Effect of Ramadan Fasting on the Blood Coagulation System in a Session Soccer Match

Document Type : Research Paper

Authors

1 Department of Exercise Physiology, Alborz Campus, University of Tehran, Alborz, Iran.

2 Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran.

3 Department of Community Medicine and Rehabilitation, Section of Sports Medicine, Umeå University, Umeå, Sweden.

4 Department of Education, Faculty of Social Science, Umeå University, Umeå, Sweden.

Abstract

Introduction: Ramadan fasting is associated with modifications in athletes' metabolic, physiological, and psychological responses, which may affect their physical performance. The present study aimed to assess the changes in some of the risk factors for thrombosis in trained men after one soccer session in fasting and non-fasting states. Methods: This study was conducted on 11 amateur soccer players with the mean age of 42±16 years and mean body mass index of 26.49±2.86 kg/m2. The subjects played in a soccer match with the duration of ~100 minutes, including 10 minutes of warm-up and 90 minutes of a soccer match, in two sessions (one week before and on day four of Ramadan). Blood samples were collected before and after the soccer game. Fibrinogen and D-dimer were analyzed using the Clauss clotting method and the turbid metric assay, respectively. In addition, plasminogen and alpha 2-antiplasmin were analyzed via spectrophotometry, and homocysteine was examined using the ELISA assay. Data analysis was performed using the Shapiro-Wilk test and independent and dependent t-test at the significance level of P≤0.05. Result: One session of soccer match increased homocysteine in the fasting (P=0.006) and non-fasting subjects (P=0.042). Alpha 2-antiplasmin decreased in the fasting (P=0.031) and non-fasting subjects (P=0.001), while plasminogen decreased only in the non-fasting subjects (P=0.012). One session of soccer match had no significant impact on fibrinogen and D-dimer in both states, as well as plasminogen in the fasting state (P≥0.05). Furthermore, no significant differences were observed between the fasting and non-fasting subjects in terms of homocysteine, alpha 2-antiplasmin, fibrinogenplasminogen, and D-dimer in response to one session of soccer match (P≥0.05). Conclusion: According to the results, one session of soccer match in the fasting state was parallel to the non-fasting state, and fasting led to no adverse consequences in the coagulation system of the subjects.

