Changes in Subjective and Objective Measures of Performance in Ramadan

The Muslim faith requires individuals to fast between the hours of sunrise and sunset during the month of Ramadan. Our recent work has concentrated on some of the changes that take place during the daytime when fasting. A questionnaire was developed to assess subjective estimates of physical, mental and social activities, and fatigue. Four days were studied: in the weeks before and after Ramadan (control days) and during the first and last weeks of Ramadan (experimental days). On each of these four days, this questionnaire was given several times during the daytime and once after the fast had been broken and just before individuals retired at night. During Ramadan, daytime mental, physical and social activities all decreased below control values but then increased to abovecontrol values in the evening. The desires to perform physical and mental activities showed very similar patterns. That is, individuals tried to conserve energy during the daytime in preparation for the evenings when they ate and drank, often with friends. During Ramadan also, individuals were more fatigued in the daytime and napped more often than on control days. This extra fatigue probably reflected decreased sleep, individuals often having risen earlier (before sunrise, to prepare for fasting) and retired later (to enable recovery from the fast). Some physiological measures and objective measures of performance (including the response to a bout of exercise) have also been investigated. Urine osmolality fell during the daytime on control days as subjects drank, but rose in Ramadan to reach values at sunset indicative of dehydration. Exercise performance was also compromised, particularly late in the afternoon when the fast had lasted several hours. Self-chosen exercise work-rates fell and a set amount of exercise felt more arduous. There were also changes in heart rate and lactate accumulation in the blood, indicative of greater cardiovascular and metabolic stress caused by the exercise in subjects who had been fasting. Daytime fasting in Ramadan produces widespread effects which probably reflect combined effects of sleep loss and restrictions to intakes of water and food.