Sport Participation and Ramadan Observance: Advice for the Athlete

Document Type : Review Article


Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada


Introduction: A growing number of Muslim athletes now engage in international competition. This raises the question of the advice they should be given if a major event occurs during the month of Ramadan. Methods: A narrative review has been based upon books and extensive reviews completed by the author and other investigators. Results: Practical considerations hamper assessment of the effects of Ramadan upon physical performance, but there seem small decreases in muscular strength and both anaerobic and aerobic capacity.  Nevertheless, athletes who wish to observe Ramadan can reduce such effects by prior adjustment of diet and training plans, minimizing sleep loss, and careful management of fluid and food intake during the period of intermittent fasting. Conclusion: Competitors in most events can observe Ramadan with a small loss of athletic performance. However, intermittent fasting can endanger health for individuals with type I diabetes mellitus, and for participants in ultra-endurance events (particularly under hot conditions).


  1. Chtourou H. Effects of Ramadan fasting on health and athletic performance. New York, NY: Omics Group International; 2015.
  2. Shephard RJ. Ramadan and the risk of sport injuries. Clin J Sports Med. 2014; 24(5):361-3.
  3. Bouhlel E, Shephard RJ. Optimizing physical performance during fasting and dietary restriction: implications for athletes and sports medicine. Boca Raton, FL: CRC Press; 2015.
  4. Nematy M, Alinnezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutr J. 2012; 11:69-75.
  5. Shephard RJ. Ramadan and sport: Minimizing effects upon the observant athlete. Sports Med. 2013; 43(12):1217-41.
  6. Shephard RJ. The impact of Ramadan observance upon athletic performance. Nutrients. 2012; 4(6):491-505.
  7. Eirale C, Tol JL, Smiley F, Farooq A, Chalabi H. Does Ramadan affect the risk of injury in professional football? Clin J Sport Med. 2013; 23(4):261-6.
  8. Zerguini Y, Dvorak J, Maughan RJ, Leiper JB, Bartagi Z, Kirkendall DT, et al. Influence of Ramadan fasting on physiological and performance variables in football players: summary of the F-MARC 2006 Ramadan fasting study. J Sports Sci. 2008; 26 (Suppl. 3):S3-6.
  9. Shephard RJ, Aoyagi Y. Seasonal variations in physical activity and human health. Eur J Appl Physiol. 2009; 107(3):251-71.
  10. Atkinson G, Reilly T. Circadian variation in sports performance. Sports Med. 1996; 21(4):292-312.
  11. Wilson D, Drust B, Reilly T. Is diurnal lifestyle altered during Ramadan in professional Muslim athletes? Bio Rhythm Res. 2009; 40(5):385-97.
  12. Chaouachi A, Leiper JB, Souissi N, Coutts AJ, Chamari K. Effects of Ramadan intermittent fasting on sports performance and training: a review. Int J Sports Physiol Perform. 2009; 4(4):419-34.
  13. Mujika I, Chaouachi A, Chamari K. Precompetition taper and nutritional strategies: special reference to training during Ramadan intermittent fast. Br J Sports Med. 2010; 44(7):495-501.
  14. Churchley EG, Coffey VG, Pedersen DJ, Shield A, Carey KA, Cameron-Smith D, et al. Influence of preexercise muscle glycogen content on transcriptional activity of metabolic and myogenic genes in well-trained humans. J Appl Physiol. 1985; 102(4):1604-11.
  15. Hawley JA, Gibala MJ, Bermon S. Innovations in athletic preparation: role of substrate availability to modify training adaptation and performance. J Sports Sci. 2007; 25 (Suppl. 1):S115-24.
  16. Moore DR, Robinson MJ, Fry JL, Tang JE, Glover EI, Wilkinson SB, et al. Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Am J Clin Nutr. 2009; 89(1):161-8.
  17. Rasmussen BB, Tipton KD, Miller SL, Wolf SE, Wolfe RR. An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exercise. J Appl Physiol. 2000; 88(2):386-92.
  18. Rodriguez NR, Vislocky LM, Gaine PC. Dietary protein, endurance exercise, and human skeletal muscle protein turnover. Curr Opin Clin Nutr Metab Care. 2007; 10(1):40-5.
  19. Chtourou H, Hammouda O, Chaouachi A, Chamari K, Soussi N. The effect of time of day and Ramadan fasting on anaerobic performances. Int J Sports Med. 2012; 33(2):142-7.
