PT - JOURNAL ARTICLE AU - Trabelsi, Khaled AU - Ammar, Achraf AU - Boukhris, Omar AU - Boujelbane, Mohamed Ali AU - Clark, Cain AU - Romdhani, Mohamed AU - Washif, Jad Adrian AU - Aziz, Abdul Rashid AU - Bragazzi, Nicola Luigi AU - Glenn, Jordan M AU - Chamari, Karim AU - Chtourou, Hamdi AU - Jahrami, Haitham TI - Ramadan intermittent fasting and its association with health-related indices and exercise test performance in athletes and physically active individuals: an overview of systematic reviews AID - 10.1136/bjsports-2023-106826 DP - 2024 Feb 01 TA - British Journal of Sports Medicine PG - 136--143 VI - 58 IP - 3 4099 - http://bjsm.bmj.com/content/58/3/136.short 4100 - http://bjsm.bmj.com/content/58/3/136.full SO - Br J Sports Med2024 Feb 01; 58 AB - Objective To systematically review, summarise and appraise findings of published systematic reviews, with/without meta-analyses, examining associations between Ramadan fasting observance (RO), health-related indices and exercise test performances in athletes and physically active individuals.Design Overview of systematic reviews with assessment of reviews’ methodological quality.Data sources PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, SPORTDiscus, ProQuest, PsycINFO and SciELO.Eligibility criteria for selecting studies Systematic reviews with/without meta-analyses examining associations of RO with health-related indices and exercise performances in athletes and physically active individuals.Results Fourteen systematic reviews (seven with meta-analyses) of observational studies, with low-to-critically-low methodological quality, were included. Two reviews found associations between RO and decreased sleep duration in athletes and physically active individuals. One review suggested athletes may experience more pronounced reductions in sleep duration than physically active individuals. One review found associations between RO and impaired sleep quality in athletes and physically active individuals. RO was associated with decreased energy, carbohydrate and water intake in adult-aged athletes, but not adolescents. One review suggests RO was associated with athletes’ increased feelings of fatigue and decreased vigour. No association was found between RO and athletes’ lean mass or haematological indices. RO was unfavourably associated with changes in athletes’ performance during high-intensity exercise testing.Conclusion Continuance of training during RO could be associated with athletes’ mood state disturbances, decreased sleep duration and performance decline during high-intensity exercise testing, while preserving lean mass. However, careful interpretation is necessary due to the low-to-critically-low methodological quality of the included reviews.Data sharing not applicable as no datasets generated and/or analysed for this study.