Expert insight into players during Ramadan and how you can stay fit if fasting

<html><head></head><body>For those who choose to fast, no food or liquid may be consumed between dawn and sunset. Fasting during Ramadan poses acute challenges to all who observe it, but particularly elite-level footballers. And currently, with the COVID-19 pandemic affecting countries across the world, those practising Ramadan face a unique task.
Crystal Palace’s Head of Sports Medicine, Doctor Zafar Iqbal, explains how supporters can stay healthy during Ramadan and provides an eye-opening insight into the life of a Premier League footballer while fasting.
This year Ramadan falls between April and May, which would normally be within the football season for Palace fans and players alike. With the COVID-19 pandemic affecting the country, we must think of the greater good and strictly follow health guidelines.
Interestingly, there is some evidence to suggest that undertaking regular physical activity may improve immune response and reduce incidences of viral and bacterial infection.
However, for those fasting over Ramadan, maintaining good physical health requires additional thought and preparation.
Fasting is difficult because the body has to adapt to not receiving food and fluids throughout the day from before dawn until sunset. Dehydration is the biggest issue causing fatigue and this slows down many of the organs’ functions.
<img src="https://media-cdn.incrowdsports.com/ab7c0ce8-3663-49a9-850e-b574de319fb4.jpg" alt="Dr Zaf 3.jpg" width="1440" height="810"/>
Not having regular quick energy provided by frequent meals during the day means the body has to rely on stores and change the way it works.
I would suggest exercising at times that limit losses in fitness or strength, with the ideal time being around midnight. By waiting for a few hours after you have eaten, you will allow your body to digest any food, clear the stomach and direct blood to the exercising muscles. 
At midnight, you also have time to consume sufficient fluid and glucose to enable you to replenish muscle glycogen stores after exercise. 
If concerned about what to eat during Ramadan, I would suggest the following diet:
At sunset
<ul>
<li>A small amount of quick-release carbohydrates (eg: dates, fruit, smoothies and pasta)</li>
<li>A whey protein shake will help with muscle regeneration and recovery</li>
<li>Try to avoid large meals at this stage, or the body goes into ‘storage mode’</li>
</ul>
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Before dawn
<ul>
<li>Focus on carbohydrates that release energy slowly (eg: non-starchy vegetables like spinach and kale; sweet potato, pasta, nuts, fruit, oats and porridge) combined with foods that will release energy in the short to medium term</li>
<li>Plenty of isotonic fluids as opposed to water - ideally between two and four litres</li>
<li>Additionally, extra electrolytes from a soluble tablet may be taken to help with the absorption of water</li>
</ul>
Fasting poses a challenge to your body, however some research reveals it can have the following benefits:
<ul>
<li style="font-weight: 400;">Weight loss</li>
<li style="font-weight: 400;">Improved blood sugar control</li>
<li style="font-weight: 400;">Improved cholesterol levels </li>
<li style="font-weight: 400;">Reduced inflammation within the body, leading to reduced risk factors for diabetes and cardiovascular disease</li>
</ul>
Anyone who has or is likely to have a health issue during fasting should always seek appropriate medical advice before starting any changes to their lifestyle.
How professional athletes cope
At Crystal Palace, we speak to the players who are thinking of fasting individually and try to support them regarding nutrition and also when the best time for them to train is.
It becomes more difficult to manage players’ training schedules as normally they train in the morning. While fasting, they then can’t replace energy stores, help recovery or rehydrate for eight-nine hours.
Our manager is well experienced and is aware of fasting but, so far this year, he hasn’t had to be involved. We will try to keep it as simple as possible for the players that are fasting - currently Jordan Ayew, Chiekhou Kouyate and Mamadou Sakho. 
<img src="https://media-cdn.incrowdsports.com/6d2659e9-e7e5-41f4-ba87-fdf6c0ae5b76.jpg" alt="PTN 21 Ayew Sakho Kouyate.jpg" width="1440" height="810"/>
The players have all been given fitness and injury prevention programmes and for those who are fasting, we have shared specific advice regarding the best time to train and what to do.
Sustaining performance levels while fasting is a huge challenge for footballers because the players are pushing themselves to the limit. 
Studies have shown that a 2% loss of body weight in fluid, which is equivalent to a couple of litres lost as sweat, is possible during a 90-minute match and can lead up to a 20% decrease in physical performance.
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As the player will not have consumed any food or fluids since before dawn, they will have to rely on other energy stores from the body to perform, which may not be readily available. 
Post-training or after games, players usually consume recovery drinks and food which help them rehydrate, replace energy stores and allow muscle recovery and repair, which will be delayed until they can open their fast (begin eating and drinking) at sunset.
Although fasting is a challenge, some players I’ve worked with feel it makes them even more disciplined and stronger mentally, knowing that they will be able to eat food and hydrate again at a particular time.
Some players I’ve worked with have fasted during training days but not on matchdays, and made up for the fast on another day.
All the players, whether fasting or not, have regular advice and updates from me and the rest of the team - including physiotherapists, sports scientists, strength and conditioning coaches and a nutritionist. We try to have further discussions with those fasting, to see how best we can support them during the month of Ramadan.
<blockquote class="twitter-tweet">
Fascinating insight from our panel on staying healthy during lockdown ahead of <a href="https://twitter.com/hashtag/Ramadan?src=hash&amp;ref_src=twsrc%5Etfw">#Ramadan</a> <a href="https://twitter.com/muslimyouthhelp?ref_src=twsrc%5Etfw">@muslimyouthhelp</a>! 😬Dealing with cravings 🍫 Reducing salt &amp; sugar 🦅Insight into <a href="https://twitter.com/CPFC?ref_src=twsrc%5Etfw">@CPFC</a> players&#39; routine Video coming soon <a href="https://twitter.com/sportsdrzaf?ref_src=twsrc%5Etfw">@sportsdrzaf</a> <a href="https://twitter.com/KawtherH?ref_src=twsrc%5Etfw">@KawtherH</a> <a href="https://twitter.com/FoodtalkRD?ref_src=twsrc%5Etfw">@FoodtalkRD</a> 📹 <a href="https://t.co/h6QXUMS39L">pic.twitter.com/h6QXUMS39L</a>
— Palace for Life Fdn. (@PalaceForLife) <a href="https://twitter.com/PalaceForLife/status/1252640363925438466?ref_src=twsrc%5Etfw">April 21, 2020</a></blockquote>

