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PHYSICAL ACTIVITY DURING THE MONTH OF RAMADAAN FASTING

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Abstract

The month of Ramadaan incorporates the fasting of Muslims for approximately 12-18 hours of the day. Because it's a month where no drink or food can be consumed during daylight, there has been a lot of speculation regarding the abstinence of exercise and physical activity during Ramadan. There have been myths with regards to a decrease in blood levels and heart function, weakening of the immunity system and syncope when exercising during Ramadan. [1] This article is an attempt to guide readers on the importance of exercise, the 'when-what-how' and some valuable pointers to remember when exercising during Ramadaan. The importance of exercise during Ramadaan Research has shown that fasting for 30 consecutive days without exercise results in a regression of strength and fitness. Individuals who train a minimum of 3 days a week for 11 months but avoid training during the month of Ramadaan, puts them at a setback with regards to cardiovascular and resistance adaptations. 'You lose more than you gain and you gain less than you lose!' Therefore, it is imperative that Muslims maintain their exercise routine during Ramadan. It is advisable not to progress your exercise routine (increase in weights, sets, repetitions, speed or distance) during Ramadan, but maintain what you've done in the previous month. [2] If one has to leave exercise for a month, it will be equal to losing 4 months of exercise. Surely, one can't afford to lose all those months of physical activity. Many Muslims would find it difficult to exercise during Ramadaan but it's integral to note that this is also a month of patience, sacrifice and exercising during Ramadaan is purely a 'mind over matter' fact. Persons with chronic diseases, injuries and complications
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MH Noorbhai , The Experiment, Feb, 2013 Vol. .7(3), 413-416
PHYSICAL ACTIVITY DURING THE MONTH OF RAMADAAN FASTING
The month of Ramadaan incorporates the fasting of Muslims for approximately 12-18 hours of the day. Because it’s a month where no
drink or food can be consumed during daylight, there has been a lot of speculation regarding the abstinence of exercise and physical
activity during Ramadan. There have been myths with regards to a decrease in blood levels and heart function, weakening of the
immunity system and syncope when exercising during Ramadan.[1] This article is an attempt to guide readers on the importance of
exercise, the ‘when-what-how’ and some valuable pointers to remember when exercising during Ramadaan.
The importance of exercise during Ramadaan
Research has shown that fasting for 30 consecutive days without exercise results in a regression of strength and fitness. Individuals
who train a minimum of 3 days a week for 11 months but avoid training during the month of Ramadaan, puts them at a setback with
regards to cardiovascular and resistance adaptations. ‘You lose more than you gain and you gain less than you lose!’ Therefore, it is
imperative that Muslims maintain their exercise routine during Ramadan. It is advisable not to progress your exercise routine (increase
in weights, sets, repetitions, speed or distance) during Ramadan, but maintain what you’ve done in the previous month.[2] If one has to
leave exercise for a month, it will be equal to losing 4 months of exercise. Surely, one can’t afford to lose all those months of physical
activity. Many Muslims would find it difficult to exercise during Ramadaan but it’s integral to note that this is also a month of
patience, sacrifice and exercising during Ramadaan is purely a ‘mind over matter’ fact.
Persons with chronic diseases, injuries and complications
Persons with the above should take caution when exercising or doing any strenuous workloads during Ramadaan. In particular,
persons with Type 1 Diabetes should not exercise at all as this can hinder their glucose levels profusely. Hypoglycemia is the most
common problem for Diabetics who exercise and is usually a concern for Diabetics taking insulin or oral medication.[3] However,
persons with Type 2 Diabetes (‘the active’ Diabetic) can exercise at a low-intensity, but for a maximum of 35 minutes focusing
predominantly on aerobic and strength training. This does not contribute any adverse effects on the adequacy of diabetic control.[4]
Persons with high blood pressure or hypertension should exercise at a low-intensity with a 75% maximum heart rate.[4] Example: a 60-
year old woman’s maximum heart rate would be 160 beats per minute (220 – 60 = 160), 75% of 160 is 120 beats per minute.
Therefore, a 60-year old hypertensive woman should not exercise in Ramadaan with a heart rate of more than 120 beats per minute.
These maximum heart rates depend on age, gender and health risk factors. With a hypertensive individual, their blood pressure
increases during and after exercise. After exercise, their blood pressure takes time to decrease when compared to a healthy individual.
