Ramadan and Sports Performance: A Review of Athlete Physiology, Nutrition, and Applied Strategies

Ramadan is an Islamic holy month during which Muslims fast from dawn (Suhoor) until sunset (Iftar), abstaining from food, drink, and oral intake. For athletes competing or training during this period, this introduces a unique physiological and logistical challenge. In elite sport environments, where marginal gains are often decisive, Ramadan fasting creates an additional layer of complexity for practitioners responsible for maintaining performance, health, and recovery. The applied sports science literature highlights that the impact of Ramadan fasting is highly individual and context-dependent. Outcomes vary based on sleep patterns, training timing, hydration status, cultural environment, and the athlete’s habitual dietary intake.

Physiological Responses to Ramadan Fasting 

Energy Availability and Metabolic Shifts

One of the primary concerns during Ramadan is reduced energy availability. The restriction of food and fluid intake to nighttime hours often results in a compressed feeding window, which can lead to insufficient caloric intake in some athletes. Studies consistently show that, while total daily energy intake does not always decrease significantly, macronutrient timing and distribution often change. This can influence glycogen replenishment, particularly in athletes with high training loads or double-session days. During fasting hours, the body relies more heavily on fat oxidation and hepatic glycogen stores. As fasting duration increases throughout the day, blood glucose levels may gradually decline, particularly in athletes with high metabolic demands.

Hydration Status

Dehydration risk is one of the most immediate physiological concerns during Ramadan, particularly in warm climates or during prolonged training sessions.

Even mild dehydration (~1-2% body mass loss) can negatively affect cognitive performance, reaction time, endurance capacity, thermoregulation and perceived exertion. Because fluid intake is restricted during daylight hours, athletes must strategically rehydrate between Iftar and Suhoor. However, achieving full fluid balance restoration overnight is not always feasible, particularly when sleep is reduced.

Sleep Disruption and Circadian Rhythm

Sleep disturbance is one of the most consistently reported challenges during Ramadan. Changes include reduced total sleep time, fragmented sleep due to late meals and early waking (Suhoor), altered sleep architecture and reduced slow-wave sleep in some cases. Sleep restriction has well-established effects on athletic performance, including reduced sprint performance, impaired decision-making, and increased injury risk. Circadian rhythm shifts may also occur due to altered meal timing and social/religious activities during the night. This can affect hormonal regulation, including cortisol and melatonin rhythms.

Hormonal and Neuromuscular Effects

Ramadan fasting has been associated with subtle changes in endocrine function, although findings are inconsistent. Reported changes in the literature include reduced insulin levels during fasting hours, alterations in cortisol rhythm and variable changes in testosterone depending on energy intake and training load. Neuromuscular performance may also be affected indirectly through fatigue, reduced glycogen availability, and sleep disruption rather than direct fasting effects.

Effects on Athletic Performance

Endurance Performance

Endurance performance appears to be the most sensitive to Ramadan fasting, particularly in prolonged or high-intensity efforts. Research suggests that time to exhaustion may decrease in some athletes, submaximal endurance performance is more likely to be affected than maximal output and well-trained athletes may exhibit greater resilience due to metabolic flexibility. However, results are highly variable. Some studies show minimal performance changes when training and nutrition are well-managed.

Strength and Power

Resistance training performance during Ramadan is generally less affected than endurance performance, particularly when sessions are scheduled after Iftar.

Findings from applied research indicate maximal strength (1RM) is often maintained, power output may be slightly reduced in fasted afternoon sessions and training quality is more dependent on sleep and hydration than fasting itself. This aligns with broader literature suggesting that acute energy restriction has a smaller impact on neuromuscular performance compared to prolonged glycogen depletion.

Cognitive and Skill-Based Performance

Cognitive performance can be impacted during prolonged fasting, particularly in the late afternoon period. Athletes may experience reduced attention span, slower reaction time, increased perceived effort and reduced decision-making accuracy under fatigue. In team sports, these effects may influence technical execution and tactical awareness, especially during congested match schedules.

