La Tunisie Médicale

Being a Muslim Elite-level Athlete Competing during Ramadan: A Multidisciplinary Reflection on Adaptation and the Pursuit of Excellence while Fasting

Karim Chamari — 2025-07-01

NON APPLIED

Fasting and Performing during Ramadan: Faith and Autonomous Spirituality as Psychological Resources for Adaptation in Muslim Athletes – A Theoretical Reflection within a Western Context

Walid Briki — 2025-07-01

Introduction: This article offers a reflection on spirituality and its role in the psychological adaptation in Muslim athletes. It focuses on the experience of athletes fasting during Ramadan, confronted with the demands of athletic performance, particularly within a western context where social support may be limited and societal resistance may emerge.

Methods: We adopted a theoretical and reflective approach, based on a conceptual analysis combining insights from religious psychology, motivational psychology, and psychodynamic approach. Testimonies from existing literature were used illustratively to support the reflection. Our positioning is also situated within the current dynamics of elite sports and contemporary debates on spiritual experience within competitive sports.

Results: We suggested that: (a) Strengthening faith could be mobilized as a psychological strategy to support perseverance and adaptation; (b) An autonomous spirituality, based on personal interest, self-congruence, or personal importance, could foster more flexible adaptation to the demands of fasting and competitive sports; and (c) A controlled spirituality, driven by external or internal pressures, could generate psychological rigidity, compromising resources management.

Conclusion: These elements call for the development of contextualized support strategies aimed at fostering autonomous forms of regulation and promoting an inclusive and respectful approach to spiritual diversity in sports.

Assessment of hydration Status and sleep in athletes during Ramadan month

Khaled Khaled — 2025-07-01

Introduction: Ramadan fasting (RF) can induce hypohydration in athletes due to the abstention from water during daylight hours, as well as sleep disturbances related to modified training schedules and increased nighttime social activities. These changes may negatively affect athletic performance, making regular assessment of hydration and sleep essential.

Methods: This review is based on data from systematic reviews, meta-analyses, umbrella reviews, narrative reviews, and expert consensus to provide practical recommendations tailored to the context of Ramadan.

Results: Body mass alone is not a reliable indicator for daily monitoring of hydration status due to changes in body composition during RF. Monitoring the specific gravity and color of the first morning urine sample is a simple, quick, and effective method. Pre- and post-exercise body mass measurement remains the most accurate approach for estimating acute fluid loss. For sleep monitoring, smartwatches and actigraphy are recommended. In the absence of these tools, sleep diaries may be used with caution. Standardized sleep questionnaires are not well-suited to the specific characteristics of Ramadan and should be avoided. Moreover, a state of hyperhydration may disrupt nighttime sleep by increasing nocturnal urination, highlighting the importance of simultaneously monitoring hydration status and sleep.

Conclusion: Hydration status and sleep must be rigorously monitored throughout Ramadan to preserve overall health, reduce physiological strain, and optimize athletic performance.

Nutritional strategies for fasting athletes during Ramadan

Khaled Trabelsi — 2025-07-01

Introduction: Ramadan fasting presents a unique challenge for athletes, requiring rigorous nutritional planning to balance sports performance and cultural practices. This report provides practical recommendations for nutritionists and physical trainers/fitness coaches, particularly for healthy athletes competing in predominantly non-Muslim countries.

Methods: The recommendations are based on scientific evidence, including systematic reviews, meta-analyses, umbrella reviews, as well as narrative reviews and expert consensus.

Results: For athletes training several hours after breaking the fast, it is recommended to consume two meals rich in low-glycaemic index carbohydrates (1.5 g/kg body mass per meal), composed of approximately 70% carbohydrates, between 1 and 4 hours pre-exercise. High-quality, low-fat protein sources (0.2 g/kg per meal) should be prioritized. Hydration is crucial, ensuring adequate intake of fluids and electrolytes during nighttime hours. When athletes break their fast during a competition or training session, heavy meals are not recommended. Instead, we recommend consuming carbohydrate gels (30-60 g/h) and energy drinks (6-8% carbohydrates), along with a snack containing 0.2 to 0.4 g/kg of proteins. Post-exercise, turmeric and cherry juice may support recovery.

Conclusion: Nutritionists should consider individual needs, dietary preferences, and logistical constraints to develop effective and culturally respectful nutritional strategies for the athletes who fast during Ramadan.

Monitoring the Mental Health of Athletes During the Month of Ramadan

Mohamed Ali Boujelbane — 2025-07-01

Introduction: Muslim athletes observing Ramadan fasting experience substantial alterations in their dietary habits, sleep patterns, and training routines, which may adversely affect their mental health. In this context, a comprehensive and methodologically sound assessment of their mental health is warranted throughout the fasting period.

