Ramadan Reflections: The Scientific View - Does Fasting Help Or Hinder Football?

Ramadan is upon us, and as every year there is no shortage of controversy on the month-long fast observed by many Muslim footballers worldwide. The question asked by interested parties is: does the dawn-till-dusk daily fast (explained here) impact on players' performance? If so, is it positive or negative?

One thing must be understood right away before we look at the issue: players should be free to fast or not fast as their conscience guides them, provided that their contractual duties are provided for and their coaches are also given free choice over selection. Regardless of the medical outcome, individual rights should in sport be considered of prime importance.

But the medical question remains a very much pertinent one. Football is a results business, and the coaches and presidents want to get the most bang for their buck. And, of course, the pursuit of knowledge is for most its own reward. Above all, though, the question of whether or not it is beneficial in a physical sense - being separate from the question of rights - can only be settled with evidence.

Thus it's no surprise that there is an active medical literature on the subject.

Sequential Studies

FIFA doctor Yacine Zerguini spoke to Goal.com's Mohammed Bhana earlier in the week, and began by saying, "The best way in my opinion is to avoid at all costs being polemic. We must analyse things very calmly.

"No serious scientific study has demonstrated during the fast of Ramadan any danger to the health of the player or even a decrease in performance.

"The most recent studies, like Umid Karli et al. from Turkey, and in particular that one conducted by F-MARC and FIFA (Zerguini, Dvorak et al.) and recently published in December 2008 as a supplement in the journal of Sport Sciences, tend to show otherwise.

"Far from being a danger fasting is a blessing. All recent studies have also demonstrated no negative impact on performance."

Dr. Zerguini's citation of the latest F-MARC study shows the mainstream view of Ramadan fasting and football: namely, that in a controlled environment, strategies can be utilised to prevent any ill effect.

That said, the literature does not provide an unequivocal backing to the view that literally no serious study has shown a decrease in performance. It is certainly true that none have indicated any danger to players, and proponents of this idea are now found to be few and far between. But in fact there is one earlier study - conducted by Zerguini and colleagues - that sees a markedly different conclusion regarding performance. And a key point is that ill effect is perceived by a majority of the test subjects themselves.

This was a previous F-MARC study (published 2006) in which 55 Algerian players were tested during Ramadan to measure both their perceived and actual physical performance. Almost 70 per cent of respondents felt themselves that they had declined in training and performance, while the actual data indicated a "significant" decrease in dribbling and speed capabilities, among other attributes. As the conclusion reads:

"The phase shift of food intake and disruption of sleep patterns affect actual and perceived physical performance. Islamic athletes need to explore strategies that will maximise performance during Ramadan."

Adaptation

But the next edition of the F-MARC study - the aforementioned 2008 version - sought to provide a more measurable atmosphere by gauging fasting players' conditions in a residential training camp environment alongside a group that did not fast, whereas the 2006 publication had no such control group. The later study, though, was also expressly designed for practical use:

"The main objective of the present investigation was to gain additional information and scientific data in conformity with the philosophical background of Islam to allow optimisation of the daily training and dietary regimen in relation to the mental and physical performance of football players," read the abstract.

In the end, the only real negative outcome for the fasting group was that they reported feeling "slightly" less ready to start training than their control counterparts. Overall this study indeed showed no decline in physical performance (in fact the opposite), perhaps due to the fact that the knowledge of how best to provide players with nutrients after dusk and before dawn was better understood.

As Dr. Zerguini says, "It is argued in other studies that a lack of food and drink in their entirety would have an effect. Ramadan does not in fact mandate this. Scientifically, on a 24-hour basis, Ramadan fasting is not fasting! It's drinking and eating at different hours.

"Nevertheless the essential concepts of respect in the sleep cycle and dietary rules seem inevitable. As well as respect for a sufficient period of adaptation of player's metabolism to its new food and water schedule."

Indeed, the 2006 study concludes, "Physical performance generally improved [during fasting], but match performance was not measured. We recommend that players should ensure adequate sleep and good nutrition during Ramadan to preserve football performance and general health."

In other words, we can take three main points from this selection of recent studies: that, if controlled without optimisation, fasting can have a negative effect (both perceived and actual) on some players; that there are ways to minimise the risk of decreased performance; and that regulating food and water intake during the non-fast hours is perhaps the biggest key to any successful strategy.

We offer the closing word to Dr. Zerguini in the spirit of further study:

"We still know very little about Ramadan fasting and exercise. The scientific debate must continue with the help of professionals in the field."

Ewan Macdonald, Goal.com

Further Reading:

Zerguini Y., Dvorak J., et al (2008) 'Influence of Ramadan fasting on physiological and performance variables in football players: Summary of the F-MARC 2006 Ramadan fasting study', Journal of Sports Sciences, 26:1, S3 — S6

Zerguini Y., Kirkendall D., et al (2006) 'Impact of Ramadan on physical performance in professional soccer players', British Journal of Sports Medicine, 41, 398-400

This is the third article in Goal.com's Ramadan Reflections series. We bring you views from the medical profession, from sporting figures, and from supporters, on the practice of fasting, as well as a special look at other examples in which religion and football intersect.

Related:

• Exclusive: I Can Keep Fasting In Ramadan Even When I Am Playing – Fredi Kanoute
• Ramadan Reflections: Understanding Ramadan And Its Role In Football
• Ramadan Reflections: Islamic Doctor Discusses Mourinho's Thoughts On Muntari