In 1986, the month of Ramadan fell during the FIFA World Cup™ in Mexico. Twenty-eight years later, the two events coincided once again at the 2014 World Cup in Brazil. Fasting and high-performance sport – is it possible to combine the two? It’s a recurring question that comes up whenever Muslim footballers have to balance the requirements of their religion and of their sport. This year, Ramadan starts on 5 June and will coincide with both the Copa América Centenario and the European Championship.

Does fasting have a negative effect, a positive effect, or no effect at all? FIFA has made great efforts to find out what the effects of restricting nutrition and fluid intake during daylight hours actually are. As far back as 2004-2006, F-MARC (the FIFA Medical Assessment and Research Centre) under the leadership of Prof. Jiří Dvořák, carried out two studies in Algeria and Tunisia on the impact of fasting on players’ performance. The issue has also been a regular topic of discussion between experts, medical professionals and players at symposiums. Football is the most rapidly developing sport in the Muslim world, and Ramadan therefore affects amateur and professional players alike.

Adapting the diet

Muslim footballers face several challenges in the month of fasting. They have to adapt to the changes in their eating habits and fluid intake and also get used to a different sleeping pattern. “Fasting changes the chronological phase of players,” explains Dr Yacine Zerguini, a member of the FIFA Medical Committee. “It is important to know how to re-organise sleep and then it is important to deal psychologically with hydration and diet changes during this month.”

Fasting during Ramadan does not entail stopping eating altogether, but rather changing the time of eating. Therefore, the amount of calories consumed over 24 hours can remain the same. Studies have shown that fasting people eat less of certain foodstuffs, but that overall the differences in eating habits compared to those not fasting were negligible. “The level of nutrition should change and also there should be a change in the quality of food in order to adapt to exercise,” says Dr Hakim Chalabi, who was the team doctor for the Algerian national team at the 2010 FIFA World Cup South Africa™.

Medical practitioners generally recommend that after doing sport, athletes should consume protein, carbohydrates and liquids in sufficient quantities to ensure regeneration and to minimise the risk of fatigue. In order to prevent a negative impact on the body, those fasting are usually recommended to train either very early in the morning or late in the evening. Experts advise eating “slow-release” proteins before sunrise, as these help to ensure the body has sufficient protein throughout the day, as well as carbohydrate-rich snacks containing eggs, cheese and milk. For those living in a Muslim country, it is easier to make the necessary dietary changes as the whole society’s daily routine is adapted for fasting and the football clubs will also adapt their schedules. Fasting Muslims living in predominantly non-Muslim countries will need to do a little more planning and organising.

Hydration and sleep

The average footballer loses up to two litres of water per training session, and even more in a match, depending on the temperature and weather conditions. During Ramadan, the athlete’s body mass is reduced by one per cent due to the lack of fluid intake during the day, but as the deficit can be made up after sunset there are no lasting consequences for the person fasting. People fasting should try to avoid sweating too much in order not to lose more fluid and to prevent acute dehydration. This can be achieved by wearing appropriate clothing, by training in the shade or in a cooler environment, and by reducing the length of training as much as possible. It is not helpful to drink more water in the morning, as this will simply lead to increased urination and doesn’t actually create reserves for the day.

In recent years, the importance of sleep for optimum performance has increasingly been recognised. Lack of sleep has negative effects on concentration and mood, and thus the performance of the professional football player. People fasting during Ramadan tend to get less sleep and it is given less importance. An F-MARC study in Tunisia showed, however, that while people fasting slept less, the quality of their sleep was not impaired. Although tiredness and loss of concentration were observed, these effects could be alleviated by having a midday nap. The results show that whether it is Ramadan or not, it would be advantageous to analyse the sleep routine of all players. Trainers should ask questions such as: is the player an early riser or a night owl? At what time of day does the player reach their peak performance? These individual preferences and characteristics can be used to develop a training plan that is adapted to the needs of the player.

Does fasting for Ramadan lead to an increased risk of injury? Studies published in the leading academic publication Journal of Sports Sciences have shown that the overall number of injuries does not change. The only difference found was in the type of injury. During the month of fasting, the number of injuries not caused by contact and injuries from training overload increased. According to the study, in the weeks before and after Ramadan, two out of nine injuries were caused by over-training, while during Ramadan, training overload caused 16 out of 19 injuries.

No single successful strategy for nutrition, fluid intake and sleep routine that works for everyone when they are fasting has been found. Rather, each case must be looked at on an individual basis to find out the best approach for the player. Dr Zerguini adds: “The main aim is to get as much knowledge as possible and to help the young athletes to deal with the situation.”

About Ramadan

Islam is a world religion with over a billion adherents who live according to Islamic laws. Ramadan is one of the most important periods of the year for Muslims, and is the name of the ninth month in the Islamic calendar and one of the five pillars of Islam. During the fasting month, for a period of four weeks, adult Muslims eat and drink nothing between sunrise and sunset. The aim of this period of fasting is to allow the body and spirit to regenerate in combination with intensified praying.

The date of Ramadan according to the Gregorian calendar changes each year, as it follows the Islamic calendar which is based on lunar cycles. Thus, the date of the month of fasting can vary each year by 10 to 12 days, meaning that Ramadan may fall during any stage of the football season.