However, individuals who have their hypertension well-controlled with diet and medication in the evenings can regulate their blood
pressure more effectively during and after exercise.[5,6] The more severe the hypertension, the worse the blood pressure levels can
fluctuate during exercise.[6]
Persons with any injuries or complications should also exercise at a low-intensity for a maximum of 30 minutes because your bodies
utilise more energy during the recovery phase of injury or pain, especially when fasting.[7] Therefore, not enough energy and glycogen
stores will be retained for more than 30 minutes when exercising.
In addition, persons with chronic diseases or complications are refrained from consuming medication while fasting. It is therefore
difficult to manage sugar levels, cholesterol levels and blood pressure without medication during Ramadaan. Exercise can manage
these as well but the above recommendations need to be adhered to when exercising during fasting. Individuals with any chronic
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MH Noorbhai , The Experiment, Feb, 2013 Vol. .7(3), 413-416
diseases, and in particular Diabetes and Hypertension, should consult with their physician first before implementing an exercise
routine during Ramadaan.[8]
When to exercise
After having a moderate exercise session, you will not adequately replenish the glycogen stores that you burnt during exercise, thus
resulting in weight loss and dizziness.[9] 90 minutes before sunset would be the ideal time to train because when breaking your fast,
you can supplement the energy and glycogen stores lost when exercising.[8]
Exercise Prescription during Ramadaan for Healthy Individuals [4]
Exercise mode Frequency Intensity Duration
Warm-up Minimum 3 days/week;
24 hours rest 50% heart rate maximum 7-10 minutes
Stretching Minimum 3 days/week;
24 hours rest Stop stretching when muscles
start to pain 20 seconds per
limb/muscle
Cardiovascular Minimum 3 day24 hours rest
s/week; 50-70% of heart rate max 20 minutes
Strength training Minimum 3 days/week;
24 hours rest 50-60% 1 repetition max 2 sets of 8-12reps
Cool-down Minimum 3 days/week 40-50% of heart rate max 5 minutes
Maximum total duration: 45 minutes
Exercise Prescription during Ramadaan for Diabetics [4]
Exercise mode Frequency Intensity Duration
Warm-up Minimum 2 days/week; 48
hours rest 40% heart rate maximum 7 minutes
Stretching Minimum 2 days/week; 48
hours rest Stop stretching when muscles
start to pain. 20 seconds per
limb/muscle
Cardiovascular Minimum 2 days/week; 48
hours rest 40-60% of heart rate max 10-15 minutes
Strength training Minimum 2 days/week; 48
hours rest 40-60% 1 repetition max 2 sets of 7-10reps
Cool-down Minimum 2 days/week; 48
hours rest 40-50% of heart rate max 5 minutes
Maximum total duration: 35 minutes
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MH Noorbhai , The Experiment, Feb, 2013 Vol. .7(3), 413-416
Dietary Intake and Hydration Guidelines per day between sunset and sunrise
- 6 to 10 grams of carbohydrates per kg of body weight
- 1.2 to 1.7 grams of protein per kg of body weight
- A fat intake of 20 to 35% of the total energy intake[10]
- Sufficient fluids to prevent a deficit of more than 3% of body mass (Calculating Body Mass: Fat mass = kg x %fat/100; Body
Mass = kg – fat mass).
- Research has indicated that the absence of fluids may have a greater impact on exercising during Ramadan than the absence
of food. Hydrate a lot during the night (after sunset and evening pray; keep a water bottle when going for evening prays).[10]
Guidelines also apply to individuals with Diabetes and Hypertension as their exercise intensity and duration is lower.
Guidelines
- Terminate exercise immediately when feeling dizzy or nauseous. One should only break their fast if they really feel weak and
fatigued.
- Plan when to sleep and when to wake up
- Consider naps and schedule times to rest as your bodies feels more fatigue during Ramadan
- Take a working lunch (since you don’t have to eat), then arrange with your boss to leave an hour earlier at the end of the day.
This will allow you to get in some time for training before you break your fast.
- Intermittent exercises such as Action Soccer or Action Cricket after sunset and evening pray is a good way to maintain
physical activity and fitness
- Endurance, plyometrics (power and explosive training), speed and agility training should be avoided completely as these
exercises utilise more energy and can place one’s body in greater strain.
REFERENCES
1. Fallah, J. Ramadaan Fasting and Exercise Performance. Asian J of Sports Med: 2010; 1(3): 130
2. Maughan R. The effects of fasting on metabolism and performance. Br J of Sports Med: 2010; 44: 490
3. Azizi F, Siahkolah B. Ramadaan Fasting and Diabetes Mellitus. J Iranian Medicine 2003; 6(4): 237 – 242.
4. Thompson WR. (2009). ACSM’s Guidelines for Exercise Testing and Prescription. 8th Ed. Lippincott Williams & Wilkins:
USA
5. Henry P, Thomas F, Benetos A. Impaired Fasting Glucose, Blood Pressure and Cardiovascular disease mortality.
Hypertension 2002; 40: 458 – 463.
