Training and competing during Ramadan – Practical recommendations for athletes and coaches.
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Abstract
Introduction: The holy month of Ramadan is a significant period for Muslims, characterized by communal gatherings and spiritual experiences. Muslim athletes must continue their training and participate in competitions while observing the fast, which presents specific challenges.
Methods: This narrative review explores how to help athletes, and their support team optimize training programs and competition participation during Ramadan, based on scientific knowledge.
Results: Ramadan fasting involves total abstinence from food and liquids during daylight hours, with nocturnal refeeding. This unique pattern can lead to hypohydration, particularly in athletes engaged in prolonged physical exertion in hot environments. In Muslim majority countries, sports activities are often rescheduled to accommodate fasting, whereas in countries with Muslim minorities, competitions typically proceed without consideration of Ramadan. This increases the risk of hypohydration and sleep disturbances for fasting athletes. Training schedules can be adjusted in four ways: just before Iftar, at night after Iftar, early in the morning after Suhoor, or by combining multiple sessions throughout the day. Each option presents its own advantages and disadvantages, particularly concerning rehydration and post-exercise recovery. The duration and intensity of sessions must also be modulated to prevent hypoglycemia and the risk of muscle injuries. Gradual and individualized adjustments to training programs, considering the specific needs of athletes, their psychological status and social and cultural environments, are crucial. Strategies for body cooling, hydration management, and psychological support are recommended to mitigate the eventual adverse effects of fasting. Conclusion: The described practical recommendations will allow optimizing sport participation during Ramadan for the fasting athletes.
Keywords:
Intermittent fasting, physical education and training, sports medicine##plugins.themes.academic_pro.article.details##

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
- Chamari K, Guezguez F, Khalladi K, Chtourou H, Moumen Jamai T, Chaouachi A, et al. Aspetar clinical guidelines: Ramadan fasting and exercise for healthy individuals. Tunis Med. 2023;101(1):1-14. 2. Chamari K, Roussi M, Bragazzi NL, Chaouachi A, Abdul RA. Optimizing training and competition during the month of Ramadan: Recommendations for a holistic and personalized approach for the fasting athletes. Tunis Med. 2019;97(10):1095-1103
- DeLang MD, Salamh PA, Chtourou H, Saad HB, Chamari K. The Effects of Ramadan Intermittent Fasting on Football Players and Implications for Domestic Football Leagues Over the Next Decade: A Systematic Review. Sports Med. 2022;52(3):585-600.
- Koppold DA, Breinlinger C, Hanslian E, Kessler C, Cramer H, Khokhar AR, et al. International consensus on fasting terminology. Cell Metab. 2024:S1550-4131(24)00269-9.
- Ahmed I. Ramadan fasting in extreme latitudes. J Soc Health Diab 2014; 2:53-54.
- Trabelsi K, Romdhani M, Morillas Pedreno JJ, Bertran C, Jahrami H, Chamari K. Assessment of hydration status and sleep in athletes during ramadan month. Tunis Med. 2025; 103(7): 917-927. DOI: 10.62438/tunismed.v103i7.5828
- Racinais S, Hosokawa Y, Akama T, Bermon S, Bigard X, Casa DJ, et al. IOC consensus statement on recommendations and regulations for sport events in the heat. Br J Sports Med. 2023;57(1):8-25.
- Farooq A, Herrera CP, Zerguini Y, Almudahka F, Chamari K. Knowledge, beliefs and attitudes of Muslim footballers towards Ramadan fasting during the London 2012 Olympics: a cross sectional study. BMJ Open 2016; 26; 6:e012848.
- Aziz AR, Png W. Practical tips to exercise training during the Ramadan fasting month. ISN Bulletin 2008; 1:13-20.
- Maughan RJ, Fallah J, Coyle EF. The effects of fasting on metabolism and performance. Br J Sports Med 2010; 44:490-4.
- Waterhouse J. Effects of Ramadan on physical performance: chronobiological considerations. Br J Sports Med 2010; 44:509-515.
- Damit NF, Lim VTW, Che Muhamed AM, et al. Exercise responses and training during daytime fasting in the month of Ramadan and its impact on training-induced adaptations. In: Chtourou H, ed. Effects of Ramadan fasting on health and athletic performance. OMICS Group eBook, OMICS Group Incorporation, California, USA, 2015:188-203.
