, CINAHL, and Google Scholar. The search was facilitated by using various combinations of key words related to nutritional interventions, i.e., IF and TRF, and outcomes of interest, i.e., BM, body composition, glucose, insulin, lipid, fitness, and performance. The article selection was made based on the inclusion and exclusion criteria concerning the participants' characteristics, study design, intervention protocols, and targeted dependent variables. Twenty-three full-text longitudinal randomized and nonrandomized controlled studies were selected for this review. Our analysis indicates that TRF can reduce BM and improve nutrient metabolism in both normal- and over-weight individuals. TRF does not appear to alter protein synthesis and fat-free mass nor hamper aerobic fitness and muscular performance among physically active individuals including athletes. In conclusion, TRF as a more easily adaptable form of IF is a promising dietary approach to improving body composition and metabolic health while maintaining fitness and muscular function. However, more research is needed before this dietary protocol can be fully recommended for athletes especially those competing in sports that demand strength and power.Key teaching points and nutritional relevanceTime-restricted feeding (TRF) differs from other fasting protocols due to its emphasis on restricting eating window rather than caloric intake and can be more easily adopted by simply skipping a meal.Its deemphasis on caloric restriction appeals to many young and physically active individuals wanting to optimize body composition but needing sufficient energy to support their physical training and daily activity.Much of what is known regarding the impact of TRF on fitness and athletic performance was derived from studies that use the Ramadan fasting protocol, which differs from TRF in terms of protocol duration and feeding schedule.This review concludes that TRF is a promising dietary approach to improving body composition and metabolic health while maintaining fitness and muscular function in both normal- and over-weight individuals.Due to limited evidence concerning TRF and athletic performance, more research is needed before this dietary protocol can be fully recommended for athletes especially those competing in sports that demand strength and power.

Seven decades of Ramadan intermittent fasting research: Bibliometrics analysis, global trends, and future directions

BACKGROUND AND AIMS

There is a large body of research focused on various aspects related to Ramadan intermittent fasting (RIF) and human health and disease. This study aimed to quantify the bibliometric data of RIF medical research over the past seven decades and explore these variables qualitatively via text mining analysis.

METHODS

We used the Scopus search engine to identify published articles related to RIF from inception to December 31, 2021. All types of research articles were included. Scientometric and bibliometric measures were determined using Excel, Biblioshiny, and VOSviewer. This study proposed a bibliometric and text mining method to qualitatively and quantitatively recognize the RIF research trend.

RESULTS

The Scopus search returned 1915 relevant articles. Most citations pertained to publications from the last two decades, and most publications were original research articles. These publications had received around 27,000 citations, and the 20 most prolific publishing journals had an average h-index of 112.25. More than one-third of all medical publications were in open-access journals. There was a 13-fold increase in medical research on RIF over the past few decades. We identified the 10 most prolific publishing countries, institutes, journals, and authors. We also identified five scientific hotspots of RIF scientific literature, which were: diabetes, metabolic health, public health, physiology, and maternity.

CONCLUSION

This is the first comprehensive bibliometric analysis of medical research related to RIF. The research gaps identified will shape future research directions and foster collaborative research activities toward enhanced medical nutrition research revolving around RIF.

Running Performance during the Holy Month of Ramadan in Elite Professional Adult Soccer Players in Russia

Religious fasting in the Holy Month of Ramadan is an important element of the Muslim culture during which no eating or drinking is permitted from dawn till dusk. A considerable number of Muslim soccer players abide by these restrictions, which may cause a negative impact on key running performance parameters during competitive matches. Alterations to diet and water intake during the Holy Month of Ramadan may affect various running performance parameters in elite Muslim professional adult soccer players. This study was conducted with two groups of soccer players from the Russian Premier League (RPL): The Exposure Group (EG) consisted of 13 Muslims age 24.0 ± 2.8 years abiding by religious fasting and the Control Group (CG) included 13 non-Muslim age 26.0 ± 4.4 years. Using the Instat system, the running performance of each player was controlled in both groups during matches from the RPL before and in the third week of Ramadan (a total of two matches for every player). None of the measured parameters demonstrated significant changes in any match. In conclusion, restrictions in diet and liquid intake during the Holy Month of Ramadan had no negative influence on the running performance of elite Muslim professional adult soccer players during daytime matches.