6. Whelton SP. Effect of aerobic exercise on blood pressure: a meta-analysis of randomised, controlled trials. Annals of Int
Medicine 2002; 136(7): 493 – 503.
7. Ramadaan J. Does Fasting during Ramadaan alter body composition, blood constituents and physical performance? Med
PrincPract: 2002; 11(2): 41-46
8. Shephard RJ. Physical performance and training response during Ramadaan observance, with particular reference to protein
metabolism. BJSM 2012; 46: 477 – 484.
9. Barac-Nieto M, Ramadaan J. Cardio-respiratory responses to moderately heavy aerobic exercise during the Ramadaan fasts.
Saudi Med J: 2000; 21(3): 238-244
10. Hormann K. (2011). Ramadaan and the Muslim Athlete: Challenges for the Athletic Trainer. Linfield College: Athletic
Training Education Program. By presentation.
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1MH Noorbhai (BA, BSpSc (Hons) Biokinetics)
1MRC Exercise Science and Sports Medicine Research Unit, Department of Human Biology, Sports Science Institute of South Africa,
Faculty of Health Sciences, University of Cape Town.
E mail id : (habib.noorbhai@yahoo.com)
... The Table 3 demonstrates the dietary intake and hydration guidelines per day between sunset and sunrise for fasting individuals (Hormann, 2011;Noorbhai, 2013). It is recommended to consume enough complex carbohydrates and protein during suhoor to sustain daily activities during fasting and recovery during iftar. ...
... A few suggested guidelines are employed as coping strategies during Ramadan fasting period (Noorbhai, 2013). Firstly, exercise should be immediately terminated when feeling dizzy or nauseous. ...
... Studies have shown that fasting for thirty consecutive days without exercise results in decline in fitness and strength. Therefore, individuals who train a minimum of three days a week for eleven months but avoid training during the month of Ramadan puts them at a setback with regards to cardiovascular and resistance adaptations (Noorbhai, 2013). The training sessions should start roughly around ninety minutes before sunset or iftar. ...
Chapter
Full-text available
This chapter attempts to explain fasting during the month of Ramadan and the suitable exercises for secondary school students during the Ramadan fasting month. Ramadan fasting is one of the five pillars of Islam and is compulsory for all healthy Muslims from puberty onwards except for people with medical conditions. The month consists of 30 days, which vary in length depending on the geographical location and the time of year. During this month, Muslims abstain from food, drink, smoking, and sex from dawn until sunset and Ramadan rotate around the seasons which causes the length of days to differ each year, depending on whether Ramadan falls in the winter or in the summer time. In Malaysia, the length of the time of fasting is usually around thirteen to fourteen hours. Schools with afternoon session also end early to allow more time for Muslim children to go back home earlier to break their fast. Students can freely participate in physical activity during this month but must adhere to the training schedule, proper dietary intake, modification of exercise and coping strategies in order to avoid fatigue and dehydration. From the previous studies, circuit training is a suitable exercise as part of the physical activity during this month. Low-intensity training for sedentary students are recommended during daylight hour of Ramadan. Furthermore, for active secondary school athletes and trained individuals, fasting also imposes a significant barrier to train and compete. In these situations, rather than accepting performance decrements as inevitable, athletes, coaches and sport scientists strive to plan strategies for training and competition that offset these challenges. To achieve this, more research is needed to determine the effects of fasting and the required attempt to alleviate any detrimental consequences.
... Individuals who stop training during Ramadhan fasting often face a relapse with regard to cardiovascular and resistance adaptation. Furthermore, going a month without exercise is equivalent to losing four months of exercise (Noorbhai, 2013). However, Ramadhan and Barac-Nieto (2000) indicated that exercising during Ramadhan provides no negative effects among sedentary individuals. ...
... Furthermore, eliminating exercising for a month is equivalent to losing four months of exercise (Noorbhai, 2013). The results of the present study indicated no significant difference in the participants' perceived exertion inany of the testing sessions. ...