Keywords


  1. Bouzid MA, Abaïdia A-E, Bouchiba M, Ghattassi K, Daab W, Engel FA, et al. Effects of Ramadan fasting on recovery following a simulated soccer match in professional soccer players: a pilot study. Front Physiol. 2019;10(1480).
  2. Waterhouse J, Alkib L, Reilly T. Effects of Ramadan upon fluid and food intake, fatigue, and physical, mental, and social activities: a comparison between the UK and Libya. Chronobiol Int. 2008;25(5):697-724.
  3. Roky R, Herrera CP, Ahmed Q. Sleep in athletes and the effects of Ramadan. J Sports Sci. 2012;30(sup1):S75-84.
  4. Sarraf-Zadegan N, Atashi M, Naderi GA, Baghai AM, Asgary S, Fatehifar MR, et al. The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Ann Saudi Med. 2000;20(5-6):377-81.
  5. Aksungar FB, Eren A, Ure S, Teskin O, Ates G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann Nutr Metab. 2005;49(2):77-82.
  6. Patelis N, Karaolanis G, Kouvelos GN, Hart C, Metheiken S. The effect of exercise on coagulation and fibrinolysis factors in patients with peripheral arterial disease. Exp Biol Med. 2016;241(15):1699-707.
  7. Van Stralen KJ, Doggen CJ, Lumley T, Cushman M, Folsom AR, Psaty BM, et al. The relationship between exercise and risk of venous thrombosis in elderly people. JAm Geriatr Soc. 2008;56(3):517-22.
  8. Kupchak BR, Creighton BC, Aristizabal JC, Dunn-Lewis C, Volk BM, Ballard KD, et al. Beneficial effects of habitual resistance exercise training on coagulation and fibrinolytic responses. Thromb Res. 2013;131(6):e227-34.
  9. Dobson GP, Morris JL, Davenport LM, Letson HL. Traumatic-induced coagulopathy as a systems failure: a new window into hemostasis. InSeminars in Thrombosis and Hemostasis. 2020; 46 (2):199-214). Thieme Medical Publishers.
  10. Zouhal H, Saeidi A, Salhi A, Li H, Essop MF, Laher I, et al. Exercise training and fasting: current insights. Open Access J Sports Med. 2020;11:1.
  11. Darzabi T, Hejazi K. The Effects of Ramadan Fasting on Electrolytes Index, Serum Osmolarity and Body Composition in Fasting and Non-Fasting Students: A Quasi-Experimental Study. Jundishapur J Chronic Dis Care. 2020;9(2):e100079.
  12. Javanmardi H, Safari A, Borhani-Haghighi A. Effect of Ramadan fasting in incidence of cerebral venous sinus thrombosis. International journal of stroke : official journal of the International Stroke Society. 2018;13(2):Np2.
  13. Arnaoutis G, Kavouras SA, Stratakis N, Likka M, Mitrakou A, Papamichael C, et al. The effect of hypohydration on endothelial function in young healthy adults. Eur J Nutr. 2017;56(3):1211-7.
  14. Chaouachi A, Leiper JB, Chtourou H, Aziz AR, Chamari K. The effects of Ramadan intermittent fasting on athletic performance: recommendations for the maintenance of physical fitness. J Sports Sci. 2012;30(sup1):S53-73.
  15. Quchan AHSK, Kordi MR. Strategies and Solutions to Return to Training for Teams and Elite Athletes After Lifting COVID-19 Restrictions. Asian J Sports Med. 2020;11(3):e106285.
  16. Costill D, Fink W. Plasma volume changes following exercise and thermal dehydration. J Appl Physiol. 1974;37(4):521-5.
  17. Jakubowski H. Homocysteine modification in protein structure/function and human disease. Physiol Rev. 2019;99(1):555-604.
  18. Herrmann M, Schorr H, Obeid R, Scharhag J, Urhausen A, Kindermann W, et al. Homocysteine increases during endurance exercise. Clin Chem Lab Med. 2003;41(11):1518-24.
  19. König D, Bissé E, Deibert P, Müller HM, Wieland H, Berg A. Influence of training volume and acute physical exercise on the homocysteine levels in endurance-trained men: interactions with plasma folate and vitamin B12. Ann Nutr Metab. 2003;47(3-4):114-8.
  20. Real JT, Merchante A, Gómez JL, Chaves FJ, Ascaso JF, Carmena R. Effects of marathon running on plasma total homocysteine concentrations. Nutr Metab Cardiovasc Dis. 2005;15(2):134-9.
  21. Gelecek N, Teoman N, Ozdirenc M, Pınar L, Akan P, Bediz C, et al. Influences of acute and chronic aerobic exercise on the plasma homocysteine level. Ann Nutr Metab. 2007;51(1):53-8.
  22. Venta R, Cruz E, Valcárcel G, Terrados N. Plasma vitamins, amino acids, and renal function in postexercise hyperhomocysteinemia. Med Sci Sports Exerc. 2009;41(8):1645-51.
  23. Bizheh N, Jaafari M. The Effect of a Single Bout Circuit Resistance Exercise on Homocysteine, hs-CRP and Fibrinogen in Sedentary Middle Aged Men. Iran J Basic Med Sci. 2011;14(6):568-73.
  24. Deminice R, Vannucchi H, Simões-Ambrosio LM, Jordao AA. Creatine supplementation reduces increased homocysteine concentration induced by acute exercise in rats. Eur J Appl Physiol. 2011;111(11):2663-70.
  25. Deminice R, Rosa FT, Franco GS, Jordao AA, de Freitas EC. Effects of creatine supplementation on oxidative stress and inflammatory markers after repeated-sprint exercise in humans. Nutrition (Burbank, Los Angeles County, Calif). 2013;29(9):1127-32.
  26. Iglesias-Gutiérrez E, Egan B, Díaz-Martínez ÁE, Peñalvo JL, González-Medina A, Martínez-Camblor P, et al. Transient Increase in Homocysteine but Not Hyperhomocysteinemia during Acute Exercise at Different Intensities in Sedentary Individuals. PLoS One. 2012;7(12):e51185.
  27. Brosnan JT, Da Silva RP, Brosnan ME. The metabolic burden of creatine synthesis. Amino Acids . 2011;40(5):1325-31.
  28. Maroto-Sánchez B, Lopez-Torres O, Valtueña J, Benito PJ, Palacios G, Díaz-Martínez Á E, et al. Rehydration during exercise prevents the increase of homocysteine concentrations. Amino Acids. 2019;51(2):193-204.
  29. Joubert LM, Manore MM. Exercise, nutrition, and homocysteine. Int JSport Nutr Exerc Metab. 2006;16(4):341-61.
  30. Zakrzewski M, Zakrzewska E, Kiciński P, Przybylska-Kuć S, Dybała A, Myśliński W, et al. Evaluation of fibrinolytic inhibitors: alpha-2-antiplasmin and plasminogen activator inhibitor 1 in patients with obstructive sleep apnoea. PloS one. 2016;11(11).
  31. Ibrahim O, Kamaruddin NA, Wahab NA, Rahman MM. Ramadan fasting and cardiac biomarkers in patients with multiple cardiovascular disease risk factors. Int J Cardiovasc Resh. 2011;7(2):1-11.
  32. MOSESSON MW. Fibrinogen and fibrin structure and functions. J Thromb Haemost. 2005;3(8):1894-904.
  33. Mahmoodinezhad S, Shakerian S, Ghalavand A, Motamedi P, Delaramnasab M. The Effect of acute training and circadian rhythm on blood hemostasis in female athletes. Int J Basic Sci Med.2016; 1(1):8-12.
  34. Kahraman S, Bediz CS, Pişkin O, Aksu I, Topçu A, Yüksel F, et al. The effect of the acute submaximal exercise on thrombin activatable fibrinolysis inhibitor levels in young sedentary males. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2011;17(4):414-20.
  35. Khademi A, Tofighi A, Tolouei Azar J, Saify Nabiabad H, Nouri Habashi A. Modulation of blood hemostasis by concurrent training in obese women with low-mobility. Studies in Medical Sciences. 2019;29(11):781-92.