- Boujelbane MA, Ammar A, Trabelsi K, Jahrami H, Briki W. Monitoring the mental health of athletes during the month of Ramadan. Tunis Med. 2025; 103(7): 877-882. DOI: 10.62438/tunismed.v103i7.5823
- Khacharem A, Trabelsi K, Dellal A, Dupont G, Chalabi H, Chamari K. Optimizing communication with athletes during the Ramadan fasting period: Strategies and tips for coaches. Tunis Med. 2025; 103(7):899-906. DOI: 10.62438/tunismed.v103i7.5800
- Dhouibi J, Jellad A, Chalabi H, Ben Saad H. How can medical staff support athletes during Ramadan? Tunis Med. 2025; 103(7):928 935. DOI: 10.62438/tunismed.v103i7.5763
- Chaouachi A, Coutts AJ, Chamari K, Wong del P, Chaouachi M, Chtara M, et al. Effect of Ramadan intermittent fasting on aerobic and anaerobic performance and perception of fatigue in male elite judo athletes. J Strength Cond Res. 2009;23(9):2702-9.
- Chtourou H, Hammouda O, Souissi H, Chamari K, Chaouachi A, Souissi N. The effect of Ramadan fasting on physical performances, mood state and perceived exertion in young footballers. Asian J Sports Med 2011; 2:177-185.
- Aloui A, Chaouachi A, Chtourou H, Wong del P, Haddad M, Chamari K, et al. Effects of Ramadan on the diurnal variations of repeated sprint performances. Int J Sports Physiol Perform. 2013;8(3):254 62.
- Chamari K, Briki W, Farooq A, Patrick T, Belfekih T, Herrera CP. Impact of Ramadan intermittent fasting on cognitive function in trained cyclists: a pilot study. Biol Sport 2016; 33:49-56.
- Chamari K, Kamal R, Mohamed-Ali V, Al-Maadheed M. Psychological Impact of Ramadan Fasting: Insights for General Population and Athletes. N Asian J Med 2024; 2(1):27-31.
- Briki W, Chamari K. Fasting and performing during Ramadan: Faith and autonomous spirituality as psychological resources for adaptation in muslim athletes – A theoretical reflection within a Western context. Tunis Med. 2025; 103(7):936-942. DOI: 10.62438/ tunismed.v103i7.6043
- Waterhouse J, Alkib L, Reilly T. Effects of Ramadan upon fluid and food intake, fatigue, and physical, mental, and social activities: a comparison between the UK and Libya. Chronobiol Int 2008; 25:697-724.
- Chaouachi A, Leiper JB, Chtourou H, Aziz AR, Chamari K. The effects of Ramadan intermittent fasting on athletic performance: Recommendations for the maintenance of physical fitness. J Sports Sci 2012; 30(Suppl 1): S53-73.
- Kirkendall DT, Chaouachi A, Aziz AR, Chamari K. Strategies for maintaining fitness and performance during Ramadan. J Sports Sci. 2012;30 Suppl 1:S103-8.
- Maughan RJ, Zerguini Y, Chalabi H, Dvorak J. Achieving optimum sports performance during Ramadan: some practical recommendations. J Sports Sci 2012;30(Suppl 1): S109-117.
- Chaouachi A, Leiper JB, Souissi N, Coutts AJ, Chamari K. Effects of Ramadan intermittent fasting on sports performance and training: a review. Int J Sports Physiol Perform 2009;4:419-34.
- Shephard RJ. The impact of Ramadan observance upon athletic performance. Nutrients 2012:4:491-505.
- Shephard RJ. Ramadan and sport: minimizing effects upon the observant athlete. Sports Med 2013; 43:1217-1241.
- Mujika I, Chaouachi A, Chamari K. Precompetition taper and nutritional strategies: special reference to training during Ramadan intermittent fast. Br J Sports Med 2010; 44:495-501.
- Rebaï H, Chtourou H, Zarrouk N, Harzallah A, Kanoun I, Dogui M, et al. Reducing resistance training volume during Ramadan improves muscle strength and power in football players. Int J Sports Med. 2014;35(5):432-7.
- Güvenç A. Effect of Ramadan fasting on body composition, aerobic performance and lactate, heart rate and perceptual responses in young soccer players. J Hum Kinetics 2011; 29:79-91.
- Aziz AR, Png W, Che Muhamed AM, Chaouachi A, Chong E, Singh R. Effects of Ramadan fasting on substrate utilization, physiological and perceptual responses during submaximal intensity running in active men. Sport Sci Health 2014; 10:1-10.
- Aziz AR, Chia MYH, Low CY, Slater GJ, Png W, Teh KC. Conducting an acute intense interval exercise session during the Ramadan fasting month: what is the optimal time of the day? Chronobio Int 2012; 29:1139-1150.