  20. Leiper JB, Watson P, Evans G, Dvorak J. Intensity of a training session during Ramadan in fasting and non-fasting Tunisian youth football players. J Sports Sci. 2008; 26(Suppl 3):S71-9.
  21. Aziz AR, Png W. Ramadam fasting and sports performance. In: Lanham-New S, Stear S, Shirrefs S, et al. (eds). Sports and exercise nutrition. Chichester, UK: Wiley-Blackwell; 2011.
  22. Chtourou H, Hammouda O, Chaouachi A, Chamari K, Souissi N. The effect of Ramadan fasting on physical performances, mood state and perceived exertion in young footballers. Asian J Sports Med. 2011; 2(3):177-85.
  23. Chaouachi A, Coutts AJ, Chamari K, Wong del P, Chaouachi M, Chtara M, et al. Effect of Ramadan intermittent fasting on aerobic and anaerobic performance and perception of fatigue in male elite judo athletes. J Strength Cond Res. 2009; 23(9):2702-9.
  24. Chennaoui M, Desgorces F, Drogou C, Boudjemaa B, Tomaszewski A, Depiesse F, et al. Effects of Ramadan fasting on physical performance and metabolic, hormonal, and inflammatory parameters in middle-distance runners. Appl Physiol Nutr Metab. 2009; 34(4):587-94.
  25. Laraqui S, Manar N, Laraqui O, Caubet A, Verger C, Laraqui CH. Influence du ramadan vécu sur la vigilance au travail chez les professionnels de santé au Maroc (Influence of Ramadan observance on wakefulness at work among health care workers in Morocco). Arch Maladies Profess Environment. 2012; 73(5):743-9.
  26. Aziz A, Chia M, Singh R, Wahid M. Effects of Ramadan fasting on perceived exercise intensity during high-intensity interval training sessions in elite youth football players. Inter J Sports Sci Coach. 2011; 6(1):87-98.
  27. Roky R, Iraki L, HajKhilfla R, Lakhlifa Ghazal N, Hakkou F. Daytime alertness, mood, psychomotor performances, and oral temperature during Ramadan intermittent fasting. Ann Nutr Metab. 2000; 44(3):101-7.
  28. Ramadan J. Does fasting during Ramadan alter body composition, blood constituents and physical performance? Med Princ Pract. 2002; 11(Suppl 2):41-6.
  29. McNay EC, Cotero VE. Mini-review: impact of recurrent hypoglycemia on cognitive and brain function. Physiol Behav. 2010; 100(3):234-8.
  30. Bentley DJ, Cox GR, Green D, Laursen PB. Maximising performance in triathlon: Applied physiological and nutritional aspects of elite and non-elite competitions. J Sci Med Sport. 2008; 11(4):407-16.
  31. Hawley JA, Schabort EJ, Noakes TD, Dennis SC. Carbohydrate-loading and exercise performance. An Update. Sports Med. 1997; 24(1):73-81.
  32. Bouhlel E, Salhi Z, Bouhlel H, Mdella S, Amamou A, Zaouali M, et al. Effect of Ramadan fasting on fuel oxidation during exercise in trained male rugby players. Diabetes Metab. 2006; 32(6):617-24.
  33. Krifi M, Ben Salem M, Ben Rayana MC, Alguemi C, Ben Farhat N, Triki S, et al. Ramadan, activité physique et variations biologiques. J Méd Nutr. 1989; 25:223-8.
  34. Ba A, Samb A, Seck D, Kane MO, Seck MB, Sarr FB, et al. Comparative study of the effect of fasting during Ramadan on the glycaemia at rest in sportsmen and sedentary individuals. Dakar Med. 2005; 50(1):22-5.
  35. Gueye L, Samb A, Seck D, Martineaud JP. Influence of a 12-hour fast on maximal exercise. Scripta Med. 2005; 77(5-6):271-6.
  36. Stannard SR, Thompson MW. The effect of participation in Ramadan on substrate selection during submaximal cycling exercise. J Sci Med Sports. 2008; 11(5):510-7.
  37. Chiha F. Variations of exercise metabolism of footballers during Ramadan fasting. Algiers:Thesis, University of Algiers; 2009.