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The unique challenge of COVID-19
The current pandemic has certainly brought additional problems, in that it can be harder for people to remain physically active and being at home may mean consuming more inappropriate foods.
This can lead to weight gain and the loss of muscle and fitness levels. It is important to <a href="/news/2020/march/tips-for-staying-active-during-self-isolation-from-crystal-palaces-head-of-medical-dr-zafar-iqbal/" target="_blank" rel="noopener">undertake some form of regular physical activity</a> and control your diet. It is much easier to reduce your dietary intake than it is increasing your physical activity to an extent where you can burn off the excess food or body fat.
For people who are fasting, one problem can be that they consume food rich in sugar or white carbohydrates (such as chips or white rice) immediately on opening fast. These foods will be readily stored as fat if not used by the body quickly. It really is important not to undo the benefits gained by being disciplined for fasting by indulging when able to eat and drink.
<img src="https://media-cdn.incrowdsports.com/83ee7feb-58a5-40e7-b633-799d9f01e12e.jpg" alt="Dr Zaf 2.jpg" width="1440" height="810"/>
Anyone who is at risk of being unwell or has an illness doesn’t have to fast. This is even more important during this current COVID-19 pandemic, where NHS resources are already stretched. People shouldn’t be putting themselves and others at additional risk of picking up an infection by having to seek medical advice or to attend hospital.
Eid, which is meant to celebrate the end of Ramadan, is normally celebrated with families and friends. It is a very difficult time for all, but it is clear that everyone will have to follow government and Public Health England guidelines and advice and continue social distancing and self-isolating if required, to stay safe and limit the spread of COVID-19.
People can still celebrate in their own homes by using online shopping and communication platforms. In fact, my parents have seen more of me and my family via online video calls than they have in a similar time period for the last 20 years!
To everyone who celebrates, Ramadan Mubarak. And to everyone, of all faiths and none, please remember to stay safe and stay at home.
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The Islamic month of Ramadan begins at the end of this week and, for many Muslim Crystal Palace fans, staff and players, this will entail a period of fasting, prayer, reflection and charity.

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