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Objective: To examine the relationships between Ramadan fasting observance (RFO) and sleep-wake patterns, daytime sleepiness, and insomnia levels in student-athletes., Methods: Sleep was measured using wrist-actigraphy in 25 semi-professional student-athletes (mean ± SD; age = 22 ± 2 years, height = 182.0 ± 5.8 cm, body mass = 81.3 ± 15.2 kg) during seven nights before RFO (academic study period), during the first half of RFO (14 nights, holiday period), and the second half of RFO (14 nights, academic study period). Additionally, participants completed the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires seven days before RFO and on the last day of RFO., Results: Actigraphy results indicated RFO was associated with significant decreases in sleep duration during the second half of RFO vs. before and during the first half of RFO (p < 0.001). However, the first half of RFO was associated with a delay of ⁓ 2.5 h in sleep onset compared to before RFO; this delay persisted during the second half of RFO (p < 0.001). The total PSQI score before RFO (6.6 ± 2.3 AU) and during RFO (8.2 ± 2.3 AU) suggested poor overall sleep quality. ISI and ESS scores were greater during than before RFO (p = 0.002 and p = 0.041, respectively)., Conclusions: The second half of RFO was associated with decreases in objectively assessed sleep duration among student-athletes. RFO was also associated with impaired sleep quality, excessive daytime sleepiness, and increased insomnia symptoms. Personalized interventions to address sleep-related issues in student-athletes during RFO are warranted., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

We aimed to examine the effects of Ramadan fasting (RF) and high-intensity short-term maximal performance on elite soccer players' shooting accuracy, executive function (EF), and perceptions. Sixteen Muslim elite players fasting during Ramadan underwent assessments before (BR), during (DR), and after Ramadan (AR). Soccer-specific technical performance was evaluated using the Loughborough Soccer Shooting Test (LSST) before and after a 5-metre shuttle run test (5mSRT), conducted at the same time-of-day (17:00 h). Performance metrics recorded included higher distance (HD), total distance (TD), and fatigue index (FI). RPE after a 5-min warm-up and each repetition of the 5mSRT were obtained, and the mean RPE score was calculated. Trail Making Test (TMT Parts A and B) were used after the warm-up and the 5mSRT. Perceived difficulty (PD) was assessed following the LSST. HD, TD, and FI were not affected by RF ( p  > 0.05). DR, RPE and accuracy scores in the LSST were significantly lower after the 5mSRT compared to BR (1.29 vs. 1.24 AU; 1.29 vs. 1.24, respectively). In conclusion, RF had no adverse effects on physical performance. However, when combined with high-intensity running sessions, RF may impact accuracy and PD, and these adverse effects seem to have been translated into EF.

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.

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 aim of the present study was to evaluate the impact of Ramadan fasting on sleep quality and daytime sleepiness in team sport referees. Seventy-eight male amateur team sport referees (age: 31.1 ± 10.8 years) participated in this study. Participants responded to the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) and the Epworth sleepiness scale (ESS) questionnaires before (10-days prior) and during (last 7-days) the month of Ramadan.PSQI and ESS scores increased significantly during Ramadan (both p < .001, ES = 0.56 and 0.54, respectively) with 83.3% of participants scoring ≥5 in the PSQI. The percentage of participants suffering from severe excessive daytime sleepiness (ESS score ≥ 16) was 3.8% before vs . 7.7% during Ramadan (p < 0.001). Sleep duration decreased by ~ 1 h during Ramadan (p < .001, ES = 0.61) and was associated with a delay in bedtime of ~ 2 h (p < 0.001, ES = 0.7) and of wake-up time of ~ 1 h (p < 0.001, ES = 0.5). The score for daytime dysfunction and subjective sleep perception, as components of the PSQI, increased (both p < 0.001; ES = 0.79, ES = 0.57, respectively), whereas the score for the use of sleep medication decreased during vs . before Ramadan (p = 0.041, ES = 0.47). Ramadan fasting impaired sleep quality and increased daytime sleepiness in team sport referees. Future studies, using objective assessment tools, are warranted.