Self-Coping Strategies Among Jordanian Athletes During Ramadan Fasting: A Questionnaire Proposal

: This study aims to categorize the adaptation strategies of Muslim athletes who fast during Ramadan and proposes a self-coping strategy questionnaire as a complementary assessment tool. A total of 109 Jordanian Muslim athletes (mean age 20.0 ± 8.5 years) were surveyed by completing a self-coping questionnaire designed to classify an individual athlete’s level of adaptation. This study was conducted during the month of Ramadan 2019 and developed based on the training, nutritional, psychological, self-control, and recovery dimensions. Seventy percent of athletes found that they developed good or very good coping mechanisms. Coping strategies vary from one dimension to another, but in general, athletes often had a positive perceived coping. Athletes expressed that they are shifting the training hours with a preference for quality training rather than quantity and associated with a longer rest time. In addition, they were in favor of food hygiene associated with a strategy of sharing meals and providing water. The majority (59%) of the athletes said they were psychologically prepared for the potential effects of fasting. This research shows that athletes develop self-adjusting strategies to counter the effects of fasting. The questionnaire on the self-coping strategies provides important and precise information on the level of coping achieved by the athletes.

UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research

Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.

Casuistic Reasoning, Standards of Evidence, and Expertise on Elite Athletes’ Nutrition

This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. Our trust in experts largely depends on the assumption that their advice is based on reliable evidence. In many fields, the evaluation of the reliability of evidence is made on the basis of standards that originate from evidence-based medicine. I show that at the Olympic or professional level, implementing nutritional plans in real-world competitions requires contextualization of knowledge in a way that contravenes the tenets of evidence-based thinking. Nutrition experts need to be able to combine and apply evidence from multiple sources, including the previous successes and failures of particular athletes. I argue that in this sense, the practice of elite sport nutrition embodies casuistic reasoning.

Does Ramadan Fasting Affect Fatigue in Nurses?

The purpose of this study was to evaluate the effect of Ramadan fasting on fatigue in nurses. The study was conducted between June 19 and July 27, 2014, with a descriptive design. This study was completed with 99 nurses working in a public hospital in the city of Gaziantep located in the Southeastern Anatolia Region of Turkey. The data of the study were collected by using a questionnaire and the Piper Fatigue Scale. The Piper Fatigue Scale includes 4 subscale/dimensional scores and total fatigue scores. Higher scores indicate more fatigue. Statistical significance levels were set at P < .05. It was determined that the fatigue subscale and total mean scores of nurses increased in a statistically significant manner except for the affective subscale after the month of Ramadan (P < .05). In addition, it was found that the fatigue mean scores of those, who were working for 0 to 4 years, were employed in surgery units, and evaluated their health as bad, were higher (P > .05). The Ramadan fasting increased fatigue levels of nurses. Therefore, it is of vital importance to evaluate fatigue levels of nurses especially in the month of Ramadan and take the necessary precautions in terms of patient and personnel safety.

Islamic fasting and multiple sclerosis

Background

Month-long daytime Ramadan fasting pose s major challenges to multiple sclerosis (MS) patients in Muslim countries. Physicians should have practical knowledge on the implications of fasting on MS. We present a summary of database searches (Cochrane Database of Systematic Reviews, PubMed) and a mini-symposium on Ramadan fasting and MS. In this symposium, we aimed to review the effect of fasting on MS and suggest practical guidelines on management.

Discussion

In general, fasting is possible for most stable patients. Appropriate amendment of drug regimens, careful monitoring of symptoms, as well as providing patients with available evidence on fasting and MS are important parts of management. Evidence from experimental studies suggests that calorie restriction before disease induction reduces inflammation and subsequent demyelination and attenuates disease severity. Fasting does not appear to have unfavorable effects on disease course in patients with mild disability (Expanded Disability Status Scale (EDSS) score ≤3). Most experts believed that during fasting (especially in summer), some MS symptoms (fatigue, fatigue perception, dizziness, spasticity, cognitive problems, weakness, vision, balance, gait) might worsen but return to normal levels during feasting. There was a general consensus that fasting is not safe for patients: on high doses of anti-convulsants, anti-spastics, and corticosteroids; with coagulopathy or active disease; during attacks; with EDSS score ≥7.

Summary

These data suggest that MS patients should have tailored care. Fasting in MS patients is a challenge that is directly associated with the spiritual belief of the patient.

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.