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Ramadhan is the fasting month in the Islamic calendar when consumption of water and food is abstained from. Previous studies of exercising during Ramadhan have shown mixed findings. The aim of this study was to determine the effects of a single bout of moderate cycling exercise during the ritual fasting of Ramadhan on mood states, rating of perceived exertion and short-term memory among physically inactive university students. Participants were 13 healthy male university students, with a mean age of 23.54±3.41 years, height of 170 ±7.02 cm, weight of 66.95±7.40 kg and body mass index (BMI) of 23.33±1.74 kg.mˉ². Data on mood states, rating of perceived exertion and short-term memory were collected before and after cycling exercise. All of the participants performed cycling exercise at progressively increasing intensities of 45%, 60%, 75% of VO 2max for 30 minutes (10 minutes for each intensity) a week before Ramadhan and in the first and fourth week of Ramadhan and 2 weeks after Ramadhan. The results of the mixed factorial ANOVA revealed no significant interactions between sessions across trials. In conclusion, exercise during Ramadhan fasting exhibited no significant effects on mood states, perceived exertion and cognitive performance.
... Gambar 2. Persepsi atlet tentang pola makan Kebugaran dan kesehatan atlet junior diperhatikan melalui transisi latihan dan pola makan yang disesuaikan saat pandemi dan bulan ramadan untuk mendapatkan imunitas yang baik. Nutrisi dan hidrasi yang tepat sangat penting selama bulan ramadan, nutrisi yang direkomendasikan saat bulan ramadan adalah kandungan nutrisi yang terdiri dari karbohidrat 6 -10 gram per Kg berat badan, protein 1,2 -1,7 gram per Kg berat badan, dan lemak 20 -30 % dari total energi yang digunakan selanjutnya untuk cairan yang masuk dalam tubuh minimal 3% dari masa tubuh (Noorbhai, 2013). Memenuhi kebutuhan cairan saat latihan sangatlah peting bagi atlet, aturan yang direkomendasikan oleh WHO adalah minumlah air dalam jumlah yang banyak diantara waktu buka puasa dan sahur dan mengonsumsi hydrating food (semangka, strawberry, peach, timun, sop, dan hydrating food lainnya) selama bulan ramadan. ...
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This study aims to identify the training transitions and dietary habits of volleyball athletes' before and during Ramadan in the Covid-19 pandemic. The research design used is descriptive quantitative with a sample of 12 male junior volleyball athletes in the academy Sidoarjo volleyball. The results showed that most athletes experienced a decrease in the frequency of exercise during the month of Ramadan, especially during the COVID-19 pandemic. A total of 33.3% of athletes maintained their exercise frequency, and 66.7% experienced a decrease in exercise frequency. Furthermore, during Ramadan and Covid-19, there was an increase in the frequency of eating 1-2 times a day (58.4%), snack consumption (50%), fruit and vegetables (75%), fried foods 4-7 times a week (8.4%), instant noodles 1-3 times a week (25%) and fast food 1-3 times a week (8.4%) in athletes. Concerning this, it is imperative to revitalize the program and monitor the athlete's training periodically, which is adjusted to the conditions of the COVID-19 pandemic and provide a dietitian to regulate the athlete's diet to obtain a balanced nutritional intake following the exercise portion.Assessmen transisi latihan dan pola makan atlet sebelum dan saat ramadan di masa pandemi Covid-19AbstrakTujuan dari penelitian ini adalah untuk mengidentifikasi transisi latihan dan pola makan atlet bola voli sebelum dan saat ramadan di masa pandemi Covid-19. Desain penelitian yang digunakan yaitu deskriptif kuantitatif dengan sampel 12 atlet laki-laki bola voli junior yang masih aktif dalam menjalani pemusatan latihan di Akademi Bola Voli Indomaret Sidoarjo. Hasil penelitian menunjukkan bahwa mayoritas atlet mengalami penurunan frekuensi latihan saat ramadan khususnya di masa pandemi covid-19. Sebanyak 33,3% yang mampu mempertahankan frekuensi latihan dan 66,7% mengalami penurunan frekuensi latihan. Selanjutnya, saat ramadan dan Covid-19 terjadi peningkatan frekuensi makan 1-2 sehari (58,4%), konsumsi camilan (50%), buah dan sayuran (75%), gorengan 4 – 7 kali dalam seminggu (8,4%), mie instant 1 – 3 kali dalam satu minggu (25%) serta makanan cepat saji 1 – 3 kali dalam seminggu (8,4%) pada atlet. Berdasarkan hal ini, maka sangat penting untuk melakukan revitalisasi program dan pemantauan latihan atlet secara berkala yang disesuaikan dengan masa pandemi covid-19 dan menyediakan dietisien untuk pengaturan makan atlet agar dapat memperoleh asupan gizi seimbang sesuai dengan porsi latihannya.