- Aziz AR, Che Muhamed AM, Ooi CH, Singh R, Chia MYH. Effects of Ramadan fasting on the physical activity profile of trained Muslim soccer players during a 90-minute match. Sci Med Footb 2018; 2:29-38.
- Bezuglov E, Talibov O, Khaitin V, Pirmakhanov B, Waśkiewicz Z, Butovskiy M, et al. Running Performance during the Holy Month of Ramadan in Elite Professional Adult Soccer Players in Russia. Int J Environ Res Public Health. 2021;18(21):11731.
- Chamari K, Haddad M, Wong del P, Dellal A, Chaouachi A. Injury rates in professional soccer players during Ramadan. J Sports Sci. 2012;30 Suppl 1: S93-102.
- Kurdak SS, Shirreffs SM, Maughan RJ, Ozgünen KT, Zeren C, Korkmaz S, et al. Hydration and sweating responses to hot-weather football competition. Scand J Med Sci Sports. 2010;20 Suppl 3:133-9.
- Lim WVT, Damit NF, Aziz AR. Recommendations for optimalcompetitive exercise performance and effective training-induced adaptations when Ramadan fasting. In: Chtourou H, ed. Effects of Ramadan fasting on health and athletic performance. OMICS Group eBook, OMICS Group Incorporation, California, USA, 2015:204-221.
- Che Muhamed AM, Mohamed NG, Ismail N, Aziz AR, Singh R. Mouth rinsing improves cycling endurance performance during Ramadan fasting in a hot humid environment. Appl Physiol Nutr Metab. 2014;39(4):458-64.
- Cherif A, Meeusen R, Ryu J, Taylor L, Farooq A, Kammoun K, et al. Repeated-sprints exercise in daylight fasting: carbohydrate mouth rinsing does not affect sprint and reaction time performance. Biol Sport. 2018;35(3):237-244.
- Fitouri C, Yaakoubi A, Dellal A, Aloui A, Latiri I, Chamari K, Ben Jomâa H. Ramadan and sport: A pilot study on the perspectives of professionals and athletes in diverse cultural contexts. Tunis Med. 2025; 103(7):891-898. DOI: 10.62438/tunismed.v103i7.5795
- Haddad M, Chaouachi A, Castagna C, Hue O, Wong DP, Tabben M, et al. Validity and psychometric evaluation of the French version of RPE scale in young fit males when monitoring training loads, Science & Sports, 2013; 28(2): e29-e35.
- Haddad M, Stylianides G, Djaoui L, Dellal A, Chamari K. Session RPE Method for Training Load Monitoring: Validity, Ecological Usefulness, and Influencing Factors. Front Neurosci. 2017; 11:612.
- Triki R, Zouhal H, Chtourou H, Salhi I, Jebabli N, Saeidi A, Laher I, Hackney AC, Granacher U, Ben Abderrahman A. Timing of Resistance Training During Ramadan Fasting and Its Effects on Muscle Strength and Hypertrophy. Int J Sports Physiol Perform. 2023; 18(6):579-589
- Trabelsi K, Morillas Pedreno JJ, Bertrand C, Chalabi H, Chamari K. Nutritional strategies for fasting athletes during Ramadan. Tunis Med. 2025; 103(7):907-916. DOI: 10.62438/tunismed.v103i7.5826
- Cherif A, Meeusen R, Farooq A, Briki W, Fenneni MA, Chamari K, et al. Repeated Sprints in Fasted State Impair Reaction Time Performance. J Am Coll Nutr. 2017; 36(3):210-217.
- Tian HH, Aziz AR, Png W, Wahid MF, Yeo D, Constance Png AL. Effects of fasting during Ramadan month on cognitive function in muslim athletes. Asian J Sports Med. 2011; 2(3):145-53.
- Aziz AR, Che Muhamed AM, Roslan SR, Mohamed NG, Singh R, Chia MYH. Poorer intermittent sprints performance in Ramadan-fasted Muslim footballers despite controlling for pre-exercise dietary intake, sleep and training load. Sports 2017; 5,4.
- Fenneni MA, Latiri I, Aloui A, Rouatbi S, Chamari K, Ben Saad H. Critical analysis of the published literature about the effects of Ramadan intermittent fasting on healthy children’s physical capacities. Libyan J Med 2015; 8;10:28351.
- Fenneni MA, Latiri I, Aloui A, Rouatbi S, Saafi MA, Bougmiza I, et al. Effects of Ramadan on physical capacities of North African boys fasting for the first time. Libyan J Med. 2014; 9(1):25391.