Methods: This review adopts a conceptual framework grounded in the biopsychosocial model of well-being. It is informed by a critical synthesis of the scientific literature, including original research articles, systematic reviews, meta-analyses, and narrative reviews, with the aim of proposing a structured and contextually appropriate framework for monitoring the mental health of athletes during Ramadan.

Results: The proposed approach integrates both global and specific assessment tools that encompass the physical, mental, and social dimensions of well-being. The quality of life scale developed by the World Health Organization, administered on a weekly basis, facilitates a comprehensive overview of well-being. Complementarily, a six-dimension mood scale—applied daily—allows for the detection of fluctuations in athletes' mood states. Perceived exertion and physical recovery are monitored using accessible tools that evaluate sleep quality, fatigue, muscle soreness, and stress. Furthermore, the use of wearable technologies enables the continuous and objective monitoring of psychophysiological parameters, including heart rate, heart rate variability, sleep cycles, and stress levels.

Conclusion: A continuous and multidimensional evaluation of mental health during Ramadan is essential for preserving athletes’ overall health. Targeted training of coaches and medical personnel in mental health monitoring is also imperative to ensure effective and timely support.

Optimizing communication with athletes during the Ramadan fasting period: Strategies and tips for coaches

Aïmen Khacharem — 2025-07-01

Introduction: Effective communication is a fundamental element of coaching, particularly in sensitive contexts such as Ramadan. Managing the challenges related to fasting requires coaches to develop an adapted communication approach, capable of reconciling performance demands with athletes' religious practices. This narrative review explores different coaching communication styles, focusing on their impact on both performance and athletes' well-being during Ramadan. Methods: This narrative review is based on a qualitative synthesis of the literature. Three communication styles are analyzed: (i) Directive, (ii) Submissive, and (iii) Cooperative. The analysis is contextualized according to the different phases of Ramadan: before, during, and after fasting.

Results: The directive style, although structuring, can reduce motivation and team cohesion. The submissive style weakens training control. The cooperative style is the most beneficial, enhancing two-way communication, motivation, and adaptation to Ramadan's constraints. Implementing tailored strategies during Ramadan, including anticipating athletes' specific needs and adjusting training loads, helps maintain their overall well-being while preserving performance. This review highlights the importance of communication adapted to the phases of Ramadan. Practical strategies are proposed for coaches, such as adopting open and respectful communication, adjusting training programs, and providing individualized support to athletes. The cooperative approach emerges as the most effective in balancing performance and well-being.

Conclusion: Coaches and club managers are encouraged to strengthen their leadership role by developing communication skills to effectively support their athletes during this critical period.

Ramadan and sport: A pilot study on the perspectives of professionals and athletes in diverse cultural contexts

Chedlia Fitouri — 2025-07-01

Background: Observing Ramadan presents a challenge for elite athletes and their technical and medical staff, particularly in diverse cultural contexts.

Objective: This study aims to examine the challenges faced by Muslim athletes who fast during Ramadan and the technical and medical staff who accompany them, both in countries with a Muslim majority and in countries with a Muslim minority.

Methods: A qualitative approach was used, gathering testimonies from professionals working in countries with a Muslim and non-Muslim majority. A thematic analysis was conducted to identify the key factors affecting performance management and adaptation to the Ramadan fast.

Results: The analysis revealed four main areas: (i) energy management and recovery, (ii) psychological dimensions, (iii) sociocultural impact, and (iv) institutional and individual adjustments required. In countries with a Muslim majority, the integration of Ramadan generally makes it possible to partially mitigate the impact on performance through schedule adjustments; however, the strategic planning of these measures often remains insufficient to meet the demands of high-level sport. Conversely, in Muslim-majority countries, the almost total absence of such adaptations leads to increased mental tension and a feeling of isolation among some athletes who fast, despite the support of their non-Muslim teammates.

Conclusion: Recognizing Ramadan as an essential part of sports planning can significantly improve the psychological well-being of fasting athletes, strengthen their self-discipline, and help maintain their level of performance. This approach is part of an inclusive policy framework, reinforced by individual initiatives, and highlights the possibility of reconciling religious commitment and high-level sports performance.

Post-exercise recovery during the month of Ramadan

Abd-Elbasset Abaidia — 2025-07-01

Introduction: Participating in a sport inducing muscle damage with a long duration leads to the appearance of fatigue. This fatigue can persist over time, but it can also be limited by the use of different recovery strategies. During Ramadan, the limitation of nutritional intake and the possible disruption of sleep can have an impact on the quality of post-exercise recovery. It is therefore important to adapt the strategies to be implemented among athletes performing in this context. The aim of the present study was to was to address the impact of Ramadan fasting on post-exercise recovery.