Applied Strategies for Athletes and Practitioners

Training Timing

One of the most important practical considerations is training time selection. Although most applied practitioners in predominantly muslim countries favour post-Iftar training for performance-focused sessions, in England, team sports often remain on the same schedule. Three main approaches are typically used:

1. Pre-Iftar (fasted training)

   - Higher perceived effort

   - Greater risk of dehydration

   - Useful for low-intensity technical work

2. Post-Iftar (fed training)

   - Preferred for high-intensity and strength sessions

   - Improved hydration and glycogen availability

   - Better training quality

   
   

3. Late evening sessions

   - Common in professional environments

   - Allows full nutritional intake

   - May interfere with sleep timing

Nutrition Strategies

Nutritional periodisation becomes essential during Ramadan. Low-volume, high quality sessions are typically prioritised to maintain performance while reducing fatigue accumulation.

Energy density

Athletes often need to consume calorie-dense meals to meet requirements within a restricted feeding window.

Carbohydrate timing

Carbohydrate intake should be prioritised between Iftar and Suhoor to restore glycogen stores, particularly when training intensity is high.

Protein distribution

Adequate protein intake is essential to maintain lean mass, especially when training volume is reduced or irregular.

Hydration strategy

Structured fluid intake between sunset and dawn is critical. This may include electrolyte supplementation to improve fluid retention.

Recovery Management

Recovery capacity is often compromised during Ramadan due to sleep disruption and altered nutrition timing. Practitioners often adjust training volume (reduced), neuromuscular load (careful monitoring), session frequency and high-intensity exposure.

Monitoring Athlete Status

Effective monitoring is essential to individualise training during Ramadan.

Common strategies include session RPE (sRPE), wellness questionnaires, sleep tracking, body mass changes and subjective fatigue scoring. This allows practitioners to identify athletes who may be struggling with recovery or energy availability.

Team Sport Considerations

In team sports such as football, rugby, and basketball, Ramadan presents additional logistical challenges due to fixed training times and match schedules.

Practitioners must balance collective training demands, individual fasting status, fixture congestion, travel schedules and recovery windows. In elite environments, flexibility and communication are key. Some teams adopt modified training loads or split-session approaches to accommodate fasting athletes.

Injury Risk Considerations

The relationship between Ramadan fasting and injury risk is not fully established, but indirect risk factors exist. Potential contributors include sleep deprivation, reduced neuromuscular coordination, fatigue accumulation, dehydration and reduced concentration. While fasting itself does not necessarily result in injury, the associated lifestyle and physiological stressors may increase susceptibility if not properly managed.

Practical Recommendations

Based on applied evidence and practitioner consensus, several key recommendations emerge:

• Prioritise training after Iftar for high-intensity sessions

• Reduce overall training load where necessary

• Maintain neuromuscular stimulus through low-volume resistance training

• Emphasise carbohydrate and fluid intake between sunset and dawn

• Monitor sleep and recovery closely

• Individualise approaches rather than applying a uniform strategy

Ultimately, successful management depends on flexibility, athlete education, and collaboration between coaching, medical, and nutrition staff.

Conclusion

Ramadan fasting presents a unique and multifaceted challenge in elite sport. While physiological systems such as metabolism, hydration, and sleep are affected, the magnitude of performance impairment is highly individual and strongly influenced by contextual factors. The applied literature suggests performance can be largely maintained when appropriate nutritional, recovery, and training strategies are implemented. The most significant risks arise not from fasting itself, but from poorly managed sleep, inadequate energy intake, and excessive training load during the fasting period. For practitioners, Ramadan should not be viewed as a barrier to performance, but rather as a period requiring careful planning, athlete-centred adjustments, and precise load management.

References

Burke et al. (2018). Science of Sport Nutrition.

Chaouachi et al. (2009). Journal of Sports Sciences.

Chtourou et al. (2012). Sports Medicine.

Maughan et al. (2012). Journal of Sports Sciences.

Meckel et al. (2008). Journal of Sports Medicine and Physical Fitness.

Reilly et al. (2007). Chronobiology International.

Shephard, R. J. (2012). British Journal of Sports Medicine.