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Competing in the Ramadan fasted state: for spirituality, health and performance
  1. Irfan Ahmed1,
  2. Ronald J Maughan2,
  3. Zafar Iqbal3,
  4. Katija Ali4,
  5. Omar Naji5,
  6. Sidra Awan5,
  7. Aessa Mahmud Tumi6,
  8. Karim Chamari7
  1. 1 Sports Medicine Department, Homerton University Hospital, London, London, UK
  2. 2 School of Medicine, St Andrews University, St Andrews, UK
  3. 3 Crystal Palace FC, London, UK
  4. 4 Herne Hill Group Practice, London, UK
  5. 5 University College London Hospitals NHS Foundation Trust, London, UK
  6. 6 Imperial College Healthcare NHS Trust, London, UK
  7. 7 Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Dr Irfan Ahmed, Sport and Exercise Medicine Registrar / General Practitioner, Homerton University Hospital, London E9 6SR, UK; irfan.ahmed5{at}

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All professional athletes require effective nutrition, hydration and sleep strategies to optimise physical and mental health during training and competition. This is an annual challenge for Muslim athletes during the holy month of Ramadan, when they abstain from ingestion of food and liquids during daylight hours in an act of spiritual devotion. During Ramadan, the length of each day’s fast depends on geographical location (latitude) and season: in the north of the UK, for example, daylight lasts less than 6 hours in winter but almost 19 hours in mid-summer. Athletes who fast usually report reduced total sleep time to accommodate pre-fast/post-fast meals (suhoor and iftar), social activities and night-time prayers.1 2 Medical teams can promote inclusivity by implementing safety criteria to optimise performance and support athletes who train and compete during Ramadan.

What to consider when advising the fasting athlete

The world’s two billion Muslims constitute the second largest religious community, accounting for ~25% of the world population. Ramadan is widely practised across the world, but few published high-quality studies exist to support specific recommendations to maintain performance in …

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  • Twitter @exerciseirfan, @katijaali, @ProfChamari

  • Contributors Manuscript prepared by all authors with equal contribution.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.