- Aloui A, Briki W, Baklouti H, Chtourou H, Driss T, Chaouachi A, Chamari K, Souissi N. Listening to Music during Warming-Up Counteracts the Negative Effects of Ramadan Observance on Short Term Maximal Performance. PLoS One. 2015; 10(8):e0136400.
- El Saleh M, Mostafa II, Shaheen W. The Effect of Listening to The Holy Qur’an on Improving Some Psychological and Physical Variables Among Yoga Practitioners. Acad J Interdisciplinary Studies. 2021; 10(4):286-295.
- Trivic T, Roklicer R, Zenic N, Modric T, Milovancev A, Lukic Sarkanovic M, et al. Rapid weight loss can increase the risk of acute kidney injury in wrestlers. BMJ Open Sport Exerc Med. 2023; 9(2):e001617.
- Aloui A, Chtourou H, Briki W, Tabben M, Chaouachi A, Souissi N, et al. Rapid weight loss in the context of Ramadan observance: recommendations for judokas. Biol Sport. 2016;33(4):407-413.
- Milovančev A, Miljković T, Ilić A, Stojšić Milosavljević A, Petrović M, Roklicer R, et al. Disrupting arrhythmia in a professional male wrestler athlete after rapid weight loss and high-intensity training Case report. Front Cardiovasc Med. 2023; 10:1091603.
- Hammer E, Sanfilippo JL, Johnson G, Hetzel S. Association of in competition injury risk and the degree of rapid weight cutting prior to competition in division I collegiate wrestlers. Br J Sports Med. 2023;57(3):160-165.
- Hammouda O, Chtourou H, Chahed H, Ferchichi S, Kallel C, Miled A, et al. Diurnal variations of plasma homocysteine, total antioxidant status, and biological markers of muscle injury during repeated sprint: effect on performance and muscle fatigue--a pilot study. Chronobiol Int. 2011;28(10):958-67.
- Eirale C, Tol JL, Smiley F, Farooq A, Chalabi H. Does Ramadan affect the risk of injury in professional football? Clin J Sport Med. 2013; 23(4):261-6.
- Bisciotti GN, Chamari K, Cena E, Carimati G, Volpi P. ACL injury in football: a literature overview of the prevention programs. Muscles Ligaments Tendons J. 2016;6(4):473-479.
- Bisciotti GN, Chamari K, Cena E, Carimati G, Bisciotti A, Bisciotti A, Quaglia A, Volpi P. Hamstring Injuries Prevention in Soccer: A Narrative Review of Current Literature. Joints. 2020;7(3):115-126.
- Djaoui L, Haddad M, Chamari K, Dellal A. Monitoring training load and fatigue in soccer players with physiological markers. Physiol Behav. 2017;181:86-94.
- Field A, Harper LD, Chrismas BCR, Fowler PM, McCall A, Paul DJ, et al.. The Use of Recovery Strategies in Professional Soccer: A Worldwide Survey. Int J Sports Physiol Perform. 2021;16(12):1804 1815.
- Aloui A, Driss T, Baklouti H, Jaafar H, Hammouda O, Chamari K, et al. Repeated-sprint training in the fasted state during Ramadan: morning or evening training? J Sports Med Phys Fitness. 2018;58(7 8):990-997.
- Aloui A, Abaïdia AE, Chtourou H, Chaouachi A. Impact of the month of Ramadan on sport performance. Tunis Med. 2025; 103(7):862 867. DOI: 10.62438/tunismed.v103i7.5767.
- Dergaa I, Chamari K. Big Data in Sports Medicine and Exercise Science: Integrating Theory and Practice for Future Innovations. Tun J of Sports Sci & Med. 2024; 2(1):1-3.
- Mhenni T, Souissi A, Tayech A, Yousfi N, Mejri MA, Chamari K, et al. The effect of Ramadan fasting on the morning-evening difference in team-handball-related short-term maximal physical performances in elite female team-handball players. Chronobiol Int. 2021;38(10):1488-1499.
- Dergaa I, Zakhama L, Dziri C, Ben Saad H. Enhancing scholarly discourse in the age of artificial intelligence: A guided approach to effective peer review process. Tunis Med. 2023;101(10):721-726.
- Dergaa I, Chamari K, Zmijewski P, Ben Saad H. From human writing to artificial intelligence generated text: examining the prospects and potential threats of ChatGPT in academic writing. Biol Sport. 2023;40(2):615-622.