The impact of intermittent circadian fasting (ICF) on skin disorders is far to be plenty deciphered. However, the circadian rhythm seems to exert a modulation on dermatoses severity, drug-response, and drug-related side effects. We aimed to evaluate ICF effect in the daily management of dermatological diseases. In this multicenter, prospective observational study we enrolled patients willing to undergo the 2018 ICF (from May 16 to June 14). Dermatoses severity were evaluated at the beginning of ICF (T0) and at the end of ICF (T1) by two independent board-certified dermatologists. Seventy-two patients suffering from different dermatoses volunteered to take part into the study. They displayed a mean age of 40.38 ± 12.46 years (median 41.0 years), 25 subjects were males (34.7% of the entire sample). The median weight change was 0 kg. The overall ICF effect size was -0.58 ([95% CI -0.83 to -0.33], P < .0001, medium effect size). Since in the present investigation no weight loss occurred, we could speculate that the impact of fasting in terms of improvements in the clinical symptoms could be rather due to the perturbation of the human biological clock. Despite our data remain preliminary, a chronobiological approach should be incorporated in the dermatological armamentarium., (© 2021 Wiley Periodicals LLC.)

Objective: To evaluate the effect of observing Ramadan on athletes' sleep patterns., Design: Systematic review and meta-analysis., Data Sources: The entire content of PubMed/MEDLINE and Web of Science., Eligibility Criteria for Selecting Studies: Single-group, prepost and cross-over design studies conducted in athletes aged ≥18 years, training at least twice a week and published in English before 12 July 2018 were included. Studies assessing sleep quantity, quality, daytime sleepiness and/or daily naps based on objective or subjective methods were deemed eligible., Study Appraisal: The methodological quality was assessed using 'QualSyst'., Results: Of 13 selected articles, 7 were of strong quality, 3 were moderate and 3 were weak. 11 studies evaluated total sleep time (TST); this decreased during Ramadan in 4 studies, increased in 1 and remained unchanged in 6. Pooled TST findings indicated a moderate effect size (- 0.97, SE=0.37, 95% CI -1.69 to -0.25, t=-2.64, p=0.01) with significant heterogeneity but no publication bias. Meta-regressions showed no effects of study year, age, sample size, type of sport or competition level, but there were effects of country (with France and Tunisia being the most affected countries and Turkey the least affected, Q=32.14, p<0.0001) and study design (Q=7.74, p=0.02). Four studies measured self-reported sleep quality and it decreased in three studies. One study of sleep architecture reported more frequent waking and more light sleep during Ramadan. Daily nap duration was increased in two studies, but daytime sleepiness remained unchanged in four studies., Conclusion: When athletes continue to train at least two times/week while observing Ramadan, TST is decreased compared with athletes' baseline levels., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

To evaluate the effects of Ramadan observance on dietary intake, body mass and body composition of adolescent athletes (design: systematic review and meta-analysis; data sources: PubMed and Web of Science; eligibility criteria for selecting studies: single-group, pre-post, with or without control-group studies, conducted in athletes aged <19 years, training at least 3 times/week, and published in any language before February 12 th , 2020). Studies assessing body mass and/or body composition and/or dietary intake were deemed eligible. The methodological quality was assessed using 'QualSyst'. Of the twelve selected articles evaluating body mass and/or body composition, one was of strong quality and eleven were rated as moderate. Ten articles evaluated dietary intake; four were rated as strong and the remaining moderate in quality. Continuation of training during Ramadan did not change body mass from before to the first week (trivial effect size (ES) = -0.011, p = 0.899) or from before to the fourth week of Ramadan (trivial ES = 0.069, p = 0.277). Additionally, Ramadan observance did not change body fat content from before to the first week (trivial ES = -0.005, p = 0.947) and from before to the fourth week of Ramadan (trivial ES = -0.057, p = 0.947). Lean body mass remained unchanged from before to the fourth week of Ramadan (trivial ES = -0.025, p = 0.876). Dietary data showed the intake of energy (small ES = -0.272, p = 0.182), fat (trivial ES = 0.044, p = 0.842), protein (trivial ES = 0.069, p = 0.720), carbohydrate (trivial ES = 0.075, p = 0.606) and water (trivial ES = -0.115, p = 0.624) remained essentially unchanged during as compared to before Ramadan. Continued training of adolescent athletes at least three times/week during Ramadan observance has no effect on body mass, body composition or dietary intake., Competing Interests: The authors declare no conflict of interest.