Methods: narrative review.

Results: We have described recovery, its physiological mechanisms and the importance of implementing a suitable protocol to accelerate recovery following a competition or training. We have discussed also the impact of fasting during the month of Ramadan on the athlete's ability to recover. Finally, we have proposed practical applications to optimize recovery in fasted athletes during the month of Ramadan.

Conclusion: Although post-exercise fatigue seems higher when fasting, recovery kinetics of performance are not impacted. However, it is appropriate to use some recovery strategies, particularly during congested schedules.

Impact of the month of Ramadan on sport performance

Asma Aloui — 2025-07-01

Introduction: The holy month of Ramadan, with its spiritual demands and significant changes in lifestyle and eating habits, presents a unique challenge for Muslim athletes seeking to maintain their physical performance while adhering to their religious commitments.

Methods: This narrative review focuses on the effect of Ramadan fasting on athletic performance, how athletes adapt to these unique conditions, and the practical strategies implemented to optimize their resilience and performance.

Results: While offering inner renewal, this period of daily fasting imposes specific challenges that can affect athletes’ ability to excel in demanding sports.

Conclusion: Future research will need to define optimal protocols for adapting training during Ramadan to maximize physiological benefits and minimize negative impacts on performance.

Understanding Ramadan fasting and its challenges for athletes: A general overview

Asma Aloui — 2025-07-01

Introduction: Le jeûne du mois du Ramadan, l’un des cinq piliers de l’Islam, impose aux musulmans de s’abstenir de nourriture et de boisson de l’aube au coucher du soleil pendant 29 à 30 jours chaque année. Ce rituel, qui se décale d’environ 11 jours par an dans le calendrier grégorien, présente des défis spécifiques, notamment pour les athlètes musulmans.

Méthodes: Nous mettons l’accent, dans cet article introductif à l’issue spéciale «Ramadan et Sport», sur les athlètes musulmans qui doivent concilier les exigences de leur foi avec celles de leur discipline sportive. Jeûner pendant le Ramadan peut entraîner des contraintes physiologiques et psychologiques chez ces athlètes, surtout lors des compétitions internationales.

Résultats: Alors que dans les pays à majorité musulmane les horaires d’entraînement et de compétition sont souvent adaptés, les athlètes des pays à minorité musulmane, comme la France par exemple, ne bénéficient souvent pas d’un tel soutien institutionnel. Cela pourrait affecter leur bien-être mental et leurs performances.

Conclusion: Cette synthèse de la littérature dans le but d’introduire le numéro spécial «Ramadan et Sport» met en lumière l’importance de l’accompagnement personnalisé des athlètes musulmans pendant le Ramadan. Nous appelons à une meilleure compréhension des défis liés au jeûne dans le cadre du sport de haut niveau, ainsi qu’à la formation des entraîneurs et des personnels médicaux pour soutenir les athlètes dans leur pratique religieuse tout en préservant leur santé et leur performance.

How can medical staff support athletes during Ramadan?

Jaouher Dhouibi — 2025-07-01

Introduction. Ramadan, a sacred month for Muslims, presents a unique challenge for athletes of this faith, combining religious requirements with athletic performance. This period requires adjustments in nutrition, hydration, sleep, and recovery. The medical staff, composed of various health professionals, plays a crucial role in supporting athletes to maintain their well-being and performance.

Methods. This document analyzes the roles of different members of the medical staff, including the physician, physiotherapist, strength coach, and nutritionist. The focus is on the prevention, diagnosis, and management of the effects of fasting on athletes.

Results. The sports physician focuses on preventing risks related to fasting, such as dehydration and fatigue, by conducting thorough medical evaluations before Ramadan. They also ensure continuous follow-up to quickly diagnose potential problems. The physiotherapist adapts rehabilitation programs to prevent injuries related to the physical constraints of fasting. The strength coach adjusts training schedules and intensity to maximize performance without compromising health. The nutritionist develops specific dietary plans to ensure adequate energy intake. Multidisciplinary support is essential to help athletes balance their religious practices and athletic performance during Ramadan. Each member of the medical staff contributes to this adaptation through specific strategies, ranging from injury prevention to optimizing nutrition and training.

Conclusion. The success of Muslim athletes during Ramadan relies on a collaborative approach, where each health professional plays a key role in balancing religious and athletic demands.

Training and competing during Ramadan – Practical recommendations for athletes and coaches.

Karim Chamari — 2025-07-01

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.