  38. Ramadan J, Telahoun G, Al-Zaid NS, Barac-Nieto M. Responses to exercise, fluid, and energy balances during Ramadan in sedentary and active males. Nutrition. 1999; 15(10):735-9.
  39. Lemon PW. Do athletes need more dietary protein and amino acids? Int J Sport Nutr. 1995; 5(Suppl): S39-61.
  40. Tarnopolsky M. Protein requirements for endurance athletes. Nutrition. 2004; 20(7-8):662-8.
  41. Chaouachi A, Chamari K, Roky R, Wong P, Mbazaa A, Bartagi Z, et al. Lipid profiles of judo athletes during Ramadan. Int J Sports Med. 2008; 29(4):282-8.
  42. Bouhlel E, Zaouali M, Miled A, Tabka Z, Bigard X, Shephard R. Ramadan fasting and the GH/IGF-I axis of trained men during submaximal exercise. Ann Nutr Metab. 2008; 52(4):261-6.
  43. Armstrong LE, Costill DL, Fink WJ. Influence of diuretic-induced dehydration on competitive running performance. Med Sci Sports Exerc. 1985; 17(4):456-61.
  44. Maughan RJ, Shirrefs SM. Hydration and performance during Ramadan. J Sports Sci. 2012; 30(Suppl 1):S33-41.
  45. Sawka MN, Montain SJ. Fluid and electrolyte supplementation for exercise heat stress. Am J Clin Nutr. 2000; 72(2 Suppl):564S–72S.
  46. Kirkendall DT, Leiper JB, Bartagi Z, Dvorak J, Zerguini Y. The influence of Ramadan on physical performance measures in young Muslim footballers. J Sports Sci. 2008; 26(Suppl 3):S15-27.
  47. Meckel Y, Ismael A, Eliakim A. The effect of the Ramadan fast on physical performance and dietary habits in adolescent soccer players. Eur J Appl Physiol. 2008; 102(6):651-7.
  48. Karli U, Guvenc A, Aslan A, Hazir T, Acikada C. Influence of Ramadan fasting on anaerobic performance and recovery from short high intensity exercise. J Sports Sci Med. 2007; 6(4):490-7.
  49. Souissi N, Souissi M, Souissi H, Chamari K, Tabka Z, Dogui M, et al. Effect of time of day and partial sleep deprivation on short-term, high-power output. Chronobiol Int. 2008; 25(6):1062-76.
  50. Khedder A, Achour N, Abou-Messad N, Bouzayan A, Nacef T. Etude comparative de l'adaptation de l'organisme cycloergocycle pendant et après Ramadan [Comparative study of adaptation to a cycle ergometer during and after Ramadan]. Méd Sport. 1983; 57(1):16-7.
  51. Faye J, Fall A, Badji L, Cisse F, Stephan H, Tine P. [Effects of Ramadan fast on weight, performance and glycemia during training for resistance]. Dakar Med. 2005; 50(3):146-51.
  52. Ramadan JM, Barac-Nieto M. Cardio-respiratory responses to moderately heavy aerobic exercise during the Ramadan fasts. Saudi Med J. 2000; 21(3):238-44.
  53. Sweileh N, Schnitzler A, Hunter GR, Davis B. Body composition and energy metabolism in resting and exercising Muslims during Ramadan fast. J Sports Med Phys Fitness. 1992; 32(2):156-63.
  54. Brisswalter J, Bouhlel E, Falola JM, Abbiss CR, Vallier JM, Hauswirth C. Effects of Ramadan intermittent fasting on middle-distance running performance in well-trained runners. Clin J Sports Med. 2011; 21(5):422-7.
  55. Fall A, Sarr M, Mandengue SH, Badji L, Samb A, Gueye L, et al. Effets d'une restriction hydrique et alimentaire prolongée (Ramadan) sur la performance et les réponses cardiovasculaires au cours d'un exercice incrémental en milieu tropical chaud. Sci Sports. 2007; 22(1):50-3.
  56. Mehdioui H, Aberkane A, Bouroubi O, Bougrida M, Benhlassa L, Beltrache C. Influence de la pratique du jeûne Ramadan sur l'endurance maximale aérobie des coureurs de fond (Effects of Ramadan fasting on the maximal aerobic endurance of distance runners). J Alger Med. 1996; 6(1):1-5.