We aimed to investigate the effects of a 25-min nap opportunity on physical performance during the 5-m shuttle run test (5mSRT), feelings (i.e., evaluated by the feeling scale), attention (i.e., evaluated by the digit cancellation test) and the perception of fatigue (i.e., recorded by the rating of perceived exertion (RPE)) during Ramadan observance. Twelve physically active men (age: 21.1 ± 3.2 yrs, height: 1.76 ± 0.05 m, body-mass: 71.2 ± 9.3 kg) voluntarily participated in five test sessions: 15 days before Ramadan (BR), the first 10 days of Ramadan (FR), the last 10 days of Ramadan (ER), 10 days after Ramadan (10AR) and 20 days after Ramadan (20AR). During each test session, participants performed the digit cancellation test, a 5-min standard warm-up, the 5mSRT (6 × 30-s with 35-s intervals-between) and the rating of perceived exertion (RPE) after no-nap (N0) and 25-min nap opportunity (N25) conditions. Participants also completed the Pittsburgh Sleep Quality Index (PSQI) during each period. The total distance covered during the 5mSRT did not differ significantly before, during or after Ramadan, but was significantly greater after N25 compared to N0 at 10AR (687.5 ± 23.0 m vs. 725.6 ± 41.1 m; p = 0.018) and 20AR (698.3 ± 19.8 m vs. 742.6 ± 58.3 m; p = 0.003). The attention scores were higher after N25 in comparison with N0 at 10AR ( p = 0.04) and 20AR ( p = 0.02). RPE scores were not significantly different between N25 and N0 conditions. Feelings scores were higher after N25 compared to N0 during both FR ( p = 0.007) and 20AR ( p = 0.04). A significant deterioration of sleep quality was recorded during Ramadan (i.e., PSQI scores were significantly higher during and after compared to BR ( p < 0.0005)). A 25-min nap opportunity was beneficial for physical and cognitive performance after Ramadan observance; however, any effect is insufficient to show significant beneficial impacts during Ramadan.

Purpose: In recent decades, the interest for the effects of Ramadan fasting (RF) on health and athletic performance has substantially increased. Moreover, it is widely accepted that body composition is a crucial measure in sport settings to evaluate training programs and optimize nutrition for athletes. This systematic review was conducted to assess the effects of RF on body composition in athletes., Data Sources: An electronic database search was performed on the Web of Science and PubMed/MEDLINE databases from inception to March 2019 using a combination of relevant keywords., Study Eligibility Criteria: RF-related measurements of any body composition indicators in athletes were considered. Only studies published in English language were included. Study appraisal: The quality and validity of the included studies were assessed using "QualSyst"., Result: Twelve studies met the inclusion criteria for this review, which involved a total of 183 participants (12 female and 171 male athletes) of different sport disciplines. Collectively, the analyzed studies indicate that body mass index, body fat, and body fat percentage were generally lower during Ramadan compared to before Ramadan, while lean mass and total body water were unchanged during Ramadan., Conclusion: Despite the importance of body composition control in sport and exercise settings, there are still many aspects of body composition that should be more thoroughly assessed in athletes during the month of Ramadan. More research, especially well-conducted randomized controlled trials, is needed to evaluate the magnitude of body composition changes in athletes during the holy month.

Objective: To evaluate the effects of Ramadan fasting on physical performance measures in soccer players through a systematic appraisal of the literature., Design: Systematic review Data sources: The entire content of two databases, PubMed/MEDLINE and Web of Science. Eligibility criteria for selecting studies: Both singlegroup, pre-post and crossover design studies published in any language before March 15, 2019 were included. Assessments of physical performance were accepted for analysis. study appraisal: The methodological quality of the included studies was assessed using 'QualSyst'., Results: Of 18 selected articles, 16 were generally of strong quality and the remaining studies (n=2) were rated as moderate, although most lacked significant details about the Ramadan fasting. Most studies showed that Ramadan fasting did not impair short-term maximal performances in soccer players (i.e., vertical jump, sprint performance, maximal voluntary contraction, hand grip, agility performance). During the 30-s Wingate test, the repeated sprint exercise (RSE) tasks, and the long-duration incremental and non-incremental exercises, most studies reported some negative effects of Ramadan fasting even when the training load was maintained. For the soccer specific skills and test with ball, most studies reported that there was no significant negative effects of the fasting month on performance when the training load was maintained or slightly reduced during the Ramadan., Conclusions: The continuance of training during Ramadan fasting, with maintained training load, has no negative effects on short-term maximal performances and soccer specific skills and test with ball. However, performances of the 30-s Wingate test, the RSE tasks, and the long-duration incremental and non-incremental exercises were significantly impaired during Ramadan fasting even when the training load was maintained.