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The aim of this study was to quantify the magnitude of the cardiovascular and respiratory changes that occur during the month of Ramadan in response to moderately heavy aerobic physical exertion. Eighteen sedentary Kuwaiti adult males were tested under thermo-neutral conditions during a spring-like month of Ramadan and one month thereafter. There were no significant changes in maximal exercise capacity, treadmill walking efficiency, percentage VO2 max, in body weight and composition associated with Ramadan fasting or one month after. Cardiac (heart rate) and ventilatory responses to moderately intense bouts of sub-maximal aerobic exercise (70% of VO2 max) were actually slightly (<5%) but significantly (P<0.05) reduced, while exercise systolic but not diastolic pressure increased slightly (6%) by the end of Ramadan. Hormonal changes associated with dehydration or fasting, abstention from consumption of substances with negative inotropy and changes in circadian rhythms during Ramadan may be responsible for these mild changes in cardiorespiratory responses to exercise. Such changes had no negative effect on the physical aerobic performance of these subjects while exercising at moderately heavy intensity under thermally neutral conditions, during the month of Ramadan. Reduced ventilation during exercise may reflect a limited glycolytic capacity by the end of Ramadan.
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Physical activity has been associated with reduced blood pressure in observational epidemiologic studies and individual clinical trials. This meta-analysis of randomized, controlled trials was conducted to determine the effect of aerobic exercise on blood pressure. English-language articles published before September 2001. 54 randomized, controlled trials (2419 participants) whose intervention and control groups differed only in aerobic exercise. Using a standardized protocol and data extraction form, three of the investigators independently abstracted data on study design, sample size, participant characteristics, type of intervention, follow-up duration, and treatment outcomes. In a random-effects model, data from each trial were pooled and weighted by the inverse of the total variance. Aerobic exercise was associated with a significant reduction in mean systolic and diastolic blood pressure (-3.84 mm Hg [95% CI, -4.97 to -2.72 mm Hg] and -2.58 mm Hg [CI, -3.35 to -1.81 mm Hg], respectively). A reduction in blood pressure was associated with aerobic exercise in hypertensive participants and normotensive participants and in overweight participants and normal-weight participants. Aerobic exercise reduces blood pressure in both hypertensive and normotensive persons. An increase in aerobic physical activity should be considered an important component of lifestyle modification for prevention and treatment of high blood pressure.
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Impaired fasting glucose (fasting plasma glucose 6.1 to 6.9 mmol/L [110 to 125 mg/dL]) is a common glycemic disorder which usually progress to diabetes mellitus. The relationships between impaired fasting glucose, other risk factors including blood pressure, and mortality have never been clearly investigated. We studied 63 443 consecutive men (ages 21 to 60 years), each of whom had a routine health examination with a fasting plasma glucose measurement. Men with known ischemic cardiac disease and treatment for diabetes or hypertension were excluded. Impaired fasting glucose was found in 10 773 (17.0%) of these men. Mean body mass index, serum triglyceride and cholesterol levels, and systolic, diastolic, and pulse blood pressure were significantly higher for men with impaired fasting glucose compared with those men with normal fasting glucose (fasting plasma glucose 3.9 to 6.0 mmol/L). When adjusted for confounding variables, relative risk of 8-year cardiovascular mortality associated with impaired fasting glucose was dependent on systolic blood pressure level (1.02 [95% CI: 0.62 to 1.70] when <140 mm Hg and 2.10 [95% CI: 1.16 to 3.80] between 140 and 160 mm Hg). Inversely, relative risk of 8-year cardiovascular mortality associated with moderate systolic hypertension (140 to 159 mm Hg) compared with normal systolic blood pressure (<140 mm Hg) was highly dependent on the glycemic status (2.97 [95% CI: 1.58 to 5.55] for men with impaired fasting glucose compared with 1.35 [95% CI: 0.84 to 2.18] in those with normal fasting glucose). Similar results were found concerning overall mortality. In conclusion, the presence of moderate systolic hypertension can identify subjects with impaired fasting glucose who are at risk of cardiovascular and overall mortality, and vice versa, probably through the metabolic syndrome.
ACSM's Guidelines for Exercise Testing and Prescription. 8 th Ed
  • Wr Thompson
Thompson WR. (2009). ACSM's Guidelines for Exercise Testing and Prescription. 8 th Ed. Lippincott Williams & Wilkins: USA
Ramadaan and the Muslim Athlete: Challenges for the Athletic Trainer. Linfield College: Athletic Training Education Program. By presentation
  • K Hormann
Hormann K. (2011). Ramadaan and the Muslim Athlete: Challenges for the Athletic Trainer. Linfield College: Athletic Training Education Program. By presentation. www.experimentjournal.com ISSN-2319-2119 RESEARCH ARTICLE