  57. Hamouda O, Chtourou H, Farjallah MA, Davenne D, Souissi N. The effect of Ramadan fasting on the diurnal variations in aerobic and anaerobic performances in Tunisian youth soccer players. Biol Rhythm Res. 2012; 43(2):177-90.
  58. Aziz AR, Wahid MF, Png W, Jesuvadian CV. Effects of Ramadan fasting on 60 min of endurance running performance in moderately trained men. Br J Sports Med. 2010; 44(7):516-21.
  59. Asl NS. The effects of Ramadan fasting on endurance running performance in male athletes. Int J Sport Studies. 2011; 1(1):18-22.
  60. Zerguini Y, Kirkendall D, Junge A, Dvorak J. Impact of Ramadan on physical performance in professional soccer players. Br J Sports Med. 2007; 41(6):398-400.
  61. Sweileh N, Hunter G, Schnitzler. The effects of Ramadan fasting on maximum oxygen intake and maximum performance. J Islamic Med Associa North Am. 1988; 22(4):148-53.
  62. Memari AH, Kordh R, Panahl N, Nikookar LR, Abdollah M, Akbarnejah A. Effect of Ramadan fasting on body composition and physical performance in female athletes. Asian J Sports Med. 2011; 2(3):161-6.
  63. Bouhlel H, Shephard RJ, Gmada N, Aouichaoui C, Peres G, Tabka Z, et al. Effect of Ramadan observance on maximal muscular performance of trained men. Clin J Sports Med. 2013; 23(3):222-7.
  64. Kordi R, Abdullahi M, Memari AH, Najafabadi MG. Investigating two different training time frames during Ramadan. Asian J Sports Med. 2011; 2(3):205-10.
  65. Aslam M, Assad A. Drug regimens and fasting during Ramadan: A survey in Kuwait. Public Health. 1986; 100(1):49-53.
  66. Garcia-Bunuel L. Clinical problems during the fast of Ramadan. Lancet. 1989; 1(8651):1396.
  67. Sulimani RA. Ramadan fasting: Medical aspects in health and disease. Ann Saudi Med. 1991; 11(6):637-41.
  68. Alkandari JR, Maughan RJ, Roky R, Aziz AR, Karli, U. The implications of Ramadan fasting for human health and well-being. J Sports Sci. 2012; 30(Suppl 1):S9–19.
  69. Loucks AB. The endocrine system: Integrated influences on metabolism, growth and reproduction. In: Tipton CM, Sawka MN, Tate CA, et al. (eds). ACSM’s Advanced Exercise Physiology. Philadelphia, PA: Lippincott, Williams & Wilkins; 2006.
  70. FIFA. Muslim players asking scientists for . Zürich, Switzerland, FIFA. Accessed July 26th; 2015.
  71. Chaouachi A, Coutts AJ, Wong del P, Roky R, Mbazaa A, Amri M, et al. Haematological, inflammatory, and immunological responses in elite judo athletes maintaining high training loads during Ramadan. Appl Physiol Nutr Metab. 2009; 34(5):907-15.
  72. White J. Doping control presents unique challenge for 2 Ramadan-fasting Moroccan footballers 2012. Huffington Post, posted 26th July; 2012.
  73. Taylor J. Islamic Olympians embrace Ramadan fasting despite UK's long summer days making it a gruelling ordeal. The Independent newspaper, London: July 31st; 2012.
  74. Hawley JA. Fat adaptation science: Low carbohydrate, high fat diets to alter fuel utilization and promote training adaptation. Nestlé Nutr Inst Workshop Ser. 2011; 69:59-71.
  75. Philp A, Burke LM, Baar K. Altering endogenous carbohydrate availability to support training adaptations. In: Maughan RJ, Burke LM, (eds). Sports Nutrition: More than Just Calories—Triggers for Adaptation. Basel, Switzerland: Karger Publications; 2011.
  76. Spriet L. Metabolic regulation of fat use during exercise and recovery. In: Maughan RJ, Burke L. (eds). Sports Nutrition: More than Just Calories—Triggers for Adaptation. Basel, Switzerland: Karger Publications; 2012.
  77. Lanham-New SA, Stear S, Shirreffs S, Collins A. Sport and Exercise Nutrition. Chichester, UK: Wiley-Blackwell; 2011.
  78. Nybo L. Hyperthermia and fatigue. J Appl Physiol. 2008; 104(3):871-8.