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.

The present study was designed to investigate the effect of Ramadan fasting on feelings, dietary intake, rating of perceived exertion (RPE) and repeated high-intensity short-term maximal performance. Thirteen physically active men (age: 21.2 ± 2.9 years, height: 175.6 ± 5.6 cm, body-mass: 72.4 ± 8.6 kg) performed a 5-m shuttle run test (6 × 30-s + 35-s of recovery in-between) during five experimental periods: fifteen days before Ramadan (BR), the first ten days of Ramadan (FR), the last ten days of Ramadan (ER), ten days after Ramadan (AR10) and 20 days after Ramadan (AR20). The study was carried out in Tunisia during the 2016 Ramadan month. During the 5-m shuttle run test, higher distance (HD), total distance (TD) and fatigue index (FI) were recorded. RPE was determined after a 5-min warm-up and after each repetition of the 5-m shuttle run test (the mean RPE score during the test was calculated). Moreover, a feelings scale (FS) was used after the warm-up and after the end of the 5-m shuttle run test. During the five experimental periods, dietary intake was assessed. The results showed that HD, TD and FI during the 5-m shuttle run test were not affected by Ramadan observance (p > 0.05). Likewise, FS scores recorded after the warm-up and the 5-m shuttle run test were not affected by Ramadan fasting (p > 0.05). However, mean RPE scores during the 5-m shuttle run test were significantly lower at ER (4.06 UA), AR10 (3.86 UA) and AR20 (3.71 UA) in comparison to BR (4.51 UA) (p < 0.05). The results showed also that Ramadan fasting has no adverse effect on energy intake, protein (g and %), fat (g and %) and carbohydrate (g). However, the fractional contribution of carbohydrate was significantly higher AR10 than FR (53.1% vs. 45.8%) and ER (53.1% vs. 46.5%) and AR20 than FR (5.92% vs. 45.8%) (p < 0.05). In conclusion, Ramadan fasting has no adverse effect on feelings, dietary intake, and short-term maximal performance. However, the RPE during repeated high intensity short-term maximal exercise was reduced AR20 in comparison to ER. Abbreviations: AR: After Ramadan; AR10: Ten days after Ramadan; AR20: Twenty days after Ramadan; BR: Fifteen days before Ramadan; ER: Last ten days of Ramadan; FI: Fatigue index; FR: First ten days of Ramadan; FS: Feelings scale; HD: Higher distance; PSQI: The Pittsburgh Sleep Quality Index; RPE: Rating of Perceived Exertion Scale; TD: Total distance.

Aim: The aim of the present study was to examine whether listening to music during warming-up might influence short-term maximal performance (STMP), cognitive anxiety, self-confidence, and enjoyment during Ramadan, and whether these affects might predict STMP., Methods: Nine male physical education students (age: 21 ± 1.1 years; height: 1.8 ± 0.04 m; body mass: 83 ± 5 kg) volunteered to participate in the present study. A within-subjects design consisted of four experimental sessions: Two sessions occurred one week before Ramadan and two others took place during Ramadan. They were scheduled at 5 p.m. and were conducted as follows: After a 10-minute warm-up either with or without listening to music, each participant performed a 5-m multiple shuttle run test, after which he was asked to answer items intended to assess his affective state during the experimental task., Results: Our findings revealed that STMP was lower during Ramadan than before Ramadan in the no-music condition. Additionally, it was found that STMP was higher in the music condition than in the no-music condition during Ramadan, and that STMP measured before Ramadan did not differ from that measured during Ramadan in the music condition. Regarding affects, the findings revealed that enjoyment was lower during Ramadan than before Ramadan in the music condition, and that cognitive anxiety was lower in the music condition than in the no-music condition before Ramadan. Self-confidence was not influenced by the experimental conditions., Conclusion: This study showed that listening to music during warming-up not only would be beneficial for STMP in Ramadan fasters, but also would counteract the negative effects of Ramadan observance on STMP.

Purpose: To examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the morning., Methods: Twelve healthy active men performed four Wingate tests for measurement of peak power and mean power before and during Ramadan at 09:00 a.m. The tests were performed on separate days, after either a 5-min or a 15-min warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. Oral temperature was measured at rest and after warming-up. Furthermore, ratings of perceived exertion were obtained immediately after the Wingate test., Results: Oral temperature was higher after the 15-min warm-up than the 5-min warm-up throughout the study. Moreover, peak power and mean power were higher after the 15-min warm-up than the 5-min warm-up before Ramadan. However, during Ramadan, there was no significant difference between the two warm-up durations. In addition, ratings of perceived exertion were higher after the 15-min warm-up than the 5-min warm-up only during Ramadan., Conclusions: There is no need to prolong the warm-up period before short-term maximal exercise performed during Ramadan in the morning.

Aim: The purpose of this study was to examine the effect of active warm-up duration on short-term maximal performance assessed during Ramadan in the afternoon., Methods: Twelve healthy active men took part in the study. The experimental design consisted of four test sessions conducted at 5 p.m., before and during Ramadan, either with a 5-minute or a 15-minute warm-up. The warm-up consisted in pedaling at 50% of the power output obtained at the last stage of a submaximal multistage cycling test. During each session, the subjects performed two vertical jump tests (squat jump and counter movement jump) for measurement of vertical jump height followed by a 30-second Wingate test for measurement of peak and mean power. Oral temperature was recorded at rest and after warming-up. Moreover, ratings of perceived exertion were obtained immediately after the Wingate test., Results: Oral temperature was higher before Ramadan than during Ramadan at rest, and was higher after the 15-minute warm-up than the 5-minute warm-up both before and during Ramadan. In addition, vertical jump heights were not significantly different between the two warm-up conditions before and during Ramadan, and were lower during Ramadan than before Ramadan after both warm-up conditions. Peak and mean power were not significantly different between the two warm-up durations before Ramadan, but were significantly higher after the 5-minute warm-up than the 15-minute warm-up during Ramadan. Moreover, peak and mean power were lower during Ramadan than before Ramadan after both warm-up conditions. Furthermore, ratings of perceived exertion were higher after the 15-minute warm-up than the 5-minute warm-up only during Ramadan., Conclusion: The prolonged active warm-up has no effect on vertical jump height but impairs anaerobic power assessed during Ramadan in the afternoon.

We aimed to examine the effect of maintaining or reducing resistance training volume during Ramadan-intermittent-fasting (RIF) on short-term maximal performances. 20 footballers (age: 18.4 ± 0.8 years; body-mass: 72.4 ± 4.1 kg; height: 183.4 ± 4.6 cm) were matched and randomly assigned to a normal-training-group (G1) or a tapering-group (G2). They were tested for muscular strength (maximal-voluntary-contraction) and power (squat-jump and counter-movement-jump) 1 month before RIF (T0), 1 week before RIF (T1), after 2 weeks of fasting (T2) and at the end of RIF (T3). From T1 to T2, subjects performed a whole-body resistance training program (8-repetitions × 4-sets with 4-min recovery in-between). During RIF, G1 maintained the same training program, while G2 performed a period of reduced training volume (3 sets/exercise; - 22%). Muscle strength and power increased significantly from T0 to T1, from T0 to T2 and from T0 to T3 in G1 and G2 and from T1 to T2 and from T1 to T3 only in G2 (p<0.05). Performance was higher in G2 than G1 during T2 (p<0.01). Moreover, the ∆-change of performance between T0 and T2 and T3 was significantly higher in G2 than G1 (p<0.05). For young soccer players, a tapering period characterized by a reduced training volume during RIF may lead to significant improvement in muscle strength and power., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To examine the time-of-day and Ramadan fasting (RF) effects on serum apolipoprotein-AI (Apo-AI) and B (Apo-B), lipoprotein particles-a (Lp-a), high-sensitive C-reactive-protein (hs-CRP), and homocysteine (Hcy) during the Yo-Yo intermittent recovery test (YYIRT)., Design: Performance and biochemical measures were completed at two times-of-day (07:00 and 17:00 h), 1-week before RF (BR), the second week of RF (SWR), and the fourth week of RF (ER)., Setting: For each session, subjects performed the YYIRT, and blood samples were taken before and 3-min after the test for biochemical measures., Participants: Fifteen soccer players., Main Outcome Measures: Total distance during the YYIRT, core temperature, body composition, dietary intakes, lipid (HDL-C, LDL-C, Apo-AI, B and Lp-a) and inflammatory (hs-CRP and Hcy) profiles., Results: Performances during the YYIRT were higher in the evening than the morning BR (P < 0.05), but this fluctuation was not observed during RF. Moreover, LDL-C, ApoB, and Lp-a were stable throughout the daytime BR. However, during RF, they decreased at 17:00 h (P < 0.05). Likewise, HDL-C and Apo-AI increased after the exercise and were higher at 17:00 h BR (P < 0.001). Moreover, these parameters increased during RF (P < 0.01). Furthermore, Hcy and hs-CRP increased during the exercise (P < 0.01) with higher evening levels BR. During ER, the diurnal pattern of Hcy was inversed (P < 0.001)., Conclusions: This study concluded that caloric restriction induced by RF seems to ameliorate lipid and inflammatory markers of cardiovascular health during intermittent exercise performed in the evening.

Purpose: This study examined the effects of Ramadan on cycling repeated-sprint ability (RSA) and corresponding diurnal variations., Methods: Twelve active men performed an RSA test (5 × 6-s maximal sprints interspersed with 24 s passive recovery) during morning and afternoon sessions 1 wk before Ramadan (BR), during the second (R2) and the fourth (R4) weeks of Ramadan, and 2 wk after Ramadan (AR). Maximal voluntary contraction was assessed before (MVCpre), immediately after (MVCpost), and 5 min after the RSA test (MVCpost5). Moreover, hematocrit, hemoglobin, and plasma sodium and potassium (K+) concentrations were measured at rest and after the RSA test and MVCpost., Results: Overall, peak power (Ppeak) during the RSA test decreased throughout the 5 sprints. Ppeak measured in the first sprint and MVCpre were lower during Ramadan than BR in the afternoon (P < .05) and higher in the afternoon than the morning BR and AR (P < .05). However, this diurnal rhythmicity was not found for the last 4 sprints' Ppeak, MVCpost, and MVCpost5 in all testing periods. Furthermore, the last 4 sprints' Ppeak, MVCpost, MVCpost5, and morning MVCpre were not affected by Ramadan. [K+] measured at rest and after the RSA test and MVCpost were higher during Ramadan than BR in the afternoon (P < .05) and higher in the afternoon than the morning during Ramadan (P < .05)., Conclusions: Fatigability is higher in the afternoon during Ramadan, and, therefore, training and competition should be scheduled at the time of day when physical performance is less affected.

This study was designed to assess the effects of Ramadan-intermittent-fasting (RIF) and time-of-day on muscle power and fatigue during the Wingate test. In a randomized design, 10 football players completed a Wingate test at 07:00 and 17:00 h on 3 different occasions: one week before Ramadan (BR), the second week of Ramadan (SWR) and the fourth week of Ramadan (ER). There was an interval of 36-h between any 2 successive tests. During the Wingate test, peak power (PP), mean power (MP) and the fatigue index (FI) were recorded. While PP, MP and FI were greater in the evening than in the morning during BR (p<0.001), these diurnal variations in muscle power disappeared during the month of Ramadan (i. e., SWR and ER) due to a significant decrease in PP and MP in the evening (p<0.001). However, the diurnal variation in FI when measured at 17:00 h increased during this month (p<0.001). In addition, ratings of perceived exertion and fatigue were higher in the evening during Ramadan in comparison with BR. These results suggest that Ramadan might modify the circadian rhythm of muscle power and fatigue during the Wingate test by decreasing power output and increasing muscle fatigue at the time of the acrophase., (© Georg Thieme Verlag KG Stuttgart · New York.)

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.